Biting Criticism

Guilherme Machado would make a nutritionist proud. Sure, the Revere High School senior grabbed a slice of pizza for lunch, but he also picked up three oranges and an apple.

"I play soccer after school, and I need to eat well," said Machado, who sat with classmates Vitou Tieng and Camila Ribiero, eating chicken Caesar salads.

Senior Gillian Otolo, however, munched a lunch of Ruffles potato chips. "I usually eat Doritos," she said.

The US Department of Agriculture's Food Nutrition Service may require schools to offer school lunches that provide a third of a child's daily recommended allowance of nutrients and calories. It may decree that students be offered a meat or meat alternative, two fruits, a vegetable, a bread item, and milk.

But offering and consuming are two different things. With growing concerns about skyrocketing rates of childhood obesity, diabetes, and worries that bad eating habits will set in motion a generation more prone to heart disease, stroke, and cancer, there is increasing clamor for schools to play a bigger role - not just in serving healthier foods, but in getting students to embrace healthier lifestyles.

"There's a lot of evidence that schools have not done as good a job as they could have done," said Dr. David Satcher, former surgeon general, who is leading a Healthy Schools Summit tomorrow and Tuesday in Washington, D.C. "The school ought to be the environment that is conducive to developing lifetime habits of good nutrition and exercise."

A report last fall by the Physicians Committee for Responsible Medicine slammed schools participating in the national school lunch program for offering too many high-fat, nutrient-poor foods. Katie Millett, administrator for nutrition programs and services for the state Department of Education, said data so far show Massachusetts schools seem to be offering healthy choices. Last year, the state began a nutrient analysis of menus for all 500 school districts - including public, private, and parochial - that participate in the federal school lunch program. One goal: no more than 30 percent of calories from fat.

Out of 43 districts reviewed so far, 24 had menus low in calories and 31 had menus high in fat, Millett said. No district had offerings with more than 36 percent of calories from fat.

"We haven't had any districts where we've said, `Oh, dear,' " said Millett. Districts can improve fat levels, for example, by simply changing the type of chicken nugget they serve or how they prepare it, she said.

The bigger challenge to healthy eating, she said, is vending machines - certain to be on the agenda in Washington. Increasingly, schools rely on vending- machine sales to support the school lunch program. But Millett argues they stock unhealthy foods and drinks, and some schools leave them turned on during lunch.

At Waltham High School, vending machines - including snack and drink machines - represent 20 percent to 30 percent of daily food sales, according to Sal Lombardi, director of food service for the Waltham public schools. Last year, he brought in two milk vending machines, but one was removed this year because of poor sales. The one milk machine that does well, Lombardi noted, is right next to a snack machine.

While Waltham schools offer healthy foods, including a salad bar, it's tough to change students' eating habits without support from classroom teachers, Lombardi said. One teacher buys Cheerios by the case so hungry students can snack on cereal in class. But to effect major change, "we need more than one teacher in a school of 1,500 students doing that," Lombardi said.

He is more concerned with just getting students to eat. "I want kids to eat the food that's out there so at least they are getting some nutrition," Lombardi said. "As far as getting them to realize that broccoli is a good part of their future, I don't see that as an integral part of my job."

So how far should schools go to get students to eat healthier?

This question is becoming more critical as researchers make connections between good eating and school performance. Bill Potts- Datema, director of Partnerships for Children's Health at the Harvard School of Public Health, recently completed a literature review of the links between nutrition and academics.

While people have known for years that undernourished children perform worse in school than properly nourished students, he said, new studies link improved test performance to healthy eating.

A study of Baltimore children, for example, showed that simply starting a school breakfast program improved student attention to academic tasks and increased math grades. Other studies show that elementary children from impoverished homes have increased test scores with good school nutrition, Potts-Datema said.

Meg Campbell, head of school at the Codman Academy Charter School in Dorchester, doesn't need studies to tell her that. Last year, prepackaged lunches were so soggy, she said, "we were hard-pressed to get the kids to eat it." By the end of the school day, starving students "would fly out of here and over to McDonald's" across the street, she said.

This year, Codman students serve each other fresh-made foods brought in from the neighborhood. In the late afternoon (school lasts until 5 p.m.), students get fresh fruit and granola bars. They're so hungry, Campbell said, "kids actually eat it."

But perhaps most critical, she said, is creating a culture around academics, fitness, and good eating, which she said starts with her health-oriented staff. "They see the faculty modeling it; they see them eating salads. Reading is cool in this school - and eating salad is cool."

Even Ricardo Semexante, a 10th-grader who used to be a McDonald's regular, has cut down on fries in favor of fruits. "They have pears, cut-up pineapple," he said. "The fruits taste sweet; they're real good."

Part of the problem remains presentation. It no longer works to slap a Salisbury steak smothered in gooey gravy on a plate with mushy carrots. Students won't eat it (if they ever did). In Revere, food service director Rich Medico, said revamping the high school menu four years ago and focusing on cleaner, better- presented food has increased the number of students buying lunch from 38 percent to 74 percent of the school's 1,200 students.

"We are very big on how it's merchandized," said Medico, as he charged past a tray of tacos, with bright orange cheese, tomatoes, and lettuce peeking out from cornmeal shells.

Small touches, Medico said, are key: the cheese on the Caesar salad is shredded, not grated, and salads are made to order and fresh, not prepackaged.

Still, even as the cafeteria displays a lunch plate with two tacos, Spanish rice, and an apple, few students reach into the wire baskets for the fruit. And although a crispy salad with cucumbers and shredded carrots sits right in front of the pizza service line, few reach for the tongs to put the greens on their styrofoam trays.

Some school officials, however, hope the key to getting students in the habit of eating more fruits and vegetables is to make it appealing starting in elementary school.

Marilyn Wiley, Pittsfield's food services director, dips apple slices in colored gelatin; arranges fruits on shiny black catering platters; makes smoothies and Italian ices packed with apricots, strawberries, and bananas; and serves fruit from watermelons carved in the shape of whales.

"Anytime you give kids a choice and it is colorful, they eat," she said.

Boston Globe - October, 2002