How much responsibility do schools bear for addressing the obesity of their students?

A Leader’s Role?

But what’s a school leader to do? Generally speaking, the care and feeding of children is the job and duty of parents, not superintendents, principals and teachers.

“Parents are ultimately responsible for their kids’ nutrition, for their education, for everything,” says Joe Bast, president of the Heartland Institute, a Chicago-based organization that promotes libertarian ideals.

Yet over the years, responsibilities that were once the sole province of parents, such as teaching about sex or drugs, have fundamentally shifted to schools. At times, it sometimes seems, educators are expected to address—in one form or another—virtually every aspect of a child’s persona and life.

That includes what they eat and their state of health.

“Making sure children eat right and well has been a shared responsibility of parents and schools ever since the first school sold or provided a food item or beverage to a student,” said Dr. Howard Taras, an associate professor of pediatrics at the University of California, San Diego.

“So in that sense, it is not an unfair burden on schools. Whoever is providing food for our children should be responsible with what foods they provide. In fact, schools may bear a certain increased burden, because as a teaching institution, they need to be a role model.”

Taras, who serves as a medical consultant to several K-12 districts, says there’s nothing terribly wrong with a child drinking a soda now and then. “But selling or otherwise providing sodas in school is inappropriate,” he contends. “Why? Because schools should be setting a positive example. What schools serve is almost an endorsement of what is healthy, of what is OK to eat.

“The same can be said for physical activity. Every man, woman and child should be active during the day, and children spend the greatest portion of their days in school so physical activity must occur there. So again, schools bear a larger burden. They share the responsibility with parents to educate students on how and why to do this,” Taras adds.

Presumably, few educators would argue otherwise.

“Our top priority is academic achievement. It’s not our job to make sure kids eat right,” said Dr. Dexter Louie, a physician and board of education member in the Moraga School District, east of San Francisco. “But as school leaders, we have the opportunity to do a really good thing. Kids are there to learn and being healthy helps them learn.”

Louie backs up his words with actions, visiting schools to discuss proper nutrition and health as part of an outreach program sponsored by the California Medical Association Foundation.

“I tell kids immediately that we’re not going to talk about the food pyramid and stuff like that,” said Louie. “I ask them if they know any diabetics. I talk about that disease and others, what they do to people’s bodies and how you can avoid them if you avoid obesity. I tell them that when they reach adulthood, the two things they will value most are their families and their health. I don’t lecture down to them. I tell them to figure it out.”

But Louie is clearly an exception to the rule.

Snacks Everywhere

According to a Centers for Disease Control study in 2000, roughly half of all school districts (with middle and/or high schools) had distribution contracts with soda vendors. Almost 80 percent of these districts negotiated to get a specified share of receipts. In these districts, students typically can buy sodas from vending machines, snack bars, school stores, even the cafeteria.

That soda helps wash down a multitude of junk food: 70 percent of the schools surveyed by the CDC permitted the sale of low-nutrition snacks during lunch. At the other end of the spectrum, fewer than 10 percent of the districts surveyed provided daily physical education classes or the equivalent—this despite the fact the CDC and other health authorities recommend children and teens participate in moderate to vigorous physical activity for one hour five times a week.

Not surprisingly, school officials find themselves in a tight spot. Most say they would like to do more, but there are other considerations.

First, selling sodas, snacks and foods like pizza and chicken wings is a lucrative and arguably necessary business. Revenue from such sales helps keep a lot of school food service programs in the black and in some places funds school activities and field trips that might not exist otherwise. Many fear, whether they admit it or not, that banning junk food sales would cause financial disaster.

Second, the higher academic standards and greater accountability of No Child Left Behind have compelled many districts and administrators to roll back or eliminate programs that might detract from a core curriculum.

“Schools have all sorts of mandates and elevated expectations,” says Purdue’s Templin. “Educators begin looking at what they’re expected to teach. They look at other activities like art, music, P.E. and health, and they prioritize what’s most important. That makes for a very difficult situation for people who value those curricular activities that tend to get cut or minimized, like P.E. and health.”

Besides, say many educators in moments of candor, solving student obesity is not really their job, even if they were adequately equipped or able to solve it.

“Our responsibility rests with that over which we have control,” says Mike Redburn, superintendent in Bozeman, Mont. “If anyone depends on the school to do the heavy lifting on student nutrition and health, their hopes will be unfulfilled. Families and communities must meet their responsibilities.”

School Food

Like it or not, schools must shoulder this weighty burden, if only because most children spend a good chunk of their waking hours five days a week there.

“We are responsible for these children for up to eight hours a day,” says Pat Cooper, superintendent of the 3,000-student McComb, Miss., School District. “It is educationally and ethically our duty to take care of them.”

The core issue for some in the food service field is the quality of what’s served to students during lunch.

“We are obligated to serve healthy food. Districts that don’t are simply being lazy. Whoever said it was OK for us to sell junk food?” asks Al Schieder, director of food services in the Folsom Cordova Unified Schools, a suburban K-12 district of 18,000 students northeast of Sacramento, Calif.

Beyond that, there’s this: Fat children tend to become fat adults. And fat adults cost this country more than $11 billion annually in health care, lost productivity and other expenses. Teaching good eating habits and health is an economic imperative.

“Not to mention,” says Louie, the board member in Moraga, Calif., “that fat adults have a reduced chance of becoming old adults.”

McComb’s Regimen

The good news about schools, nutrition and health is that there’s plenty of good news. An array of school districts in schools across the country have launched programs to eliminate or reduce sodas and snacks on campus, improve the nutritional quality and appeal of school lunches, bolster lessons and classes on health and increase opportunities for physical exercise.

The California legislature in 2001 established the first nutrition standards for so-called “competitive foods and beverages.” These are products not sold as part of a school meal, but separately, such as pizza or soda, in cafeterias, student stores and vending machines. Because such fare had not been regulated previously, competitive foods tended to be junk foods high in sugar and fat, boasting only minimal nutritional value compared to school meals that are subject to government regulation.

The California Department of Education then ordered a pilot program involving 16 middle schools and nine high schools to evaluate how the new nutrition standards affected food service programs and income. Conducted by the state’s Linking Education, Activity and Food program, the study found most test cafeterias actually boosted their income by reducing or eliminating competitive foods that did not meet the state’s nutrition standards.

The reason? More students purchased the healthier school lunches, if only because they had no other option.

In Folsom, Schieder junked the a la carte menu and ended sales of unhealthy snacks and soda in the district’s 30 schools. The lunch menu was redesigned to give all students the same eight daily options: salads, pasta, wraps, even sushi. Prices were adjusted so that even the poorest students could afford the healthier meals, eliminating the stigma of some students having to buy the cheaper and definitely uncool government meal.

“And you know what? We’re doing fine financially,” Schieder says.

Cooper, who directed the Centers for Disease Control’s National School Health Education Coalition before becoming McComb’s superintendent, did something similar in his conservative, low-income district. At the K-8 level, he and his school board banned all fund raising using candy or other less nutritious offerings. The district set guidelines for what sorts of snacks could be brought to school. At the high school, the lunch menu was revised and soda sales restricted to after school.

“If we’re going to do what No Child Left Behind says—and I think we should—then we can’t ignore the health issues,” says Cooper. “It’s a cop-out to say you can’t change the way kids eat. If there’s nothing else to eat but what you feed them, you can be assured that kids are going to eat the right foods.”

A Parental Complaint

But such sentiment isn’t easily swallowed everywhere or by everyone. One of the chief objections to restrictions or outright bans of non-nutritious foods at school is the matter of choice. Witness what happened in 2004-05 in the Millburn Township School District in Essex County, N.J.

Meme Roth, the mother of two young children, became increasingly alarmed at how much cake, cookies and candy her kindergarten-age son was eating at school and the booty from classroom parties and celebrations he was bringing home. Roth, who says her family has long battled weight and health problems, also objected to the food options in the school district’s elementary lunch program, which is run by the volunteer Parent-Teacher Organization.

Because the affluent district does not participate in the federal lunch program, none of the Millburn PTOs are obliged to meet government nutritional requirements when developing their schools’ menu.

“So a typical lunch (at her son’s school) would be a white bagel with cream cheese or butter, a side of Pringles, maybe some watermelon and some Smarties,” Roth said. The lunches are very popular and are among the school’s most effective means of raising funds.

Eventually, Roth got approval to organize an alternative lunch program that featured whole grains, organic meats, fresh fruits and vegetables. The four-week pilot proved to be a hit with children, she contends, even though the lunches were more expensive. But when she lobbied the school to junk the PTO lunch program in favor of healthier fare, she says she hit a wall.

Support from other parents was lukewarm at best. “A teacher I talked to said there was nothing she could do, that she was ‘just a teacher.’ The principal said it wasn’t his responsibility. The head of the PTO said what was being served ‘wasn’t heroin.’ Nobody thought it was an issue,” Roth says.

Richard Brodow, superintendent of the 4,000-student Millburn district, sees things somewhat differently.

“We certainly support good nutrition. Just two years ago, we removed from the middle school a number of sweets and candies that kids could purchase. And there was a loss of income,” Brodow says.

“But the question here is really whether the district should dictate to parents who volunteer what they should and shouldn’t be serving their children, whether the district should ban things like cupcake celebrations.

“I believe in moderation.,” Brodow explains. “I don’t want to order bans, decree that at no time can a parent bring in cupcakes for a class. That seems very harsh. But we also don’t want a situation where kids are bombarded with snacks during the day. That’s unhealthy and that’s not what school is all about. What we need is simple common sense.”

Exactly, says Marshall Manson, vice president of public affairs for the Center for Individual Freedom, an Alexandria, Va.-based advocacy group.

“It’s not unreasonable to say that local schools and local districts ought to be able to do what they want without oversight from the state or federal food police. Everybody wants children to eat healthy,” Manson says. “But the correct solution involves balance. You don’t want every vending machine on campus to sell only Cokes or only carrots. People who espouse limiting choice because kids might make the wrong choice are supporting a point of view that can only lead to other limits on freedom down the road.”

Freedom of choice was the reason Connecticut Gov. M. Jodi Rell recently vetoed a state bill that would have restricted the sale of some snack foods and beverages in all public schools while requiring a minimum of 100 minutes a week of recess for younger students. Rell, a Republican, said the bill usurped the longstanding authority of local districts to decide such issues for themselves. Critics said her veto was a blow to children and a nod to the powerful snack food lobby.

Societal Impact

In the end, it seems, the question of how much responsibility public school leaders shoulder for the health and well-being of students ultimately depends upon the individual administrator.

If he or she decides to act, there can be no half-measures, says Mary Ann Lopez, food service director for the 5,500-student South Windsor, Conn., district.

“Schools that try to do both, offering good foods and bad, aren’t going to succeed,” Lopez says. “Kids will always buy the bad. It’s all or nothing. You just have to know going in that you’re going to take a hit at first. Kids need time to adjust to new menus that don’t have the usual unhealthy foods. But they all learn.”

Taras at UCSD goes further, saying good school leaders do as much as they can, not just because it’s educationally or economically the right thing to do, but because lives hang in the balance.

A recent study, published in The New England Journal of Medicine, said childhood obesity threatens to create the first American generation of kids whose average life span will be shorter than that of their parents.

“As a society,” Taras says, “we have to ask ourselves what it is we want for our youth. Do we want kids who are literate and math-ready, but who are significantly more likely than necessary to drop dead at a young age from medical ramifications of a poor lifestyle?

“If this is not what we want in our society, then the mandated core curriculum as it is currently written (for literacy, math and science) is deficient. It should also include outcomes that will help us produce productive citizens who will live long enough to demonstrate their full productivity.”

Scott LaFee is a science and health reporter with the Union-Tribune in San Diego. E-mail: scott.lafee@uniontrib.com