In compliance with provisions of the Richard B. Russell National School Lunch Act (79 P.L. 396, 60 Stat. 230), the USDA recently published its proposed rule to establish the requirements for operating the Fresh Fruits and Vegetables Program (FFVP). Intended to encourage schoolchildren to consume fresh fruits and vegetables, the rule would provide administrative and operational requirements for FFVP food service operators at the state and local levels (77 Fed. Reg. 10981 (Feb 24, 2012)). As the USDA considers responses to its proposed rule, this may be an appropriate time to assess the efficacy of state measures aimed at similar goals.
Concerns about childhood and adolescent obesity have stimulated enactment of a wide array of state statutes and regulations applicable to the public schools. Among these are state-created programs to make fruits and vegetables available to students at no charge. School nutrition legislation addresses such topics as diabetes screening and management, insurance coverage for obesity prevention and treatment, nutrition education and physical education, among others. States have limited students' access in schools to foods deemed non-nutritious; banned the sale of many sweetened beverages; required schools to provide free, fresh drinking water in food service areas; required schools to calculate and report students' BMIs; required creation of nutrition and physical education curricula; and imposed minimum standards for time dedicated to physical education.
Unfortunately, even though many of the relevant legal requirements have been on the books for a decade or longer, data on their effectiveness are rather limited. A study of the efficacy of such enactments in Arkansas — whose approach to the problem has been particularly aggressive — suggested that although parents developed increased awareness of the association between childhood obesity and health problems, and of the connection between childhood and adult obesity, there was no evidence that parents had promoted physical activity or modified nutrition behaviors at home. Obesity rates among Arkansas schoolchildren remained stable.1 More recently, another paper evaluated California's efforts to reduce obesity and improve fitness. It concluded that among schoolchildren there, increases in rates of obesity slowed from 2003 to 2008, but students entering fifth grade were more obese every year. The authors concluded that early obesity was not reversible within the existing school program.2 Parental notification of BMI scores in California seems to have had no effect, either.3
Well-intentioned enactments might have some potential for benefit, but at present evidence of actual efficacy appears to be limited. Food service operators serving public schools, as well as their suppliers, are nevertheless obliged to conform to requirements such as these, and to any similar regulations that may be promulgated in future. Before enactment of additional regulations or legislation, it may be reasonable to await a more persuasive showing that these measures actually work. At McGuireWoods, the food and beverage team can offer assistance to organizations in analyzing such measures, and in fashioning appropriate responses.
Footnotes
1. Larson, A., "The American Childhood Obesity Evidence: Probable Causes and the Legislative and Judicial Responses," 28 Child. Legal Rts. J. (2008).
2. Aryana, M., et al., "Obesity and Physical Fitness in California Schools," 163 (2) Am. Heart J. 302–12 (2012).
3. Madsen, K.A., "School-based BMI Screening and Parent Notification: A Statewide Natural Experiment," 165 (11) Arch. Pediatr. Adolesc. Med. 987–97 (2011).
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