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Kids and Health Care: Schools and Diets...and Obesity

When it comes to diet and nutrition matters, the middle school years (fourth through sixth grades) are often a bigger crisis point than junior high or high school. In these years, kids often develop poor nutrition habits. For the first time, they're making their own choices at cafeterias and snack bars in school. While some schools are careful about the foods they make available to kids, others are not.

According to a 2003 study co-authored by Baylor College of Medicine nutritionist Karen Weber Cullen, consumption of healthy foods -- fruits, non-fried vegetables and non-processed dairy products -- dropped by at least a third among children in one Texas school district when they made the transition from primary to middle school. Perhaps more importantly, the students ate almost 70 percent more junk food -- things like french fries and sweetened beverages -- than they did the year before.

Cullen pointed out that most school diet studies focused on cafeteria menus, which don't always reflect what kids are actually eating. For example: Diet studies rarely consider the food and drinks offered at school snack bars. These items lean heavily toward junk food. Few elementary schools have snack bars, but middle and high schools often do -- giving students as young as 10 years old the chance to buy food ranging from fruit and salads to soft drinks and candy.

Cullen's study surveyed nearly 600 fourth- and fifth-graders in a southeast Texas school district from 1998 to 2000. Offered three options -- bringing food from home, buying a hot lunch or choosing items at a snack bar -- 35 percent of the students told Cullen that they chose to "graze" entirely at the snack bar.

Many students even went to the snack bar after receiving a subsidized hot lunch for free.

The study concluded that part of the problem was that the snack bars didn't offer fruit. And, even when a snack bar did stock healthier food, it seemed not to appeal to the students.

Cullen's suggestion: Better presentation of healthy foods. Oranges require peeling and can make a mess for students pressed for time between classes. School districts could make fruit more appealing by cutting and slicing it. And fruit juices or bottled water could become a bigger seller, if offered at the same price as smaller bottles of soft drinks.

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