Walmart to Assist With School Nutrition Initiatives

The Lake County General Health District is glad to see another private industry join the fight against obesity.  The Walmart Fondation is donating a total of $9.5 million nationwide to various health promotion and healthy eating initiatives.  One such program, Action for Healthy Kids, a non-profit organization helping schools provide better nourishment for children, will be receiving a grant for $1.5 million.   This grant will be used to help increase access the healthy foods, provide students with nutrition education, and provide 20 state teams with funding to recruit more volunteers and carry out support services. The additional funding will assist in reaching 160,000 children at about 400 schools nationwide. 

Action for Healthy Kids reaches students in all 50 states and has over 20,000 volunteers.  In the 2009-2010 school year the organization reached about 4.5 million students in over 9,000 school districts.  Many of the programs focus on increasing physical activity and healthy eating habits for life.  Volunteer and donation materials can be found on their website, along with information regarding some of their different programs.  

The Lake County General Health District is the representative to the Ohio Action for Healthy Kids Zone 4 efforts on behalf of Lake County.  Visit http://www.ohioactionforhealthykids.org/ to find out you can get involved. 

If you would like more information on the different organizations receiving money for health promotion activities from the Walmart Foundation, you can find that information on their corporate website by clicking here. 

Change is Good: USDA's New Standards for School Lunches

On January 25, 2012 USDA Secretary Tom Vilsack and First Lady Michelle Obama announced new school lunch guidelines that will gradually be phased in starting in Fall 2012.  The changes reflect the 2010 Dietary Guidelines for Americans, which were released last January, and are a part of The Healthy, Hunger-Free Kids Act of 2010.  The Dietary Guidelines for Americans focus on calorie balance, consuming nutrient-dense foods and beverages, limiting added fat and sugars, limiting sodium, increasing whole grain intake, and increasing intake of fruits and vegetables.  The new guidelines for lunches follow these recommendations.  Schools will now offer children portion sizes consistent with their estimated calorie needs, provide a full serving of fruits and vegetables each day, vary the colors and types of fruits and vegetables, limit saturated and trans fats, limit sodium, and increase whole grains.   For more specific information on these changes you can view the USDA press release here.  Also, a sample menu depicting the changes can be viewed here.

About 32 million children in the United States participate in school lunch programs everyday and with about one-third of school school-aged children being classified as overweight or obese, these changes have the potential to help kids establish healthy eating habits.  For now these changes will only effect school meals and do not apply to vending machines or á la carte items.  New guidelines for those foods will be released in the future. 

If you would like more information regarding the recommendations of the 2010 Dietary Guidelines for Americans you can view the Executive Summary online here.

*Information adapted from the USDA, Dietary Guidelines for Americans 2010, and “Government requires more fruits,  veggies for school lunches” USA Today available at http://yourlife.usatoday.com/fitness-food/diet-nutrition/story/2012-01-25/Government-requires-more-fruits-veggies-for-school-lunches/52779404/1

Great News for the Fight Against Obesity!

For Medicare beneficiaries with obesity, who are competent and alert at the time that counseling is provided and whose counseling is furnished by a qualified primary care physician or other primary care practitioner in a primary care setting, Centers for Medicare & Medicaid Services (CMS) will now cover:

• One face-to-face visit every week for the first month;
• One face-to-face visit every other week for months 2-6;
• One face-to-face visit every month for months 7-12, if the beneficiary meets the 3kg weight loss requirement as discussed below.

At the six month visit, a reassessment of obesity and a determination of the amount of weight loss must be performed.  To be eligible for additional face-to-face visits occurring once a month for an additional six months, beneficiaries must have achieved a reduction in weight of at least 3kg over the course of the first six months of intensive therapy. This determination must be documented in the physician office records for applicable beneficiaries consistent with usual practice.  For beneficiaries who do not achieve a weight loss of at least 3kg during the first six months of intensive therapy, a reassessment of their readiness to change and BMI is appropriate after an additional six month period.

For the purposes of this decision memorandum a “primary care physician” and “primary care practitioner” will be defined consistent with existing sections of the Social Security Act (§1833(u)(6), §1833(x)(2)(A)(i)(I) and §1833(x)(2)(A)(i)(II)).

§1833(u)

While this is a HUGE step in the right direction of putting a stop towards the rising rate of obesity it is sad to see that Registered and Licensed Dietitians, who are uniquely qualified to effectively address weight management at low cost. 

For more information on this newly developed benefit visit:

More information about this major Medicare policy revision can be found at http://www.eatrightwashington.org/docs/Reimbursement/Medicare%20Coverage%20for%20Obesity%20Counseling%20Nov%202011.pdf

 Sincerely,

Ron H. Graham RD, LD, MPH

Nutrition Facts and Menu Labeling Law

My apologies as it has been awhile since our last post.  I wanted to briefly discuss the recently passed menu labeling law.  The law is a HUGE step towards providing easily accessible nutrition information to the general public by being posted on the menus of chain restaurants.   If you would like to see more of the details regarding the law you can visit http://cspinet.org/new/pdf/nationalmllaw.pdf , for a excerpt from the law beginning with Section 4205.  The actually rules have yet to be adopted for implementation.

Do you think this will change the habits of fast food customers? Will knowing that a large latte is 405 calories or that a double bacon cheeseburger is 715 calories change our behaviors as Americans when we are often driven to make choices on "getting the most for our money"?   This law IS a huge step in the right direction for population based education but I wonder if it will help unless you know the average adult should only consume 2,000 to 2,500 calories per day and is recommended to get at least 30 minutes of physical activity as well.  I certainly hope that presentation of calories on menus will do at least two things; (1) that at least 20% of patrons will change their menu choices and (2) that the high calorie foods are slowly modified by restaurant chains to provide reduced calorie versions of these items.  How great would it be if this law resulted DECREASE PORTION SIZES?  For more information on how portion sizes have changed visit http://hp2010.nhlbihin.net/portion/

Have a Healthy Day!

Body Mass Index Screenings.

In my last BLOG, it referenced the opportunity for Schools to become part of the fight against childhood obesity and its impact on their quality of life and future health care costs.  The Ohio Senate Bill 210, known as the Healthy Choices for Healthy Children Act, became law June 18, 2010. The law contains provisions to combat childhood obesity in the next several years by increasing students’ physical activity and ensuring access to healthy meals and beverages at school.

The law's most immediate requirement is for districts and schools to provide students and their parents or guardians with information about student health. Beginning in the 2010-11 school year, all city, exempted village, local and chartered nonpublic schools, community schools and a district owned schools must begin conducting body mass index (BMI) screenings each year for all students in kindergarten, third grade, fifth grade and ninth grade. Districts also must report aggregate BMI data to the Ohio Department of Health (ODH) by June 1 each year.

The general public needs to understand more about the use of the Body Mass Index (BMI) measure.  BMI stands for Body Mass Index. Body Mass Index is a number calculated from a child's weight and height. It is a way of checking to see if your child has a healthy weight. The results of the BMI screening are given as a “percentile,” and the results compare your child’s height and weight those of other children of your child’s age and sex. In general, the higher the BMI, the more fat there is in the body.  Most important is the fact that as a child’s BMI increases their RISK for acquiring other chronic diseases such as diabetes and heart disease greatly increases dramatically.

 Parents and guardians are also concerned with “how will the school protect my child’s results, so that my child is not embarrassed or teased or by other students?” Schools understand the importance of privacy. Similar health screenings, such as hearing and vision tests, have been done for many years, and schools always keep those results private. The law requires that no other students or school staff (except for the health professional completing the weighing) be present when your child’s weight and height are measured. Your child’s school may mail the BMI screening results to you, or the school will discuss these results with you in private meetings. The law says that schools may share students’ “individual” screening results only with their parents or guardians.

Why is BMI screening important to public health officials and health districts such as the Lake County General Health District (LCGHD)? Simply, it is a measure of the general health of our children and allows us to measure if our publically/grant funded programs are effective.  For each school, BMI results from individual children will be combined into a summary of how many children are in each weight category. Each school will send its summary to the Ohio Department of Health (ODH). These summaries will not show results for any individual child. Only a child’s parents or guardians will know that child’s results. The summary will help ODH and LCGHD determine how children’s BMIs are changing over time in counties throughout the state. It is important for ODH and LCGHD to have accurate community-level information about this to plan its public health and prevention programs.

Unfortunately, the law allows schools to "waive" the requirement annually and represents a missed opportunity on improving our children's health.   I continue to hope that schools will opt to adopt the screenings. 

If you are a Lake County School District interested in supporting the BMI screenings, please contact me immediately to allow us to provide your district with support. 

Sincerely,

Ron Graham R.D., L.D., M.P.H.

Deputy Health Commissioner

A Missed Opportunity.

In regard to the fact that many Ohio schools are choosing not to follow the new Childhood Obesity  Law requiring that schools measure a child’s height and weight (see the article at http://www.fox8.com/news/wjw-ohio-schools-weight-law-txt,0,3543812.story ) , I find this a huge step backward for our children.  Body mass index, or BMI, is a calculation that uses your height and weight to estimate how much body fat you have. Too  much body fat is a problem because it can lead to illnesses and other health problems.  Many years of research show that a child’s physical health affects their success in school.  I truly hope that school districts in Lake County will step up to actively support the law and its BMI screening program. 

I believe part of the problem is that schools must often deal with complaints of parents over controversial subjects such as BMI screenings.  That along with the fact that schools are required to do more tasks with less resources could cause them to be turned-off to unfunded programs due to the amount of time it takes to address these concerns.  As a local health district, we can relate to unfunded mandates; but as concerned citizens who want the best for our children and our future as a nation, it is worth the extra effort.  I urge all schools to help us collect critical data, such as BMI, so that community agencies like the Lake County General Health District and Lake Health may develop school-based programs to help the children most at risk.   If you are a parent or guardian with a vested interest, please consider contacting your Board of Education and ask them to partner in the fight against obesity by adopting the BMI screening. 

Sincerely,

Ron Graham

Invitiation to Lend Your Voice

Looking for a way to get involved in helping inprove the health of Lake County residents.  As the Deputy Health Commissioner I invite you to lend your voice.  The Lake County General Health District (LCGHD) is seeking comments on a Community Health Improvement Plan (CHIP) that will be used to plan health improvement projects and policies in Lake County. The draft CHIP will be available in electronic format on LCGHD’s website at http://www.lcghd.org/ from October 24, 2011 until November 4, 2011to get feedback from interested residents, businesses, providers, and other service organizations. 

The CHIP is a product of the second stage of a process to improve community health for the residents of Lake County.  Several focus groups made of public and private stakeholders in Lake County have been created and meetings held to use the 2011 Lake County Community Health Assessment to develop the three-year CHIP. 

This is an exciting time and a perfect opportunity for change.  Everyone is experiencing the impact of the poor economy and many agencies need to cut costs in order to provide services.  This process will allow us to be transparent and work together to be more efficient in addressing the community needs.incredibly supportive. All too often, planning is completed in a vacuum because individuals may be concerned about criticism or diluting the ideas they started with.  The fact is that public agencies should be open to new ideas and challenge the way services have been developed in the past.

The Health District and I started the process knowing its success depends on building open communications and partnerships with new organizations, such as businesses and the faith-based community.   The two-week commenting period is one strategy to help accomplish this goal.  The second strategy is the expansion of its hugely successful Action Communities in Health, Innovation, and Environmental Change (ACHIEVE) Lake County initiative, which will act as the oversight body of the process from its adoption to its implementation phase.  ACHIEVE Lake County will also monitor its success over the three-year period.   Individuals interested in joining the ACHIEVE Lake County project may contact project lead, Tori Sinclair at 440-350-2442 or for more information visit www.lakecountyohio.gov/achieve.

Keep warm and we look forward to your feedback.

Ron H. Graham RD, LD, MPH