Deadline looms for extending school nutrition programs

Washington -- As Congress returns from its Labor Day recess, some in organized medicine will be keeping close tabs on legislation that would reauthorize school nutrition programs for the next five years.

Unless Congress acts, funding for several federal programs considered vital to children's health is set to expire Sept. 30. The National School Lunch Program, the School Breakfast Program, the Summer Food Service Program, the Child and Adult Care Food Program and the Special Supplemental Nutrition Program for Women, Infants and Children are among the programs that would be affected.

The House must act for money to continue flowing to the programs. The Senate passed its version of the legislation -- the Healthy, Hunger-Free Kids Act -- on Aug. 5. It provides an additional $4.5 billion over 10 years for federal school nutrition programs. It passed after a bipartisan group of senators were able to agree on offsets to pay for the package completely.

The bill provides "for the first noninflationary increase in the federal reimbursement rate for school lunch programs since 1973," said Sen. Blanche Lincoln (D, Ark.), chair of the Agriculture, Nutrition and Forestry Committee.

Pending in the House is companion legislation, the Improving Nutrition for America's Children Act, sponsored by Rep. George Miller (D, Calif.), chair of the House Labor and Education Committee.

The committee passed the legislation July 15 with a 32-13 bipartisan vote. Now it's up to the full House to pass a measure. Nutrition experts who favor the bill are hopeful that will happen before the Sept. 30 deadline, especially because Congress is scheduled to go into recess Oct. 8 for the November elections.

"There isn't much time. If the programs aren't reauthorized exactly on Sept. 30 it would not be too much of a problem, but they cannot go much further than a few days past that," said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, a nutrition and food safety nonprofit based in Washington, D.C.

The center supports the bill largely because it would get unhealthy foods out of vending machines and increase the reimbursement rate for lunch by 6 cents per meal. It also enhances nutrition education and supports healthy eating and school wellness.

The Congressional Budget Office said the House bill will cost about $7.5 billion over 10 years. Wootan said the House probably is going to have to make some cuts before it can agree with the Senate on a bill to send to President Obama.

Wootan, who has worked in nutrition for 20 years, said this is the best child nutrition bill she has seen. She said the measure would be in danger of falling apart if it does not pass before lawmakers adjourn for the midterm elections.

"If there's a changeover in the House or Senate, then Republican leadership could produce legislation that looks very different," she said.

Doctors, associations weigh in

The American Academy of Pediatrics, the American College of Preventive Medicine, the American Diabetes Assn. and the American Heart Assn. are among the groups that have lent their support to the House bill.

AAP said it endorses the legislation because it seeks to address the challenges of hunger and obesity.

"This legislation takes significant steps toward increasing the nutritional value of meals served through these programs while also reducing the fat and caloric content to promote a healthy, balanced diet," Judith S. Palfrey, MD, AAP president, wrote in a July 1 letter to Miller.

"This bill would allow the [U.S. Dept. of Agriculture] to institute nutrition standards for all foods sold in schools outside the school meal setting, including vending machines, snack bars and a la carte lines," Dr. Palfrey wrote. "[It] would improve access to school meal programs by allowing schools to use census data to identify high-poverty communities and allow these schools to provide universal meal service to students."

The bill also would provide more children who participate in home care with meals by reducing administrative costs for child-care sponsors and promoting stronger collaboration and nutrition education coordination, the AAP said in its letter.

"Good nutrition is critical to children's health, development and ability to learn and grow," Dr. Palfrey wrote.

The obesity epidemic

As the AAP and other experts in organized medicine point out, both pieces of legislation seek to curb the country's growing obesity epidemic by reducing the fat and calorie contents in school meals, and by setting limits on what kind of food content would be available for sale in school vending machines.

A study released by the Brookings Institution on Aug. 12 concluded that the total costs of obesity in the U.S. may exceed $215 billion annually. Of that amount, $14.3 billion is attributed to children.

Brookings is a public policy think tank based in Washington, D.C.

On Sept. 2, the American Medical Association issued a statement of support for National Childhood Obesity Awareness Month.

"Obesity kills more Americans every year than AIDS, all cancers and all accidents combined," said AMA Board of Trustees member Mary Anne McCaffree, MD. "It is causing health problems in children that were unthinkable 30 years ago. That is why the AMA is working to halt the spread of obesity."

The AMA's "Healthier Life Steps" is a comprehensive online tool to ignite greater discussion between patients and physicians about healthy lifestyle choices.

The tool kit includes screening checklists, intervention plans and other components.