Are publicly funded school lunches contributing to the childhood obesity epidemic?

About 80 percent of Merced County’s children are eligible for government subsidized free and reduced-price school meals, according to a UC Davis study. The county, one of the poorest in California, is the third worst in the state when it comes to children without enough access to food, at 27.3 percent, according to a study of 2015 data.

Obesity is a major problem in Merced County, especially for children. A 2016 county health assessment determined that children here are three times more likely to be obese than the average kid. One out of every four children between the ages of 5 and 12 in the county is obese.

Childhood obesity is widely accepted to be a main contributor to a plethora of life-shortening diseases, including diabetes and heart disease.

Obesity itself is a drain on public resources. “Severe obesity” in adults cost state programs about $9.1 billion in 2013, according to a study published two years later. About $1.3 billion of that was covered by Medi-Cal, which covers just more than half of Merced County residents, second most in the state, according to the California Budget and Policy Center.

These statistics seem to indicate a crisis in the county that could carry a number of negative health outcomes in coming decades for a region already burdened with poor health. It also seems like a crisis when you factor in the local school district’s meal menus. A week’s slate of meals at one school district looks like this:

• Monday breakfast: Sausage breakfast pizza or yogurt with graham crackers
• Monday lunch: Hot dog or burrito
• Tuesday breakfast: Buttermilk bar or breakfast bowl
• Tuesday lunch: Spaghetti or cheesy breadstick
• Wednesday breakfast: Pancakes or chipotle burrito
• Wednesday lunch: Chicken drumstick or cheese pizza

And so on.

Daily breakfast choices include fruit juice, fresh fruit, and 1 percent white milk or fat free chocolate milk. And daily lunch choices include seasonal fresh, canned or frozen fruits and vegetables and the choice of either milk again.

Other district meal plans are similar. Is this what a healthy diet for children looks like?

According to federal guidelines based on decades of high-carb, low-fat messaging and assumptions, a healthy school breakfast includes a full cup of fruit, fat-free milk, vegetables, and meat to pair with whole grains with fiber. School breakfasts and lunches in Merced County seem to align with the guidelines.

But a recent wave of health studies has started to question and upend the federal government’s guidelines. 

Recent studies have shown no significant correlation between dietary fat and cholesterol, and heart disease, arguing the real culprit, among other factors, is obesity caused by insulin resistance obtained through sugar-loaded, high-carb diets. 

Top cardiologists suggest adopting a Mediterranean diet that does not severely limit or restrict fats, which can instead be “protective” of health. And the federal government’s recent changes to its own guidelines have eliminated calorie restrictions for overall dietary fat, and introduced limits to added-sugar intake.

Added sugars are higher in foods and drinks that are labeled low fat, according to a 2016 study.

But there is still a raging medical debate over which school of thought can help most people.

So how are school districts choosing their breakfast and lunch options? Are they working off federal guidelines as fact? Are they looking at the latest research on childhood obesity? Are their solutions evidence-based? What conversations are they having on this topic?

On top of that, do students even eat their vegetables? Hopefully, federal school lunch data can help answer that. There also appears to be a public health push by a collective at the University of California, Merced that aims to improve health outcomes. What are they doing to address the cultural climate of food in the county?

Since most schools in the county participate in federal school lunch programs, I hope to use publicly available data from numerous sources along with patient interviews to draw connections between children’s food consumption and obesity.

In addition to answering the questions raised here, my project for the 2018 Data Fellowship will seek to figure out the extent of the childhood obesity problem in Merced County. I’ll also report what stakeholders in the county are doing to combat childhood obesity and ask whether more can or needs to be done.

My end goal is to publish a multi-part series that delves into the childhood obesity crisis from the angle of their diet. I’m hoping that this provides a public service that can be used to cut down on childhood obesity and related health problems.