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Philadelphia School Teaches Healthy Food Choices

Posted on Sat, May. 18, 2002
Reading, writing and 100 percent juice

A pioneering program has some city schools teaching the importance of good
eating habits.
By Marian Uhlman

Ruth Anderson realized she was going to have to lose weight, too.

It would do no good to rally her 510 students behind the quest for good
nutrition while her own body was lumpy in spots that had been firm just 10
years before. Anderson, an educator for four decades, knew that the best
lessons were taught by example.

Here she was, a first-year principal, regularly sending heartfelt advice to
her children over the loudspeaker at Tanner G. Duckrey School in North
Philadelphia. "It is nutrition time all the time," she'd say to the pupils,
in pre-kindergarten through sixth grade. "Replace soda and candy with
popcorn and juice."

She'd become an unflagging nutrition booster, but was failing miserably to
follow her own counsel.

If not for a nutrition task force's pledge to Duckrey, Anderson probably
would have overlooked her appearance entirely that December day during a few
precious uninterrupted minutes. She would have been worrying about how to
raise test scores or get more parents reading to their kids. Or doing the
payroll, since no one else could input it on the school's cranky computer
system.

But the pledge had made her take a closer look at all nutrition-related
issues, including her own.

At stake, if Duckrey lived up to the offer's terms - conducting as many as
1,500 hours of nutrition-related activities by summer - was as much as
$10,000 for her school, where books, paper and lightbulbs are in short
supply. "Anything to help the children" was her motto. If they'd eat better
and learn what was good for them, she was for it. Too many mornings, she'd
watch students snacking on candy and soda they'd bought at the yellow store
across the street. Others got treats elsewhere or came to school on an empty
stomach. And she was troubled by how many were overweight.

She'd seen a burst of enthusiasm when the school started trying in October
to go after the pledge. She even got staff support when she banned candy at
Duckrey, although it meant teachers could no longer hand it out as a reward.
("Candy was cheaper," said Michelle Rosbach, who now doles out pencils,
pretzels, popcorn, stickers and grapes to her second graders.) But as
Christmas break approached, Anderson was worried that nutrition was being
pushed aside as teachers added report cards and parent conferences to their
already frazzled workdays. Too much was at stake to give up.

Principal Anderson could thank a dead soft-drink contract for giving Duckrey
a crack at the nutrition money.

In the spring of 2000, when she was still a senior teacher at another
elementary school, leading nutrition experts in the region gathered at the
Presbytery of Philadelphia offices at 2200 Locust St. Normally, these
experts toil quietly at such places as the University of Pennsylvania, the
American Cancer Society, the School District of Philadelphia, and the
Greater Philadelphia Food Bank.

They had been galvanized, though, by Coca-Cola Bottling Co.'s recent attempt
to strike a $43 million deal with the school district for exclusive rights
to sell beverages in the city's cash-strapped schools.

They would have been happier if health concerns alone had scuttled the deal.
But some school officials felt it was too meager. Who knew what would happen
if a more lucrative contract was offered one day? As they talked at the
Presbytery, the experts resolved to make a healthy foods agenda a district
priority. Outfitted with a new name - the Comprehensive School Nutrition
Policy Task Force - they set as a goal revolutionizing the way kids,
parents, teachers, administrators and support staff in every Philadelphia
school think about food.

They wanted to upgrade vending machines as well as cafeteria a la carte
lines. They wanted nutrition injected into every subject ("favorite foods"
as a writing topic; vegetable soup to spur a science talk about herbivores).
And they hoped their agenda would spill into neighborhood stores and family
grocery carts.

"We were trying to get people back in touch with what they know is right,"
said Sandy Sherman, the task force's leader and a nutrition educator at the
Food Trust in Philadelphia, until recently the Farmers' Market Trust.

Such aspirations might seem outlandish in a world stuffed with Big Macs and
Big Gulps. Timing is everything, of course. And kids' eating habits are
suddenly a hot issue. They are guzzling more soda and eating more snacks.
Their diets, along with inactivity, are being blamed for the nation's
soaring number of overweight children.

About 13 percent of children and adolescents are now seriously overweight,
according to government measures for weight and height. That's about the
percentage at Duckrey, too. Extra pounds make these children vulnerable to
major health problems, from heart disease to Type 2 diabetes.

"Left unabated, overweight and obesity may soon cause as much preventable
disease and death as cigarette smoking," wrote outgoing U.S. Surgeon General
David Satcher in December. More than 60 percent of American adults are
overweight; almost 30 percent are obese.

But solutions are not as obvious as the problem. Satcher urged schools to
think beyond phys-ed and health classes and to gear their entire environment
toward healthy eating and physical activity - an exhortation that made the
Philadelphia task force look prescient.

Schools elsewhere have taken steps toward healthier eating. Some set up
salad bars. Others shunned exclusive soda contracts. But few have embarked
on as comprehensive a program to promote general nutritional health as the
one that sprang from the powwow at the Presbytery.

"Philadelphia is among the innovators," said Howell Wechsler, a specialist
in nutrition and physical activity for the Division of Adolescent and School
Health at the federal Centers for Disease Control and Prevention. "People
are coming together with a systematic, long-term approach, not just being
negative and trying to stop something from happening."

Nobody opposes good nutrition. There are simply so many countervailing
forces.

Teachers motivate children to read with fast-food coupons. Parents bake
cakes and cookies for fund-raisers. Principals throw pizza parties to honor
students. And school cafeterias cater to kids' tastes rather than risk the
loss of sales to the neighborhood competition.

Teachers and principals have little, if any, nutrition education. Most don't
see it as part of their job. How can they inspire children to choose baked
potatoes instead of french fries and to skip the sour cream?

"Money is a big barrier, and so is the lack of perceived importance of
nutrition," said Simone French, an epidemiology professor at the University
of Minnesota, who researches school-based interventions. "School
administrators want kids to eat healthy, but it is not one of the things
people spend time to develop and make policy on."

The Philadelphia task force realized it needed a gimmick. Something with
more pizzazz than the Food Guide Pyramid. Where better to find inspiration
than among the masters of marketing - McDonald's, Burger King, Pizza Hut?
Prizes and rewards had lured millions of children to buy fast food. Perhaps
prizes could get them to eat better.

The incentives would be aimed not only at children, but at the school staff,
too. Teachers would be paid for taking two-hour nutrition classes, and they
would also earn up to the $10,000 for school supplies that Anderson would
come to covet.

It took about a year for task-force members to develop a pilot program,
obtain federal grant money, and get the go-ahead from school district
officials.

"Personally, I'd like to see no junk food in the schools," said Joan
Nachmani, a task force member and coordinator of dietetic services for the
district's food services division. "We can teach them in school to select
healthier options, but the key is to have reinforcement outside the school
in the home."

Four schools were chosen to be pilots - including Duckrey.

Principal Anderson has nothing against the brightly painted yellow corner
store across Diamond Street from her industrial-looking brick school.

She just doesn't like to see her students leaving it with black plastic bags
filled with candy, soft drinks and chips - especially when there's a free
hot breakfast waiting in Duckrey's cafetorium, a spacious, multipurpose room
with an auditorium stage separated from a kitchen by three rows of long,
brown tables.

She'd been watching the morning routine since arriving at Duckrey in January
2001. Often, so many children gathered before school at the tiny store they
couldn't all get in at once. (The shopkeeper declined comment for this
article.) Anderson thought a sugar-laden breakfast made learning harder for
children and established bad eating habits. So when a Food Trust staff
member asked her in September what she first wanted to accomplish, it was a
no-brainer. She wanted her students to eat the school breakfast, so they
would get a nutritious start to the day.

Marjorie Scharf, a public health nutritionist who is one of two Food Trust
staffers spearheading the project, had already started to market good
nutrition at Duckrey and the three other pilot schools - South Philadelphia
High School, William L. Sayre Middle School in West Philadelphia, and John
Story Jenks, a kindergarten-through-eighth-grade school in Chestnut Hill.

She'd hung a banner above the food line in the Duckrey cafetorium,
distributed purple Food Pyramid folders to each child, and soon would hand
out white plastic water bottles. Each bore the project's slogan - "Want
Strength, Eat Healthy Food" - and a logo of an orange character with
sunglasses and flexed biceps.

But the raffle tickets were what really got things going. During October,
each time a child ate the school breakfast - such as French toast fingers,
grits, sausage, cold cereal, juice and milk - he or she would earn a small
blue ticket. It was a chance to win a new bicycle.

At times during the month, Anderson's clear, melodic voice would float over
the school's loudspeaker system, coaxing: "The only way to get a chance to
win the prize is if you come to the cafetorium to eat a healthy breakfast."
Anderson, who has a lively sense of humor, later discovered that she'd been
pushing the wrong button on her intercom and broadcasting her messages all
the way down to 13th Street and Susquehanna Avenue.

More children started to turn out for breakfast, eager for the tickets.
"Everyone thought they were going to win it," said third-grader Ashley
Garnett. Some kids even searched the large trash cans desperately looking
for lost tickets.

Anderson didn't stop there. She got nearby Temple University to send
athletes to eat breakfast with her students. And she made up for the candy
ban with a Temple-led pep rally - gymnasts, basketball players,
cheerleaders, even the mascot Temple Owl - cheering: "Want Strength, Eat
Healthy Food!" Not all the kids were impressed. Sixth-grader Tamika Austin,
who later would become a school nutrition leader, said it was "corny."

By November, breakfast attendance averaged just over 300 children a day - 60
percent more than in September.

Now it was the staff's turn. After school one day, 19 people, including the
Head Start teacher, the cafeteria manager and the computer science teacher,
straggled into a first-floor meeting room. Scharf praised them for the
project's strong launch, and then said, "I want to hear what you want to
accomplish."

The teachers perked up. Get the parents involved, they said. See how a good
breakfast makes kids feel the rest of the day.

"I'd like to see children exposed to a variety of food," said Beverly
Mackaman.

"I want to broaden the word diet so it means things they like to eat," said
Lisa Szybowski.

"We are not looking for nutrition to stand alone," Scharf said. She nudged
them. Use food labels to hone math skills. Read stories with food themes.
"The more you teach, the more money you have for resources."

But by Christmas, Duckrey teachers had recorded only 107 hours toward
nutrition activities, garnering a mere $804.98 of the $10,000 pledge. Even
the children's breakfast attendance had fallen, despite raffles in December
for 25 jump ropes and indoor basketball hoops.

Anderson overdid it during the Christmas holiday. Chitlins. Ham hocks. And
her favorite concoction of eggnog and rum-raisin ice cream splashed with
milk. She indulged with purpose. One last hurrah, she thought, before taming
her urges.

Her doctor had suggested a year earlier that she lose weight to control her
high blood pressure. Her husband also had been on her case. Most of her
life, Anderson had followed her mother's simple advice: Eat well, but avoid
extra portions. However, a decade ago she had started to reach for food for
comfort as she nursed her mother and sister during the final stage of
chronic illnesses.

"I just blew up," said Anderson.

Her first year at Duckrey didn't help either. She'd gained 25 pounds, and
was now carrying about 200 pounds on her 5-foot-4 1/2-inch frame. She'd seen
other first-year principals put on weight because the job is so demanding.

She was inspired before Christmas by one student whom she'd heard had been
asking for nutrition pointers. When she spotted the cheerful girl, she said,
"I understand congratulations are in order."

The girl looked perplexed.

"I understand you lost four pounds," Anderson said.

The girl scrunched up her shoulders and put a hand over her broad grin.

"If you can lose four pounds, I can try, too," Anderson said.

The girl bounded back into the classroom, shouting, "Y'all, I lost four
pounds." Anderson laughed.

The principal promised herself she'd start eating better and exercising more
in the New Year.

After the holiday, the Duckrey program faced a major test. Throughout the
fall, the thrust at all four pilot schools had been generating enthusiasm
for the project. Now the task force members wanted to make a change in the
beverages kids drink and make them conscious about their drink choices. A
small alteration, but a tricky one.

The quandary that arose was this: What is nutritious? What balance of
ingredients is sufficient?

Sandy Sherman, a Food Trust staffer, bumped up against these questions in
mid-January at the Jenks school when she tried evaluating the lunch drinks
of some first-grade boys.

The boy with 100 percent fruit juice obviously deserved a raffle ticket for
healthy eating. "Water is good," she told another, giving him a ticket. The
boy whose drink was only 10 percent fruit juice she had to turn down. Sorry,
she said.

But as she moved from table to table through three lunch periods, she
puzzled about the amount of juice a beverage should contain to be considered
healthful. If 10 percent is not adequate, what about 20 percent?

Many sports drinks and iced teas contain less sugar and fewer calories than
100 percent juice, but they don't match its nutritional value. Fruit drinks
often are fortified with vitamins. But their juice content typically is
between 5 percent and 25 percent. Not as much juice - as juice.

Sherman was eager to take the crucial step of devising a policy for drinks
sold a la carte and in vending machines at the four pilot schools. (The task
force didn't focus on school meals because they already comply with federal
nutrition standards.) But Sherman was perplexed. "Everyone," she said, "has
a different idea of what healthy is."

She solicited input from other nutritionists and food service managers.
After much debate, they settled on a simple standard for the school day,
something that promoted nutrition and was easily understood: 100 percent
juice was in. So were milk and plain water. Everything else was out. Now,
the task force had to find juices kids were willing to buy. And then the
schools had to stock them.

Easier said than done.

In late January, Duckrey's nine student nutrition ambassadors met for the
first time. They sized up unfamiliar-looking mini-Cheddar cheese rice cakes
heaped on a white plastic plate. None of them had ever tried the
70-calorie-per-serving treat, but in less than 10 minutes the plate was
empty. It was a warm-up drill for their new job.

"Has anyone done a taste test before?" asked David Rice, a Food Trust
staffer.

Craig Seawright, cocooned in two sweatshirts, raised his hand. "There was
some nasty foods and some that weren't," said the sixth-grader. "We had to
write down what we thought on a piece of paper."

Rice chuckled. In a few minutes, you'll be judging new juices for the
school, he explained. "We are not going to tell you what they are," he said.
"But there is nothing too nasty."

The first three students earnestly approached the taste-testing table. They
circled, sampling five 100 percent juices in unmarked paper cups. Craig's
cheeks puffed out like a chipmunk's as he rinsed his mouth with water
between drinks. He tried hard not to smile. Or to reveal his favorites while
the other kids took their turns.

The children formed a semicircle at the juice table to hear the results,
wincing as they recalled the pineapple and nodding slight approval for the
apple. The winner was the previously unheard-of kiwi-strawberry juice.

Scharf told the children it was their job to market it to other students.

"Can we bring it around?" Melissa Cosby, a fifth-grader, asked excitedly.

"We can put them in little cups on a tray," Craig suggested.

Scharf thought it was a first-rate idea, reinforcing one of the nutrition
project's basic tenets: Kids are the best promoters for good nutrition.

Anderson hadn't planned for it to be a confessional.

She'd called the impromptu nutrition meeting merely to touch base with four
of her top Duckrey lieutenants.

They'd almost finished when she fixed her attention intently on Scharf, who
had joined the mid-February meeting. "I have high blood pressure," she
blurted out. "I went for a checkup three weeks ago. My cholesterol is going
off the wall. If I could stop this crazy eating...."

The last six weeks had been a blur. Restoring heat to classrooms. Calling
police to flush out drug dealers near the school. Prepping students for
state tests. Battling the flu. And wondering about Duckrey's future - and
her own - under the pending school reforms.

Anderson admitted she was "eating day and night."

"I'm supposed to be a role model," she wailed, referring to the nutrition
program. Noticing the giggling and nodding heads, she laid into her
lieutenants: "They are feeding you constantly around here."

In gentle tones, Scharf backed her up. Looking at the smiling culprits, she
said she understood they bring food because they care. "But," she said, "you
have to stop." Change would be much easier, she explained, if they didn't
supply so many temptations.

Duckrey's asphalt playground was a whir during recess on a gray, cool March
day. Footraces. Pickup basketball. Double-Dutch. Tag. It was a rare child
who stood still.

But recess was just 15 minutes a day. Down from a half-hour a few years ago,
when the school had more supervisory staff. Physical education class was
only 45 minutes a week - minus time to change clothes, listen to the
teacher, and take turns during relays. After-school sports, which once
included track and tennis, have dwindled to only a few offerings.

Getting enough exercise is hard for kids like Tamika Austin. She loves to
jump rope, but can be sidelined by asthma. Her doctor recently told her she
is at risk for developing Type 2 diabetes. Exercise and healthy eating can
reduce that risk.

"When I exercise, because of my asthma, I start getting out of breath or
real tired," said Tamika, a sixth-grader and a member of the student
nutrition committee. "I like to do sports on my block. I jump rope and play
wall ball. That's it, unless I go to the courts, once in a blue moon. Most
of the time, my mom doesn't let me."

Avoiding sweets has also been tough for Tamika. She'd go to the neighborhood
store several times a day with friends or on errands for her mother. "When I
get something for the house, I want junk, too," Tamika said. "I don't know
why. It is just tempting."

"It's hard for me, too," said Tamika's mother, Michelle Austin, who has been
diagnosed with Type 2 diabetes. "Every time I go to the store, I want to buy
a Pay Day. I know I am not supposed to eat it. ... A lot of ways I had
before diabetes, it is hard to change them."

However, she has observed subtle changes in her daughter since the advent of
Duckrey's nutrition program. Tamika has been cutting down on snacks and
starting to read food labels. On one recent shopping trip, Tamika surprised
her mother by asking for 100 percent juice instead of soda.

Changing eating habits isn't for wimps. It's not orderly. It's not
short-term. And if the goal is to prevent disease or obesity, it takes years
to find out if the effort is making a difference.

"It is unrealistic to expect to shift the patterns of society sufficiently
to have a trickle-down effect on weight levels in two or three years," said
Shiriki Kumanyika, a Penn epidemiology professor and public health nutrition
expert, who is advising the Philadelphia task force. "... It is like having
a child and wanting the reward of him graduating from college when he is 2
years old."

"It took 30 or 40 years to get into this mess," said the CDC's Howell
Wechsler. "You can't change attitudes and practices overnight."

By March, it was as though the pilot schools had reached base camp in their
trek to the Mount Everest summit. That still was quite an accomplishment.
Success in the nutrition arena is measured in modest steps.

At Duckrey, the second-grade teachers added diet-related words such as
protein, dairy and grains to the spelling list. They practiced the math
concepts of "greater than" and "less than" using suggested servings from the
Food Guide Pyramid. A fourth-grade class made taproot soup to tie into a
science chapter on plants.

Over at Jenks, parents limited unhealthy foods at fund-raisers and the
principal penned nutrition tips daily on an office memo board. Students
scripted healthy food promotions for South Philly High's in-house TV
station. Most important, each pilot school spawned nutrition advocates like
Alexzina Bryant, the food service manager at Sayre Middle School, who'd ask:
"Where are we going with this? I am looking for change!"

Amid the many small steps was a notable one: Coca-Cola had agreed, at least
on a trial basis, to stock glass-front vending machines with 100 percent
Minute Maid juices and Dasani water at Sayre and South Philly High.

Since Coke's actions had inspired the nutrition project, events had now come
full circle.

The Duckrey nutrition kids gathered in the cafetorium shortly before lunch.
Juice already had been poured into scores of small paper cups.

Like a coach before the big game, Marjorie Scharf huddled with the children
to explain the X's and O's of food sampling.

"You really got to believe in what you are selling," Scharf urged them on.
"Say whatever you want to say, but say it like you mean it."

Pair off in teams. Hand out bookmarks you've designed with healthy juice
slogans. Offer a juice sample to every Duckrey student. Tell them the new
drinks will be sold after spring break.

"Unfortunately," Scharf said, the juices "you liked most aren't available."

"You mean we can't have the kiwi-strawberry?" asked Craig Seawright.

"Arhhhh," sighed a chorus of children.

Task force members had anticipated many obstacles, but rounding up healthy
food options just wasn't one of them. They were surprised by the limited
selection of available 100 percent juices for the schools. Stymied, they
scaled back their policy to permit drinks with as little as 25 percent
juice. And vendors still don't have every item on hand. The demand needs to
be there, said Joan Nachmani of the school district's food services.

Task force members also gulped at the size of most available bottles: 16
ounces or more. Such large portions are factors in weight gain. But what was
the alternative?

"You are always uncovering something, something that you didn't know about
that can move the project along like a committed individual or discovering
something that is really a barrier or a challenge," said Scharf, who had
also encountered similar problems with snack food. "If we want to move
forward, we have to move within the given system. ...

"At least 25 percent juice is a major success from what many people were
drinking and think is healthy."

The sampling went well at Duckrey despite some grabbing and spilling. The
nutrition kids even chased down Anderson with a juice cup and bookmark. On
the whole, Tamika Austin said, the kids liked the juices - apple, orange and
cranberry-grape. "They wanted to come back for more."

Away from the schools, the task force is making progress toward Year Two.
The school district has signed off again on the pilot, and will permit the
task force to expand to five schools. Penn obesity researchers are planning
tie-ins for a study. And the Pennsylvania Health Department wants to link
one pilot school to a broad obesity prevention project that also would
include the National Park Service and the City of Philadelphia.

In that role, Joseph W. Catharine Elementary School in Southwest
Philadelphia is joining the group. Jenks will continue in a limited role
because of funding changes. Sayre, South Philly High and Duckrey have
accepted invitations for Year Two. (South Philly High's new beverage vending
options, largely 100 percent juice and water, were so popular, said Sandy
Sherman, that sales increased by about 460 percent in the first month
compared with the same period a year ago.)

At Duckrey, the outside world is intruding yet again. The drug dealers
threatened Anderson after spring break for advocating they move away from
the school grounds' perimeter. And the cops were called in.

But Anderson is pleased by the School Reform Commission's decision to have
Temple University manage her school. Not just for the university's
wide-ranging expertise in education, but also for its desire to focus on
nutrition.

More and more ideas are spilling from the Duckrey staff as the year's end
approaches. The counselor had more than a dozen kids interview senior
citizens about their childhood diets. The art teacher coordinated a
nutrition poster contest. One third grader's entry: "I'm superbread and I
give energy to work and play." In the coming year, sixth-grade teacher
Sandra Black plans more hands-on nutrition activities such as keeping food
diaries so the kids will understand "what it looks like and feels like to
eat healthy."

"Duckrey has certainly shown that it has all the essential elements to
promote healthy eating," Sherman said.

In all, 20 staffers recorded almost 400 hours of nutrition education between
January and March - about four times the number of hours from October to
December. Steven Lomax, the school's congenial computer science teacher,
tallied 100 hours. "It wasn't too hard," he said.

Despite the progress, by April the staff had generated only $4,200 of the
$10,000 prize. Still, it is a start on the purchases the school hopes to
make - an overhead projector, a large screen projector, microphone, videos,
math textbooks and more - to further nutrition education.

"Things are really changing," Anderson marvels. "I never thought this would
take off like this and be so enjoyable."

As for her personal goals, Anderson hasn't lost any weight. She started
exercising several days a week, but has been inconsistent because of the
relentless demands of her job.

She has seen a nutritionist. She even bought a $40 electronic food scale.

"Now it is my turn," she said, "to be part of healthy eating, good nutrition
and weight loss, and a healthier body.

"I think I will be able to do it," she said. "I'm in the mode."

------------------------------------------------------------------------
Marian Uhlman, an Inquirer medical writer, spent the last six months on a
University of Maryland Journalism Fellowship in Child and Family Policy.
Contact her at 215-854-2473 or muhlman@phillynews.com.


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