Now that sugary sodas are verboten in public school cafeterias and veggie burgers have arrived on the menu, pediatricians have turned their attention to the brown bags and lunchboxes that come from home. It turns out their contents are in need of an overhaul, too.
Indeed, homemade lunches are often higher in calories and lower in nutritional value than the fare served in the lunch line. That’s not so surprising since they tend to reflect the packaged foods that fill the American diet, says Mark Corkins, chief of pediatric gastroenterology at Le Bonheur Children’s Hospital at the University of Tennessee Health Science Center. He was a member of the group that wrote a recent American Academy of Pediatrics policy statement advising parents to pack more produce and fewer processed snacks. “Everybody knows that fruits and vegetables are good for you,” Corkins says. “But when you look in the fridge, they don’t keep them at home.”
What’s in those lunch boxes (and what’s not) is part of a much larger worrisome trend. In a recent study of 9,000 children ages 2 to 11, researchers at Northwestern University Feinberg School of Medicine in Chicago found that fewer than 1 percent ate a diet emphasizing fruits, vegetables, whole grains and fish, and with daily sodium intake of less than 1,500 milligrams and no more than 450 sugar calories from sugar-sweetened beverages per week. What’s more, 40 percent didn’t have healthy cholesterol levels, and more than 90 percent consumed too much sodium. Says study co-author Donald Lloyd-Jones, a professor of cardiology and epidemiology at Northwestern: “From the 10,000-foot level, what we can tell is that very few children seem to be getting healthy diets.”
The grown-ups in their lives haven’t exactly set a stellar example. About half of American adults suffer from chronic diseases that stem from poor diet and too little exercise, according to a report released last spring by the federal government’s Dietary Guidelines Advisory Committee; more than one-third are obese. The outlook for the next generation is even bleaker. In their annual report on obesity in 2012, the Trust for America’s Health and the Robert Wood Johnson Foundation projected that more than half of adults — today’s kids — will be obese by 2030, leading to a 20-fold increase in new cases of chronic diseases.
Nutritionists worry most about the habit-forming power of packaged foods and beverages. When young palates are honed on salt, sugar and fat, Lloyd-Jones warns, “it’s much harder to change” as kids get older. Sodium alone takes a huge toll on adults now. “We’re getting seven or eight times the amount we need,” he says, noting that 90 percent of adults have hypertension before they die. Research shows that Americans eat nearly a third more calories than they did 40 years ago, including more than 50 percent more fat; the average person takes in 15 more pounds of sugar a year than in 1970.
That said, the AAP cautions against demonizing certain foods, since a broader approach is more realistic. “We’re trying to get rid of the witch hunt,” Corkins says. The policy statement advises emphasizing the five groups recommended by the government’s Dietary Guidelines for Americans (to be updated later this year): vegetables, fruits, dairy, foods high in protein and grains. Sugar, salt, fats and oils are OK used sparingly, especially if they raise the appeal of the recommended foods. (A teaspoon of sugar sprinkled on oatmeal is fine; sugary drinks, not so much.) And “anything that comes in a can or a bag we should be really careful about limiting,” Lloyd-Jones says. The pediatricians’ group also urges families to engage in outdoor exercise together — riding bikes or walking the dog, say — to help kids meet the recommendation that they get an hour of physical activity a day.
Experts advise providing new food experiences as a way to make children more accepting. The more you offer a given food to a child, the more likely he or she is to see it as the norm, says Ihuoma Eneli, medical director at Nationwide Children’s Hospital’s Center for Healthy Weight and Nutrition in Columbus, Ohio. Don’t give up: It may take up to 15 exposures for an unfamiliar food to become palatable. It helps if parents set an example. Corkins recalls the mother of a patient who asked him to tell her child to eat vegetables. “So I asked her what her favorite vegetable was, and she said ‘I don’t eat vegetables.’ If parents eat vegetables, kids are more likely to eat them,” he says.
Kristi King, senior dietitian at Texas Children’s Hospital in Houston, tells parents to give children leeway to make acceptable choices. “Allowing your kids to have some say in what goes in their lunch means they’re more likely to eat it. It gives kids ownership,” she says. “And when they get to be in middle school, they can pack their own lunch.” On those days when everyone’s running late and convenience food beckons, you’re better off forking over cash for the cafeteria.
Excerpted from U.S. News’ “Best Hospitals 2016,” the definitive consumer guidebook to U.S. hospitals. Order your copy now.
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Taking Stock of What’s in That Lunchbox originally appeared on usnews.com