A Single Federal Program Cut Obesity by 3% (And Saved Twice What It Cost)

, food systems & health analyst | September 14, 2015, 9:25 am EDT
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A recent study by researchers at the University of Arkansas found that the federal Fresh Fruit and Vegetable Program decreased childhood obesity rates in elementary schools by 3 percent at a cost of only $50 to $75 per student per year. That’s significant. Previous studies looking at other strategies to reduce childhood obesity rates estimated costs of $280 to $339 per student every year to move the needle by a mere 1 percent.

Let’s hope that Arkansas Sen. John Boozman is aware of this newer study’s results. He’s on the Senate Agriculture Committee, which is set to vote this week on legislation reauthorizing federal child nutrition programs, including taxpayer-subsidized breakfast, lunch, and snack programs in the nation’s schools. Sen. Boozman advocates for alleviating childhood hunger in his state, but he also supports “flexibility” for schools to reduce food and financial waste. This translates to giving schools the option to not serve children fruits and vegetables. Giving schools a pass on this important provision in the Child Nutrition Act means giving up on a generation of children.

A single federal policy cut obesity by 3% and saved twice what it cost—why not expand it? Learn more: http://j.mp/1O6bnRH

Posted by Union of Concerned Scientists on Monday, September 14, 2015

 

The Fresh Fruit and Vegetable Program

The Fresh Fruit and Vegetable Program is a federally-assisted child nutrition program that provides free fresh fruits and vegetables as snacks outside of school meals to elementary school students. Elementary schools with at least 50 percent of students receiving free and reduced lunches are eligible for the program. Eligible schools receive $50 to $75 per student to implement the program over an entire school year.

The goals of the program are to improve children’s overall diet and create healthier eating habits to impact their present and future health expand the variety of fruits and vegetables available to children, exposing them to new flavors and increasing their fruit and vegetable consumption.

These are critically important goals, but they can’t be achieved if Congress does not maintain the programs and standards set in the 2010 reauthorization of the law. Fresh fruit and vegetables are high in fiber, vitamins and minerals, and contain essential nutrients that support children’s growth and development. When children consume too many unhealthy foods high in fat, sugar and sodium in lieu of healthy foods, they are more likely to become obese and develop diet-related health conditions.

The Costs of Childhood Obesity

Approximately 18 percent of the 24.7 million elementary school-aged children in the United States are obese. Beyond the obvious health risks that are associated with being obese, there are societal costs as well. Researchers at Duke University estimate that the lifetime obesity-related medical cost for just one obese child is $19,000. If childhood obesity rates remain the same, Americans could be saddled with $83 billion in obesity-related healthcare costs over the lifetime for our current generation of children.

Expanding on Arkansas’s Success

What would happen if the Fresh Fruit and Vegetable Program were implemented in all public schools nationwide?

I did some back-of-the-envelope calculations based on the Arkansas study’s findings. We estimate that the cost of offering the program for all children during their entire elementary education ($50 per child for 24.7 million children for five years) would amount to $6.1 billion. Assuming students experienced the same impacts on weight, obesity rates would drop from the current 18 percent to 15 percent nationwide, reducing those children’s lifetime obesity-related medical costs from $83 billion to $69 billion. That would save families, health insurers, and taxpayers $14 billion.

In other words, spending $6 billion to implement the program would save $14 billion in healthcare costs over the current elementary school generation’s lifetime. Now that’s a return on investment I’d be willing to make.

Earlier this year, UCS released the report Lessons from the Lunchroom: Childhood Obesity, School Lunch, and the Way to a Healthier Future, which documents the importance of healthy school food, and how it can change their eating habits for the better. We’ve recommended that Congress prioritize fruits and vegetables in schools, at meals and also with programs like the FFVP that enable them to offer these healthy foods as snacks between meals.

We did our homework on the benefits of fruits and vegetables. Before next week, we hope the members of the Senate Agriculture Committee will do theirs. But, in case they need a little encouragement, you can send them a letter today!

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  • Richard Solomon

    Any of those UCS members who agree with this post should send the Senate Committee the letter noted above. I did!

    • Lindsey Haynes-Maslow

      Thank you Richard for your support!

  • Andree Pages

    I love the results, but the problem is that it is localities that pay for school food budgets, and health insurers and Medicaid that reap the cost savings of lower obesity rates. That is why even these great results are a difficult sell. If you had something closer to single-payer insurance and federal funding for education, this would be a no-brainer for even the most ardent anti-regulation person. It’s really too bad. In addition to the health costs, there are also obesity’s costs to children’s self-esteem. Given that state and federal health programs probably see some cost savings, maybe they could provide grants to cover some of the costs of such a program to localities.

    • Lindsey Haynes-Maslow

      Thank you for the comment Andree. Please note that needs-based food programs, such as the Fresh Fruit and Vegetable Program, are federally subsidized programs. Schools are reimbursed for their food costs with taxpayer dollars. This is why UCS supports federal policies that invest in healthy food – because we don’t want taxpayers to have pay twice: once for unhealthy food subsidies and later on for diet-related chronic disease healthcare costs.

      • Andree Pages

        Thank you for your correction. It is unfortunate that the Arkansas study in AAEP cannot be accessed for free, so that we could read it and learn from it. A brief synopsis of the study’s method, sample size, and results would strengthen your article. As it is, the abstract notes that that “the FFVP program causes an economically meaningful reduction in the obesity outcome of participating children.”

        I reviewed the FAQ for the program and find the financials challenging for a school. (I have attached in italics relevant FAQ bits below.)

        Let’s take a hypothetical school of 300 students. In addition to serving breakfast and lunch, it is now required to create a third eating time, because the SNAP foods cannot be given at breakfast or lunch. This means taking kids away from class during learning time (or incredibly scarce recess) to tromp them down to the cafeteria). Hard to imagine that this could take less than 20 minutes. Lunchtimes are usually staggered in a school, so the cafeteria and workers must be up and running for an extra set of shifts (perhaps another hours). When would these shifts take place? I have heard of kids( lunches starting as early as 10:30 in big schools. If school breakfast ends at 8:00, who is preparing lunch while rounds of children are coming for snack?

        In addition, the preparation of fresh fruits and veggies to get kids to actually eat them is labor intensive. Per a recent Mother Jones article (http://www.motherjones.com/environment/2015/03/brian-wansink-cornell-junk-food-health):

        “Many parents won’t be surprised to learn that Wansink found children to be exquisitely sensitive about food presentation. One of his studies, in 2011, determined that serving fruit in colorful bowls instead of metal trays more than doubled fruit consumption at school. In another, from 2013, he found that schools that switched from whole to sliced apples saw 48 percent fewer apples wasted and a 73 percent increase in students eating more than half of their apples.”

        If food is brought into classrooms, you still need personnel to take it around, retrieve leftovers, etc., and the time to hand it out, eat it, and wash hands. Another valuable 20 minutes of class time. (Not that I quibble with the priority of health, but it is understandable that some teachers might equivocate.)

        Back to our hypothetical school of 300. At funding of $50 – $75 per pupil, a school would get a $15,000 to $22,500 subsidy annually. Divided by a 38-week year, the school is allocated $395 to $592 a week, and encouraged to distribute food at least twice a week. Given the costs of fresh food, inevitable food spoilage, and the cost of washing, preparation, distribution, and cleanup, I find it hard to see how the locality doesn’t end up absorbing extra cost on this. At two snacks a week for 300 kids, schools are receiving from 66 to 99 cents to provide each serving. Given the food prep, refrigeration, handling, and clean-up costs in addition to raw food cost, I don’t see the school not taking a loss, given that they must also “give students an educational program about nutrition and…aggressively advertise the program.”

        The salary of a program coordinator and curriculum developer alone makes a mockery of the subsidy’s size.

        So in turn, I find it difficult to believe the Arkansas results without getting a chance to see them. I believe that getting good food and learning how to live healthily in the world is worth more than much of what children learn in school, but I still don’t see how the program would be an attractive one financially for struggling schools.

        If there are fundamental errors in my math or another gross misunderstanding on my part, I’d be grateful to be further enlightened.

        Elementary schools participating in the program receive between $50.00 – $75.00 per student for the school year. The State agency decides the per-student funding amount for the selected

        schools based on total funds allocated to the State and the enrollment of applicant schools.
        With these funds, schools purchase additional fresh fruits and vegetables to serve free to students
        during the school day. They must be served outside of the normal time frames for the National School Lunch (NSLP) and School Breakfast Program (SBP). The State agency or SFA determines the best method to obtain and serve the additional fresh produce.
        Schools participating in the FFVP submit monthly claims for reimbursement which are reviewed by the SFA before payment is processed to the State agency. Schools are reimbursed for the cost
        of fresh fruits and vegetables and limited non-food costs….”

        Schools must create “a program implementation plan including efforts to integrate the FFVP with other efforts to either promote sound health and nutrition…Schools must also agree to
        widely publicize the availability of the program.”

      • Lindsey Haynes-Maslow

        Thank you for your thorough reply. It is unfortunate that the study cannot be accessed for free. You might consider contacting the authors directly to review their methods.