GAPA Health Watch: What Are Our Kids Eating in the School Cafeteria?

The leadership of the Georgia Association of Physician Assistants (GAPA) takes a look at Georgia’s school lunch program, in light of the growing obesity epidemic in this state.

Online PR News – 28-July-2012 – Atlanta, GA – Preparations are underway for a new school year across Georgia. Parents are filling out school forms, stocking up on school supplies and purchasing new clothes for their children. Schools are also gearing up for the year with teachers making lesson plans and cafeteria staff planning healthy breakfast and lunch menus. At least, that’s what parents hope the meal planners are doing. Earlier this year, an article in the Savannah Morning News reported that the local school system was considering a plan to fight a rapidly rising cafeteria deficit by selling more Rice Krispy Treats and cutting back on offering healthy foods that kids don’t like to eat.

So what are our schools feeding our children? The leadership of the Georgia Association of Physician Assistants (GAPA) decided to take an in depth look at Georgia’s school lunch program, especially in light of the growing obesity epidemic in this state. More than 12% of Georgia’s children are now considered obese and at risk of chronic illnesses such as type 2 diabetes and heart disease.

“What we found is that Georgia school systems are expected to abide by specific regulations regarding federal nutritional requirements and there is a regulatory body in Georgia that oversees this process as well as provides programs aimed at improving nutrition, and thus health and education, for our children in a cost effective and safe manner,” said Beckie S. Hayes, MSPAS, PA-C. Hayes is a GAPA Board member and faculty representative at South University’s Physician Assistant (PA) program in Savannah.

Hayes consulted the Georgia School Nutrition Association (GSNA) about this topic. GSNA is a nonprofit professional organization of school food service employees founded in 1951 with the mission “to advance the availability, quality and acceptance of school nutrition programs as an integral part of education.” The goal is to encourage local boards of education to support nutrition education and school nutrition programs to fight childhood obesity.

“Even though we follow a lot of regulations and have a tight budget of approximately $1.07 per tray to feed a child, a lot depends on the local district as to how the implementation of the regulations is carried out,” said Lydia J. Martin, MSRDLD, SNS, who is a registered dietitian and Georgia’s School Nutrition coordinator. “Menus are written on a local level but follow USDA (United States Department of Agriculture) regulations.”

The USDA provides those regulations in its publication, A Menu Planner for Healthy School Meals, but school districts have some leeway in following them.

“My district, Richmond County, uses the Traditional Food Based Menu Planning Option, while the district in which I reside, Chatham County, uses the Enhanced Food Based Menu Planning Option,” explained Martin. “As recently as last year, some districts have used Nutrient Standard Menu Planning, such as in Bulloch County, however, that option will no longer be available next year.”

In overseeing the school districts, Martin interprets and implements regulations to tailor menu decisions and maintain compliance while offering the healthiest of all possible approved options. For example, in 2002 she advised systems that had been offering 2% and whole milk options to change to 1% or skim milk. Other menu changes have included adding whole grains and more fruits and vegetables.

“Whole grains have been in school meals for several years as well as brown rice and whole grain pasta,” she added. “Pizza on the school menu now has a whole grain crust, which is much different than what we get from a restaurant or grocer, along with low-fat cheese and turkey-pepperoni.”

Martin also emphasized that schools offer a variety of fresh fruit and vegetables on the menus as well as salads, but noted that positive steps like these, along with lowering fat and adding whole grains, are not usually considered newsworthy. However, she admitted that there is still a long way to go in improving school lunch programs.

“I would delight in providing more from-scratch preparations on the menu and less processed food,” she added, while acknowledging obstacles such as the short time interval between the breakfast and lunch meal; food safety issues such as handling raw meat and poultry; economical considerations and current level of staff training needed. “Plus, school systems need to be diligent in following federal guidelines in selecting food items.”

Martin also cautioned that schools aren’t to be held solely responsible when it comes to making sure children eat healthy foods.

“One of the most important aspects of school lunches begins at home,” she explained. “No matter how healthy the food offered, if it is not consumed, it is wasted. If children are not introduced to spinach at home, for example, they are not likely to eat it at school.”

For children who do have access to nutritious meals at home, Martin explained that Georgia’s school lunch programs offer nutrition education and customized counseling about lifestyle changes such as item selection, portion control and exercise. Parents may also apply for free or reduced-cost breakfasts and lunches for their children if their family’s status meets certain income or other federal requirements through the Georgia School Breakfast and Lunch Program.

“Georgia has been proactive with providing nutritious lunch programs since the 1940s,” Hayes observed. “In fact, the federal regulations guiding Georgia’s school lunch programs actually got their start when Georgia Senator Richard B. Russell proposed a school lunch program in 1944 to combat the problem of childhood malnutrition especially prevalent in rural areas.”

The Richard B. Russell National School Lunch Act (79 P.L. 396, 60 Stat. 230) was passed by Congress in 1946 and now provides lunches to 25 million students nationwide. The act also fostered the Child Nutrition Act of 1966 and the Special Supplemental Nutrition Program for Women, Infants, and Children in 1972.

“As front line healthcare providers, Georgia PAs are also eager to be in the forefront in educating patients about healthy food and lifestyle choices with patients,” continued Hayes. “GAPA members are helping them fight the obesity epidemic through the innovative ‘Get Fit with GAPA’ initiative and we regularly increase our medical knowledge and skills through GAPA’s continuing medical education courses.”

A seminar held recently at GAPA’s 2012 Summer Conference emphasized the principles of the Strong4Life Program. Stephanie Walsh, MD, MS, and a pediatrician representing Children’s Healthcare of Atlanta, presented the course, “Improving the Effectiveness on Childhood Obesity Counseling.” The curriculum offered tools to healthcare providers who need to counsel patients about obesity, focusing on lifestyle changes and promoting buy-in amongst individuals and families.

“Children need these tools within the home so that they may extend them outside of the home when parents are not there to regulate the choices,” observed Hayes. “Our patients may not have anybody beyond their PA healthcare provider to counsel them on their health choices. We are the boots on the ground in this war on childhood obesity.”

The mission of the Georgia Association of Physician Assistants is to promote high quality, cost-effective, accessible healthcare as part of a physician-directed PA/physician team in Georgia. To learn more about how PAs make healthcare more affordable and accessible in Georgia, please visit and click on “Patients.” GAPA also offers “Find a PA,” a free searchable database for healthcare consumers with listings of Physician Assistant providers throughout the State. Learn more about GAPA’s health initiatives, “Get Fit with GAPA” and “Rx for Fitness,” at

Photographs and radio PSAs are available upon request and at

visit our website