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Dr. Ayala

Dr. Ayala
Philadelphia, Pennsylvania, USA
V.P. Product Development
Herbal Water
I’m a physician (Pediatrics and Medical Genetics), artist, and mother of 3 school age active kids. I recently co-founded Herbal Water Inc. (www.herbalwater.com) with my husband, Albert. I am a serious home cook, and love to entertain. My expertise is vegetarian food (I have been a vegetarian all my life). I strongly believe that eating healthy and enjoying good food go hand in hand. My main interests are science, nutrition and art, and I am overall a very curious person that tries to learn something new every day. Dr. Ayala (Ayala Laufer-Cahana M.D.)


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Editor’s Pick
FEBRUARY 15, 2010 7:07AM

”Let’s Move” to reform school food

Rate: 20 Flag


School food received some major media attention in the past week.

Michelle Obama launched the Let’s Move anti-obesity campaign last Tuesday, with improving school food as a major program cornerstone. Congress will reauthorize the Childhood Nutrition Act this year—with some planned overhauls and budget proposals underway. And the Obama administration wants Congress to remove sugary snacks and drinks from school vending machines.

Say what? The federal government is trying to limit big food’s footprint in our schools?

If Agriculture Secretary Tom Vilsack gets his way, he intends to do just that: "Food served in vending machines and the a la carte line shouldn't undermine our efforts to enhance the health of the school environment,” he said.

A short introduction to school food

On any school day more than 30 million kids eat a school lunch and 10 million kids eat a school breakfast. Fifty-nine percent of the kids eating a school lunch are from low-income homes, as are 80 percent of school breakfast eaters. The school lunch program operates in all public schools and in many private schools.

The National School Lunch Program was created with a dual purpose—to feed kids and prevent dietary deficiency and to provide an outlet for surplus agricultural commodities. One can already see that the dual purpose of the program throws in some problematic conflicts of interest, but let’s go on.

The government provides $2.68 per day for kids qualifying for a free lunch, $2.28 per day for a reduced-price lunch, and $0.25 per day for all other kids. That sum includes the overhead and facility costs associated with the meal, which leaves just $1—or less—for the food itself. This is clearly not enough money to fund from-scratch cooking or quality, fresh produce. President Obama proposes bumping up the school lunch budget a tad—which will be better than nothing—but the additional funding probably won’t afford a huge amount of change.

What kind of meal can you get for $1?

An adventurous school teacher vowed to eat the school lunch every day this year, and she’s posting musings and photos of her cafeteria meal in a daily blog. Take a look at the pictures (take note of the amount of packaging) and you’ll get the idea.

I’ve devoted several posts to this subject and analyzed the typical school lunch menu, concluding that the best description for this food is “fast-food”. Overall, it’s salty, sweet and fatty; the meat is breaded and crunchy; and it’s been highly processed—even the fruit and vegetables aren’t fresh for the most part. Most of the schools have no kitchens and just heat and un-wrap low-grade foods. Nevertheless, the subsidized school lunch complies with some nutritional guidelines and provides plenty of protein and vitamins, and while I think guidelines based on the nutrient profile of foods alone are an ill-advised way to evaluate food quality, at least some rules exist.

But if the federally sponsored and regulated school lunch program leaves much to be desired wait till you get the full picture, because challenging the school lunch, are what’re called competitive foods.

These competitive foods—comprised of foods and beverages sold in the cafeteria or in a school store, from a vending machine or in fundraising events—are expressly marketed to our kids and make up a big part of what kids actually eat while they’re in school.

Kids love the vending machines and the school stores, but that’s not the only reason these outlets exist. Schools depend on the revenues that vendors bring in to fund much-needed programs. This creates an unusual and worrying conflict, in which schools share an interest with the manufacturers of snacks and junk foods.

School candy-land

Here are some facts about the scope of the competitive food problem. (The source is an article in the Journal of the American Dietetic Association that looked at data collected in 287 nationally representative schools and included 2,314 kids.)


• One or more sources of competitive foods are available in 73 percent of elementary schools, 97 percent of middle schools, and 100 percent of high schools.

• À la carte foods sold in the cafeteria are common in all school levels.

Vending machines are available in more than one quarter of elementary schools, 87 percent of middle schools and virtually all high schools.

Consumption of competitive foods :
40 percent of school kids consume these foods on any given day.
Consumption is much higher among high schoolers—55 percent.

Energy contribution of competitive foods:

• Kids consume about 280 calories per day from competitive foods, and almost two- thirds of these calories were from “low-nutrient” and “energy-dense” foods. (The study defines “low-nutrient, energy-dense food” to include cakes/cookies, desserts, donuts, toaster pastries, snack chips, French fries and caloric beverages, excluding milk and 100% juice.)

• A typical high school kid gets about 340 calories per day from competitive foods, 65 percent (or 220 calories) of which are from junk food.

The most commonly consumed competitive foods:
Desserts, snacks (cakes, cookies, candy and ice cream) and sweetened beverages.

So, we have low-quality foods sold in the schools competing with a low-quality school lunch–a competition that’s a lose-lose for our kids. Wherever our kids turn they have snacking opportunities that contribute mostly empty calories.

The only existing federal restriction on foods sold in school is that foods of “minimal nutritional values,” such as candy and soda, won’t be sold in the cafeteria during meal times. That of course doesn’t mean they can’t be sold right outside the cafeteria doors. And although some school districts have taken initiatives to impose restrictions banning some junk food sales in schools, progress is very slow.

It is high time school food begins to resemble a lesson in how to eat healthfully. Right now, the school lunch—and especially the school foods for sale—resemble all that’s wrong in our popular food culture, and explain quite well why one in three American kids is overweight or obese.

Kids spend half their waking hours in school and consume half of their daily calories while on campus. Changing school food is critical in the effort to combat obesity.

I applaud the White House and especially our First Lady for taking on this important issue. “Let’s Move” is the politically savvy way to name what will have to really become a “Let’s Eat Less Junk” effort—but whatever it takes let’s indeed move it!

Dr. Ayala

Full disclosure: I’m vice president of product development for Herbal Water, where we make organic herb-infused waters that have zero calories and no sugar or artificial ingredients. I’m also a pediatrician and have been promoting good nutrition and healthy lifestyle for many years.

Read more from Dr. Ayala at  http://herbalwater.typepad.com/ 

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It seems to sensible and good for the welfare of a huge number of people--and it crosses Big Food, especially Big Sugar. I expect some wrinkles will develop and setbacks will ensue, as occurred with health care reform.

I loved your candy-land section, too. Rated.
Thanks, Steve.

Wrinkles and all, we have to remain optimistic about the possibility of positive change :)
I still wonder if the first lady is somewhat naive about what she thinks Big Food and Big sugar will let her get away with!
Glad to see someone writing about this -- I heard an interview with Michael Pollan the other day and he mentioned school lunches. It's disturbing how much money we spend on the business side of food and yet skimp on what we feed our youngsters.
Thanks for writing this, Ayala. I am completely disgusted by the school lunch offered at my kids's school. Despite the fact that it would save a lot of time in the morning before I zip off to work, it is completely worth it to me to make my kids' lunches. I am thankful that their school has no vending machines. My K daughter's teacher has parents volunteer for a week at a time to supply snacks for the kids, and mandated that they include fresh fruit, lowfat milk, and little if any processed food. The kids have learned to cook through this process. We're also lucky to have started a school garden with state funds in the past year, and the kids have been involved from the beginning. We're having our first farmer's market tomorrow with the first crop of winter greens! It has worked out wonderfully and sets a great example for the kids for good nutrition. I have tried to do school lunch reform in their school, looking at some grants and innovative companies who can provide better alternatives, but money is always the issue.
Dr. Ayala. It's getting harder and harder to find pure water with air bubbles in the liquids.
Bubbles in tummies tickle.

I wonder what is gonna be the condition of the future. Zombie meandering La La Land?

I know a VAC nutritionist.
I've eaten and been in her home.
She asked me to grow food too.
The VA hospitals won't pay fair.
You gotta Love? Mrs. Obama too.
I shook her hand twice in one day.
She almost reminds me of __huh.
It was pure thought. Barack's lucky.
I have a beautiful photo of Michelle.

If you Google Flicker-photo see her.
I am bragging?
the marigold lei?
if you see the garland?
My Granddaughter gave that marigold necklace to the First Lady.

It was Sept 17th, 2009 at the White House Market. Behave.
I always try to ...
The Secret Service seemed pleasant. But, No gifts. No flower.
No farmer can give flowers to the First Lady - SS did order it!
We were told that. I understand. I bumble bee may sting her.
I love that some women and almost six-year olds give flower.
Look, if you want? The White House Farmer Market events.

The First Lady gave a great 'down-on the-farm' earth speech.
I'll learn to 'cut & paste' someday. I'll show Michelle's smile.
The White House even sent a few other photos. Kindness.

I NO never understand why some pundits dare oppose?
She has warmth and graciousness. She may wear bib?
I think the couple would look pretty with bib overalls.
Who cares if she is on Vogue's front cover. That's EP.

I want to banter on and on.
But, I know you understand.
This gets to my VAMC Friend.
We have to eat healthy victuals.
No wonder people become duh.

Automatons become poisoned.
The body is alive? Feed health.
People who are sick dissed self.
The self-loath is physical/spirit.
People and nation become toxic.

Seriously, I'll get this piece shared.
Hi, Ya know who?
O, Ya so visceral.
not Ya Dr. Ayala.
The other foodie.
I love nutritious.
There is no way - right now anyway - that a govt. program will have ANY effect on obesity. Child or other wise.

The deck is stacked so far in favor of Big Food that it's ridiculous to even entertain the notion of reducing the ability of these mega-companies from supplying their addicts.

Even the name of this new program is disingenuous. "Let's Move"? This implies that more exercise will address the issue. The usual dodge. There is no way exercise will combat - in any meaningful way - the deluge of fats and sugars consumed.

Many M. Obama has her heart in the right place, but this is all PR for Big Food. Bet on it.
We're killing our kids with junk food. The goal shouldn't be eliminating just childhood obesity, it should be creating childhood health. There are lots of thin kids who eat abominably bad diets, so the focus should be on creating health across the board.

The school district in which I live has a contract with Coke, which is simply legal kick-backs for having vending machines dispensing Coca Cola products. It's all about the money, not the health.
Dammit everyone. Yes, the Monsanto's and Tyson's and Coca-Cola's of the world will likely step in with their pitchforks and horns to try and put the First Lady in her place, but we should be applauding any efforts to stand up to them. A paradigm shift needs to occur with the general population, where they start demanding OTHER food products so that a little something called supply and demand requires healthier food on our shelves and in our schools. It takes press, media, education, etc. to make this happen and even if this doesn't pass, it's a start. It's getting some attention. It's triggering conversations just like this. I don't have great things to say about politicians, but I'm behind Michelle, no matter if her efforts are in vain. Rated.
In Puerto Rico, which as you probably know is an unincorporated territory of the USA, federal government is in charge of all foods served at all public schools and several private schools. All public schools have a full kitchen, and private schools on the program are required to have one, and food is cooked, almost always, from scratch using variations of the Puerto Rican diet, its staple being rice and beans. The only beverage available is milk or juice. Sometimes students are served canned ravioli, and at least at the school I teach, we teachers protest loudly when we hear it is being served more than once a week. There is no á la carte menu, there is no cafeteria. All students qualify for free breakfast and lunch regarding their family income. (Which is lower compared to any state, anyway). Federal guidelines for us mandated the removal of all soda and candy machines from the schools, allowing only the sale of water bottles. It was expanded to include juice and "nutrient replenishment" drinks such as Gatorade. Again, the teachers at school complained that it was dangerous for students to be drinking large quantities Gatorade if they did not involve themselves in strenous exercise.
The documentary Super Size Me showed how it goes for schools over the US. It was really interesting to see how schools who had only sensible, nutrient rich, healthy food available noticed a decreased incidence of problematic behavior from otherwise beligerent students.
Food for thought.
We have to try. Years ago, I was horrified to find out that there was no kitchen in my son's elementary building. Two years ago they switched to a "healthier" menu which basically means that instead of white carbs with no fiber, you get highly processed "tan" carbs with maybe 1 gram. Now that he's in middle school, my son (who used to just eat tons of salad bar) can get pizza, burgers, Poptarts...all the things I have worked so hard to limit at home. We have to try.
Now we are going to pick on school lunch programs? Programs prepared by dedicated concerned staff who pride themselves in serving good meals to children? I will not be a part of this.

I watched for over a quarter of a century these near angels on earth trying to provide for our children. I saw how much they cared and how well they did on limited resources. I saw kids gobble the food at lunch and years later saw this same staff serving good solid breakfasts as well. These meals kept kids alive and healthy.

My experience is limited to the schools in the Northwest so I can speak for the rest of the country, but in this region kids are fed good, solid meals. I ate them for years and years. I loved the staff. They are not some uncaring mob who throws stuff in a pan and calls it good. Lumping these caring people in with the same crooks who have pop and vending machines in schools is bullshit.

I admire the Obama administration for trying. Get the pop machines out would be a good first step.
Oh, my goodness. Now, I have heard it all. On this thread it was suggested we turn the lunch programs over to Burger King, Pizza Hut and others? That is the most insane thing I have ever heard.
All well and good, and it's the same kind of thing -- garbage dispensed from machines -- that bothers me.


For a look at the problem from the flip side, from someone actually in the trenches and having to deal with recalcitrant kids and the problems engendered by lack of resources, check out this:


She's quite right.
Dr Spuddman44,

Regardless of their divinity or good intentions, cafeteria workers have very little to do with procuring the basic ingredients.

With the budgets supplied, no matter how lovingly assembled, the final product is a gut bust of processed corn products and synthesized fats. Sorry but them are the facts.
wow. eye-opening post. great job.

this is sure daunting. i am not the guy to figure it out, but i sure support getting it fixed--or at least making a good start on it.
@Will Azeperak

I does seem ridiculous that small sums can buy companies the opportunity to brand themselves inside schools. I think your example is a representative one—you can buy signage and the chance for a lifetime customer from a young age for very little because the schools need the money so badly.

The fact that school systems sell out to junk-food makers is sad. What’s tragic is that they also sell out cheap.
Okay Roy, since you directed a comment toward me. It is simple. Here is an excerpt from what I said at Lunchlady's post that is a counter to this one.

I ate school lunches almost every school day for twenty-five years. The cooking staff members were dedicated and worked hard at providing fine meals. These meals were the only ones many of my students ate. I saw lunch expand to breakfast servings.

In fact, I was just over at the middle school here. They had a salad bar, which is there everyday. The main thing today was spaghetti, pears, green beans and a large freshly baked roll and milk. I don't know where you get your "facts" but I looked at the meal with my one good eye. I would have eaten it. By the way, I have a 34 inch waist and weigh 175 pounds even after all those years of eating shit. Just my perspective on things. It may be worse in other parts of the country.
Part of the reason that school lunches are so underfunded, I think, is that they represent support given to the poor. Since Ronnie Rayguns and his Welfare Queen mythology, its been allowable and even fashionable to dis the poor as somehow deserving of their plight.
Yet you left out the original driver of the school lunch program. In the early days of WWII it was discovered by the Army that so many draftees were underweight and undernourished. If we were going to have our children protecting us they had to be physically able to do so ~ and so the school lunch program was born. Too many conservatives who like to talk about how the government cant do anything right, but Looooove their military ignore this piece of history.
Excellent post, Dr.
Very good article. I pack my daughter' s lunch precisely for these reasons.
I agree with some of your argument but your post brings up one question. Does your overpriced water compete with competitive soft drinks in schools ?
Where does it all end? The government can't be all and do all for all people.

This is just another Obama power grab. You wait. Something will happen or be wrong and they will step in and take over something else that is not in their domain.
Thanks for the great comments.
@Cindy Ross and @Dr. Spudman 44--I just posted a comment on lunchlady 2 response. Here's what I wrote:

Dear lunchlady,

I’d like to start with words of appreciation for your work and dedication. Feeding kids well on a budget isn’t easy.

I based my assessments of school foods on The third School Nutrition Dietary Assessment Study and the several studies based on its findings. The study was based on a sample of almost 400 representative public schools that offer subsidized school meals, and about 2,300 students grades 1-12. I link to the source in the other posts, mentioned in today’s post, where I also write:

“There are a few schools that serve healthy, nutritious food, made from real ingredients. There are a few schools that teach kids how to cook healthy meals and even grow their own vegetables.”

The main theme of today’s post was actually the competitive foods at school, and that an improved school lunch will be wasted if kids have readily available sugary snacks for sale to use their lunch money on.

I’m really with you and agree with a lot of the things you write.
You are right on, Dr Ayala!
Unfortunately, the opposition has Billions of dollars.
And all they care about is their bottom-line.
It's simply cheaper to feed people processed food. That's why most people with low income buy from the dollar menu at fast food places.....and you wonder why the health of the nation is so bad?

Watch the movie Food Inc. It will certainly open your eyes and make you never want to step into a fast food joint or eat out ever again!
This is a great post. I think Michelle O has taken on a bigger task than it first seemed. If only there was a way to get schools cooking actual food again. Maybe then kids would learn what real food tastes like.
Good morning. This post & comments has interested me.
I comment 2 X's because of Karen P.'s suggestion`Food Inc.,
Food Inc.
Food Inc.
Food Inc.
I agree. Eater MUST MUST MUST see the eye-opener `
Food Inc.,
I guess it's not possible to get in any more predicaments so how `bout a lousy joke?
There was a prudish food film critic who
The USDA assigned the critic to inform
to counter the toxic Food Industries
and in a kitchen setting in school
a child embarrassed the Doctor

a child ask the dear Doctor
and caused Doc to blush

after reviewing Food Inc

Food Inc. /Food Inc. See!

a lovely child ask Doc`

Did you see the movie`


We lurned?

I hop sops?

Eat good
Feel well
do work
"The (US) government provides $2.68 per day for (American) kids qualifying for a free lunch."

The average Haitian lives on less than two dollars a day. And that's the average of the rich, the middle class and the poor.

Puts it in perspective, doesn't it?
Malusinka, If I may, yes we do get reimbursment for feeding the children. What no one realizes is that out of that money the government gives us to feed your children we must be self supporting. We must, out of that money, pay our utilities, wages, benefits, upkeep on appliances, new equipment, AND food. Everything that goes on in the cafeteria is payed for out of the money we are reimbursed. Try doing that on the amount of money budgeted for school meals. Plus raises and benefits are out of our hands. The money can go nowhere else but to the cafeteria. We still ,many of us, spend more than we can bring in. Our purpose is to get as many butts in seats as we can. Without support we can't do it.
Please I ask of you all, if yoy have a problem ask questions, there is much more to running a cafeteria than meets the eye. Thank you, lunchlady
And again we blame someone else for apathetic parenting. Good life choices begin at home be they physical, mental or emotional. Kids are obese because it's easier to let them sit for hours in front of the television stuffing their faces with Doritos than it is to take an interest in their lives. Get out the bikes. Go for a walk. Throw a ball around the backyard. Jump rope. Pay attention to your kids and monitor their lives they way a parent should. Schools have a hard enough job providing an education without having to be the next iron chef. If our government truly considered education a right for all people, they would provide the funds necessary to teach and it wouldn't be necessary for corporations to hang their sponsor banners over soda and candy machines. Don't talk to me about how difficult it is for some people to buy healthy food. What's the nutritional value of beer?

Okay so perhaps that's a bit unfeeling. Some kids really do depend upon school to get fed. What's wrong with that picture? The problems in this country go much deeper than school lunches, and I don't think apples and celery once a day are the answer.
hi, Dr. Ayala

I had a post on this as well, though dealing primarily with the "show pony" aspects of it as a "news" item.


This "play" by the Administration will not change a thing.
We need to make a lot of changes and this issue must be put on the top list. I don`t like at all what is happening with our kids, I have a masters of public administration online and I see a lot of ways to improve things in schools but unfortunately there are people that don`t want this. It`s time for a change, hope this won`t be too late.