Dr. Virginia Stallings

Staff Photo by John Rawlston Central High School student Lizzie Winter holds her lunch tray with a single slice of pizza in the school cafeteria.

No matter how good the spaghetti with meat sauce looked, it was no honeybun and Cheetos.

For Central High School junior David Eaton, the vending machine was the obvious choice. The line for the hot food was longer, and the meal was more expensive.

“The (cafeteria) food just isn’t that appealing,” the 16-year-old said. “Maybe if I’m extremely hungry.”

It’s a constant refrain for school nutritionists — you can lead students to the lunchroom, but you can’t make them eat.

Most schools are trying to make their lunches healthier, but they still battle the picky-eating habits of students as well as the ease of cheap — but often unhealthy — snacks in vending machines.

Added with the high cost healthy food, getting nutrition in the mouths of students is a daily challenge.

“We can offer all healthy food, but unless kids accept it, we will miss the boat,” said Carolyn Childs, Hamilton County’s director of school nutrition.

America’s concern with the obesity epidemic has focused attention on what’s being served to millions of students. The prevalence of obesity among children 6 to 11 more than doubled in the past two decades to 17 percent in 2006, according to the U.S. Centers for Disease Control and Prevention. The rate among adolescents 12 to 19 more than tripled, increasing from 5 percent to 17.6 percent, the CDC reported.

In 2007, 13 percent of high school students were obese, according to the CDC.

In Tennessee, about 43 percent schoolchildren are overweight or at risk of becoming overweight, according to the state Department of Education. What schools serve at lunch is important because for many schoolchildren, that meal is the most nutritious of the day, officials said.

local menus

In recent years, Hamilton County cafeteria managers have begun baking items such as chicken nuggets, and using whole wheat pizza crust and reduced fat cheese.

At Hamilton County’s Big Ridge Elementary School, cafeteria Manager Michelle Smith knows she can’t push her students toward well-rounded meals. She has to guide them gently.

“If I see someone come out with just a sandwich, I’m like, ‘Well, honey, are you sure you don’t want to get a fruit, too? Or a vegetable?’ ” she said.

Any time Ms. Smith makes a healthy change to a lunch menu, such as using whole-grain bread items, she makes certain to keep it under wraps.

“You’ve got to make it appealing, and you don’t tell (students) it’s healthier,” she said.

A new report by the Institute of Medicine recommends that the U.S. Department of Agriculture update its school lunch guidelines with stricter standards. The current guidelines were established in 1995.

The new recommendations mostly suggest increasing the amount of fruits, vegetables and whole grains, all of which would cost more.

In some cases, Hamilton County already is providing more produce than is required, Ms. Childs said.

In addition to the numerous health problems caused by unhealthy eating habits, nutrition experts recognize that in a school setting, there are other negative consequences to eating junk.

If students like Mr. Eaton regularly hit the vending machine for sugary, fattening foods, they won’t perform as well in classes, Ms. Childs said.

“Those are empty calories. He’s going to peak and crash,” she said. “He’ll have an afternoon slump and he’ll not be attentive.”

The cost of eating well

Technically, Mr. Eaton should never have been able to make a meal of vending machine junk.

Tennessee law requires that vending machines in school cafeterias be turned off during lunchtime, but that doesn’t always happen.

Cash-strapped administrators say it is difficult for their schools to go without the supplementary profits from vending machines. And sometimes people simply forget to unplug the machines.

Central High School principal Finley King said the new vending machines in the school’s cafeteria are supposed to be on a timer that turns them off during lunchtime, but it hasn’t been working.

Ms. Childs said money is also one of her biggest hurdles.

Elementary students pay $2.25 for lunch, and middle and high schoolers pay $2.50. Because the typical cost breakdown provides 40 percent of that money for food, 40 percent for labor and 20 percent for equipment, Ms. Childs typically has about $1 to spend on a healthy lunch.

“We’ve got to provide five items: an entree, one bread, a fruit, a vegetable and a milk,” she said. “Milk alone is 19 cents, an entree could easily run 40 to 60 cents. We easily go over a dollar.”

Parents and teachers have high and sometimes unrealistic expectations of what should be provided in school lunch menus, she said.

A four-ounce serving of canned apples is about 16 cents, Ms. Childs said, but a fresh apple is 20 cents.

“In Hamilton County, we have 40,000 students. If 20,000 wanted a fresh apple, that’s $8,000 extra a day,” she said. “It may be worth it when you’re home, but when you’re feeding the masses ... .”

Because there’s never enough money for some of the more expensive fresh food, Ms. Childs has begun applying for grant money to supplement her funds. She recently applied for a $10,000 Love Your Veggies grant from the makers of Hidden Valley Salad Dressings on behalf of East Ridge Elementary School. If awarded, the money would be used to purchase fresh produce.

picky eaters

For every child who picks off and eats only the cheese from his pizza, there are others who seem to understand the importance of eating well.

On a recent day at Big Ridge, 6-year-old Dylan Cardin chose a chicken patty on a bun, green gelatin and chocolate milk.

“I chose this because it’s healthy,” he said. “I like chocolate milk because it’s yummy. And you can recycle the cartons.”

Tamika Taylor’s two children attend Lakeside Academy and their biggest criticism of the cafeteria food is that there are too few vegetables. Ms. Taylor said she feeds her kids plenty of fruits and vegetables at home and said she’d like to see more produce in the school lunches.

Pamela Kelle, a Chattanooga registered dietitian and nutrition therapist, said the school system would have an easier time getting students to eat healthfully if more parents cooked like Ms. Taylor.

“Parents have got to buy in to the fact that it’s their responsibility to feed their kids healthy,” she said. “So many people feel that it’s the school’s responsibility, but the parents need to teach their kids why it’s important to make those choices at home.”

Otherwise, if the school system spends money on fresh fruits and vegetables and whole grains and no one eats them, the district won’t buy them again, she said.

Comparison of Current Requirements and New Recommendations

Report Brief

LUNCH REQUIREMENTS (USDA)

* 1/2-1 cup of fruit and vegetables combined

* 1.5-3 oz. equivalents of meat or meat alternates

* 1.8-3 oz. grain equivalents

* Whole grains encouraged

* 1 cup of milk

A DIETITIAN’S VIEW

Pamela Kelle, a Chattanooga registered dietitian and nutrition therapist, reviewed school menus from Hamilton, Catoosa and Walker counties and also reviewed the USDA National School lunch program guidelines.

“The menus offered in this area frankly do not look very appetizing from my perspective as a parent and as a dietitian,” she said. “It is apparent from looking at the menus that much improvement could be made to the offerings in our schools to help address the growing concerns about obesity in our country and certainly in Hamilton County and surrounding areas.”

Still, she said, the caloric distribution meets the nutrient needs set forth by the school lunch program. Blaming the schools is not the answer, she said.

She suggests parents teach children the following:

* Why the child should choose whole wheat when offered

* Why they want their child to choose fresh fruit or even canned fruit over sweet desserts

* Why they expect their child to drink milk with lunch

* Why they should look for and choose a variety of colors in their lunch meal

* Why the child should pick a vegetable every day (not fried)

UPCOMING COVERAGE

MONDAY: Chattanooga’s Biggest Loser contestants will sweat through an obstacle course. See photos online and in print in Metro.

THURSDAY

Dr. Jay Marcum, a Chattanooga cardiologist and director of HeartWise Ministries, hosts a radio show on eating addictions in particular. Life.