Trimming the Fat

On a sunny, sultry day in early June, 16-year-old Stephany Tyler relaxes at the outdoor courtyard of the Georgetown Square shopping center. Walter Johnson High School, which caters to Maryland’s upscale Bethesda and Chevy Chase neighborhoods, looms a quarter-mile away. At 10:45 a.m., Stephany and her friends are enjoying the student perk of being able to leave campus for lunch. A bottle-blond girl of average build, she’s opted for her favorite standby—a bagel with cream cheese.

“I always come here and get the same thing,” she says. “I only eat once a day, and this is it. Hey, it works—I lost 15 pounds this way!”

Stephany prefers the shopping center’s restaurants to the school’s cafeteria. “It’s too busy and uncomfortable at the cafeteria,” she explains. “Plus,” her friend, another girl with a blond dye job, chimes in, "[the food] is disgusting. Nobody eats there.”

And, indeed, a steady stream of students continues to pour out the side door of Walter Johnson High and travel a well-beaten, grassy path to the back entrance of the shopping center. Once in the courtyard, some stroll with subs or mocha cappuccinos in hand, while others tote plastic bags containing potato chips, cookies, and liters of soda. One lanky boy, basking in his adolescent metabolism, sits down to eat what appears to be an entire coconut cream pie. No, he doesn’t want to talk—he’s eating.

“People just prefer it here,” explains Stephanie Molina, a petite, brown-haired 16-year-old wearing a plaid miniskirt. “Even though they just remodeled the cafeteria and it’s nice and clean, I like to eat here—even if it’s more money.”

It’s what the kids are eating, however, both on and off campus, that concerns some of their adult counterparts. This past year, intensive media coverage of the country’s childhood-obesity problem, sparked by the release of alarming statistics, created a junk food backlash. The Montgomery County school system, home to Walter Johnson High, has followed suit—as have many districts nationwide—with plans to curtail unhealthy menu items and assess the lifestyle choices of its high schoolers.

But Montgomery County, like many suburban communities, is populated by middle-class kids who aren’t sure what all the hype’s about. “I don’t know how much I’m surprised by the statistics nationwide,” says one teen, “but the kids at my school are pretty healthy.”

The same can’t be said of all teenagers. A number of university studies have concluded that kids from lower socioeconomic backgrounds—lacking in education, resources, and examples of healthy alternatives—are more likely to display the symptoms of obesity. Yet even in the most affluent districts, mixed messages abound. From laissez-faire attitudes toward lunch time and vending machine offerings to limited PE requirements, suburban students face the same unhealthy influences as peers elsewhere and will soon be faced with more attempts to curb them.

Joan Stern, a Maryland state legislator, recently tried to push through a bill that would ratchet up PE requirements for K-12 students statewide. During a committee hearing on the issue, she told colleagues: “We’re at a point where we were with tobacco 20 years ago, when we didn’t understand the extent of the problem.”

Everyone’s known about America’s weight problem for years: More than two-thirds of the adult population is either overweight or obese, according to the federal Centers for Disease Control and Prevention. But in late 2002, the CDC released even more alarming news, stating that 15 percent of Americans ages 6 to 19 are overweight—a figure that’s more than tripled in 30 years. That translates into more than 9 million children. And 75 percent of those, according to Richard Carmona, the U.S. surgeon general, will likely become overweight adults. Carmona shared this information with a Congressional subcommittee in July 2003 just after calling obesity a “crisis” and “the fastest-growing cause of disease and death in America.”

The reactions in school districts nationwide have been swift and varied. Administrators and boards of education that a year ago were arguing in favor of the economic benefits of school vending machines are now removing them. And many school cafeterias are rejiggering their menus.

In Montgomery County, at the end of the 2003-04 school year, incremental changes have been made, and more are on the way this fall. Sodas and foods high in sugar and fat will not be available in vending machines. Whether from the machines or the cafeteria, snack foods will contain no more than 7 grams of fat, 2 grams of saturated fat, or 15 grams of sugar per serving. And in 2005, 9th graders will be given a lifestyle- assessment survey put together by the CDC. Results, according to Stern, will be used to secure federal grants for future dietary changes.

But in this relatively affluent district just outside of Washington, D.C., kids don’t see the reasons for all the fuss. “Most people here are involved in school sports and activities or, if not, are doing something on their own,” says Andrea Fraga, a sophomore at Winston Churchill High School in Potomac. “Plus, the ‘skinny is pretty’ pressure is there and motivates a lot of people to watch their weight.”

The vending machine changes, she predicts, won’t go over very well. “A lot of people will be upset because they use them,” she explains. “People develop a routine of what they get from the machines, and there are people who rely on the caffeine.”

Andrea admits, however, that her peers eventually will become acclimated. “People will buy whatever is there for the convenience,” she says. “But [school officials] should have gone into the reasons—given us information as to why they’re making these changes. We didn’t really have any notification, and it will probably be all the talk for the first few days.”

Educating teens about their diets is, indeed, a good idea. Sarah Lee, a physical activity specialist with the National Center for Chronic Disease Prevention and Health Promotion at the CDC, says children need to be given good reasons for developing healthy eating habits. “Right now, kids can be of a normal weight and still have some health indicators that could lead to heart disease, diabetes, and even osteoporosis in young girls,” she explains. “The idea we need to impress is prevention, prevention, prevention.”

The clank of well-used weights echoes in the small, freshly painted weight room at the YMCA in Silver Spring, Maryland. A wiry boy sits up from an inclined bench press and looks around. His red face and sweat-soaked T-shirt indicate he’s been working out for a while. “You finished?” a slightly larger boy asks. “Uh-uh—one more set,” the first boy says. Then he leans back and presses the weight above his chest.

Down the hall, other young men race up and down the fluorescent-lit gym in a game of pickup basketball. Their shouts, and sometimes shoulders, bounce off the concrete walls. At one point, an older man steps into the gym and says, “Seth, let’s go. Your mom’s making dinner.” Seth tries to keep playing, but a withering look from Dad means the game’s over.

This YMCA—with its gym, kids’ programs, and year-round pool access—is a big draw for families in nearby neighborhoods. But its fitness program also attracts students from nearby Montgomery Blair High School. Jeff Holliday, a studious-looking, average-size junior, says he joined last winter because he felt inactive. “I was looking for someplace to use my energy. In the winter, there isn’t any baseball or soccer, and you gotta do something,” he explains.

Academic work, however, keeps him from visiting as often as he’d hoped. “The idea was to come here after school,” he says. “But I kind of forgot all about the other stuff I have to do. I have a pretty heavy schedule.”

Busy or not, kids need to eat better and exercise more, according to Stern, a Democratic state legislator who, after attending a health conference in 2001, looked closely at what Maryland was doing about its weight problem. What she found was disappointing. “I hadn’t seen anything relating to [fighting] obesity,” she says. “Maryland was way behind other states.”

So this past spring, during the 2004 legislative session, she proposed a bill that would require all K-12 public school students to engage in five hours of physical activity per week. Stern says she wasn’t pushing for strenuous activity—walking to school and mowing the grass would have counted. But the bill was shot down because of budget restrictions and the difficulty of implementing such a requirement, according to Stern. She’s now repackaging the bill for next year’s session. “We pump all this money and information into kids, but if they don’t eat well or exercise, they won’t learn as well,” she says.

Tracy Fox, a nutrition consultant who helped develop Montgomery County schools’ new vending policy, agrees that adequate exercise is important. In the district, the time spent in physical education ranges from 30 minutes per week for kindergartners to 50 minutes per day for middle schoolers. But in high school, only two semesters’ worth of weekly PE classes are required for graduation. “There’s solid research indicating a link between academic and physical education,” Fox says. “We’re shortchanging our kids by filling them with math and reading but not giving them enough physical activity to help boost their academic performance.”

Fox is not enthusiastic, however, about government mandates. “Five hours of exercise a week is important, absolutely. Do the students need it? Absolutely. Should we legislate it? Maybe not.”

Jeff Holliday certainly doesn’t want anyone telling him how to stay healthy. “My mom’s really into fruit and vegetables, and everyone in my family is always doing something [physically active]—we feed off of each other’s activities,” he says. “I’ve seen all the stories about kids being overweight, but it doesn’t seem to be about anyone I know. They always have these perfect examples of little Jimmy who only eats Pepsi and Twizzlers and doesn’t exercise and now he’s fat. Of course he is, but I don’t think that’s the norm. I was raised with healthy habits.”

Still, fitting exercise into the school day isn’t easy. PE is a course option throughout all four years at Montgomery Blair High, as are many extracurriculars, from aerobics to basketball. But Jeff, like many of his classmates, is college-bound, with the tough academic course load to prove it. “There are so many other classes I’d rather take that it seems like a waste of time to spend school time in the gym—especially if it’s not required,” he says. “If they begin to require more [phys ed], it just seems unreasonable considering how overcrowded our schedules already are.”

Fellow junior Elizabeth Alberts, 16, who says she, too, is being brought up in a health-conscious house, concurs. “There are so many other academic classes I’d rather take, like AP European history or something that will help me,” she says. “I think it’s important that we are taught why we should exercise, but, really, by the time you get to high school, it should be up to you to make it happen.”

Because it’s a brilliant first day of summer—clear skies, low humidity—cars zip into the parking lot of Westfield Shoppingtown Montgomery in Bethesda with windows open and tops down. Inside, at 11 a.m., the mall’s food court restaurants are hectic, catering to the growing lines of people at the registers. The smell of fried food mixes with the sounds of families bickering over what to order and where to sit. Three teenage boys are seated at a table beneath a skylight. Two are dressed in T-shirts, shorts, and baseball caps, the third in khakis, shirt, tie, and a name tag that reads “Dave.”

Dave (who refuses to give his last name) will be a senior this fall, and he’s on a half-hour lunch break from his part-time job at one of the department stores. His friends, still looking for summer jobs, have joined him for lunch. Their choices: pepperoni and cheese calzones, two orders of large fries, three sodas, and cookies.

“Yeah, this is a lot of food, but I have to work until six, so this has to last me a while,” Dave explains. “I suppose I could get a salad or something, but my mom cooks healthy at home and this is just easier.”

While the typical food court may not offer many healthy culinary choices, teenagers do have to make decisions in the real world. And by controlling the types of food available in school, proponents of the changes in Montgomery County hope to influence those decisions. But the transition hasn’t been easy. Jeff Holliday reports that when Montgomery Blair temporarily restocked its vending machines this past spring, replacing candy with granola bars, “people were upset.”

“Everyone knows what a Snickers Bar is,” he explains. “No one knows what some of this other stuff is and won’t buy it.”

Kathy Lazor, director of the district’s Division of Food and Nutrition Services, dismisses such complaints. “It’s change for them, and part of this reaction is just typical teenagers voicing their independence,” she says. “When people hear ‘nutritional requirements,’ they think all they will see are granola bars and rice cakes, but there are so many other products that give a selection of healthy food.” Among them are pretzels, baked chips, and popcorn, she says.

But vending machine changes are “a small part of a much bigger picture,” according to Fox, the nutrition consultant. “Right now they have some control over what they consume, so they are comfortable complaining when we make changes. They say, ‘We’re practically 18, we can vote. Why can’t we choose what we eat?’ Who can blame them? If they want to eat junk food, they will, but the schools shouldn’t be the provider.”

At the very least, she explains, the students “need to know their school cares about them.” Because down the line, in their 20s and 30s, they’ll “begin to see more and more of their friends with type 2 diabetes or more of their peers having heart attacks....That’s why these changes are so important. If we wait for them to make their own changes, they won’t because they have so many other priorities in their lives right now.”

It’s a warm evening, and, as Jeff Holliday lingers outside the YMCA’s main entrance, parents call their kids out of the nearby pool, then dry them off and pack up for the day. Beyond a line of trees and a sound-blocking wall, the D.C. beltway, packed with rush-hour commuters, hums persistently. Jeff’s mother stands at the end of the sidewalk and asks if he’s ready to go home.

Jeff gathers his things and gradually moves toward his mother as he ponders the upcoming school year. While the new vending machine stock probably won’t be well-received early on, he agrees that schools have the right to control the food served to students and predicts that whatever changes are made ultimately will be accepted.

“The machines provide funding for the school, so really they can have whatever they want in them,” he adds with a shrug. “Actually, after that first test, people stopped caring about the vending machines. But we just got this great ice cream machine in the cafeteria that everyone likes. If they took that, it would be a real problem.”