Health Officials Take Obesity Battle to the School Lunchroom
April 19, 2010
The laughing commenced when Rene Cox exited her cubicle. She had donned a new persona that covered her in green, head to toe: Ms. Broccoli.
“It kind of looks like Gumby,” Cox, a program assistant with the University of Tennessee’s Extension Office in Blountville, said while modeling the costume.
But Ms. Broccoli and five other fruit and vegetable personas that Cox and her co-workers use when they visit local schools are becoming a big hit.
Their goal is to teach students about vegetables, and promote healthy living by encouraging healthy eating.
“We know that it works,” said Misty Keller, a coordinator of school health with the Kingsport schools. “When a person in the broccoli costume comes to a school, our nutrition staff tells us they are serving two to three times the amount of broccoli that they normally serve on the line.”
Habit changing
The veggie visits are a highlight of the Tennessee Nutrition and Consumer Education Program, which is part of a two-pronged approach to fighting childhood obesity in the Mountain Empire region.
The other approach is in full force at Fairmount Elementary School in Bristol, Tenn., where teachers stop by their cafeteria twice a week, open the door to a special refrigerator, and pull out trays full of fresh fruits and vegetables they take back to their classrooms.
Fairmount is one of 12 schools in the region providing the healthy snacks through the U.S. Department of Agriculture’s Fresh Fruit and Vegetable Program.
The program, in July 2009, distributed $72.5 million in grants to public education agencies in all 50 states, the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. Sixty-one schools in Virginia, including seven in the state’s far southwest corner, received grants from the state’s $2.5 million allocation. Tennessee provided $1.4 million in grants to 71 schools, five of which are in Northeast Tennessee, including Fairmount.
Ron Fink, the Bristol Tennessee City Schools director of nutrition, said Fairmount received $21,443.
“It’s really just about getting the kids to eat more fruits and vegetables,” he said.
Stopping obesity
County health officials claim the two programs, united in a goal to encourage better eating habits among children, can go a long way toward addressing the region’s battles with obesity and other health problems.
“We live in the obesity capital of the United States,” Sullivan County Regional Health Department Medical Officer Stephen May said, referring to the Mountain Empire and several other communities in the Southeast.
The U.S. Centers for Disease Control and Prevention ranked the Kingsport-Bristol metropolitan area – including both Bristols, Sullivan County in Tennessee and Scott an d Washington counties in Virginia – as the 10th unhealthiest place in the country in 2007. Based on several data factors including interviews with residents, the report said that 29.9 percent of those living in this area claimed they had “fair” or “poor” health.
The national median for that question was 15 percent, according to the report.
The Kingsport-Bristol metropolitan area also had the country’s 31st highest obesity rate, and ranked among the top 25 metropolitan areas in terms of diabetes, high blood pressure and heart disease rates – all of which can be tied to obesity and poor eating habits.
The worst city in that report – with 31.2 percent of its residents claiming they were in “fair” or “poor” health – was Huntington, W. Va., about 200 miles north of the Twin City.
A reality show
Huntington’s unhealthy label caught the eye of a celebrity chef who has since launched a personal crusade – and a reality television show – to help save the Appalachian city’s residents from themselves.
English restaurateur Jamie Oliver, also known as The Naked Chef, set out to change Huntington’s eating habits by getting its school cafeterias to serve food made with fresh ingredients rather than frozen or prepackaged meals that are often high in fat and preservatives and low in vitamins and nutrients. The celebrity chef also opened a store-front kitchen to teach people how to cook quick and cheap meals using recipes from his book, “The Naked Chef,” and 11 other cookbooks he authored. The goal, he said, was to make Huntington’s residents less dependent on fast food and other junk food for their daily meals.
“If you can create an environment in which the public expects more, all the cogs in life as we know it will fall into place,” Oliver said in a March interview with the Associated Press.
The whole effort has been chronicled in the ABC reality show, “Jamie Oliver’s Food Revolution,” which airs its sixth and final episode at 9 p.m. Friday.
Oliver’s target audience – school-age children – is no surprise, according to many community health leaders.
May, with the Sullivan County Health Department, said the key to countering the health problems listed in the CDC report – obesity, diabetes, heart disease and more – is encouraging people to eat healthy, particularly at an early age.
“You have to help children learn what the right things are to eat and you have to do it by setting an example,” May said.
And schools, he said, are the perfect venue – because they are already set up to function as a learning environment.
Blood oranges and carrots
The USDA had in mind that connection between schools and the ability to encourage healthy eating when it launched the Fresh Fruit and Vegetable Program in 2002.
Managed by the federal agency’s Food and Nutrition Service, the program used a $6 million budget to help 105 schools in four states, and an American Indian reservation, buy fresh fruits and vegetables for their students to snack on. The initial effort was considered a hit among school administrators and students at the participating schools, according to a 2003 review of the program conducted by the agency’s Economic Research Service.
“Many students described improvement in their eating habits, [and] greater willingness to try different fruits and vegetables,” the 2003 report states. “Or, at the very least, a greater consciousness about eating too m uch of what they call ‘junk foods.’ ”
Because of that success, the USDA expanded the program in 2004 to include eight states and three tribal organizations. Four years later, it was expanded again to schools across the country.
Fairmount Elementary started using its 2009 program allocation, about $46 a student each year, to serve three healthy snacks a week, Fink said. The school has since pared its service to twice a week, he said, because the three weekly servings “looked like it was going to break the budget.”
Fink said he has prepared standard fruit and vegetable snacks for Fairmount students, including sliced apples, bananas, cucumbers, celery and carrots. But he also tries to serve some unfamiliar items for the kids, such as blood oranges and kiwi.
“It’s been interesting to get the kids to try new stuff,” Fink said.
Carrots and the deep-red blood oranges are an all-time favorite among Fairmount’s students, the nutrition supervisor said, while snacks involving celery or cherry tomatoes tend to fall flat.
When the current school year ends, Fink said, he will diligently petition state education officials to keep Fairmount’s status as a Fresh Fruit and Vegetable grant recipient, because: “We do see the kids eating those things in the classroom,” he said.
Yet despite its popularity among students, Fink said, he’s not sure whether the program has had any lasting effect on their healthy eating habits.
“That would be the $20 million question right here,” Fink said.
The USDA hopes to answer that question with a study that its Food and Nutrition Service is working on now – evaluating the whole program’s results.

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Meeting Mr. Grape
The extension office in Blountville picked up the veggie costumes after Keller went to a statewide school health conference and bumped into someone from West Tennessee who was dressed up as Mr. Grape.
“I thought, wouldn’t it be neat if I could do that,” Keller said as she looked back on that September meeting. “We’re just taking it to see where it goes.”
Now, in addition to Ms. Broccoli and Mr. Grape, the extension office has carrot, pea, watermelon and apple costumes.
Cox and the others donning the costumes spend an entire lunch period wearing the healthy eating personas when they make their rounds visiting schools each month.
They distribute food pyramid guides that explain the importance of a proper diet, Cox said, and give students cups and other trinkets designed to look like their favorite vegetables.
“It will give you some calcium,” Cox said while in the persona of Ms. Broccoli. The green vegetable also is high in antioxidants, she said, which go a long way toward preventing heart attacks and other illnesses.
Keller couldn’t be happier with the program’s results, and this year is pushing the Kingsport system to buy its own set of costumes, including a Tina Tater costume.
The program has proven to be such a hit among school health officials that the Tennessee Nutrition and Consumer Education Program started wearing vegetable costumes at its schools, said Lisa Holt, the Sullivan County School System’s director of nutrition.
Holt already has made appointments for the program staff to visit the county’s Weaver Elementary School at its campus on Weaver Pike in Bristol on April 27. They’ll be visiting Valley Pi ke Elementary School, off Carolina Avenue, on April 28.
“Hopefully, this will create an atmosphere of healthy snacking,” Holt said, adding that she’s also seeking money from the Fresh Fruit and Vegetable Program to provide students at some of the county’s schools with healthy snacks.
May said that’s just the type of atmosphere that could help the county reduce its high obesity rate and the incidence of several health problems such as diabetes and high blood pressure. But he cautioned that reaching the goal would not be an easy task.
“This is not something you can fix overnight,” May said. “This is going to take a long period of time because you are changing an entire culture.”