This is a position paper NOT A FORMATIVE PAPER

Topic: The effects of nutrition programs on decreasing the burden of childhood obesity in US.

Thesis Statement: Nutrition programs have significant contributions in decreasing the burden of childhood obesity in the United States of America. For this reason, supporting these programs and their additional funds is necessary in order for them to continue expanding.

AS EXAMPLES OF NUTRIONS PROGRAMES PLEASE USE LETS’ MOVE COMPING BY MICHELLE OBAMA AND2 OTHER EXAPLES.

The Assignment:

You are required to write a cogent paper describing a well conceived and supported position on a controversial issue related to public health, based on the list of topics available on the CDC’s Winnable Battles website (THE LINK TO MY TOPIC IS: https://www.cdc.gov/winnablebattles/obesity/index.html)

Requirements:

1. Each paper draft should be at least 2500 words (about 10 standard double-spaced pages), plus additional pages for title page and references.

2. You MUST use section headings labeled: Introduction, Background, Supporting Arguments (with subheadings for each argument), Opposing Arguments (with subheadings for each argument), and Conclusion.

3. Introduction -- Clearly state your position on the issue in a concise manner in an introductory paragraph. Place the issue in the proper context, with any needed statistics or supporting facts. Identify the audience for whom the position statement will be useful.

4. Background -- Describe the background of the issue that constitutes the rationale for the topic being labeled as an issue. Background must include contemporary, relevant data and appropriate citations. Remember this is NOT an opinion paper.Therefore the background should include:

· Terminology related to your issue

· Summary of the controversy related to your issue

· Legitimate research done on your issue

· Descriptions of the impact this data has on your issue.

5. Supporting Argument -- When presenting your position, you will need to discuss both sides of the issue and clearly state the position you are supporting. Present the supporting argument first, with at least THREE points supporting you position. These points must be firmly rooted in findings from research studies and should not be conjecture, supposition or opinion. Use subheadings for each supporting point so that it is clear that your points are distinct from each other.

6. Opposing Argument – Why might your target audience be opposed to your position? There may be research studies that have found results counter to your points, state these and explain how your position takes these counterpoints into consideration. It may also be that the news media has presented less well researched positions that have influenced public opinion. Address the flaws in their points. You may include these sources in your counter arguments as long as they are from reputable sources. If you are unsure, check with your professor. Again, use subheadings to ensure that you are providing three distinct counterarguments.

7. Conclusion – Bring the paper to a logical conclusion by summarizing the essence of the argument and then conclude by restating your thesis or position in similar words used in the introduction to your position.

8. References – Your list of references must include a minimum of ten reputable sources. These should be academic sources, such as current journal articles. Do NOT use videos or TV shows and avoid the popular press. In some cases reputable newspapers and magazines may be useful, but you must have 10 peer reviewed sources before you use a popular press source. In any event, a popular press piece must be a supplemental source, not the main source for your paper. Reputable web sources are acceptable (CDC, WHO, HHS, etc.) Look for .gov, .edu or .org endings but when in doubt, ask the professor!

Be sure that all references used are listed on the references page. Further, references listed on the reference page should be used in the paper. Do not list what you do not use and do not use what you do not list. Double check for accuracy!

9. Apply principles of good composition, including appropriate sentence structure, grammar and meticulous attention to detail in every aspect of your writing.

10. Strict APA format standards will be applied to the grading of your paper so pay close attention to citations within the text and in the list of references. The title page should also conform to APA style. These standards also apply to the draft. If you are in doubt, check the Hacker Handbook APA style section. There are no excuses for lack of APA style.

11. Correctly cited paraphrasing is expected. You may use exactly one (1) quote if you feel it adds to your paper in a way that paraphrasing cannot. The use of more than one quote will result in the deductions of points. You are at the point in your academic career that you do not need to rely on other’s words. You are capable of synthesizing and citing information properly. If you do use a quote, be sure to introduce it and integrate it into the paragraph. Do not just slap the quote into the paragraph and expect it to wondrously explain everything. Remember, quotes require page numbers, synthesized and paraphrased information does not; however, all work that is not your original thought requires citation.

Below is an example of a paper that should be similar to my paper:

Vending Machines in Schools: Removing the Junk, Supplying Healthier Options

Introduction

School-age children consume about 35-50% of their daily caloric intake during school hours (Robert Wood Johnson Foundation, 2013). In recent years, federal and state policies have begun to change food offerings to children during school hours in order to improve the health status of children in the United States. Campaigns such as Michelle Obama’s “Let’s Move!” teaches Americans about the importance of proper diet and regular physical activity in children to prevent obesity and other disease (letsmove.gov, 2013). Nutrition in childhood is important because it teaches healthy habits and behaviors that will last through life, preparing children for a healthy and happy adulthood.

Vending machines located in primary and secondary schools traditionally provide snacks and beverages for children to consume during the day, but many do not offer healthy options such as low-sugar drinks and healthy snacks, such as fruit and granola bars (Rovner, Nansel, Wang, & Iannotti, 2011). Providing healthy foods to children in schools helps them learn about proper nutrition and also sets the stage for a healthy learning environment. In addition to breakfast and lunch provided by schools, many districts also supply their schools with vending machines for children to choose additional snacks to supplement their meal options. This paper is aimed to educate parents, educators, school board members, and policy makers about the dangers of too much junk food in children’s diets and persuade them to change the options offered to school-age children in vending machines. There are some counter arguments for healthier vending machines, including mostly financial concerns, and these will be discussed to acknowledge that there may be some readers opposed to the position of this paper.

Background

Obesity is a health problem that can lead to devastating chronic diseases. Diabetes, heart disease, high cholesterol and hypertension are possible direct effects of being overweight (Park, Sappenfield, Huang, Sherry, & Bensyl, 2010). A sustained status of obesity can also be linked to arthritis, stroke, liver disease, cancer, and a shorter life (Riis, Grason, Strobino, Ahmed, & Minkovitz, 2012). Obesity is measured by BMI, or body mass index, which is defined as a ratio of height to weight for each sex. The term obese is used for anyone falling over the 85^th percentile of BMI for his or her sex, height, and weight (Park, et al., 2010).

Obesity during childhood is a strong indicator of obesity in adulthood and, in addition to causing physical health problems, obesity in children can also cause emotional problems linked to bullying and social stress (Park, et al., 2010; Cunningham & Zavodny, 2011). The prevalence of obesity among children has been rapidly increasing over recent decades, with rates almost tripling in children aged 6-19 since the 1970s (Fletcher, Frisvold, & Teft, 2010; Wang, Orleans, & Gortmaker, 2012). It is estimated that 23.5 million children in the United States are currently overweight or obese, according to the Robert Wood Johnson Foundation (2013). To counteract these rising statistics of obesity in children, goals have been set for reduction of these rates in Healthy People 2020, which are goals set by the U.S. Department of Health and Human Services for improving the health of Americans by certain deadlines. One of the goals is to reduce the prevalence of childhood obesity rates to 14.6% by 2020, which is ten percent less than the prevalence of obesity in children aged 2-19 years in 2005-2008 (Wang, et al., 2012).

Nation-wide, students eat about 400 billion calories in junk food served in schools every year (Robert Wood Johnson Foundation, 2013). To achieve the goals set by Healthy People 2020 and reduce childhood obesity by ten percent by 2020, a decrease of 64 calories per day, per child would be necessary to reduce the weight of children to meet these goals (Wang, et al., 2012).

It has been shown that children learn valuable and significant lessons about nutrition and diet from their teachers and peers, so changing eating behaviors in school is one step towards decreasing obesity and improving the health status of children (Rovner, et al., 2011). To decrease consumption of empty calories in junk food, increase nutrient intake, and improve the health status of children across the country, states and school districts have set policies in place, following federal legislation signed in 2004, to improve the quality of school lunches and food offerings sponsored by the school (Kubik, Wall, Shen, Nanney, Nelson, Laska, & Story, 2010). However, vending machines are not included in school nutrition programs and are not required to comply with federal regulations for the nutritional quality of offered foods, since they exist on private contracts between the schools and venders (Kubik, et al., 2010; Rovner, et al., 2011; Kramer-Atwood, Dwyer, Nicklas, Johnson, & Schulz, 2002; Finkelstein, French, Variyam, & Haines, 2004). Though some policies do already address the offering of vending machines and other non-sponsored food options, more rigorous policies are necessary to enact significant change in vending offerings to reduce obesity in children (Riis, et al., 2012; Fletcher, et al., 2010).

Supporting Argument

In order to create a healthy food environment for students, it is important to remove the availability of junk food in schools’ vending machines and replace vending offerings with low-sugar beverages and nutrient-dense, low-calorie snacks, to supplement the increasing healthful nature of school lunches. Children who attend schools that provide vending machines with high calorie snacks, such as chips, candy, and sodas are more likely to consume these items instead of healthier options, such as granola bars or low-fat milk, and to be or become obese (Park, et al., 2010; Cunningham, et al., 2011). As many as 68% of students may buy a sugary drink (such as soda or sports drinks) every day, adding empty calories and added sugars to their diet (Robert Wood Johnson Foundation, 2013). When soft drinks and sugary snacks are available to students, it displaces the potential for more healthy options to be chosen, such as low-fat milk, water, and baked snacks or fruit (Finkelstein et al., 2004). When more fruits and vegetables are available to students in vending machines, these students consume more fruits and vegetables than students who did not have access to healthy snacks in their vending machines (Rovner, et al., 2011). There is a positive correlation between availability of junk food at school and the amount consumed by students (Cunningham, et al., 2011), supporting the argument that reducing the amount of junk food available to students would reduce the amount that is consumed during the school day.

In a study sponsored by the Centers for Disease Control (CDC), it was found that one fourth of school districts in the nation restricted the sale of junk food and sweetened beverages from vending machines during breakfast and lunch hours (Merlo, Harris, & Lane, 2012). Furthermore, the same research showed that 67.6% of school districts restricted the hours during which soft drinks were sold, and 60.8% restricted the hours of sale of junk food (Merlo, et al., 2012). Students who attend schools participating in nutrition programs and restricting junk food in vending machines are more likely to have healthier diets, consuming more fruits, vegetables, and necessary nutrients, than those students who have more access to junk food in school (Finkelstein, et al., 2004). A study analyzing laws in 40 states showed that students living in states with more strict nutrition policies and laws regarding vending in schools gained less weight over a three-year study period than students who lived in less rigorous states (Robert Wood Johnson Foundation, 2013).

In 2004, Congress approved a new law stating that all school districts participating in federally-funded meal programs must “develop and implement wellness policies that address nutrition and physical activity by the start of the 2006-2007 school year,” (Rovner, et al., 2011). However, these wellness policies were left to the individual states and school districts to decide, leading to a variance of nutrition policies in schools across the nation with different restrictions and results. The lack of clarity of these guidelines for wellness policies created the discrepancies seen between school districts and states, and more clear policies are needed to lead school districts to create more synchronized wellness guidelines to cause forward progress in childhood nutrition and wellness across the nation.

The sale of junk food and sweetened beverages from vending machines has been shown to negatively impact the consumption of healthier school-provided lunches. A study in Florida in 2010 (conducted after the federal legislation required schools to implement nutrition and wellness policies) showed that 99% of respondents stated they had access to a snack vending machine in school and 89% stated they had access to a soda machine (Park, et al., 2010). Of these respondents to the study, 70% of those who bought vending machine offerings instead of lunch confessed that they chose junk food instead of the healthy lunch that was offered by the school (Park, et al., 2010). An analysis of risk factors in this Florida study showed that availability of beverage vending machines during lunch hours more than tripled the chances of students choosing vending offerings instead of the school-provided lunch (Park, et al., 2010).

There are some states with existing policies that have released information regarding their success with their wellness and nutrition programs. In California, legislation requires restriction of junk food and sweetened beverages, and it was found that three years after the implementation of these laws, high school students consumed 158 fewer calories per day than students who attended schools without strict vending policies (Robert Wood Johnson Foundation, 2013). These 158 fewer calories are far more than the recommended reduction of 64 calories per day to meet the Healthy People 2020 goal, leading to the potential for the success of this goal if more states and districts were to implement similar policies to California’s nutrition standards (Wang, et al., 2012).

Forming healthy nutrition behaviors early in life will lead to lasting habits into adulthood, theoretically reducing the prevalence of obesity in future decades as the current generation ages. Promoting healthier eating habits, including reducing fats and sugars in addition to caloric intake, will not only reduce rates of obesity but also of other related diseases, such as diabetes. Education programs about nutrition should be comprehensive, teaching children about proper nutrition and the importance of regular physical activity, beginning early in childhood and lasting throughout their education in both the classroom and the cafeteria (Kramer-Atwood, et al., 2002). A more well-rounded knowledge about nutrition and wellness could incite in students of all ages a desire to make healthier food choices, a behavior change which can only take effect if there is increased access to healthier vending options in schools and decreased access to junk foods and sugary beverages.

Opposing Argument

While there are a great many reasons for why schools should transition to healthier options in vending machines, there are some arguments for why this is not a feasible option. A Harvard poll surveyed Americans about childhood obesity, and found that while 75% of respondents supported measures to prevent childhood obesity even if it cost them money, only 59% supported the removal of junk food and sweetened beverages from schools (Finkelstein, et al., 2004). What is the reason for the difference in opinions?

One significant argument is that, while school policies can restrict consumption of junk foods and sugary beverages while students are present during school hours, they cannot prevent children from consuming these products after school hours and outside of school grounds (Cunningham, et al., 2011; Fletcher, et al., 2010). One study found that, in schools where soft drinks were available, 86% of children were consuming sodas, compared with 84% of children consuming soda in schools that did not offer them (Fletcher, et al., 2010). As such, it is feasible to reason that students who do not have access to junk food or sweetened beverages at school will spend their money on these items elsewhere (Finkelstein, et al., 2004).

Another possible reason for the poll’s results of almost half of Americans disagreeing with a movement to remove junk food from schools is the potential for profit for the school and the school districts. Profits from competitive foods, or foods sold outside the school’s designated meal plans, are often used to fund school operations, activities, and materials (Finkelstein, et al., 2004). As previously mentioned, schools enter into private contracts with vendors and brand name fast foods, agreeing to sell those items in their vending machines for a portion of profits (Kramer-Atwood, et al., 2002). This is happening in school districts across the country: one soft drink company signed contracts with different school districts in 1998-1999 for amounts of $9.1 million, $14 million, and $15.5 million; a Maryland school district signed a contract with a soft drink company that awarded the district 45% of the profits in addition to an additional $175,000 profit per year (Kramer-Atwood, et al., 2002). These monetary contributions to school districts may be important in certain areas where there is a lack of funding for public schools.

Many federal policies only regulate the sale of junk foods during the lunch hour and in the cafeteria (Kramer-Atwood, et al., 2002). While this does aid in the reduction of purchases of junk food and sugary drinks by students during mealtimes, it still allows for the purchase of these items during other hours of the day. If regulations were to only allow junk food to be sold before and after school hours, and to increase the availability of healthy snacks in vending machines to all hours of the day, students may be more inclined to purchase healthier snacks since they are the only available option while school is in session. This would require the purchase of additional vending machines, which would only hold healthy items, but having the possibility of vending profits to be lengthened to the entire school day could hold profits for the schools.

A final argument that may be presented against the option of supplying healthier food options in school vending machines is that students won’t improve their diets if given the chance. Changing from a choice of full-fat milk and a candy bar to solely diet soda may indeed greatly decrease caloric intake, but it also takes away nutrients that the student may not supplement elsewhere (Fletcher, et al., 2010). Also, if only some vending machines offer healthier options but others with junk food and sweetened beverages remain available to the students, only a small proportion of students may willingly make the change, whether that is in regard to personal preference or to lack of knowledge on a healthy diet.

Conclusion

So, how can we change the proportion of Americans that are in disagreement (41%, Finkelstein, et al., 2004) to changing the options in vending machines in schools? While there is some evidence that the transition may be expensive, and that students may still consume junk food outside of school hours, the habit of healthy eating during the day could be long-lasting and benefit the children for many years to come.

Though financial concerns are reasonable arguments, it is still possible that profits may be made from healthier options. In fact, a recent study found that when states enforced their nutrition policies about food and drinks, they had an increase in profits from food sales (Robert Wood Johnson Foundation, 2013). Prices in vending machines should be carefully monitored and set so that healthier options are more cost-effective than junk food, and that school meals provide the best deal for students (Kramer-Atwood, et al. 2002). It is also of extreme importance to educate children from an early age about proper nutrition, to ensure that they are knowledgeable enough to make healthy food choices if given the option (Kramer-Atwood, et al., 2002).

Vending machines located in primary and secondary schools traditionally provide snacks and beverages for children to consume during the day, but do not offer healthy options such as low-sugar drinks and healthy snacks, such as fruit and granola bars. The proposal of this paper was to create more rigorous policies to increase a transition to machines that offer nutrient-dense options to promote healthy eating habits to help reduce and prevent obesity, diabetes, and other health issues in children.

References

Cunningham, S. A. & Zavodny, M. (2011). Does the sale of sweetened beverages at school affect children’s weight? Social Science & Medicine, 73, 1332-1339. doi:10.1016/j.socscimed.2011.08.003

Finkelstein, E., French, S., Variyam, J. N., & Haines, P. S. (2004). Pros and cons of proposed interventions to promote healthy eating. American Journal of Preventative Medicine, 27 (3S), 163-171. doi:10.1016/j.amepre.2004.06.017

Fletcher, J. M., Frisvold, D., & Tefft, N. (2010). Taxing soft drinks and restricting access to vending machines to curb child obesity. Health Affairs, 29 (5), 1059-1066. doi: 10.1377/hlthaff.2009.0725

Kramer-Atwood, J. L., Dwyer, J., Hoelscher, D. M., Nicklas, T. A., Johnson, R. K., & Schulz, G. K. (2002). Fostering healthy food consumption in schools - focusing on the challenges of competitive foods. Journal of the American Dietetic Association, 102 (9), 1228-1233.

Kubik, M. Y., Wall, M., Shen, L., Nanney, M. S., Nelson, T. F., Laska, M. N., & Story, M. (2010). State but not district nutrition policies are associated with less junk food in vending machines and school stores in US public schools. Journal of the American Dietetic Association, 110 (7), 1043-1048. doi: 10.1016/j.jada.2010.04.008

Letsmove.gov (2013). Let’s move: America’s move to raise a healthier generation of kids. Retrieved fromhttp://www.letsmove.gov/

Merlo, C. L., Harris, D. M., & Lane, K. G. (2012). Nutrition services and the school nutrition environment: results from the School Health Policies and Practices Study 2012. In Results from the School Health Policies and Practices Study 2012, 75-89. Retrieved from: http://www.cdc.gov/healthyyouth/shpps/2012/pdf/shpps-results_2012.pdf#page=81

Park, S., Sappenfield, W. M., Huang, Y., Sherry, B., & Bensyl, D. M. (2010). The impact of the availability of school vending machines on eating behavior during lunch: the youth physical activity and nutrition survey. Journal of the American Dietetic Association, 110 (10), 1532-1536. doi: 10.106/j.jada.2010.07.003

Riis, J., Grason, H., Strobino, D., Ahmed, S., & Minkovitz, C. (2012). State school policies and youth obesity. Maternal and Child Health, 16, S111-S118. doi: 10.1007/s10995-012-1000-4Cunn

Robert Wood Johnson Foundation. (2013). How can healthier school snacks and beverages improve student health and help school budgets? In Health Policy Snapshot: Childhood Obesity Issue Brief. Retrieved from: http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf72649

Rovner, A. J., Nansel, T. R., Wang, J., & Iannotti, R. J. (2011). Food sold in school vending machines is associated with overall student dietary intake. Journal of Adolescent Health, 48, 13-19. doi: 10.1016/j.jadohealth.2010.08.021

Wang, Y. C., Orleans, C. T., & Gortmaker, S. L. (2012). Reaching the Healthy People goals for reducing childhood obesity: Closing the energy gap. American Journal of Preventative Medicine, 42 (5), 1-8. doi: 10.1016/j.amepre.2012.01.018