    [Senate Hearing 111-242]
    [From the U.S. Government Publishing Office]

                                                            S. Hrg. 111-242

                             BEYOND FEDERAL SCHOOL
                            MEAL PROGRAMS: REFORMING
                         NUTRITION FOR KIDS IN SCHOOLS

    =======================================================================

                                    HEARING

                                   before the

                           COMMITTEE ON AGRICULTURE,
                            NUTRITION, AND FORESTRY

                              UNITED STATES SENATE

                         ONE HUNDRED ELEVENTH CONGRESS

                                 FIRST SESSION

                                   __________

                                 MARCH 31, 2009

                                   __________

                           Printed for the use of the
               Committee on Agriculture, Nutrition, and Forestry

      Available via the World Wide Web: http://www.agriculture.senate.gov

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               COMMITTEE ON AGRICULTURE, NUTRITION, AND FORESTRY

                           TOM HARKIN, Iowa, Chairman

    PATRICK J. LEAHY, Vermont            SAXBY CHAMBLISS, Georgia
    KENT CONRAD, North Dakota            RICHARD G. LUGAR, Indiana
    MAX BAUCUS, Montana                  THAD COCHRAN, Mississippi
    BLANCHE L. LINCOLN, Arkansas         MITCH McCONNELL, Kentucky
    DEBBIE A. STABENOW, Michigan         PAT ROBERTS, Kansas
    E. BENJAMIN NELSON, Nebraska         MIKE JOHANNS, Nebraska
    SHERROD BROWN, Ohio                  CHARLES E. GRASSLEY, Iowa
    ROBERT P. CASEY, Jr., Pennsylvania   JOHN THUNE, South Dakota
    AMY KLOBUCHAR, Minnesota
    KIRSTEN GILLIBRAND, New York
    MICHAEL BENNET, Colorado

                    Mark Halverson, Majority Staff Director

                        Jessica L. Williams, Chief Clerk

                Martha Scott Poindexter, Minority Staff Director

                     Vernie Hubert, Minority Chief Counsel

                                      (ii)

                                C O N T E N T S

                                  ----------
                                                                       Page

    Hearing(s):

    Beyond Federal School Meal Programs: Reforming Nutrition for Kids
      in Schools.....................................................     1

                                  ----------

                            Tuesday, March 31, 2009
                        STATEMENTS PRESENTED BY SENATORS

    Harkin, Hon. Tom, U.S. Senator from the State of Iowa, Chairman,
      Committee on Agriculture, Nutrition, And Forestry..............     1
    Chambliss, Hon. Saxby, U.S. Senator from the State of Georgia....    16
    Lugar, Hon. Richard G., U.S. Senator from the State of Indiana...     3

                                    Panel I

    Cooper, Pat, President, Early Childhood and Family Learning
      Foundation, New Orleans, Louisiana.............................     4
    Felton, Reginald M., Director, Federal Legislation, National
      School Boards Association, Alexandria, Virginia................    12
    Garrett, Byron V., Chief Executive Officer, National Parent
      Teacher Association, Chicago, Illinois.........................     9
    Huehnergarth, Nancy, Director, New York State Healthy Eating and
      Physical Activity Alliance, Chappaqua, New York................     7

                                    Panel II

    Brown, Miriam Erickson, Chief Executive Officer, Anderson
      Erickson Dairy Company, Des Moines, Iowa.......................    33
    Ehrens, Karen, Public Policy Chair, North Dakota Dietetic
      Association, Bismarck, North Dakota............................    31
    Izzo, Hank, Vice President, Research and Development, Mars
      Snackfood U.S., Hackettstown, New Jersey.......................    35
    Neely, Susan K., President and Chief Executive Officer, American
      Beverage Association, Washington, DC...........................    37
                                  ----------

                                    APPENDIX

    Prepared Statements:
        Baucus, Hon. Max.............................................    48
        Chambliss, Hon. Saxby........................................    50
        Brown, Miriam Erickson.......................................    52
        Cooper, Pat..................................................    59
        Ehrens, Karen................................................    72
        Felton, Reginald M...........................................    76
        Garrett, Byron V.............................................    82
        Huehnergarth, Nancy..........................................    87
        Izzo, Hank...................................................    94
        Neely, Susan K...............................................   100
    Document(s) Submitted for the Record:
        American Frozen Food Institute, prepared statement...........   108
        ConAgra Foods, prepared statement............................   112
        Physicians Committee for Responsible Medicine, prepared
          statement..................................................   114
        Potato Industry Child Nutrition Working Group, prepared
          statement..................................................   119
        School Nutrition Association, prepared statement.............   122
        The Schwan Food Company......................................   123
        ``Safeguarding The Health of America's Children: The
          Importance of Dairy Foods in Child Nutrition Programs''....   125
    Question(s) and Answer(s):
    Harkin, Hon. Tom:
        Written questions for Hank Izzo..............................   158

                            BEYOND FEDERAL SCHOOL
                           MEAL PROGRAMS: REFORMING
                        NUTRITION FOR KIDS IN SCHOOLS

                                  ----------

                            Tuesday, March 31, 2009

                                           U.S. Senate,
             Committee on Agriculture, Nutrition, and Forestry,
                                                         Washington, DC
        The committee met, pursuant to notice, at 9:35 a.m., in
    room 328-A, Russell Senate Office Building, Hon. Tom Harkin,
    Chairman of the committee, presiding.
        Present or submitting a statement: Senators Harkin, Casey,
    Klobuchar, Johanns, Chambliss, and Lugar.

     STATEMENT OF HON. TOM HARKIN, U.S. SENATOR FROM THE STATE OF
       IOWA, CHAIRMAN, COMMITTEE ON AGRICULTURE, NUTRITION, AND
                                FORESTRY

        Chairman Harkin. Good morning. The Senate Committee on
    Agriculture, Nutrition, and Forestry will please come to order.
        Welcome to today's hearing. This is the third hearing of
    this committee toward enacting new legislation to extend and
    improve nutrition for our kids through school lunches and
    breakfasts, summer meals, Child Care Food Assistance, and the
    Special Nutrition Program for Women, Infants, and Children.
        In previous hearings, we heard how essential the Child
    Nutrition Programs are and about the evolving challenges facing
    our families, schools, and communities and States in supplying
    good nutrition to children, especially in a tough economy. We
    have received a lot of valuable suggestions. Modernizing and
    strengthening these programs is a vital part of our efforts to
    fight hunger, improve children's health, and boost education
    and learning.
        Over 60 years ago, President Truman and the Congress
    founded the Federal Child Nutrition Programs on the principle
    that sound nutrition promotes lifelong health and prevents
    illness and disease. Of course, that principle still stands,
    although details have changed. The nutritional and diet-related
    conditions and diseases plaguing today's kids include
    previously unheard of rates of overweight, obesity, diabetes,
    and blood pressure, things that didn't happen when I was young.
        That is why the child nutrition bill that we are writing is
    integral to reforming our nation's health system, and I want to
    emphasize that. We are trying to do health reform and to focus
    more on prevention and wellness. Well, a lot of that falls
    outside of the box of doctors and hospitals and into the realm
    of schools and how we feed our kids in their earlier years.
    Sound nutrition is indispensable to preventing illness and
    disease and helping Americans lead healthier and longer lives
    and reduce health care costs.
        Schools have improved the nutritional quality of federally
    sponsored meals over the years and progress continues but there
    is still room for improvement. But because they must meet USDA
    standards, meals reimbursed by USDA are, by and large,
    nutritious and consistent with the Dietary Guidelines for
    Americans.
        To see how America's children are really eating, though, we
    must look to the entire school nutrition environment, not just
    the School Lunch or Breakfast Program. We know from surveys and
    common experience that the majority of our schools offer
    children ready access to heavily sweetened beverages, highly
    salted snacks, sugary and high- fat goods and candy. These
    items are sold in vending machines, at snack bars, school
    stores, or right in the cafeteria in a la carte lines, which
    sell food in direct competition against USDA-sponsored meals
    that meet the nutrition standards.
        On an average day, only 62 percent of American kids who
    could do so eat the federally sponsored lunch. We know from
    research what any parent understands from common sense, that
    junk food obtained from vending machines, snack bars, school
    stores, or a la carte lines is far less nutritious, far less
    nutritionally balanced than meals that meet the USDA standards.
    Clearly, these sales undermine the $11.5 billion annual
    investment that taxpayers make in nutritious school lunches and
    breakfasts. But even worse, they are damaging the health and
    lives of our nation's kids.
        Today, we will hear from educators, parents,
    representatives of the food and beverage industries. Where
    schools have succeeded in improving the nutritional quality of
    foods and beverages they sell, a crucial element of that
    success has been adopting and carrying out clear nutrition
    standards and objectives. But unfortunately, such progress in
    schools across the Nation is extremely limited and dwarfed by
    the magnitude of the threat to our kids' health.
        Research shows a large majority of the local school
    wellness policies that were adopted by this committee in the
    2004 Reauthorization of the Child Nutrition Act are either weak
    or, even worse, simply collecting dust on the shelf. And
    despite more than a decade of effort, just a handful of States
    have adopted their own school nutrition standards.
        It is increasingly clear to me that we will continue to
    fail to provide American children the sound nutrition so vital
    to their health and well-being in the absence of effective
    Federal leadership and standards. In a decided shift over the
    past 15 years, many different stakeholders now broadly agree.
    Local school officials, education groups, people on both sides
    of the political spectrum, the medical and scientific
    community, and many in the food and beverage industry agree
    that the time has come for the Federal Government to establish
    sound, science-based nutrition standards for all foods and
    beverages in schools.
        Experience shows that school nutrition standards are
    feasible and practicable. Already, to suit the marketplace,
    food and beverage suppliers are offering new products that are
    nutritious and healthful and appealing to kids. Schools have
    learned that they need not lose revenue when they set standards
    and offer healthier, more nutritious food and beverages. Some
    have found they have even increased their revenue.
        Well, the task is not simple, but with commitment and
    leadership, it can be done and that is what we will hear from
    our witnesses today.
        Our Ranking Member is not here right now. I will hold the
    record open for his opening statement. I would yield to our
    former distinguished Chairman of this committee, Senator Lugar,
    who has always been interested in good health and nutrition,
    for any opening comments or statements.

    STATEMENT OF HON. RICHARD G. LUGAR, U.S. SENATOR FROM THE STATE
                               OF INDIANA

        Senator Lugar. Thank you very much, Mr. Chairman. I think
    you have recited the history well. Both of us have been
    discussing this issue with distinguished witnesses, as well as
    fellow Senators, for over a decade and perhaps longer, and with
    some headway. But this is a good year for us to concentrate on
    a subject in which sometimes we have dwelled on the thought
    that these programs ought to be handled by the States.
        You have pointed out, perhaps by the States that are not
    responding very rapidly, you almost come back to the common
    sense argument that we have also dealt with. Should we have a
    Federal lunch program? Can a child determine which State he or
    she is going to be in or what will be available? We have come
    to the thought that this is a national endeavor and that
    children do not have the option of choosing States depending
    upon the programs that are presented.
        So it is an interesting question today in terms of our
    Federal system as well as the responsibility of distinguished
    American firms who provide nutrition and to many who really
    want to work with us. So I am hopeful the hearing will be a
    constructive one and that we will make more headway this year.
        I thank you for this opportunity to make a comment.
        Chairman Harkin. Thank you, Senator Lugar. You have been a
    great leader in health for many years and a great example to
    many people for all of us to stay healthy. I appreciate that
    leadership.
        We would like to call our first panel, if we could: Dr. Pat
    Cooper, President of the Early Childhood and Family Learning
    Foundation of New Orleans, Louisiana; Ms. Nancy Huehnergarth
    Director of the New York State Healthy Eating and Physical
    Activity Alliance from Chappaqua, New York; Mr. Byron Garrett,
    the Chief Executive Officer of the National Parent Teacher
    Association from Chicago; and Mr. Reginald Felton, the Federal
    Relations Director of the National School Boards Association in
    Alexandria.
        If you would all take the witness stand. We have copies of
    your statements and they will be made a part of the record in
    their entirety, and so we would ask if you could just sum up
    your statement in 5 minutes or so.
        We will just go in the order I introduced you all, so first
    of all, we will start with Dr. Pat Cooper.

    STATEMENT OF PAT COOPER, PRESIDENT, EARLY CHILDHOOD AND FAMILY
              LEARNING FOUNDATION, NEW ORLEANS, LOUISIANA

        Mr. Cooper. Thank you very much, Senator, for allowing me
    to come and speak before this committee on such an important
    issue. I want to say right off the bat that I fully agree with
    you and would even expand on what you said about the connection
    to health reform by saying that there is a huge connection to
    education reform here that we seem to have left out in the
    equation, speaking as the former superintendent of schools in a
    couple of school districts where we have put in very visible
    and very quantitative school nutrition standards along with the
    additional Coordinated School Health Model that the Centers for
    Disease Control has allowed us to partake in, that we have seen
    some major, major results in terms of the kinds of things that
    you want to have happen in education reform, whether it be in
    improved test scores or attendance and it even goes to bigger
    issues, and that is kind of what I want to talk about today
    very briefly, is how this connects in a more broad way.
        When we talk about child nutrition, we talk about the
    obvious issues, obesity and the fact that a lot of our kids
    come from poverty situations where they don't have access to
    meals. Those are no-brainers to me. Those are things that we
    need to look at. But there is also the bigger issue, as a local
    school superintendent who is dealing with No Child Left Behind
    for the last few years and Goals 2000 before that and A Nation
    At Risk before that. The commonality of all of those education
    reform issues was that we really didn't pay attention to the
    health part, and that if you are not healthy--I know that is an
    oft-used term, but truly, if you are not healthy, you are not
    going to be able to learn, and a lot of our kids come to school
    without that luxury.
        So that larger issue is what I want to talk about and I
    want to start backwards with you because I don't want you to
    isolate child nutrition in a box here at the bottom. I want you
    to look at child nutrition as something that has everything to
    do with things like the failure of our corrections system, the
    failure of our mental health system, the failure of our health
    systems in general, because it all goes back to the failure of
    our public school system.
        If our public school systems don't have children that we
    produce as quality adults, then the rest of those systems are
    going to falter. Even if we have the highest test scores, if we
    don't have children that graduate from high school, and part of
    my new standard is I understand we have to have good test
    scores, but I want every one of my children to graduate, 100
    percent, with no baby, with no drug habit, with no criminal
    record, and hopefully not obese and not mentally ill. If I
    could do that, I think you would say we have the best school
    district in America. But the problem is, we don't rely on those
    health issues to give us any kind of--or take the temperature
    on what the rest of the products are going to be.
        So what we decided was, and I am just going to tell you
    very quickly, we decided to look at our school districts as
    places where we were going to do for all kids what you do for
    yours and I do for mine. We were going to approximate that. We
    know that what you need is a good two-parent household so that
    children can be taught what to do, what decisions to make, what
    things to eat, and be offered those kinds of things, but we
    know that doesn't happen for a lot of our kids.
        And so what we wanted to do with our schools was to create
    a family where we could nurture our children, and we used this
    nurturing idea to come to Maslow's Hierarchy of Needs, which is
    something we have all known forever and ever and ever, but I
    guess the problem is it doesn't cost any money so it doesn't
    ever get popular. You know, Maslow said that you had to be
    physically healthy in order to get to the point where you could
    maximize your potential and your opportunities, and the anchor
    for being physically healthy is the nutrition program. It is
    what we teach our children to eat, how they make their choices,
    and what we offer to them.
        In the districts where I have been superintendent, we have
    come into situations where we had lots of kids who were coming
    from houses and homes that weren't like yours and mine and
    didn't have the things that you provided to your children and I
    provided to mine in terms of just the basic needs, food and
    nutrition being one of those things. And we looked at the
    realities of why we weren't addressing that issue and we
    weren't addressing that issue very well because we were selling
    junk in our schools. We were not allowing time for kids to eat.
    We were allowing vendors--through no fault of their own, I
    might add, because this can be a win-win for everybody--to
    guide our nutrition standards.
        And so we had to make some decisions. So went to our
    community and we said, look, here is the condition of our
    children. We gathered all this baseline data that looked at the
    obesity and the diabetes and we looked at the asthma and we
    looked at all of the other attending factors that created a
    failed school system, because kids were not attending, or when
    they were attending, they weren't able to be taught as
    effectively. We also looked at it in terms of our staff,
    because we were doing as much damage to our staff as we were to
    our children.
        So we introduced to our community this Centers for Disease
    Control Coordinated School Health Model, and the very first
    thing we did with that model is we took Maslow's basic rung,
    which is physical health, and we took the CDC model and said,
    where on that model do we address physical health, and
    obviously there is the food and nutrition area, there is the
    P.E. area, there is the staff wellness area.
        And so we looked at what we needed to do to make that
    happen first, and it was almost like we were paving the
    highway, Senator, so that all of the other reform mechanisms
    could work, because if you don't have healthy children, then it
    doesn't make any difference how many computers you have or how
    many curricula you use or how many books you buy that our
    children are not going to learn, and if they don't learn, they
    are going to drop out. If they drop out, they are going to end
    up in whatever situations they end up in which are not good.
        So we looked at certain policies, school board policies,
    and keep in mind we had to do this on our own because there was
    no national standard. There was no national emphasis on this.
    Yes, there was a wellness policy, but as a superintendent, I
    can tell you, most of us ignored that. Most of us just sat it
    on the shelf, like you are saying. Most of us said to our food
    service director, go ahead and put something together because
    the State wants it. And that is not an indictment of
    superintendents in general, it is an indictment of the system,
    because it wasn't important because all we were thinking about
    was test scores and we weren't thinking about the fact that we
    can't have those better test scores if we don't have healthier
    children and healthier staff.
        So one of the things that we looked at was how do we make
    that work, and we got our own school board, and I will just
    praise them to the high heavens, because they were willing to
    take this on. We set up policies for more time for meals. We
    went to the Coke people and we said, look, why don't we redo
    the contracts and let us sell all water instead of your Cokes.
    See, I used to think God made water, but then I found out Coke
    made water.
        [Laughter.]
        Mr. Cooper. It is called Dasani. And so we said, we will
    put more machines in our buildings. We will put a machine for
    every 150 kids and we will have a school board policy that says
    children and staff can buy Coke--I mean, buy water whenever
    they want. They can take it wherever they want because the
    research says they need to stay hydrated. And all of a sudden,
    our principals were making more money than they ever made
    because we were filling up those water machines two and three
    times a day. All of a sudden, our kids were staying hydrated.
        And yes, we had some teachers that said, oh, don't let them
    bring it into the classroom. They will spill it. Well, it is
    water. Wipe it up. It is not No. 2 red Kool-Aid. There were
    issues there, but they weren't insurmountable issues.
        So all of a sudden, we took our vending out that had
    unhealthy things. We put vending in that had healthy things and
    we were selling more of it because we changed some policies and
    we made some right decisions for kids. We changed our classroom
    award policies. We changed our fundraising policies. None of
    those things hurt in any way the implementation of health
    standards in our schools.
        And I will close by just telling you this. When we did
    these things in conjunction with a Coordinated School Health
    Model, what we saw was that our reading scores and our math
    scores went up. What we saw was that our attendance scores went
    up. What we saw was that our staff wellness was much improved
    because we included them in this policy. What we saw was that
    our Breakfast and Lunch Programs went from 74 percent
    participation to about 94 percent participation.
        Now, part of that is a no-brainer. There wasn't anything
    else to eat because we didn't have the vending. But it was good
    food and it was food that our kids should be eating and we
    created the opportunity for it to be successful.
        And then the last thing that I would mention to you is that
    when you do these things in the context of coordinated school
    health, then what you do is you create a culture of health and
    environment in your schools.
        So I would ask you to do two things. Yes, we need to make
    this national law have more teeth so that superintendents pay
    attention to it. We need to make it so that it is part of a
    broader coordinated school health program that includes the
    staff wellness, that includes the P.E., because one of these
    things is not going to do the trick. I love the idea of going
    down to the child care with a much more intense effort, because
    it all starts right there.
        And then the last thing I would say is that if it is at all
    possible, connect this somehow with whatever NCLB is going to
    be in the future, because if we don't connect it to education
    reform, then it is going to be by the wayside.
        Thank you very much.
        [The prepared statement of Mr. Cooper can be found on page
    59 in the appendix.]
        Chairman Harkin. Thank you very much, Dr. Cooper. Very
    enlightening.
        Ms. Huehnergarth--did I pronounced that----
        Ms. Huehnergarth. Yes, you said it beautifully.
        Chairman Harkin. I thank you. Welcome. Please proceed.

       STATEMENT OF NANCY HUEHNERGARTH, DIRECTOR, NEW YORK STATE
     HEALTHY EATING AND PHYSICAL ACTIVITY ALLIANCE, CHAPPAQUA, NEW
                                  YORK

        Ms. Huehnergarth. Thank you, Senators, for having me here.
    I am deeply honored and I think this is a very important issue
    and I am glad we are having this discussion here today.
        I am a concerned mother. I am also the Director of the New
    York State Healthy Eating and Physical Activity Alliance. I
    have been working to improve school food standards on both the
    local and State level since March 2002, which is when my then-
    ten-year-old daughter came home from school and excitedly
    announced that she had won a fitness contest in gym class. Her
    prize? A big old candy bar.
        [Laughter.]
        Ms. Huehnergarth. The coalition that I represent is made up
    of over 100 public health, consumer, and education
    organizations, and we have been lobbying for passage of school
    nutrition standards in Albany, New York, since 2006. We also
    support what you are doing here, evidence-based national
    standards for foods sold and served outside the National School
    Lunch Program.
        The good news is that there is very strong support for
    standards now. It is no longer a controversial issue. The bad
    news is that two-thirds of the States, including New York,
    still have weak or no policies addressing the nutritional
    quality of foods and beverages in schools. And only 12 States
    have comprehensive policies that apply to the whole campus for
    the whole day and at all grade levels, and these are the kind
    of policies we need that are really going to make a difference
    and bring down--help bring down our obesity rate.
        There are forward-looking States, like Kentucky, Oregon,
    California, Rhode Island, Mississippi, and Connecticut that
    have very high standards and we can use them as a model.
    NYSHEPA, my organization, also urges you to propose strong
    national standards that do not preempt the States' ability to
    enact even stronger standards in the future. We believe that
    our kids will be healthier and live longer if both State and
    Federal Government have the power to improve on standards in
    the years and decades ahead.
        To date, New York State has not been able to enact updated
    nutrition standards, I am sad to report. It is not because
    there is a lack of interest. We have had at least nine bills
    promoting school nutrition standards in our legislature since
    2006. It is not because there is lack of support. We have a
    broad coalition of 41 prominent organizations that support
    standards. We have got the media on their side. There have been
    wonderful editorials from the New York Times, the Buffalo News,
    the Poughkeepsie Journal. And the public is on board. They
    actually make calls and write letters to our legislators and
    they support our school nutrition bills.
        But we don't have any legislation in New York State, even
    though two of our neighboring States, Connecticut and New
    Jersey, have enacted strong standards. So as a mother, I find
    this deeply upsetting. I want to know, are the kids in
    Connecticut and New Jersey more deserving of healthy food than
    our kids in New York State? This just makes no sense to me.
        NYSHEPA has come up against a number of impediments in
    trying to advocate for State nutrition standards. We have
    encountered powerful, deep-pocketed food and beverage industry
    opponents, who apparently are going to resist changes until
    they are literally forced by you to get healthy.
        We have State legislators who refuse to educate themselves,
    like my favorite assembly member who introduced the Cupcake
    Law, which is a measure that will make the cupcake the official
    State kids' snack in New York State. And it also would have
    provided that parents can bring any food into school that is
    legal. I would like to know exactly what those foods are.
        We have opposition from some school leaders whose districts
    have entered into pouring rights contracts or who fear that
    healthy standards are going to hurt their school finances.
        Now, let me get right to debunking a myth that schools will
    automatically lose money if they implement healthy nutrition
    standards. It is absolutely just not true. There are a number
    of surveys out there that completely debunk that, like the
    survey of 17 schools and school districts that was conducted by
    the U.S. Department of Agriculture and the Centers for Disease
    Control and Prevention. The results of that survey? Twelve
    schools actually increased their revenue and four reported no
    change.
        There is also two pilot studies that have recently emerged
    that evaluated the financial impact of switching to healthier
    school food and they found that the revenues increased at the
    majority of schools because losses from a la carte were offset
    by an increase in the National School Lunch Program meal
    participation and reimbursements.
        Now, in New York State, NYSHEPA has been conducting its own
    best practices interviews with schools that have voluntarily
    switched to healthier food. Most of these school food directors
    have told us the exact same thing. When the non-nutritious a la
    carte fare is removed, more kids purchase the reimbursable
    school meals. Because of increased participation, the district
    offsets the losses with increased reimbursements. Let me state
    this one more time a different way. When the junk is gone, kids
    buy the healthier National School Lunch Program lunch had
    districts will still run in the black.
        There was also a 2005-2006 study sponsored by the USDA's
    Food and Nutrition Service and it found that a la carte foods
    usually don't subsidize school meals. It is actually the other
    way around, because too often the cost of a la carte foods
    falls short of the cost of producing them. So school meals
    actually subsidize the a la carte.
        NYSHEPA has also learned that school vending contracts are
    not all that profitable for schools, and that is very good news
    for me. When a very young child that I know walked into our
    middle school cafeteria years ago and saw row after row of
    vending machines with chips, cookies, candies, and my favorite,
    six different kinds of candy- coated ice cream, she asked if
    she was at an amusement park. Fortunately, by the time my kids
    had entered middle school, clearer heads and a whole slew of
    aggravated mothers have prevailed and the worst of the junk
    food was gone. And so was the superintendent, who had
    complained that the nutrition advocates were trying to take
    away my Twinkies.
        [Laughter.]
        Ms. Huehnergarth. A national study found that school
    vending contracts raise only an average of $18 per student per
    year for schools and/or school districts. Another study found
    that soft drink sales in schools raised a median of 70 cents
    per student per year in middle schools and $6.38 per student
    per year in high schools. Also, please keep in mind that it is
    money from the pockets of kids that is funneled back into these
    school districts via pouring rights contracts, and where is
    that money coming from? From their parents.
        Typically, school districts only get to keep 33 percent or
    less of the profits. The overarching question I think we should
    all be thinking about is, should we really be financing our
    schools at the expense of children's health?
        With our nation's obesity rate through the roof and
    economic woes affecting every State, NYSHEPA believes that
    National School Nutrition Standards must be addressed this
    year. We can't afford to wait any longer. The more we invest
    now in our kids' nutritional health, the greater the payback in
    the future, namely a lower rate of obesity and obesity-related
    medical expenditures, lower rates for health insurance, an
    adequate number of healthy adults to staff our military and
    workforce, and longer and healthier lives for more Americans.
        Thank you very much for this opportunity and I hope you
    will act this year.
        [The prepared statement of Ms. Huehnergarth can be found on
    page 87 in the appendix.]
        Chairman Harkin. Thank you very much, Ms. Huehnergarth.
        And now we turn to Mr. Byron Garrett, CEO of the National
    PTA. Mr. Garrett, welcome.

        STATEMENT OF BYRON V. GARRETT, CHIEF EXECUTIVE OFFICER,
         NATIONAL PARENT TEACHER ASSOCIATION, CHICAGO, ILLINOIS

        Mr. Garrett. Thank you, Chairman Harkin and Ranking Member
    Chambliss, committee members, and my fellow distinguished
    panelists. I am certainly honored, like all of my colleagues,
    to have the opportunity to speak before you today.
        I sit here on behalf of over five million members of the
    National Parent Teacher Association across the country and at
    Department of Defense schools around the globe, as well as our
    25,000 local units that actually run and function in
    communities across the country, and we are excited to discuss
    the significant issue of the upcoming reauthorization of the
    Child Nutrition Act.
        As the oldest and largest volunteer child advocacy
    association in the United States, PTA's legacy of influencing
    Federal policy to protect the education, health, and overall
    well-being of children has made an indelible impact on the
    lives of millions across the country. There is no question
    about that. This legacy includes the creation of kindergarten
    classes, a juvenile justice system, child labor laws, and
    mandatory immunizations for school children.
        One of the fundamental purposes of the National PTA has
    always been to preserve children's health and protect them from
    harm. You know, as early as 1899, we advocated for a National
    Health Bureau to provide families and communities with health
    information. In 1923, we worked to secure hot school lunches.
    In the 1940's and 1950's, we were involved in the establishment
    and expansion of the School Milk Program. We also worked to
    ensure the passage of both the National School Lunch Act and
    the Child Nutrition Act. I believe we have a little to say
    about this issue today.
        While the majority of the debate surrounding the upcoming
    reauthorization centers on the National School Lunch and
    Breakfast Programs, I would like to commend this committee for
    looking at these programs in the context of all available food
    options students have during school hours. It is imperative to
    consider the overall effect the regulations governing these
    programs will truly have when our students are given the choice
    to buy unhealthy snacks and sodas from vending machines on
    school grounds. It is critical to approach child nutrition
    holistically and assess issues in the entire school foods
    environment.
        For this reason, PTA is a strong supporter of the Child
    Nutrition Promotion and School Lunch Protection Act. School
    meals must meet detailed nutrition standards set by Congress
    and be updated regularly by the USDA in order for a school food
    service program to receive Federal subsidies. In contrast, the
    nutrition standards for food sold outside the meal programs
    have not been updated since 1979. Such foods include those sold
    in vending machines, cafeteria a la carte menus, and school
    stores.
        The only nutritional criteria for school foods sold outside
    of meals are that foods are of minimal nutritional value and
    they may not be sold in the food service area during meal
    times. You see, many low-nutrition foods are not considered
    foods of minimal nutritional value, and I quote that FMNVs, as
    they are referred to, despite their high content of calories,
    saturated fat, salt, or added sugars, and they can be sold
    anywhere on school campuses at any time during the school day.
        Three decades later, this outdated practice no longer
    stands up to the scrutiny of contemporary science, dietary
    patterns, or health standards. The best interests of our
    children demand that the nutrition standards be modernized.
        For more than 50 years, school meals have been regulated at
    the Federal level. Each year, the Federal Government invests
    billions in school lunches and breakfasts, approximately $11.7
    billion in financial 2008 alone. Selling low-nutrition foods in
    schools undermines this entire investment. The widespread
    availability of drinks high in sugar, chips, candy, cookies,
    and snack cakes in our schools also undermine our parents'
    efforts to feed their children healthy and nutritious meals.
    You see, each school day, parents entrust schools to care for
    their children all across our nation. They should not have to
    worry that their children will use lunch money to buy snacks,
    you know, honey buns and Snickers, as opposed to buying a well-
    balanced meal.
        According to a national poll by the Robert Wood Johnson
    Foundation, 90 percent of parents and teachers support the
    conversion of school vending machine contents to healthy
    beverages and foods. In addition, a 2005 Wall Street Journal/
    Harris Interactive poll found that 83 percent of all adult
    respondents think that public schools should do more to limit
    children's access to unhealthy foods, like snack foods, sugary
    soft drinks, and fast foods.
        All across our nation, parents and community groups are
    making remarkable strides in addressing this issue. For
    example, the Connecticut State PTA worked with a consortium of
    children's health groups to pass State legislation which limits
    the beverages that can be served to students from any source on
    school campus, including vending machines and school stores. In
    addition, the law incentivized schools to adhere to State
    health standards for food sold in schools, providing extra
    State reimbursement for their Free and Reduced Lunch Program.
    Only 1 year into the program, 101 school districts out of the
    179 that were eligible signed on to the new standards.
        At Aptos Middle School in San Francisco, California, the
    school principal created the Aptos Parent Teacher Student
    Association Student Nutrition Committee, convened by a PTA
    member, which included parents, students, teachers, and staff.
    They created a plan to eliminate junk food from the entire
    school store. Non-nutritious foods were gradually eliminated,
    being replaced with healthy alternatives. Although the school's
    food program was operating at a deficit the year before, it
    netted a $6,000 profit for the school district's Student
    Nutrition Services Department after implementation. As a result
    of the pilot's success, the school district and that program at
    Aptos has now been instituted and serves as a model for the
    district's efforts to improve nutrition at its other middle and
    high schools.
        These and other efforts across our nation have helped, but
    the burden of removing unhealthy foods and beverages from our
    schools cannot, should not, and must not rest solely at the
    local level. Unlike other aspects of education, school foods
    have been primarily regulated at the national level since the
    Truman administration. Furthermore, the majority of the
    nation's 14,000 school districts are not equipped to develop
    science-based nutrition standards for schools, and only 30
    percent of the school districts prohibit the sale of junk food
    in school vending machines nationwide.
        A minimum Federal protected nutrition standard for food
    sold outside of school meals is necessary to protect the
    integrity of not only the School Lunch Program, but the health
    of all children in our nation's public schools. After all, the
    nutritional needs of our children remain the same whether they
    live in Iowa or Georgia. It is untenable to force parents to
    fight for healthier school foods one school at a time,
    reinventing the wheel after wheel after wheel while facing the
    same obstacles at each and every turn. Reasonable national
    nutrition standards would ease this burden while allowing for a
    great deal of local control over the implementation of such
    standards. Without question, the decisions made during this
    reauthorization will not only impact our schools, our
    hospitals, our economy, our military, and most importantly, our
    homes.
        Thank you, and I will be very happy to respond to questions
    along with my colleagues.
        [The prepared statement of Mr. Garrett can be found on page
    82 in the appendix.]
        Chairman Harkin. Mr. Garrett, thank you very much for a
    very powerful statement.
        Now we turn to Mr. Felton on behalf of the National School
    Boards Association. Mr. Felton?

    STATEMENT OF REGINALD M. FELTON, DIRECTOR, FEDERAL LEGISLATION,
        NATIONAL SCHOOL BOARDS ASSOCIATION, ALEXANDRIA, VIRGINIA

        Mr. Felton. Good morning, Mr. Chairman, Ranking Member, and
    other members of the committee. Again, it is an honor for us to
    be here to discuss this very, very important issue. As you
    know, we represent over 15,000 school boards across the nation,
    including 95,000 school board members.
        Let me just say that, without question, NSBA believes that
    child nutrition is vitally important to fostering a healthy and
    positive learning environment for children to achieve their
    full potential. Local school boards across this nation continue
    to actively promote nutrition education, physical education,
    and obesity prevention.
        The issue to us is not whether child nutrition is
    important. Rather, it is whether child nutrition would
    significantly improve by additional federally mandated
    nutritional standards on all foods and beverages. To this
    question, in our view, the answer is no. While there is the
    expectation that federally subsidized programs may be
    accompanied by certain restrictions, such restrictions are not
    fully supported within local communities regarding all other
    foods and beverages available to students.
        The next question should be, what behavioral changes might
    one expect at the local school level from such additional
    restrictions and whether such new patterns of behavior add
    value to the intent and purpose of the additional restrictions.
    From a local school board's perspective, what is likely to
    happen in our view is that there will be significant increases
    in purchases beyond the school grounds, particularly where high
    school students and others are permitted to leave the campus
    for lunch.
        Second, we believe there will be increased regulatory
    disagreements in schools over what foods and beverages should
    and should not be sold as new products are developed and
    marketed.
        And third, we believe there will be increased
    misunderstandings and complaints from parents regarding the
    banning of certain foods and beverages based on perceptions of
    school officials being culturally incompetent.
        Additionally, local school boards view any Federal efforts
    to regulate or codify into statute the types of foods and
    beverages that can and cannot be sold in schools throughout the
    entire school day and at school events as overly intrusive and
    burdensome to school districts. School districts believe that
    such efforts dismiss the work of wellness councils and usurp
    the jurisdiction of local school boards to create a policy that
    reflects the values and financial capabilities of local
    communities.
        In our view, these new behaviors will result in several
    unintended consequences that will require the redirection of
    additional time and resources away from the schools' primary
    responsibilities. NSBA urges you to reconsider any efforts to
    enact expanded legislation.
        Now, beyond the concerns over the operational impact of
    such expanded restrictions, local school boards are also
    concerned with the potential impact on local budgets and
    revenue streams. As you are aware, the primary responsibility
    of local school boards is to deliver high- quality educational
    programs to ensure that such students are career and college
    ready to compete in a global society. The reality, however, is
    that many school districts promote the sale of foods and
    beverages as a means of supplementing the cost of athletic and
    other extracurricular activities, which would further redirect
    the ability of school districts to fund these activities. The
    expansion of such restrictions on all foods and beverages could
    substantially reduce revenues.
        Therefore, NSBA urges Congress to refrain from enacting
    legislation that would further restrict the authority and
    flexibility of local school boards to sponsor and promote
    revenue-producing activities involving foods and beverages
    outside the current federally subsidized programs.
        Such school districts are caught in a bind between demands
    to deliver high-quality education and, unfortunately, an
    economic crisis. A national vision for child nutrition is
    needed, but that vision cannot convey nor equate to Federal
    mandates. The Federal Government must acknowledge more broadly
    that the efforts over the previous decade to employ a top-down
    approach has not worked. In our view, we suggest the Federal
    Government play a new role to facilitate, not dictate.
        As you are aware and has been mentioned earlier, under the
    Child Nutrition, Women, Children, and Infants Reauthorization
    Act passed in 2004, every school district was required to
    participate in Federal meal programs to enact wellness
    policies. A study conducted by the Pennsylvania State
    University on local wellness program implementation, at least
    among Pennsylvania local school districts, indicates that 84
    percent of the districts have written implementation or action
    plans and that 56 percent of the school districts reported that
    there are more opportunities for students to be physically
    active in classrooms outside physical education, and 58.2
    percent of the school districts reported that their students
    are receiving higher-quality nutrition education. School boards
    across the Nation are actively engaged with their communities,
    as they should be, to create policies and requirements to have
    the full support of the people in their local communities.
        In closing, we want to reiterate that local school boards
    are committed to improving child nutrition and clearly view
    wellness policy as important. As these school boards' actions
    increase, positive changes in behavior will take place,
    reflecting the will of the local communities. We are very
    committed to changing attitudes and sustaining positive
    behavior related to nutrition. Therefore, we feel that
    community-based decisions are much more effective in the long
    run than mandates from the Federal Government. Federal mandates
    in our public schools cannot be the vehicle for change in
    society.
        In order to significantly improve child nutrition and
    health, it will not be achieved through expanded authority of
    the Secretary of Agriculture. Rather, it will be through the
    active engagement of local communities that hold strongly to
    the belief that those at the local level should best make such
    determinations.
        Thank you very much for this opportunity.
        [The prepared statement of Mr. Felton can be found on page
    76 in the appendix.]
        Chairman Harkin. Thank you very much, Mr. Felton, and thank
    you all for your wonderful testimony.
        We will open a round of questions for just 5 minutes each,
    and I will start in order. Dr. Cooper, again, I followed your
    career paths. I remember we had, I think, one of your school
    nutrition persons up here from McComb, Mississippi, a few years
    ago. I remember her testimony, because I have cited it a lot,
    and I think she was under your jurisdiction at that time, in
    which she said about changing the foods they put in vending
    machines that they found that they didn't lose any money, that
    they really maintained the same amount of income from the
    vending machines when they put water and healthy snacks and
    things in them.
        She said something that I will never forget. She said, you
    know, we found that kids are funny. They love putting money in
    machines.
        [Laughter.]
        Chairman Harkin. They don't much care what comes out, they
    just like putting money in them.
        [Laughter.]
        Chairman Harkin. And so when they put the healthier foods
    in, kids kept putting their quarters and stuff in the vending
    machines. I have always remembered that.
        But the other thing I remembered was her testimony, and now
    yours today, about all that you have done. If you would just
    talk just a couple of minutes more about the skepticism and
    resistance you have met when you started doing this and how you
    worked through that. What would you say to people who say,
    well, let each school district decide it. You have done this on
    your own. You have done this in different school districts.
    Mississippi has done a great job in this, but other States
    haven't.
        So again, a two-pronged question. How do you overcome the
    resistance, and what was that like, and second, address
    yourself again to the idea of whether we should just leave this
    to States and local jurisdictions or whether we should extend
    the nutritional guidelines to all foods sold in schools. That
    is really the essence of what we are talking about here in this
    legislation this year.
        Mr. Cooper. Yes, sir. Overcoming the resistance, well, part
    of it is persistence, but part of it was gathering the baseline
    data that we could present to the community and to the school
    community that would indicate that our children were very
    unhealthy and that we presented the data also that connected
    better physical education, better food and nutrition options in
    schools to better academic achievement. The data is out there.
    We just don't ever take the time as educators to collect it all
    and present it to the lay community in a coherent, uniform
    manner.
        The other part of this was to go to the school communities,
    specifically the principals and the PTAs, and outline a way for
    this to be a win-win, to say from the start, we don't intend to
    cut your revenue. We don't intend to harm your programs. But we
    intend to reach your goals in another way. After our Food and
    Nutrition Director came and spoke to you earlier, years
    earlier, about 2 years after that, we then eliminated all of
    our vending machines that had food in them and all we had was
    the water machines. But we put one water machine for every 150
    students, created that policy that allowed students to buy
    water and take it wherever they wanted, and we increased the
    intake of funds to our principals by some major, major
    percentages just because of that one move.
        So I think the first thing, we have to make it a win-win.
    We had to go to the Coke folks and say, it is a win-win. We are
    not going to take your product out, we are just going to change
    the product that you are selling and we are going to allow you
    to sell it 24/7 instead of just after one o'clock in the
    afternoon. So we tried to present this as a win-win to people.
        And I think if you take your time and you have the baseline
    data, because all of us, when we bring the baseline data to our
    community saying our children are less healthy now than they
    have ever been, when you bring the pediatricians in your
    community to speak to your school board to say, this is what I
    am seeing in my practice now, it not only gives the school
    boards information, but in some ways it gives the school board
    liability, because now they know that we have a hand in
    creating a generation of unhealthy children.
        So that is how we did that part, and then the second part
    of your question was----
        Chairman Harkin. Well, I guess, and I would ask everyone,
    since my time is running out, do you see this as a part of the
    whole overall health reform that we are trying to do in
    America, in terms of prevention and wellness? Do you see this
    as----
        Mr. Cooper. I think it has a direct connection to how our
    children perform in schools. I do not think we are going to do
    this locally, by and large, because we have too many other
    things that we put ahead of it because they are supposedly
    important, and they are important. But unless you codify this
    some way nationally, then I think people are going to pick and
    choose. And you will have some superintendents that do it, some
    boards that do it, but, in fact, most will not because they
    will go to the point of highest pressure, and that is the laws
    that are there that require the academic kinds of things.
        Chairman Harkin. Thank you very much, Dr. Cooper. My time
    has run out.
        I will yield to our Ranking Member, both for an opening
    statement and questions that he might have. Senator Chambliss?

    STATEMENT OF HON. SAXBY CHAMBLISS, U.S. SENATOR FROM THE STATE
                               OF GEORGIA

        Senator Chambliss. Well, thank you very much, Mr. Chairman,
    and let me apologize for running behind this morning. I will
    submit my opening statement for the record.
        [The prepared statement of Hon. Saxby Chambliss can be
    found on page 50 in the appendix.]
        Senator Chambliss. Let me just thank all of our witnesses
    for your attendance here this morning. It is very informative
    testimony there.
        I want to start out with an anecdote. I mean, this issue of
    obesity obviously among our children is of concern to all of
    us, and I think you have all expressed some very strong
    opinions about the direction in which we ought to go. I
    particularly appreciate the mention by you, Mr. Felton, and
    you, Dr. Cooper, about an issue that I think is just as
    important, if not more so, than the issue of what our children
    are eating and that is what they are doing when they are not
    eating. It both reflects on their abilities and their
    concentration in the classroom, certainly, but primarily their
    physical activity outside.
        You are exactly right, Dr. Cooper. If we just concentrate
    on nutrition, we are not going to solve this issue. It goes
    well beyond that and we have to incorporate some kind of
    physical exercise program in every school in America to be
    coordinated along with a nutrition program.
        Mr. Felton, I am particularly appreciative, too, of what
    you said about the Federal Government knowing better about how
    children in every school district in America react to, No. 1,
    what is served to them, and the importance of the ability to
    have flexibility on the part of local school boards relative to
    what is fed.
        My anecdote about that is I have got a 12-year-old grandson
    who is picked up by his grandmother on a regular basis when she
    is at home. She is a 30-year classroom teacher, a retired 30-
    year classroom teacher, so she has had a lot of experience with
    nutrition in schools. John immediately has to go somewhere and
    get a snack after school. There is nobody on that panel that
    would say that the snack that John gets every day when he
    leaves school is nutritious. But the fact is, John does not
    have an issue relative to obesity. In fact, it is on the other
    end. We have to keep John loaded up with calories because he is
    so active from a physical standpoint. That is why I think your
    statement, Mr. Felton, is important, from a flexibility
    standpoint and why, Dr. Cooper, you are exactly right relative
    to physical exercise there.
        And also, the second point about this is that unless we
    engage the parents in this issue, it is a losing exercise from
    a Federal policy standpoint. So my question to each of you, and
    Dr. Cooper, we will start with you, is what is your experience
    relative to programs that work from the standpoint of engaging
    parents on this issue of nutrition, on this issue of physical
    exercise, and on this issue of having an understanding on their
    part of the issue of child obesity?
        Mr. Cooper. Well, I think those are two really different
    issues because most parents that I have worked with over the
    years really believe in the whole physical education part of it
    and they question why we are taking that away. They question
    why we don't let our children have a good quality physical
    education program.
        The nutrition part is a little bit harder because we are
    that generation that is probably--our children are probably
    going to live a shorter lifespan than we are, but we are not
    going to live as long a lifespan, either, and so we have to do
    a lot of education, and we do it through the PTAs, but we have
    also done it through community meetings, where we have brought
    in the data that I am talking about. We brought in the health
    experts that could say to the community, we are going to
    restructure our school district, but we are going to use
    physical health as the baseline, and we gave them the data
    about the condition of our children. We gave them the data
    about the health care costs. We gave them all that kind of
    information that they can understand and as a reason for us
    beginning to look at the nutrition issues.
        And then the other part of it was going to those groups,
    like the football boosters and the PTA folks and all of them to
    say, we are not trying to shut you down, but here is why we
    need to do this. There is a reason. And showing them with the
    data and with the research that you are not going to lose money
    and that it is better for our children. So there has to be some
    effort in that regard.
        Ms. Huehnergarth. The school districts that I have gotten
    to know that have made healthy changes have done a few things
    right. First of all, they have communicated with the parents,
    just like Dr. Cooper started to say. They just don't lay down
    the law and expect families to understand. There is some
    outreach. There are newsletters that go out explaining the
    changes, explaining why they are undergoing them. Teachers
    actually talk to the students and explain what is going on.
    When there are changes in the cafeteria, sometimes there is
    sampling in the cafeteria so that kids get to taste foods and
    get to be encouraged to try new things.
        The other thing I think we have to think about is what we
    call reverse learning. You know, a lot of times kids come home
    from school and they teach parents things. One thing that I
    learned was to turn off the water tap, because my kids told me,
    don't let it run too long. You are going to waste water. Well,
    it is going to be the same thing with healthy foods and with
    physical activity. If kids are eating healthy, then they are
    going to come back to their parents, demand those foods. They
    are going to ask their parents to go out and enjoy physical
    activity with them. And I think that is how families will
    learn.
        Mr. Garrett. Senator, and I guess what I would share with
    the committee, obviously speaking on behalf of the PTA and
    parents across the country, the reality is, parents, as I
    mentioned in my statement, parents expect that when their
    children go to school, that they are provided with healthy
    options. And so parents do all they can, I would say, between
    the hours of 3 p.m. in the afternoon until 6:45 a.m., roughly,
    in the morning to do some education about nutritious items,
    what it is you should eat. And even within classes, we fund
    from an educational perspective across the country, through
    Federal dollars and State dollars, nutrition education, telling
    children how many portions you need to eat of what, whether it
    is the food pyramid from USDA. We do all of those things. But
    then a kid will exit a classroom at two o'clock in the
    afternoon and go right to a vending machine and we then ask
    them to practice what they have been taught and the reality is,
    when they look directly at the vending machine, they have no
    option. Their options are to choose between Cheetos or perhaps
    Baked Lays, a form of potato chip, but their options are very
    limited. So what they may do outside of the confines of the
    school campus, one could recognize that I may choose on my own
    time to choose a Twinkie. I may choose to do that at four or
    six o'clock in the evening. But during the school day, in this
    particular environment that has spent so much money and
    resources saying we should have a qualified breakfast and
    lunch, we should make sure children have nutritious
    opportunities. When they then are forced to make a choice, we
    limit the options. We don't even give them the ability to make
    the appropriate choice because it is not readily available to
    them.
        And so what I would share with you is that our parents
    would recommend that while we help raise money for schools and
    we raise money for a host of issues and we believe that there
    needs to be a level of local authority, we believe that there
    is sufficient room within how this is structured to help
    facilitate this conversation. It is not dictatorial by any
    stretch, but there needs to be some universal standards.
        The last thing I would say is this. As of 2000, and
    everyone probably knows this, but if you don't, approximately a
    third of our children in this country are in danger of having
    Type II diabetes. So there is no question about who is
    overweight, who is obese, what are the ramifications and
    impacts. The other piece you look at is that approximately 9
    percent of all citizens in this country, our health spending
    for approximately 9 percent of them are related to obesity and
    overweight issues. We have got to figure out that if adults
    have the same issues, we begin in the educational setting in
    trying to rectify that, to teach the appropriate habits but
    also to give one an opportunity to exercise the right choice
    throughout their educational experience.
        Mr. Felton. Senator, I will offer you, as I said before,
    that is really not the question. I think school boards across
    this nation support nutrition. There is no school board out
    there that says, gee, I would rather have unhealthy kids. I
    think it is a matter of how we engage parents and how we engage
    communities so that they again have the education, so that they
    can make the choices. Again, our position is that there should
    be choices, but that the restrictions and the parameters of
    that ought to be left to local communities and States, that the
    Federal Government should leverage their authority and their
    funds with the States so that programs are better incentivized
    so that we do begin to see what is happening.
        The reality is that parents will understand what is good
    for their children, and of course they will support that. But
    when school boards are sitting with parents and communities and
    they are saying, here are all the things we want for your kids.
    We want to have a laptop computer with every child. We want to
    have a teacher-student ratio that ensures that your children
    will succeed. We want to have safe campuses so that you are
    free from abuse and bullying. We want clean campuses that are
    free from toxics. We want a transportation system that allows
    your children to participate in extracurricular activities and
    perhaps other forms of exercise. We want facilities that are no
    longer have code violations in which we must place our kids day
    to day. And then the question to parents and school board is,
    how do we keep that kind of balance, because these are all
    important.
        And so our point to you is that States and local school
    districts need the flexibility so that they can reflect the
    desires of local communities who have to address all of these
    issues. And again, we support child nutrition, but let us
    understand that when you begin to deal with a school district,
    it has to deal with a number of broad issues that each of us
    feels is very, very important.
        Chairman Harkin. Thank you very much.
        Senator Casey, we will turn to you now.
        Senator Casey. Mr. Chairman, thank you very much, and I
    know you may have to go, and when you do, we will work that
    out.
        I want to thank our witnesses for your appearance today but
    also for the work that you do, the daily challenge of meeting
    the obligations we have to our children. I guess I wanted to
    start with kind of a broad question, and this would go really
    to several of our witnesses and not anyone in particular. But
    if you could just tell us about the challenge that we face with
    regard to the fact that we want to have a national commitment
    to better nutrition, and I am a great believer that every child
    is born with a bright light inside them which represents, of
    course, their potential, and that our obligation, those of us
    who are elected officials certainly, as well as other
    officials, have an obligation to make sure that light burns as
    brightly as that potential indicates. The only way we can do
    that is to have every child get the benefit of health care and
    nutrition and early education. Of course, they are all
    interrelated.
        I think now we are beginning to realize that CEOs know this
    now better than they used to, that if we don't work on those
    issues in the dawn of a child's life, you can't even begin to
    talk about an educated person or a high-skilled person or a
    stronger GNP for the country or economic growth or competing in
    a world economy. All those phrases we hear over and over again
    start with that one child and the investment we make in him or
    her.
        But one of the challenges we have is we have a country that
    I think believes we should make a national commitment, but we
    also have school districts and a strong tradition of local
    control and a tradition that I am well aware of in
    Pennsylvania. We have 501 school districts in the State of more
    than 12 million people. But as much as there is a State
    responsibility for education, we still have a very strong
    tradition of local government and local school district
    governance.
        So how do you make that work in the context of a desire for
    national standards, the desire for a national commitment, with
    a tradition and the reality, not just a theory, but the reality
    of local control, local decisionmaking? And some of you may
    have addressed this in your testimony. We are juggling hearings
    today, so if this is redundant, I am sorry, but it doesn't hurt
    to repeat yourself in Washington once in a while.
        [Laughter.]
        Senator Casey. But do any of the four witnesses want to
    kind of begin to tackle that?
        Mr. Felton. Well, certainly, I commented earlier, it cannot
    be a fragmented approach. I talked about the need for a
    national vision and the fact that that vision has to understand
    how our States and local school districts operate.
        We know when we want folks to take on different behavior
    patterns, we provide incentives, and certainly we are not
    opposed to any Federal incentives that would encourage States
    and school districts to begin to move toward nutrition
    education, and health standards, just as we have done in other
    facets of basic community life. But the point still remains is
    that unless the Federal Government wants to take on all of
    the--the whole issue, it can't be fragmented. I mean, even if
    we look at our subsidized food programs, we know that there are
    some issues with reimbursement funds. We know that there are
    issues with commodities in terms of the nutritional value of
    those products. And yet we want to compartmentalize a single
    piece of the puzzle.
        And our advice is, if we are prepared to deal with it in a
    comprehensive way, we all know that it requires, again, active
    engagement through incentives, through programs, through
    education, of the parents, of the major stakeholders.
        Mr. Garrett. Senator, I would offer that it is not an
    either/or conversation, so it is not an either/or. It has got
    to be a ``yes and.'' I guess I would share with you, from a
    national perspective, leadership is needed on this issue. It is
    not as if the opportunity to create wellness policy--as Dr.
    Cooper had mentioned earlier, it is not as if the opportunity
    to create wellness policies does not currently exist. The
    reality is that in communities across this country, over two-
    thirds of our States lack State standards or they are extremely
    weak when it comes to nutrition for items that are sold outside
    of the school timeframe at some point in time, in order to
    protect the overall budget.
        So when you look at this as a comprehensive issue, when you
    think about health care spending, and I will say it again, 9
    percent of our funding federally on medical issues are
    associated with folks who are overweight and obese. We have got
    to figure out how we offer as much guidance as possible and as
    much structure. I contend, being a former K-8 school principal,
    that a superintendent or school board would still have enough
    latitude within whatever guidelines that might be established
    to exercise that flexibility to meet their appropriate needs
    locally.
        But I will tell you that parents every single day when they
    drop their kids off, either at the bus stop or they physically
    take them to school, they take them under the presumption, and
    rightly so, that they are going to an environment that is going
    to provide healthy choices for their child. So basically you
    ask a student at the age of six or eight or 12, who may be on
    the School Lunch Program, who may not be, when they walk
    through a school line and have a variety of options, you force
    a six- or 7-year- old to choose between a Twinkie and a bag of
    carrots. I would like to think that a 6-year-old could make
    that same distinction, but we have grown adults in this country
    that can't make that distinction themselves.
        So my suggestion to the committee as you consider these
    potential recommendations for reauthorization is to understand
    the reality of what plays out in every single school across
    this country, and by creating a similar set of national
    standards that are somewhat prescriptive but still provide an
    appropriate amount of latitude, I think would still accomplish
    the objective, which is to ensure that children have healthy
    options on campus throughout the school day.
        Mr. Cooper. I would like to answer that question this way,
    if I might, from a school superintendent standpoint, and that
    is that we have to frame this up the same way that we frame up,
    why do we insist on water quality standards? Why do we insist
    on air quality standards? It is we are looking at food quality
    standards. Why do we insist on immunizations? See, we have
    immunizations now and what we know is we have far fewer kids
    that are contracting polio and those other diseases than we
    have kids that are contracting obesity and the related diseases
    that come from there. We have obliterated polio. We can
    obliterate obesity, too, but we have to have some standards
    that are ranked right up there with air and water and
    immunization.
        Senator Casey. I know I am out of time----
        Ms. Huehnergarth. I was going to say, if you don't do it,
    it is not going to happen on the local level. You just don't
    have the base of knowledge at the local level that you even
    have at the State and Federal level. You have superintendents
    and principals and teachers that not only don't understand this
    issue, but refuse to educate themselves. So we really do need
    national standards.
        Senator Casey. Thank you very much.
        Chairman Harkin. Senator Lugar?
        Senator Lugar. Let me thank the panel, because you have
    offered, I think, diverse views and that has been helpful.
        I come with some prejudices just from experience, and
    Senator Casey has mentioned he has had some experiences. My
    first responsibility was as a school board member elected 45
    years ago in Indianapolis, and the first issue we had was one
    of school food. The problem was that so-called latchkey
    children in public housing projects got no breakfast at home,
    came into school and did not perform well. That had been going
    on for quite some time. From a local community standpoint, they
    could have helped alleviate the problem, but they didn't.
        The Federal Government came along with the program to help
    out breakfasts for latchkey children and one would have thought
    that in a humanitarian way our school board would have leapt at
    that opportunity. Wrong. They said, this is the Federal
    Government intruding on the Indianapolis school system. The
    Indianapolis News editorialized that this would be a violation
    of everything Indianapolis ever stood for. Unbelievably,
    Indianapolis took no Federal aid for anything at that point. I
    say that was unbelievable, but that was 45 years ago.
        And so, as a matter of fact, by a vote of about four to
    three, as I recall, our school board decided to take those
    lunches to help those children get nutrition, with the
    condemnation of the Indianapolis Chamber of Commerce, the
    newspapers, the citizenry. Those are the realities.
        I appreciate very much, Mr. Felton, your representation,
    and as a school board member, we fought everybody. But at the
    same time, my own judgment was that when we came down to even
    more serious issues, such as trying to desegregate even a part
    of our school system racially, once again, the local situation
    was very, very negative. And the thought that the Federal
    Government could ever intrude in this, which they did 12 years
    later with the Federal court suits and the whole situation was
    desegregated, but a sense at the local level at that particular
    time failed.
        Now, that is history and now we do not want to resegregate
    the school system or take the children's lunch away. This is
    the reason the issue, I think, is an important one, that by and
    large, we are talking about very minimal changes. I think the
    food companies, by and large, the progressive ones are prepared
    to work with us. They understand the problem. The problem of
    obesity now that we are discussing is at least a different one
    than people not having food at all. So we made some headway in
    the last four decades or so.
        But at the same time, we won't make it rapidly in
    Indianapolis, my hometown. The inner-city school situation is
    even more difficult than it was when I was on the board, and
    this is with regard to academic standards, quite apart from
    nutritional ones.
        So this is why, if I have a prejudice in the situations, I
    want to speak to it.
        Now, I appreciate that even if we all are motivated
    correctly, should there be some panel in the Department of
    Agriculture, somebody that advises this committee or the
    Congress as to how do we fight childhood obesity? Is there at
    this point some body of knowledge, given all the tests and
    research that you have talked about, that even if we wanted to
    regulate the vending machines, we come to some conclusion as to
    what the minimum standards ought to be for the machine, quite
    apart from the hours that it is open or the availability and so
    forth?
        In other words, what I am looking for now is some
    confidence in terms of the data that we really fight childhood
    obesity well, or that technically we can work with food
    companies and others who want to share that thought as opposed
    to simply being perceived along with the maybe local school
    boards who want to retain all controls regardless of what
    happens as the enemies of the project? Do any of you have any
    idea how you would proceed if you were to determine what is in
    the machine or what is available? Is there a body of standards
    that is available to us? Ms. Huehnergarth?
        Ms. Huehnergarth. There was a report by the Institute of
    Medicine making some very sensible recommendations for school
    nutrition standards and I think that is one place that you
    would start. They really described exactly what should be sold
    in elementary, middle, and high schools. I think they laid out
    the road map for us.
        Senator Lugar. Good. So we have at least one reference
    point there. Is there any general agreement among school
    administrators, State, local, or anywhere else, that those
    standards look reasonable? Mr. Felton?
        Mr. Felton. Well, as we talked earlier, sir, the issue is
    that there are several reports that make recommendations, but,
    I mean, there isn't a unanimous agreement that what is out
    there is, in fact, what we should have, and that obviously
    creates a challenge for implementing such a law, which is one
    of the points that we raised.
        Mr. Garrett. Senator, I guess I would just add to that,
    while there may not be consensus or uniform agreement on what
    should be contained within the machine, there is certainly
    consensus on what is not healthy for our children and that data
    is very clear and----
        Senator Lugar. So there is some minimum standard, at
    least----
        Mr. Garrett. Correct, and so I guess what I would offer,
    and having worked at USDA before, not in the Food and Nutrition
    Service, but obviously very familiar with most of the programs,
    I would offer that the expertise is available to determine what
    may be the appropriate minimal standards. And again, you are
    talking about a very--what I would consider to be a small-scale
    change, but again still providing folks with enough flexibility
    and latitude.
        I think when you hear from other folks, I guess on your
    second panel, they will also talk about the differences when
    you begin to look at if you utilize local school boards in
    setting their own policies, the disparity between what could be
    contained, what type of content, what size product, what
    nutritional level. I mean, I believe--I guess the end of it
    would be I believe that there is the potential and the research
    does exist and the folks are there to convene to really create
    a minimum set of standards that would be across the board that
    could be applicable in this situation.
        Mr. Cooper. I would just like to mimic that a little bit. I
    think the precedent somewhat has already been set in various
    areas. For instance, when I apply for an Early Reading First
    Grant from the Federal Government, they only allow you to use
    practices and curriculum that are evidence- based, and I think
    that is the same way we approach this. There might not be a
    single menu, but there is a wealth of evidence out there that
    gives a world of choice still to the local school boards that
    keeps them within the realm of healthy offerings.
        Senator Lugar. Thank you very much.
        Thank you, Mr. Chairman.
        Senator Casey. [Presiding.] Senator Klobuchar?
        Senator Klobuchar. Thank you very much, Mr. Chairman. Thank
    you to all of you.
        My fellow colleagues here have heard me talk about this
    quite a bit. When I was listening to Senator Lugar, I was
    thinking the same thing, that we just--it is not working for so
    many of our kids. My daughter was in a school that was 90
    percent free and reduced lunch in Minneapolis and I saw
    firsthand what those kids were eating out of the vending
    machines. Even though people would donate food and the school
    would have some yogurt there, I saw what they went and picked,
    exactly what Mr. Garrett is talking about. Then we move her to
    Virginia where she is in a school with much different
    demographics and the kids are bringing carrots to eat for a
    snack.
        I just think it is unfair if we think that kids in certain
    urban districts are going to have the same kind of food that
    their parents are going to send to school with them. They are
    not. Kids get, what is it, 30 to 50 percent of their calories
    in school on school days, and this just isn't working with
    them. I mean, the proof is in the statistics, Mr. Felton, of
    how these kids are getting obese, and the proof is also in what
    I have seen of these own kids' lives. And so I am just devoted
    to changing this. We are not going to be able to keep going the
    way we are going.
        So my question is, first of all, Dr. Cooper, with this idea
    of allowing the Secretary of Agriculture, which I support, to
    put forth some kind of a dietary standard nationally, how do
    you think this would work with the local districts when you
    have different food, produce in different parts of the country,
    and how would this work, Dr. Cooper?
        Mr. Cooper. Well, I mean, I don't see this being earth-
    shaking changes. We are already well on the road to asking
    people to provide healthy foods. In my--this is just my
    opinion, I know that when we put in what I call tougher
    standards for food and vending, we adapted very quickly. Of
    course, in my experience, we were in Louisiana and we were in
    Mississippi and so there is lots of fresh produce coming in.
    There may be other places where that is not the case.
        But I think, again, going back to the wealth of information
    about what could be possible to be looked at in terms of a
    healthy choice is great enough so that no matter where you were
    in this country, you could still provide that.
        Senator Klobuchar. And Ms. Huehnergarth, I was interested
    when you talked about the schools able to increase their
    revenues in other ways and that study. Could you elaborate on
    that more, the schools that were having healthier food and
    eliminated some of the unhealthy foods in the vending machines,
    how they were able to increase revenues.
        Ms. Huehnergarth. Well, first of all, if they took out
    unhealthy food from the vending machines, they would substitute
    healthier foods, like water, as Dr. Cooper told us before. And
    also sometimes they put in dried fruits or good granola bars.
    Kids will buy it. If they are hungry and they are staying after
    school, they will buy those foods.
        As far as changing out--taking unhealthy foods out of the
    cafeterias, once again, if you take them out, the kids will
    gravitate to the meal program, to the Federal meal program.
    They will buy those meals which are nutritionally balanced and
    those reimbursements will help balance the program.
        Senator Klobuchar. The other thing I have heard, and we
    have a lot of food producers in Minnesota, food processors,
    frozen foods, all these things, is that there is a very good
    argument that school districts could save money, not to say,
    which I was asking Dr. Cooper, that you have to have the same
    produce in every--you couldn't in every State, if you want to
    use local. But for some of these meals, like if they are going
    to have a pizza or they are going to have something like that
    as part of their school meal, that all of these different
    school boards requiring different requirements actually adds to
    the cost as opposed to having one standard. Could someone
    comment on that?
        Ms. Huehnergarth. Probably from a distribution standpoint,
    it strikes me if all the schools across the Nation have similar
    standards and they are all buying the same amounts in bulk,
    perhaps it would actually bring prices down. It seems to make
    sense.
        Senator Klobuchar. Mr. Garrett?
        Mr. Garrett. I guess I would share--I know being a school
    principal, and I was at a charter school, so I had discretion
    over what it is we purchased as long as it met both the State
    and Federal guidelines from a meal perspective. I do know that
    when you go in and you attempt to work with a vendor and you
    are asking them to create a customized package or a customized
    size specific to your local needs, the costs go up, and I would
    venture to say that if there is a national set of minimal
    standards and you begin you to talk about whether it is four
    ounces or six ounces, I would assume that it would allow
    organizations or companies to create more of a wholesale system
    of product offerings that make it much more universal, and
    that, I would believe, would drive the cost down from that
    perspective. Obviously, I don't work in that specific industry,
    but I know having been an administrator, it was much easier for
    me to pick something that met the nutritional guideline that
    fit within the size and scope as opposed to saying, I want
    something customized. It generally would cost us a lot more in
    order to do that.
        Senator Klobuchar. Mr. Felton?
        Mr. Felton. Senator, I mean, I would just be very cautious.
    Most of us, when we speak about school districts, we have in
    mind the experiences that we had growing up in terms of the
    size of the school and the wealth of the school and the poverty
    of the school. As we look across the nation, there is such a
    broad--I mean, we still have three one-room schoolhouse
    districts in America and we have school districts with tens of
    thousands within a single school. So the challenge for us is to
    begin to have guidelines, but that provide sufficient options
    so that those who must operate in one kind of environment are
    not totally restricted to the advantage of simply because they
    are not in a different kind of environment.
        What I understand is under consideration is not just
    vending machines. There has been a lot of talk about vending
    machines, and I think for the most part, parents and school
    boards and districts are working with those vending machine
    efforts, not perhaps to the level of some of my colleagues on
    the panel, but certainly we believe there is progress in the
    right direction.
        But when you talk about beyond the vending machines and you
    are talking about total availability of foods and beverages for
    events related to schools, 24 hours, 7 days a week, that is a
    different level of----
        Senator Klobuchar. But Mr. Felton, why wouldn't we want to
    have healthier foods available for----
        Mr. Felton. We do, as I said earlier in my statement, that
    school boards do support nutrition. This is not an issue of
    should our children be healthier. Of course, our children
    should be healthier. Should we----
        Senator Klobuchar. But the way we have been doing it hasn't
    been working. These kids are getting fatter and fatter.
        Mr. Felton. Well, I think, again----
        Senator Klobuchar. It is not working to not have some kind
    of national standard, and to me, when you have got a President
    that is focused on this, when you have got a Congress that is
    focused on it, you should say this is a national priority and
    we are going to look at schools as a whole because we know
    these kids are going to run and get a Twinkie, or if they are
    selling high-sugar things at every event, they are going to
    drink those. Why wouldn't we want to have things that were
    better----
        Mr. Felton. Well, again, our response is that those same
    public--those same citizens and residents elect those Federal
    officials and State officials and local officials. In our
    society, we should be responsive to those communities. And if
    we demand at the Federal level, these people should be----
        Senator Klobuchar. If it was working, I would say, fine,
    Mr. Felton, but it doesn't seem to be working for these kids,
    so--Mr. Garrett?
        Mr. Garrett. And I guess I would just share, Senator, the
    reality is this across the country. There is disparity
    regarding what is available. When you look at the breakfast or
    the lunch program specifically, there are some guidelines
    associated. But when you talk about these other items, so
    whether it is a vending machine, whether it is the a la carte
    service that is available at a school, whether it is what a
    school store may sell or the booster clubs, et cetera, the
    reality is there is no nutritional standard that is utilized
    whatsoever.
        And so to that end, we have got to get to the point from a
    Federal perspective that we offer something that is minimal,
    but it also is somewhat prescriptive to let folks know that
    there has got to be some basis. And I would contend, as you
    just alluded to, that parents across the country are saying,
    the local wellness policies, while we advocated for them and
    support them, are not doing the job and we need something that
    is going to be more stringent.
        Senator Klobuchar. I have gone way too far, but I just want
    to--long on my time, but I just want to say that I want to save
    money here and I see this as saving money in health care costs
    and saving money in how we buy, purchase food. If there are
    ways to save money here, we have got to find them right now. We
    are in tough budget times. And if there is a way to have
    healthier kids and have a more fair system, we have to move
    toward that system.
        Senator Casey. Senator Johanns?
        Senator Johanns. Thank you very much.
        I have found this to be very informational and instructive
    and, I think, a good diversity of views. Let me offer a
    thought, if I might. As a former Agriculture Secretary, former
    Governor, former mayor, former city council member, county
    commissioner, first of all, I would say, having been there at
    the Department, childhood obesity is a very, very complex
    issue. If it was as simple as banning vending machines, we
    would probably just ban vending machines, fix the problem,
    declare victory, and move on. It is not that simple.
        There are all kinds of things involved here. Physical
    activity has been mentioned. I released the first food pyramid
    that actually said, enhance your physical activity. You know,
    we had the stick figure running up the side of the pyramid. We
    came to the conclusion after studying this for months and
    months and months that you can enjoy a diversity of foods. You
    can enjoy meat and poultry and vegetables and even sweets if
    you do it in moderation. But that is often the problem. There
    was no moderation. There was no physical activity, and so
    obesity levels go up.
        We oftentimes hear at the national level, we think we are
    all wise and so we grab a policy. We pass it, and then we look
    back years later and then we say, well, why is it if we have a
    children's health care program that is really good--and
    incidentally, it is, we implemented it when I was Governor of
    Nebraska--but why is it that in some States, 60 percent of the
    kids aren't even enrolled when it is available and free? Do you
    know why? Because people don't grab hold of it. They see this
    another Federal mandate that we are trying to jam down their
    State's throat and they back off away from it and they don't
    promote it.
        So I think we have to try to figure out what the right
    balance is here. Mr. Felton, in your testimony, you raised the
    fact that under Congress in 2004, said that every school
    district participating in the Federal meals program had to put
    in place a nutrition education program, goals for physical
    activity, et cetera. How are schools doing out there with that?
    Are they making progress?
        Mr. Felton. I think the reality, sir, is that they are all
    making progress. It is just a matter of degree. I provided data
    in my testimony that suggested that, on average, we are still
    looking at probably 30 to 40 percent who are not at the level
    that we certainly had hoped that they would be at this point.
    What we are unsure of is what are the things that are
    contributing to that slow performance. But again, as an overall
    policy, they are there. In terms of having plans, they are
    there. In terms of beginning the implementation, they are
    there.
        But are they 100 percent where they should be? I think not,
    and we have not denied that fact. But we are saying that with
    the appropriate incentives and the appropriate leveraging with
    State governments and State funds, they could move to a
    different degree, and that would be acceptable.
        Senator Johanns. Let me follow that up with maybe a little
    bit more of a general question. You talked about the
    responsibility of school boards and administrators. We do want
    safe campuses. We do want clean campuses. We do want standards
    and performance and we want kids to be able to go on to college
    or trade school or whatever. Just a general question. Are we
    overloading the system?
        Mr. Felton. Well, in our view, we are overloading the
    system because we are expecting, again, the local school
    district to take on every issue facing society within a very,
    very limited resource budget. I think that, again, education is
    important, and we all understand philosophically in order for
    that child to succeed, all these things must be supported. But
    when the Federal Government on average invests only 10 percent
    of the total cost of education in America, someone has to
    question who is bearing this, and who is bearing this are
    States and local governments trying to figure out how to do
    what is best for all their kids given the limited resources
    available.
        Senator Johanns. You raise a very valid point, and I am
    running out of time, so I will wrap up with this thought,
    again, coming from a Governor and a mayor's perspective. It
    always seemed a little high-handed to me that the very junior
    partner in education, being the Federal Government, which
    provided, as you point out, and there was some more money in
    the stimulus funds that lasts for the next year or 2 years, but
    they provided about 9 percent, I think, nine or 10 percent of
    the funding. But it always seemed a little high-handed to me
    that they were the ones that felt they had the ability to force
    down the standards, that they knew best right down to the
    smallest school district in Nebraska. They knew best what was
    good for those kids. And when I talked about the smallest
    school district, in our State, we still have one-room schools
    that are, incidentally, doing a great job educating kids.
        But when you talked about the responsibilities we are
    putting on schools, I must admit, you touched a chord with me,
    because it is very easy to pass the law, as I said, only to
    look back years later and say, well, gosh, it isn't doing what
    we thought it would do because we have weighted the system down
    so aggressively, it can't perform. It is almost set up for
    failure, if you know what I am saying. Does that make sense?
        Mr. Felton. It makes sense very much, sir, and we have
    pointed out as we are engaged in other Federal legislation is
    to be very cautious about the additional burdensome
    administrative requirements and over-expectations for the very
    limited dollars that are out there. Again, I agree with you,
    school boards want to do the right thing and communities want
    to do what is best for their children, but we cannot continue
    to have a broad range of Federal requirements unless the
    Federal Government is willing to take on that financial burden
    with that.
        Senator Johanns. Thank you.
        Senator Casey. I wanted to--we have an obvious conflict
    here, the debate between national standards and the opposite
    point of view.
        Mr. Felton, I wanted to ask you about something that arose
    in the last couple of weeks when the School Nutrition
    Association representatives were in Washington. At that time,
    they talked about a whole range of issues, but in particular
    they asked about Federal standards to streamline packaging and
    beverage purchase. And I would ask you, in light of that point
    of view, in light of that desire that the School Nutrition
    Association has on packaging and beverage, how can we get
    there? How can we achieve that if we have nutrition standards
    being set district by district?
        Mr. Felton. Well, as I said earlier, sir, the--it is the
    environment in which we all operate that would suggest to us
    that guidelines can be issued and developed. The question is
    when they move from guidelines that provide flexibility to
    simply mandates which do not reflect or acknowledge that there
    will be circumstances that simply do not fit in certain school
    districts and certain communities. We believe that you can
    engage the community, you can engage evidence-based research to
    produce a broad range of guidelines in which local communities
    could operate in, and to the extent that they can, first of
    all, they want to do this. This is not a matter of not wanting
    to. But to the extent that they are able, based on other kinds
    of requirements, typically being influenced by the financial
    resources, then that has to be acknowledged.
        And so to have a requirement without the ability for
    flexibility or adjustments or, you know, circumstances that
    could certainly provide some relief, that what we do is indict
    those local school districts when it is no fault of their own.
        Senator Casey. And I have a real concern about guidelines
    not being enough.
        Mr. Felton. I understand.
        Senator Casey. We probably disagree about that, but, I
    mean, some of the basic data that has been cited already--Ms.
    Huehnergarth, you cite in your testimony that only 12 States
    have comprehensive school food and beverage standards that
    apply to the whole campus for the entire school day and at all
    grade levels.
        Ms. Huehnergarth. Correct.
        Senator Casey. I mean, look. Guidelines are great if people
    are adopting them and implementing them. I want to know if the
    other three witnesses have a perspective on the question of
    guidelines. Is that enough? I am assuming----
        Ms. Huehnergarth. I don't think----
        Senator Casey [continuing]. You will say no. What is your
    experience with how guidelines work or don't work, in your own
    experience?
        Ms. Huehnergarth. So you are talking voluntary guidelines,
    correct?
        Senator Casey. Mr. Felton, is that your----
        Mr. Felton. Well, I mean, whether we are talking guidelines
    or voluntary standards, the issue is once you have a Federal
    mandate that is standard and you tie Federal funding directly
    to that, even if you are calling it voluntary, it is de facto
    mandated. So I agree with you that we need to talk about
    whether we are talking about an options for school districts
    and States to participate or we are talking about a standard in
    which everyone is expected to meet, and that is a different
    answer.
        Ms. Huehnergarth. Well, as far as voluntary guidelines, I
    mean, wellness committees, as we have them set up in our
    country, issue a set of guidelines that are relatively
    voluntary and there really are no teeth behind them. So
    oftentimes I hear from parents in districts that have set what
    they think are strict wellness standards that they are just not
    being followed.
        I think the only real way to get real change in this
    country is to have uniform standards across the board.
    Voluntary is just that. It is for the most motivated, and not
    every district across the country is motivated or interested in
    making these changes.
        Mr. Garrett. And Senator, I guess I would offer to that, as
    well, the thought that it is either a top-down or bottom-up
    approach. Neither are going to work in isolation. So you have
    got to have both. And so just as my colleague just shared, when
    you talk about voluntary guidelines, the reality is we need
    some set of minimum standards across the board, and I think--I
    know on behalf of our constituencies, parents are asking for
    that, because what we recognize, even though we had advocated
    for local wellness policies, and many of our parents may be
    included in how you make those decisions and how the policy is
    structured, we recognize that they simply fail to meet the
    expectation. It is not meeting the need.
        And so short of action on a local level, we have got to
    figure out a different way and our belief would be developing a
    system of national standards that are minimally prescriptive
    that really enforce and have folks own up to the requirement of
    making sure the children have healthy options on campus.
        Mr. Felton. Well, much of our discussion, sir, reminds me
    of the hearings that local school boards have to deal with
    frequently, and that is parents are testifying before school
    boards and some parents feel this way and some parents feel
    another way. And I think that the concern is that while we do
    not disagree that some parents feel very, very strongly about
    standards, we know that there are many, many parents who feel
    very, very strongly that there should not be standards.
        What we want to be sure of is that whatever Federal
    legislation there is, that it acknowledges and recognizes the
    fact that down where the rubber meets the road, where school
    boards must implement programs with very, very limited budgets,
    that they aren't so restricted that this simply becomes another
    poor grading system of our public education.
        Mr. Cooper. Could I add something to that just real
    quickly, because----
        Senator Casey. Yes. We have to move to our next panel,
    but----
        Mr. Cooper. OK. I don't think voluntary guidelines are
    enough, but I do want to agree with Mr. Felton. I think we have
    overburdened our school districts with things, but I think our
    priority is in the wrong place. I think we ought to loosen some
    of the other things and take care of our children and the
    health of our children first. That definitely needs to be
    something that we all agree to.
        I don't think it is a financial burden. We have got lots of
    data to say that if we do this, it is not going to be a
    financial burden.
        And the last thing, I would think in a one-room
    schoolhouse, that would be the easiest place to be healthy. I
    mean, you have water, you have oatmeal, you have milk. You
    don't have all the distractions of the big city items.
        I just want to go back to the issue of it is about our
    children. It is not about safety codes. It is about if you
    don't do the right things for our children in terms of their
    healthy, they are not going to be riding those buses. They are
    not going to be coming to those buildings.
        Senator Casey. I want to know if either of our colleagues
    have any more questions.
        Well, thank you very much for your time and your testimony.
    We will go to our second panel.
        Our second panel, we have four witnesses. The first is Ms.
    Karen Ehrens. She is the Public Policy Chair of the North
    Dakota Dietetic Association in Bismarck, North Dakota.
        We will be moving left to right. Our second witness is Ms.
    Miriam Erickson Brown. She is the Chief Executive Officer of
    Anderson Erickson Dairy Company in Des Moines, Iowa.
        Our third is Mr. Hank Izzo, Vice President of Mars
    Snackfood U.S., Hackettstown, New Jersey. They have a couple
    hundred employees in Pennsylvania. I wanted to cite that for
    the record. Thank you for being here.
        And finally, Ms. Susan Neely, Chief Executive Officer of
    the American Beverage Association in Washington. She is outside
    the hearing room and will be in shortly.
        But welcome, and we are grateful for your presence here
    today and your taking the time to provide testimony.
        Ms. Ehrens, why don't we start with you and we will move
    from left to right. Thank you.

     STATEMENT OF KAREN EHRENS, PUBLIC POLICY CHAIR, NORTH DAKOTA
              DIETETIC ASSOCIATION, BISMARCK, NORTH DAKOTA

        Ms. Ehrens. Good morning. I am Karen Ehrens, Public Policy
    Chair of the North Dakota Dietetic Association, which is an
    affiliate of the American Dietetic Association. Senator Casey,
    Ranking Member Chambliss, and Senator Lugar, thank you for your
    interest in this issue.
        My thoughts today are with my neighbors in North Dakota,
    South Dakota, and Minnesota as we are battling both blizzards
    and floods, and so my thoughts are there with my neighbors. But
    I am also very glad to be here today because this issue is so
    important.
        I am sure you have heard that between the 1970's and today,
    childhood obesity has doubled and in other age groups has
    tripled in these years. Kids face not only social and emotional
    health risks of obesity, but long-term risks, including the
    development of chronic diseases like heart disease, cancer,
    arthritis, and diabetes.
        I brought along some kids today. This is my daughter's
    fifth grade class in Bismarck, North Dakota. There are 21 kids.
    They were born at about the turn of the century, and if things
    continue on as they are today, seven of these kids have the
    potential of developing diabetes as some point in their lives.
    And I am here today----
        Senator Casey. I am sorry. What grade did you say?
        Ms. Ehrens. Fifth grade.
        Senator Casey. Fifth. I am sorry. Thank you.
        Ms. Ehrens. I am here to help these kids and all kids
    across the United States beat those odds.
        Despite the increase in childhood obesity, you have heard
    that many of our schools are continuing to sell candy, snack
    foods, and sweetened drinks to children through vending
    machines or a la carte, in school stores and as fundraisers. I
    can't help but wonder how we got to this place in time when we
    accept that it is normal to provide access to children to these
    foods throughout the school day and why it is that schools are
    considered a marketplace to begin with. Adults are raising
    money while gambling with children's health.
        It reminds me of what we are learning about the origins of
    the current financial crisis today. For the sake of profit in
    the present, people disregarded the long-term consequences of
    what their actions. Like toxic assets in the financial system,
    schools and other areas in our communities have been left with
    toxic environments.
        Competitive foods sold outside of meals aren't required to
    meet Federal nutrition standards that have been set for school
    meals. USDA policy does address food sold outside of schools
    minimally in the foods of minimal nutritional value policy.
    They can't be sold in the food service areas during school
    times, but those foods can be sold at any other place and time
    throughout the school day. These foods are on that list because
    they make only minimal contributions of nutrients, but
    calories, fat, salt, and sugars aren't counted to determine
    whether a food is of minimal nutritional value, as it is
    called. This is a 30-year-old policy that doesn't really make
    sense anymore.
        The sale of low-nutrition competitive foods outside of
    school meals is associated with increases in children's body
    mass index, or BMI as it is called. In fact, one study
    estimates that up to one-fifth of the average increases in BMI
    in teens in the 1990's can be attributed to the increased
    availability of these low-nutrition foods in schools.
        The sale of low-nutrition foods in schools is
    counterproductive, as we have heard this morning. When these
    foods are sold in schools, fewer kids eat school lunches.
    Healthy foods are displaced, and so kids' nutrient intake goes
    down. More food is left uneaten and thrown away. The
    availability of unhealthy foods also sends a mixed message when
    we are trying to teach kids through nutrition and health
    education in schools about the importance of choosing healthful
    foods as part of an overall healthy diet.
        The sale of competitive foods is especially harmful to kids
    who come from families with lower incomes. If students from
    families with limited budgets eat less healthy snack foods
    during the day instead of a free or reduced-price school meal,
    they lose out nutritionally in a bigger way than kids that come
    from more affluent families who might have the chance at some
    point during the day in or outside of school to access healthy
    foods.
        I am a member of our Bismarck Public Schools School Health
    Council. We are a team of teachers, administrators, parents,
    students, and health professionals who have been working
    together to write and implement a local wellness policy. It
    took us over a year and a half to write a strong policy, and
    that was as a result of the legislation that required schools
    to have local wellness policies in place.
        Our strong wellness policy in Bismarck did result in the
    removal of soda pop machines from our schools. Students may
    purchase milk, water, 100 percent fruit or vegetable juice
    during the day. At other schools in our State, however,
    children still have access to soda pop, other sweetened
    beverages, and snack foods.
        The legislation that put these local wellness policies in
    place was a big step forward and I thank you as Members of
    Congress for making that happen. However, some local wellness
    policies are strong and others sit filed on a shelf collecting
    dust. It also, as we found out in Bismarck, takes committed
    administrators throughout the school districts from school to
    school on a day-to-day basis to make sure that the policies are
    not just in place, but that they are carried out. And if there
    isn't a champion in a particular school, the policies may not
    get implemented at all.
        All children should have the opportunity to attend school
    in a healthy environment. Parents in small school districts or
    low-income school districts may not have the time, the
    resources, or the opportunity to advocate for strong nutrition
    policies. This can create health disparities between large
    districts and small districts or between well-funded districts
    and those with fewer resources.
        Schools are one of the key settings for public health
    strategies to address overweight and obesity. As Senator Harkin
    mentioned earlier, as Congress and the administration move
    forward with health reform this year, the ADA believes that
    establishing nutrition standards is a part of health reform and
    is directly connected to prevention. Nutrition is the
    cornerstone of prevention and it is not going to be just in the
    schools where these changes can take place or just in our
    communities or just in health care facilities. Because this
    problem is so great, it is going to take all of us in all of
    these different venues working together.
        We need financing systems and policies for health reform
    that support prevention and better managing chronic diseases.
    We have to equip children in school, starting at the very
    youngest ages, with education, motivation, and skills they can
    use to be healthy and environments that support their personal
    responsibility for making healthy choices.
        I encourage you to take that first step by establishing
    meaningful nutrition standards for all foods sold in schools.
    Thank you.
        [The prepared statement of Ms. Ehrens can be found on page
    72 in the appendix.]
        Senator Casey. Ms. Ehrens, thank you very much.
        I failed to mention before your testimony that each of you
    will have testimony that will be submitted for the record. If
    there is any way you can keep your remarks within the 5
    minutes, that would help. I should have said that earlier.
        Ms. Erickson Brown?

     STATEMENT OF MIRIAM ERICKSON BROWN, CHIEF EXECUTIVE OFFICER,
           ANDERSON ERICKSON DAIRY COMPANY, DES MOINES, IOWA

        Ms. Brown. Good morning, Chairman Casey and committee
    members. I am Miriam Erickson Brown, President and CEO of
    Anderson Erickson Dairy in Des Moines, Iowa. We are a third-
    generation family owned dairy, and I am here today representing
    two leading dairy organizations, the National Milk Producers
    Federation and the International Dairy Foods Association. I
    appreciate the opportunity very much to testify before the
    committee today on the nutritional standards for foods served
    outside of the Federal School Milk Programs.
        Because of the critical role of milk and milk products in
    children's diets, I ask the committee to consider three
    actions. First, make nutrient-rich foods a central part of the
    school nutrition environment. Then help increase consumption of
    nutrient-rich low-fat and fat-free milks and other milk
    products as part of the strategy to lower obesity rates in
    children. And finally, to establish consistent nutrition
    standards for all foods and beverages sold or provided in
    schools.
        Children and teens need dairy products. A range of dairy
    products are available in schools, including white milk,
    lactose-free milk, flavored milks, as well as yogurts and
    cheese. Milk is the top source of nine essential nutrients, and
    a six-ounce carton of yogurt contains as much protein as a
    large egg, more potassium than an orange, and less fat than a
    quarter-pound of lean ground beef. Cheese is a very good source
    of protein and calcium. Adding cheese to foods like vegetables
    and whole grains often helps students to increase consumption
    of these healthful foods. The complete protein found in
    products like milk, cheese, and yogurts promotes satiety, an
    important part of maintaining a healthy weight.
        Nutrition standards should help children and teens get more
    nutrients from their calories. Today's children are
    increasingly overweight and undernourished. Balancing caloric
    intake and nutrient consumption is still the most effective way
    to help students get their overall nutritional needs met.
        Nutrition guidelines for school meals are constructed to
    average meals over the course of a week. A similar approach can
    be effective for foods and beverages sold in the a la carte
    programs. Overly restrictive nutrition standards applied to
    individual foods may put nutrient-rich foods, such as yogurt
    cups and cheese sticks, out of the reach of our children, and
    this would be very unfortunate since the dietary guidelines
    indicate that these types of products are among the foods to
    encourage.
        The dairy industry has invested in extensive research and
    development of new ingredients and products that minimize added
    sugars, sodium, and allow for a variety of fat levels.
        So whether as a nutrient-rich ingredient in the foods kids
    like to eat or as an a la carte menu item, dairy foods come in
    a really wide variety of versions and packaging that provide
    unbeatable nutritional benefits. We encourage you to set
    school-wide nutrition standards that include milk, yogurt, and
    various types of cheese as a valuable and important part of a
    child's healthy diet in schools.
        Milk consumption plays a part in combating obesity. There
    appears to be a simple inverse relationship between rising
    obesity rates in kids and declining milk consumption. According
    to the Department of Agriculture research, for every one ounce
    decline in milk consumption, there is a 4.2 ounce rise in
    consumption of other beverages, resulting in a gain of calories
    and a loss of calcium and other important nutrients.
        Nutrition standards for all beverages available in schools
    should put milk on a level playing field with other beverages.
    That means, for example, in a vending machine that sells sports
    drinks, milk should also be available there in a variety of
    sizes and packaging. Offering flavored, low-fat, or fat-free
    milk is an excellent way to increase milk consumption among
    children and teens. According to a study in the Journal of
    American Dietetic Association, children who drink flavored milk
    drink more milk overall and are more likely to meet their
    calcium needs without consuming more total fat and calories as
    compared with their peers.
        The dairy industry is working very hard to develop flavored
    milk formulations that have fewer added sugars and total
    calories while maintaining kid appeal. But establishing
    guidelines that are overly restricted on added sugars would not
    only drive up costs significantly, but would also be difficult
    to achieve without the use of non- nutritive sweeteners.
        As school districts across the Nation struggle to provide
    healthy meals on tight budgets, many depend on additional
    revenues generated through a la carte sales. USDA has a very
    small program that subsidizes a la carte milk sales called the
    Special Milk Program and we would encourage the committee to
    increase its funding so that schools can be partially
    reimbursed for the milk that they serve to kids outside the
    school milk program.
        Consistent nutrition standards for all foods and beverages
    must be granted in the dietary guidelines. Today in schools,
    there are a la carte menus, vending machines, and they provide
    an array of competing foods. Yet only the USDA School Milk
    Programs operate under the direction of the dietary guidelines.
    We believe our students are best served by having one set of
    standards for foods and beverages available in our schools,
    which should apply equally across the country.
        In conclusion, we share your commitment to improving school
    nutrition. We will continue to find innovative ways to support
    the overall goals of the Dietary Guidelines, providing new
    products, new flavors, and new ways for students to enjoy the
    taste and goodness of dairy products in schools. Thank you.
        [The prepared statement of Ms. Brown can be found on page
    52 in the appendix.]
        Chairman Harkin. [Presiding.] Thank you very much.
        And now we will turn to Dr. Hank Izzo from Mars Inc. Mr.
    Izzo?

         STATEMENT OF HANK IZZO, VICE PRESIDENT, RESEARCH AND
       DEVELOPMENT, MARS SNACKFOOD U.S., HACKETTSTOWN, NEW JERSEY

        Mr. Izzo. Thank you, Mr. Chairman and members of the
    committee. I am Dr. Hank Izzo, Vice President of Research and
    Development from Mars Snackfood U.S. and I appreciate the
    opportunity to testify today in support of updating our
    National School Nutrition Standards.
        I would like to begin by thanking Chairman Harkin for his
    consistent leadership on this issue. As you know, Mars worked
    closely with your office during the most recent farm bill in an
    effort to update these standards and we look forward to
    continuing to work with you on this very important issue.
        I would also like to thank Ranking Member Chambliss for his
    consistent support of Mars, Incorporated. We were very pleased
    to have the Senator visit our Georgia plant in August and look
    forward to continuing to build on this relationship in the
    future.
        Mars, Incorporated is a family owned U.S. company that
    manufacturers a wide range of confectionery, food, and pet care
    products. As one of the world's largest companies, we employ
    more than 15,000 associates in 40 factories across the United
    States. Mr. Chairman and members of the committee, Mars
    believes the time has come for Congress and the USDA to update
    our National School Nutrition Standards. Our position on this
    issue reflects our continuous commitment to health and
    nutrition space.
        Mars was the first chocolate company to stop advertising
    and marketing directly toward children under the age of 12 in
    2007. Last year, we implemented easy-to- ready front-of-pack
    nutritional labeling to help consumers make more informed
    choices about the foods they eat. Mars has also eliminated
    transfat, reduced sodium, and added more whole grains across
    our lines of products.
        Finally, we were proud to be one of the first companies to
    partner with the Alliance for a Healthier Generation. As you
    may know, the Alliance was created by the William Jefferson
    Clinton Foundation and the American Heart Association. The goal
    of the alliance is to empower kids to make healthy lifestyle
    choices. Mars was one of the first companies to partner with
    the Alliance in 2006.
        At that time, we pledged that we would not offer for sale
    any products in schools that do not meet the strict 35- 10-35
    nutrition standards, meaning less than 35 percent calories from
    fat, less than 10 percent calories are from saturated fat, and
    less than 35 percent sugar by weight. To meet this commitment,
    Mars was the only company to develop an entirely new line of
    products, our Generation Max line, which I am pleased to say
    fit those guidelines and are available for schools across the
    country today.
        Our commitment to the Alliance reflects Mars' beliefs that
    schools are unique environments that warrant special treatment
    when it comes to nutrition standards. At home, parents make
    decisions about the food. But at school, children make
    decisions about foods for themselves, such as products they
    might buy from a vending machine.
        We believe that new standards will help make sure that
    children across the Nation have access to a broad selection of
    nutritious foods at all schools. An updated National School
    Nutrition Standard will make it easier for schools and
    manufacturers to work together to help children make smart
    decisions about the foods they consume. It will provide some
    peace of mind, as well, for parents, knowing that foods for
    sale in a school meet nutrition guidelines.
        As you know, the existing standards for school vending have
    not been updated since the 1970's. Today, we understand so much
    more about the relationship between food and health, and Mars
    believes it is time to apply that knowledge to a new school
    nutrition standard. It is our opinion that the National School
    Nutrition Standard should be modeled after the guidelines
    issued by the Alliance for a Healthier Generation. We believe
    that 35-10-35 is a meaningful, practical standard that can be
    adopted and implemented quickly. We also believe it would
    generate significant support across the nutrition community and
    progressive companies in the food industry.
        Mr. Chairman and members of the committee, the challenge of
    improving the nutritional environment in schools is too
    important to get delayed by extended rulemaking by USDA. The
    time to act is now. We look forward to working with the
    committee to draft legislative language to ensure that these
    new standards are implemented as quickly as possible.
        As the father of four young sons and as a youth coach in my
    community and a volunteer in my community, and as an associate
    of Mars, Incorporated, I would like to take the chance to thank
    you for the opportunity to testify on this very, very important
    issue.
        [The prepared statement of Mr. Izzo can be found on page 94
    in the appendix.]
        Chairman Harkin. Thank you very, very much.
        And now we will turn to Ms. Susan Neely, President and CEO
    of the American Beverage Association. Welcome back.

      STATEMENT OF SUSAN K. NEELY, PRESIDENT AND CHIEF EXECUTIVE
         OFFICER, AMERICAN BEVERAGE ASSOCIATION, WASHINGTON, DC

        Ms. Neely. Thank you, Mr. Chairman. It is good to be back.
    And Senator Lugar and the committee, I do represent the non-
    alcoholic beverage industry, all of our many brands,
    manufacturers and distributors across the country, and their
    220,000 employees. I am also the mother of an elementary school
    child and now a middle school child, so this is a topic that is
    near and dear to my heart for many reasons.
        It is a pleasure to be back and tell you how we are doing
    with the commitment that we as the entire beverage industry
    made with the Clinton Foundation and the American Heart
    Association to implement a common sense standard in schools
    across the country. I have been working in this policy space
    for 30 years now, inside government and outside government, and
    I can't say that I have never seen any industry sector commit
    so much and deliver in such a robust way on their commitment. I
    am very proud to give this report to you and to the rest of the
    committee.
        As you will recall, we made this agreement with the
    Alliance for a Healthier Generation in May 2006 and had three
    school years basically to implement it, so we are nearing the
    end of the third year and I can tell you we are doing very,
    very well. The policy that is being implemented draws heavily
    from obviously the expertise of the policy experts at the
    Clinton Foundation and the nutrition scientists at the American
    Heart Association, but also parents. Parents told us they
    wanted an age-appropriate policy. They wanted to limit choices
    for their younger children and they wanted more choices for
    their older children mirroring a more real-world experience,
    but still educating them on beverages that are healthy and low
    in calories, and that is what our policy does.
        I think our policy is very consistent with the recent
    research that was funded by NIH and published in the New
    England Journal of Medicine that really made the strong points
    that counting calories and achieving energy balance is the best
    way to manage weight, and I think our policy is certainly
    consistent with that science.
        The policy says milk, juice, and water only for elementary
    school and middle school children. Again, age appropriate,
    limiting choices for those younger children. And then for high
    school kids that are a little older, it is low-calorie, zero-
    calorie, or portion capped beverages.
        So very specifically, the punch line I always want to get
    across is that we are taking full-calorie soft drinks out of
    schools across the country, and for beverages that are higher
    in calories but have other attributes, we are bringing the
    portion sizes down. So even the 100 percent juice comes in a
    limited portion size.
        This has been a lot of work. We have had to train marketing
    and sales staff so that they understand the policy and can talk
    to their school partners about it. We have had to amend tens of
    thousands of contracts. We have had to reformulate products. We
    agreed to package sizes that didn't exist, so we had to create
    those containers and change the vending fronts so that they are
    commensurate with what is actually in the machine.
        But the industry has been doing it and we are getting it
    done, and as of the last report, which we put out in September,
    along with President Clinton and Dr. Tim Gardner of the Heart
    Association, we had lowered calories in beverages shipped to
    schools by 58 percent. Eighty percent, or almost 80 percent of
    the schools under contract in this country are in compliance,
    or were in compliance. And 65 percent--there was a reduction of
    65 percent in full-calorie soft drinks in schools, so that is
    essentially at the end of the second year. I look forward to
    giving you our final report this fall after we are able to
    compile the data on our final year of implementation.
        So in closing, Mr. Chairman, I also, along with Dr. Izzo,
    thank you for your leadership. We were pleased to work closely
    with you and Senator Murkowski to try to update the standard as
    part of the farm bill and we are ready to continue to work with
    you to see that a common sense standard can be implemented in
    schools across the country. Thank you very much.
        [The prepared statement of Ms. Neely can be found on page
    100 in the appendix.]
        Chairman Harkin. Thank you very much, Ms. Neely.
        I apologize for having to leave and come back, but we have
    a hearing today on the nomination of Governor Sebelius to be
    head of Health and Human Services, so I just went over there
    for my questioning period and I told her I was chairing this
    hearing on the Child Nutrition Reauthorization bill, and I said
    while it is not directly under her jurisdiction, I would hope
    that as the new Secretary of Health and Human Services, that
    she would work closely with Secretary Vilsack and Secretary
    Duncan in helping us through this process, because I see it as
    a part of health care reform and how we deal with our kids in
    schools and the kind of food and beverages that they consume in
    schools. So I hope all of you see it in that light, also, that
    it is an integral part of our health reform measures that we
    want to enact, hopefully this year.
        Ms. Ehrens, in your written testimony, you talked about the
    changes that you made in North Dakota. I just again would like
    you just to express yourself again on the barriers that you
    encountered? We have heard sometimes we can't enact these
    school nutrition standards because they are going to hurt
    lower-income schools the most. They get the most from vending
    machines, and therefore we are going to hurt them the most. I
    have heard that a lot of times. But I think the testimony I
    have heard from others here is that that just isn't the case.
        Ms. Ehrens. Yes. Thank you, Chairman Harkin. As we heard
    earlier this morning, the actual amount in nickels and dimes,
    the profit margin is very small on these, and so I think that
    we are making a few nickels and dimes now and that the longer-
    term cost to our health care system, there is no comparison. We
    also have heard that schools can still make money if they
    choose to sell foods to children, that they can still make
    funds if they sell healthier schools--excuse me, healthier
    foods in schools.
        So yes, I think that also the schools that we have in our
    State, and South Dakota are some of the most--school districts
    that struggle the most, and I think they are also the ones that
    need the standards the most so that there is a level playing
    field, because I don't think that healthy school environments
    should just be for schools with more resources, but that
    opportunity should be available to kids no matter where they go
    to school.
        Chairman Harkin. Let me ask another general question for
    all of you. I think it was in one of the written testimonies of
    the previous panel, and I didn't get a second round of
    questioning, but it has often been said that, well, if you take
    away all these choices for kids in school, especially high
    school, that the kids will leave the campus during the day and
    they will go to the local 7-Eleven or something like that and
    they will buy all that junk food there.
        Well, that raised a question in my mind. Isn't it up to the
    local school board to decide whether or not kids can leave the
    campus during the day? I don't know what is happening out
    there, but when I was in school, we couldn't leave in the
    daytime. When my daughters were in high school, they couldn't
    leave the campus during the daytime. They had to have a
    permission slip. If they left without a permission slip, it was
    a violation of school policy and there were certain punishments
    that followed from that. I don't mean physical punishments, but
    staying after school and things like that.
        So I just find it odd that because a school board decides
    to let kids go off the campus, that somehow we have to permit
    junk food to be allowed on the campus. I turn that around. Why
    don't you just have a policy that kids can't leave the campus
    during the day unless they have a permission slip from the
    principal? Am I missing something here?
        Mr. Izzo. Yes.
        Chairman Harkin. You are a father. I mean, am I missing
    something here?
        [Laughter.]
        Mr. Izzo. I concur. I agree.
        [Laughter.]
        Mr. Izzo. Absolutely.
        Chairman Harkin. After wrestling with it, I can't figure it
    out.
        Mr. Izzo. Absolutely. I think I will just go back to
    schools are a unique environment and a unique opportunity to
    offer more balanced choices to students. It is a unique
    opportunity to teach students the appropriate way to eat, what
    they should do from a physical activity standpoint, and it is
    up to us to make sure that the appropriate choices are in the
    schools. And I think it is important to outline in every school
    for every child.
        That is why Mars supports a National School Nutrition
    Standard, and we believe, again, that the Alliance for a
    Healthier Generation, the 35-10-35 guideline is a practical
    guideline. Actually, to the point made earlier, there are both
    large companies and small companies and medium companies
    participating in the Alliance and we have developed in a very
    short period of time over 300 products that fit these
    guidelines and we feel that by having a guideline, by codifying
    one, is extremely important to direct some of the research and
    development that will help to offer healthier products for kids
    in the schools.
        Chairman Harkin. Maybe you can enlighten me. I just asked
    my staff this. As I understand it, is it 35-10-35?
        Mr. Izzo. Yes.
        Chairman Harkin. So it is 35 percent, or no more than 35
    percent of the calories can be from fat----
        Mr. Izzo. Correct.
        Chairman Harkin [continuing]. No more than 10 percent of
    the calories can be from saturated fat----
        Mr. Izzo. Correct.
        Chairman Harkin. and no more than 35 percent by weight?
        Mr. Izzo. No, no more than 35 grams of sugar by weight.
        Chairman Harkin. No more than 35 grams of sugar by weight.
    So if you have a 50-gram bar, you can have 35 grams of sugar? I
    don't understand that. No. Is that right? It is 35 grams of
    sugar by weight, but what if you have a 50- gram bar or 60-gram
    bar? That means half of it can be sugar?
        Mr. Izzo. No, actually, it is 35 percent sugar by weight.
        Chairman Harkin. OK, that is what I thought. Thirty-five
    percent sugar by weight.
        Mr. Izzo. Right.
        Chairman Harkin. So that if I have a bar, one-third of it
    can be sugar? More than one-third can be sugar.
        Mr. Izzo. Less than 35 percent sugar by weight.
        Chairman Harkin. Well, but 35 percent is one-third. So one-
    third of that bar can be sugar. I have a problem with that.
    When I heard that, I thought, well, that means that if I buy
    something, one-third of that can be sugar.
        As Ms. Neely has heard me say many times, and, of course,
    again, we have worked very closely on this and the standards we
    worked on were very good, but a 20-ounce soft drink has the
    equivalent of 15 teaspoons of sugar.
        Ms. Neely. Yes.
        Chairman Harkin. Well, I just have a problem, and help me
    think this through, that if one-third of something that a child
    can purchase at school, get in an a la carte line or a vending
    machine, is sugar, is that really a good measure? I mean, is
    that a good nutritional standard? I have trouble with that. I
    can understand the 35 percent of fat. I can understand the 10
    percent of saturated fat. But I can't understand why we would
    allow one-third of something that a child would buy to be
    sugar.
        I think we need to work on this. I think we need to work on
    this. I thought I understood it, and now that I do, I just--it
    seems to be very high, especially when we see the milk
    companies out there have done a lot--well, beverage companies,
    too, have done a job of reducing the sugar contents of their
    beverages. The milk industry has done a job. The beverage, soft
    drinks have done that, too, reducing their sugar down to, well,
    zero in many cases, down to very little in milk cases.
        And I just think that we need to look at that and I would
    ask your industry--and you have been a great leader. I mean, I
    said this to you privately, that what Mars has done has, I
    think, been kind of a gold standard in advertising to kids and
    everything. I don't mean to be a scold on candy. I like candy
    as much as anybody else, but, I mean, in moderation, obviously.
        So I just think we are going to have to look at the 35
    percent standard. Would this be lower than what it would be in
    a normal candy bar?
        Mr. Izzo. Absolutely, yes.
        On the guidelines, for example, the only products for us
    that would be allowed in school would be our Generation Max
    line, and that is one of the challenges that we have. Without
    guidelines, one of the issues that comes up is we can take the
    position that we will remove and not have those products in
    schools. Since we don't control the distribution angles or the
    distribution systems of the different distributors, they can
    make their way into schools, OK, a very unique environment. In
    addition, if it is left up to the local schools, they may very
    well say, we want to have those type of products in this unique
    environment, as well. So again, the need for codifying a
    guideline is extremely important from a national standpoint.
        Chairman Harkin. I would like to delve a little bit more
    into that one standard, the 35 percent standard, to see if that
    really is a good standard. As I said, I am making no judgment
    on it right now. I am just questioning about it.
        The other thing I just want to ask about the milk
    products--I hope you don't mind if I am a little partial to an
    Iowa company.
        [Laughter.]
        Chairman Harkin. I have been drinking AE milk since I was a
    kid and that is a long time ago.
        Ms. Brown. Thank you, Senator Harkin, Chairman.
        Chairman Harkin. We started drinking AE milk when we got
    rid of our cows.
        [Laughter.]
        Chairman Harkin. Before that, we drank our own milk from
    milk cows. But AE has been a part of our whole institution in
    Iowa for a long, long time. And so I am very supportive of how
    you have reformulated your products there and what we can do.
        You raised the issue, though, that I want to delve into, of
    using non-nutritive sweeteners, like Splenda, in milk. Is this
    widespread? Is it growing? Are there further opportunities to
    use it to reduce calories in other things that kids might eat?
        Ms. Brown. I think our main issue, Chairman Harkin, is that
    we would like to be able to provide kids with options for milk
    products in the school environment and flavored milks are a
    part of that. Children often will choose flavored milks over
    white milk----
        Chairman Harkin. Sure.
        Ms. Brown. [continuing]. And some flavored milks, if the
    restrictions are too low on calories or grams of sugar, then
    flavored milks just don't taste good and then you either have
    to use a non-nutritive sweetener or you have to have a higher
    standard for, or a higher-level standard for grams of sugar.
        So I think our issue is, let us provide the nutrient
    richness of flavored milks in the school environment, get the
    kids to drink more milk. Kids that drink flavored milk have
    lower BMIs or body mass indexes and they get the calcium that
    they need.
        Chairman Harkin. You stressed a lot on the non-fat and low-
    fat milk.
        Ms. Brown. Yes.
        Chairman Harkin. Are we moving more to that in our schools?
        Ms. Brown. Yes. Sixty-seven percent of processors already
    provide non-fat and low-fat milk or alternatives in the school
    system and many of them have reformulated their products to
    meet those standards. But that also is happening in all
    different parts of our industry--in yogurts, in milks, in
    cheeses, so that there are a variety of options for many
    students.
        Chairman Harkin. It is a matter of taste and acquired
    taste. I mean, look, I grew up drinking whole milk.
        Ms. Brown. Yes.
        Chairman Harkin. Whole milk, a lot of cream in it. When I
    got to be an adult, at some point, I switched and started
    drinking non-fat milk and I thought it tasted terrible. I have
    been drinking it so long, now I think whole milk doesn't taste
    very good because I have been drinking non-fat milk for so
    long.
        Ms. Brown. Yes.
        Chairman Harkin. I think as kids acquire these tastes, it
    is hard to switch. So that is why, if kids start out early in
    life drinking non-fat milk or low-fat milk, then they get used
    to it and they like it.
        Ms. Brown. We have no problem with that. The dairy industry
    is fully supportive of low-fat and non-fat milk in the schools.
    Our issue is variety.
        Chairman Harkin. Yes.
        Ms. Brown. And I also have to add that the most popular
    grocery store milk is still 2 percent.
        Chairman Harkin. Yes. It tastes like whole milk to me.
        [Laughter.]
        Chairman Harkin. Well, thank you very much. I don't mean to
    belabor the point any longer.
        Senator Chambliss?
        Senator Chambliss. Thank you, Mr. Chairman.
        First of all, let me ask unanimous consent that two
    letters, one from ConAgra Foods and another one from Swann
    Company, along with written statements from the Potato Industry
    Child Nutrition Working Group and the National Frozen Food
    Institute be submitted for the record.
        [The information from Hon. Saxby Chambliss can be found on
    page 112 through 123 in the appendix.]
        Chairman Harkin. Without objection.
        Senator Chambliss. First of all, Mr. Izzo, the best thing
    about your company, in addition to being a great citizen of my
    State, is you have got the best looking NASCAR car out there.
        [Laughter.]
        Senator Chambliss. And we appreciate you recognizing that
    the most nutritious part of M&Ms are the Georgia peanuts that
    you put in them.
        Mr. Izzo. Yes, sir.
        Chairman Chambliss. Ms. Neely, in your written testimony,
    you referenced that the investment made by your member
    companies in terms of changing the product mix in the schools.
    Can you elaborate and characterize those investments for the
    committee and also share with us your views on what it would
    mean for your members if a new standard were to be imposed by
    Congress or USDA?
        Ms. Neely. Yes, sir. Thank you. Well, it has been a lot of
    work to implement the standard. We have had to reformulate
    products, create new package sizes to meet the portion
    limitations that are a key part of the guidelines, train
    thousands of marketing and sales staff so that, as happens when
    people sit in Washington and actually sign a piece of paper to
    agree to something, it has to get done across the country.
    People had to know how to do that.
        And renegotiate contracts. We are at almost 80 percent
    compliance now in schools under contract across the country,
    and that doesn't just happen. People have to know what the
    guidelines are and be able to talk to our school partners about
    it so we can get to the level of implementation that we have
    achieved. So it has been a major effort on the part of the
    industry and cost millions of dollars. But we are getting the
    results that we desired and that is a good thing.
        A lot of extra leadership from some of our companies. One
    company--I love this story--to ensure that a marketer, a member
    of the marketing team didn't sell a product that wasn't in
    compliance, they locked the buttons on the hand- held device
    that the salesman or saleswoman uses when they are talking to a
    school to ensure that only the products that are in compliance
    with the guidelines, they were able to sell those. So a lot of
    work that was done.
        We think it is a common sense standard. It is one supported
    by parents. It was developed with nutrition scientists and we
    think that is the standard that should be implemented across
    the land.
        Senator Chambliss. And how do you perceive the voluntary
    standard to be working at this point?
        Ms. Neely. Well, we think it is working well. We--as I
    said, almost 80 percent of schools under contract are in
    compliance, and that means a lot fewer calories are being
    shipped to schools in beverages shipped to schools. So the
    beverage landscape is changing and we are getting the results
    that were the intent.
        Senator Chambliss. Ms. Erickson Brown, one of my
    weaknesses, probably my biggest weakness nutrition-wise is I
    love butter pecan ice cream. I wish I could ask you about the
    nutritional value of that, but I don't think I will get into
    that. My doctor reminds me of that. It means an extra 30
    minutes in the gym for me, but I still enjoy it.
        Some nutrition groups have been calling for rules that
    would only allow the sale of non-fat milk in school and
    therefore prohibiting the sale of 1 percent and 2 percent milk.
    Are you concerned that this could impact the overall
    consumption of milk by school-age children?
        Ms. Brown. Yes, I am. Milk provides nine essential
    nutrients, unlike any other food, and three of those nutrients
    are currently lacking in children's diets--calcium, magnesium,
    and potassium. We need to provide students and children with
    options: flavored milks in a variety of butterfats, fat-free,
    and 1 percent. We do support having fat-free and 1 percent
    milks in the schools and limiting that, but we would like to
    have the option of having 1 percent milks.
        Senator Chambliss. I really share that concern with you.
    Unlike the Chairman, all I drink is 2 percent and it makes a
    huge difference. If you are used to drinking 2 percent or you
    are used to drinking something other than non-fat milk, boy, it
    is tough to get used to totally non- fat milk.
        Ms. Brown. That is right. It is.
        Senator Chambliss. Particularly for my grandchildren, who
    drink whole milk, by the way.
        Mr. Izzo, as a global company, can you please share any
    observations you have regarding school nutrition policies in
    other countries around the world that we should be aware of.
        Mr. Izzo. Yes. Thank you, Senator. If you look around the
    world, one of the challenges that I think is a global challenge
    is setting the right standards and getting the right specific
    guidelines outlined for any country. That is why for us, the
    way we look at this is, again, a school is a very unique
    environment, and by codifying guidelines that would set a
    standard that a food industry could work against and work with
    schools, work directly with schools and partner with
    organizations like the Alliance for a Healthier Generation, I
    think we will get ourselves ahead of the game. Each day that we
    wait is another day that we will have another issue in the
    marketplace in regards to childhood obesity, in regards to lack
    of education on health and wellness.
        So I think, globally, the obesity rates, a lot of people
    think that this is a U.S. issue. It is not a U.S. issue. It is
    a global issue. And even in countries where the obesity rates
    are low, they are starting to rise, especially for the area of
    children. So it is something that is a global issue and I think
    for us as a country that takes the lead in the world, we feel
    that we should take the lead on this issue and, again, codify
    school nutrition standards.
        Senator Chambliss. Thank you, Mr. Chairman.
        Chairman Harkin. Thank you, Senator Chambliss.
        I always like to take these opportunities to just talk a
    little bit, again, about the standards and people's perceptions
    of things. Now, I know the Chairman knows this, but I can't
    tell you how many times I have talked with people about milk. I
    happen to be a big milk drinker, but non-fat milk.
        The one other issue that has arisen over the past few years
    in terms of our health in this country, and now we are seeing
    it show up in children, and that is consequences of too much
    sodium intake. Everything is just salted. And I have got to
    admit, I didn't know much about this, either, until later on. I
    have started now checking sodium contents of foods in stores
    and, I mean, it is just almost shocking, how much sodium goes
    into our foods, and then a lot into kids' foods. We are looking
    at this, also in terms of our guidelines and how we look at
    that, because kids are now showing up with hypertension caused
    by too much sodium. We have just become a sodium-saturated
    society. It is hard to find anything without just a whole lot
    of salt in it.
        So I am just wondering if you have any thoughts on that. I
    don't know, you said, I think, Mars is doing a lot. You are
    doing some stuff and Mars is doing some stuff, I am told, about
    reducing the amount of sodium.
        Mr. Izzo. Yes.
        Chairman Harkin. Different companies are.
        Mr. Izzo. Across our flavored rice products, the past
    several years, we have reduced sodium levels by 30 percent.
    Now, one of the biggest challenges on sodium, to your very
    point, is in many cases, sodium is augmented by how much salt
    you then throw on top of your foods that you eat. So obviously
    we can't control that piece but through education.
        One thing that we have done that we believe will help is we
    went to a global commitment to do voluntary front-of- pack
    labeling and back-of-pack labeling for key nutrients. So what
    does that mean? In the United States, we are required to have
    certain nutrients on the pack by the NLEA. What we did was we
    took those same nutrients, though, and brought them into a much
    bigger, bolder statement, larger fonts on the back of pack and
    calorie count on the front of pack. So whenever you pick up one
    of our products, you will be able to see that. Of the nutrients
    stated on the back of pack, again, it is fat, saturated fat,
    sugar, and salt.
        Chairman Harkin. Yes.
        Mr. Izzo. So the most important thing for people to know,
    we believe and we feel is to know what is inside the foods that
    they are eating. I think you so eloquently put it that you were
    very surprised when you looked at some of these products to see
    how much salt was actually in these products. The ability to
    know what is inside, we feel is extremely important for you to
    manage your dietary impact throughout the day. So that is a
    measure that we have taken on pack to take care of that. I know
    there are other companies out there, global food companies,
    that are going in that direction.
        We would invite other companies to join us in this, because
    as we create more of a standardized label that people can see
    and is very transparent and easy to understand, will help
    people, and children as they grow up and they learn about the
    right way to eat and how to eat foods and how to count not only
    calories, but count specific nutrients. It will teach them to
    lead a balanced, healthy lifestyle.
        Chairman Harkin. Any other observations? Yes, Ms. Ehrens?
        Ms. Ehrens. Yes, Senator Harkin. I believe that sodium is--
    most of it that we eat as Americans comes from processed foods
    so that we do have little control over it unless we pay close
    attention. So we appreciate efforts by the industry to lower
    the sodium content and we think that the industry needs to
    really keep striving toward lowering the sodium content of
    foods.
        Also, just a point on your milk. I believe that 2 percent
    and 1 percent are percent by weight of the milk. But if you cut
    out--if you drink three glasses of milk per day, you can save
    up to 150 calories by making a switch from 2 percent to non-fat
    milk, and that is enough to at least not gain weight or cause
    some weight loss to take place.
        Chairman Harkin. I understand. I think most people, when
    they think of 2 percent milk, they are thinking of the fat
    content. That is what they are thinking about.
        But the sodium thing, I think in the reauthorization of the
    child nutrition bill, I have asked my staff to start looking at
    this and thinking about some kind of better guidelines for
    sodium content in all the foods that they have to buy for the
    kids in school. If they come to school and they get a school
    breakfast that has a lot of sodium in it--I am surprised how
    many cereals have high sodium contents. I am amazed at this.
    Then they have high sodium there and then they have a lunch
    that is high in sodium and then maybe they go home and have
    more. I mean, these kids, they are just getting too much sodium
    and it is showing up now in our health statistics among
    hypertension in kids and high blood pressure in young kids.
        So I think we are going to have to pay some attention to
    that, also.
        Is there anything else that anybody wants to add to this
    before we adjourn? I just appreciate all of your testimonies,
    your leadership, all of you, in so many areas of this. We look
    forward to working with you through the year. We are going to
    get this bill done, working with the House side. I know the
    administration is interested in having a good reauthorization
    bill done, looking ahead, and I think we do see it--well, I
    speak only for myself. I see this really as a part of our
    overall health reform. This fits right in with that, and if we
    get our kids started early in eating well and getting the right
    nutritious foods, they are just going to have healthier lives
    later on, part of prevention and wellness.
        So I congratulate all the industry people who are here. We
    worked very closely on this. We didn't quite get it done in the
    farm bill, but we will get it----
        Ms. Neely. We are ready to go again.
        [Laughter.]
        Chairman Harkin. We will get it done this time. So thank
    you all very, very much.
        With that, the committee will stand adjourned.
        [Whereupon, at 12:06 p.m., the committee was adjourned.]