Spending bill allows schools that show 'hardship' to vary from requirement to serve 100 percent whole grains

By Melissa Patrick
Kentucky Health News

The massive 2015 spending bill signed by President Obama Dec. 16 includes a provision to help schools struggling with the whole-grain and sodium requirements that are part of the Healthy, Hungry-Free Kids Act. It did not allow, as House Republicans had hoped, schools to opt out of the healthier school meal standards if they lost money on meal programs over a six-month period.

Beginning with the 2014 school year, schools had to serve 100 percent whole grains in their meals and snacks, and also follow the first restrictions on sodium, or salt. The sodium restrictions were scheduled to get progressively stricter over the years, with the next move set for 2017.

The law allows schools that demonstrate the rule is a "hardship" to continue serving 50 percent whole grains. It also says sodium standards cannot be tightened until the "latest scientific research establishes the reduction is beneficial for children," Mary Clare Jalonick reports for The Associated Press.

Some schools say they have had trouble complying with these requirements because many of the affordable whole grain pastas have proven difficult to cook en masse and the whole-grain versions of many foods, like biscuits and tortillas, simply don't taste the same.

On salt, schools say budgeting the allowed amounts among meals, snacks and a la carte items is often a challenge. The issue hit Anderson County schools earlier this year when they couldn't find a low-sodium ketchup; their solution was to not offer ketchup. Parent and student complaints prompted a reversal of that move, but to do that, sodium had to be removed elsewhere in the menu.

The new law won't have much effect on Fayette County Schools, Director of School Nutrition Michelle Coker said in a telephone interview. "Basically, we use 100 percent whole grains in everything," she said. "But there are products, like tortilla shells, that aren't as flavorful and this gives us some flexibility."

Fayette County has transitioned slowly to whole grains over the last five to six years to help students adjust to them, Coker said, and as whole-grain products have become "tastier" the transition has not been an issue.

"Whole grain pasta products have come a long way," Coker said. "Three to four years ago they were dark, but now it is difficult to tell the difference. Kentucky has really good vendors."

Coker, a registered dietitian, welcomed the possible delay in lower salt limits, saying most students are active and involved in sports and shouldn't need such low sodium restrictions. "These kids are growing and need electrolytes," she said.

The School Nutrition Association, a group that represents both school nutrition directors and the food companies that produce foods for schools, wanted even deeper rollbacks than the spending bill included, but said it "strongly supports" the budget-bill language.

Alabama Rep. Robert Aderholt, chairman of the House subcommittee that oversees nutrition issues, said the whole-grains waiver is "the best bill that we are going to get" as long as Democrats are in control the Senate, Jalonick reports.

Republicans will control both houses of Congress next year, so the battle is far from over, and the overall law governing child nutrition policy, including school lunches, expires next year and will require legislation to be renewed, Jalonick notes.

First Lady Michelle Obama, champion for improving school's nutrition and decreasing child obesity, said this summer that she would fight "to the bitter end" to make sure kids have good nutrition in schools.

#ThanksMichelleObama: Students use social media to voice their unhappiness with revamped school lunches

School kids around the country are tweeting pictures of their unappetizing school lunches and blaming the most prominent advocate for healthier school meals for their "bowls of mush and mystery proteins," Roberto A. Ferdman reports for The Washington Post.

The tweets use the hashtag #ThanksMichelleObama, which dates back to 2012. They were "being sent out at a rate of 40 per minute last week, but started to gain momentum some 10 days back," Ferdman writes.

The tweets and pictures vary, with some presenting a "mealy substance" or mystery food that is supposed to pass for the entree while others poke fun at how pitiful the presentation is.

"We've seen the photos being tweeted," said Sam Kass, executive director of Let's Move!, the organization Obama founded to fight childhood obesity. "But we don't dictate the food that schools serve—school districts do." He added, "We’ve seen thousands of examples of healthy, delicious school lunches that meet the new standards being made across the country by talented school chefs."

Obama has been a key player in the implementation of the new health standards in schools, which mandate an increase in fruits, vegetables and whole grains and place restrictions on calories,sodium, sugar and fat served in a school day. These restrictions were also added to snacks and beverages this year.

Several studies have reported great success with these new requirements. In Virginia, a recent study found that school lunches were "significantly healthier" than home packed lunches and a study in Massachusetts concluded the same thing.

But others say that this healthy food is not being eaten, but instead thrown away. A Harvard School of Public Health study in Massachusetts supports this conclusion, finding that "some 60 percent of vegetables and 40 percent of fresh fruit are thrown away (for good measure, even more vegetables—some 75 percent—were thrown out before the USDA school meal standards went into effect)," Ferdman reports.

Complaining about cafeteria food in certainly not a new phenomena, what is new is that "everyone has a camera on their phone and a public platform to share pictures," Ferdman writes.

Millions of children on Medicaid are missing free check-ups; Kentucky is a little below the national average

Millions of low-income children across the country aren't getting free preventive exams and screenings guaranteed by Medicaid, and some experts say federal and state health officials aren't doing enough to fix the problem, according to a federal watchdog report.

The report from the Department of Health and Human Services’ Office of Inspector General says that while the Obama administration has boosted rates of participation for children getting regular wellness exams, dental checkups and vision and hearing tests, it needs to do more.

The report says that 63 percent of children on Medicaid received at least one medical screening in 2013, up from 56 percent in 2006, but most states are still falling short of the department’s 80 percent goal. Only Iowa and California met that participation rate goal last year.

In Kentucky, 57 percent of the 381,231 children covered by Medicaid who should have received at least one annual screening exam did so. Most states require at least one annual exam, and more frequent exams for infants. The reports shows that Kentucky's rate is better than 20 other states and equal to the rates in North Carolina, Rhode Island and Florida.

Some experts say state officials bear most of the responsibility for the low rates because they run Medicaid, the state-federal program for the poor, reports Phil Galewitz of Kaiser Health News. The OIG reports says the federal administration should be doing more to encourage states to address the problem.

"Child health advocates cite several factors for the low completion rates, including a shortage of doctors treating Medicaid patients, states’ low pay for providers and parents’ lack of awareness about the importance of the visits," writes Galewitz.

Congress introduced the Medicaid benefit, known as the Early and Periodic Screening, Diagnosis and Treatment program in 1967. In Kentucky, the EPSDT benefit includes screenings and special services, according to the Cabinet for Health and Human Services. Preventive care, such as routine physicals or well-child check ups, is provided under the screenings program.

Last year, 514,298 children were eligible for Kentucky’s EPSDT, says the the cabinet's annual participation report. Based on that number and eligibility periods, about 507,000 screenings were expected, but only 391,079 were, for a ratio of 83%. Additionally, the report says 236,830 children received dental services of any kind, with 208,783 receiving preventive services.

Some states require Medicaid health plans to educate members about the EPSDT benefit and what it covers. Others have implemented incentive plans that offer gift certificates for screenings. According to the National Academy for State Health Policy, Kentucky requires Medicaid managed-care organizations to provide an EPSDT coordinator to coordinate case-management services and continuity of care. Click here for more information about EPSDT screenings in Kentucky.

Early-childhood specialists want to help parents teach kids good oral-health habits; 40 percent have cavities by kindergarten

A recent report by the American Academy of Pediatric Dentistry showed that cavities are the most chronic disease for young children in the U.S. More than 40 percent of children suffer from tooth decay before kindergarten, Greg Stotelmyer reports for Public News Service. Groups of early-childhood professionals gathered in Louisville Thursday to learn how to educate parents to help improve their children's oral health.

Dr. Laura Hancock Jones, an outreach dentist with the University of Kentucky, emphasized the importance of teaching children how to brush their teeth and avoid too many sugary drinks before they turn 2. "We really need to foster the oral-health knowledge of those parents and not really delay that until [their children] are into preschool or elementary population," she said.

Molly Oliver, who runs a day-care center for the Trigg County school system, is one of those learning how to teach parents how to foster good health habits in their children. "We want to help build a relationship with our parents to try to help the parents and the children have better oral health for their families," she said.

Jones noted that food and beverage companies' marketing is making it harder for parents to steer their children away from unhealthy products. Parents need to make sure their children are brushing their teeth both morning and night. "And, for parents to understand that until their child is in second grade, they don't have the dexterity to get the job done themselves," she said. "You know, it's not enough for a parent to say, 'Hey, go brush your teeth,' when you're dealing with a 3-year-old. They still need to be in there doing the work themselves."

The Kentucky Oral Health Coalition is partnering with the UCLA Health Care Institute and the Governor's Office of Early Childhood to offer $1,000 grants to train early childhood professionals in 10 communities, Stotelmyer reports. The trainers will strive to provide children with the support of adults—both parents and child care professionals—who can help them understand how to maintain good oral health. (Read more)

Raw milk suspected as cause of bacterial infections among four children in Hardin County and one in Oldham County

Five children in the Louisville region were recently hospitalized with E. coli bacterial infections, and all had consumed unpasteurized milk, state health agencies found. Investigators have not yet proven that raw milk caused the infections, but "found raw milk was the only common factor among the sick children," Forrest Berkshire reports for The Kentucky Standard in Bardstown and The News-Enterprise of Elizabethtown.

Four of the children are from Hardin County, and one is from Oldham. All went to a hospital to be treated for complications of E. coli, which attacked their red blood cells and affected their kidneys. The Lincoln Trail District Health Department said tests of milk from the suspected dairy and distributors were negative for E. coli, a bacterium common to the intestinal tracts of mammals.

"Pasteurization is the process of heating a liquid such as milk to a high enough temperature to destroy disease-causing microorganisms," Berkshire explains. "It also increases the shelf life of milk by destroying spoilage microorganisms and enzymes."

The state Department for Public Health said, "DPH is stressing the dangers of unpasteurized milk after learning all the affected children had consumed it and because it is a known source of E. coli bacteria, as well as numerous other pathogens that can lead to illness."

Selling raw milk is illegal in Kentucky, but is available through a "herd share," which allows members to buy an interest in a cow that allows them to take the milk home. "Northern Kentucky U.S. Rep. Thomas Massie, a Republican, introduced two bills earlier this year he characterized as 'milk freedom legislation' and would strip the U.S. Food and Drug Administration of its authority to police raw milk sales," Berkshire writes. Supporters of raw milk say it helps people resist disease and promotes better growth, stronger teeth and better behavior.

However, the federal Centers for Disease Control and Prevention conducted a study over a decade that found "the risk of outbreaks caused by raw milk is at least 150 times greater than the risk of outbreaks caused by pasteurized milk," Berkshire reports.

Kentucky law requires milk must be pasteurized, and officials encourage buyers to check labels to make sure it is, and throw it out if pasteurization cannot be confirmed. "Even negative tests do not guarantee that raw milk is safe to drink," the CDC says on its "Raw Milk Questions and Answers" webpage. "People have become very sick from drinking raw milk that came from farms that regularly tested their milk for bacteria and whose owners were sure that their milk was safe." (Read more)

Lots of research has established that children with egg allergies can still get a flu shot; those with asthma especially should

Flu season can start as early as October, and  children with egg allergies are now encouraged to get a flu shot, especially if they have asthma, according to a news release from the American College of Allergy, Asthma and Immunology.

Children with egg allergies may have been told in the past to not get a flu shot because of a possible reaction to trace amounts of eggs in which the vaccine is produced, but recent research now says that the vaccine is safe for these kids.

“We now know administration is safe, and children with egg allergies should be vaccinated,” Michael Foggs, president of the American College of Allergy, Asthma and Immunology, said in the news release. “We recommend that, as with any vaccine, all personnel and facilities administering flu shots have procedures in place for the rare instance of anaphylaxis, a life-threatening allergic reaction.”

The release says "a large number of research studies published over the last several years have shown that thousands of egg-allergic children, including those with a severe life-threatening reaction to eating eggs, have received injectable influenza vaccine as a single dose without a reaction."

More than 21,100 children under the age of five are hospitalized annually because of the flu, with only 55 percent of children ages 5-17 getting a flu shot, according to the Centers for Disease Control and Prevention, says the release.

Foggs especially recommended that children with asthma get the vaccine, because even though they are not more likely to get the flu, it can be more serious for those with asthma, says the release.

"Children with asthma really need to get the flu vaccine," Foggs said in the release. “Asthma sufferers are among the most vulnerable because the flu compromises their airways even further than they already are.”

Chickenpox outbreak reported at Crab Orchard

Five students at Crab Orchard Elementary School in Lincoln County have been diagnosed with chickenpox, putting the county school system on alert, Ben Kleppinger reports for The Interior Journal in Stanford. Eva Stone, the schools' health coordinator, told the newspaper that the students had been diagnosed with by at least four health-care providers, and an unknown number of siblings under school age have also been diagnosed.

"A letter was sent home to Crab Orchard parents earlier this week, notifying them of the diagnoses and informing them on how to identify the symptoms," Kleppinger reports. "The letter encouraged parents to make sure their children are vaccinated against chickenpox and warned that people with chickenpox should avoid contact with others who have not had the illness or the vaccination. The chickenpox vaccination is about 80-85 percent effective after one dose, so a second vaccination is routinely recommended, according to the letter."

Kids Count report says hard times in early childhood are more likely in Ky. than rest of U.S.; bad times have long-term effects

By Melissa Patrick
Kentucky Health News

One of every five children in Kentucky, by the time they are 5 years old, has experienced two or more adverse childhood experiences such as child abuse, economic hardship, exposure to violence, living in a household with mental illness or substance abuse, or where a family member has been incarcerated.

That is one of the major points of the 24th annual Kids Count report, released Tuesday by Kentucky Youth Advocates. The report is part of a state-by-state effort with county-by-county data; nationally, only one in eight children by age 5 have had two adverse experiences, defined as events or circumstances that can affect the quality of the child's adult life, including their health and length of life.

"The higher the total number of these events a child experiences, the higher the risk of obesity, chronic illness, substance abuse, smoking and mental health problems," the report says. Another study cited in the report found that "Children who had experienced four or more adverse events had lower incomes, lower education attainment and lost more days of work or school as adults due to problems with physical or mental health."

“We know when children experience traumatic events such as abuse and neglect or having an incarcerated parent, it negatively impacts their health and often causes barriers to success later in life. Kentucky leaders need to enact solutions to prevent these experiences in the first place and when they do happen, help children successfully recover,” Dr. Terry Brooks, executive director of Kentucky Youth Advocates, said in a press release.

This report by Kentucky Youth Advocates measures 16 indicators to determine the overall well-being of children in Kentucky counties and focuses on four areas considered critical to well-being: economic security, education, health, and family and community strength.

The Kentucky counties with the highest overall child well-being rankings are Oldham, Boone, Spencer, Woodford, and Calloway; the lowest are Martin, Owsley, Wolfe, Clay and Elliott.

Overall Child Well-Being, based on four factors:
economic security, education, health, and family and community.

The 2011-12 survey said that Kentucky children are more likely to experience two or more adverse events  (30 percent) than children are nationally (22.6 percent). The four most common adverse events among Kentucky's children, says the report, are economic hardship, living with a parent or guardian who got divorced or separated, living with anyone who had a problem with alcohol or drugs, and living with a parent or guardian who was incarcerated.

This study evaluated four indicators of health: smoking during pregnancy, low-birthweight babies, children and young adults without health insurance and teen births.  Oldham and Boone counties scored higher than the other counties on health and Elliott County ranked last.

Overall Health: County Comparisons.  Based on county
scores for the four indicators in the report.  

The study found Kentucky has the highest rate of mothers who smoke during pregnancy, one in five, compared to states with comparable data, reporting that the county rates varied widely in this area with less than 14 percent of expectant mothers in Fayette, Jefferson, and Oldham counties smoked, compared to 40 percent or more of mothers in Clay, Elliot, Lee, and Owsley counties.

The percentage of low-birthweight babies in Kentucky, often a result of smoking during pregnancy, between 1994-2012 (8.7 percent) was found to be consistently higher than the U.S. percentage (8.0 percent).

“All parents want what is best for their children, and we know that smoke is bad for kids,” Bethany Hodge, a pediatrician in Louisville, said in the release. “Kentucky needs an indoor smoke-free law so working mothers-to-be do not have to choose between their jobs and protecting their unborn babies.”

One in eight under 26 lacked health insurance in this study, but this number is expected to decline.

“Kentucky has effectively connected young people to health insurance, especially with the outreach efforts of KCHIP over the past few years and kynect over the past year,” Brooks said in the press release. “It’s important to build on those successes with innovative ways to connect all young people to coverage. One solution is to automatically enroll youth aging out of foster care in Medicaid to make sure they maintain health insurance as they leave the state’s care.”

As for teen births, in 2012, Kentucky's rate of births to teen mothers (42 per 1,000) "substantially" exceed the national rate (29 per 1000).

Many of Kentucky's children face adverse childhood experiences related to economic security.

According to the report, Kentucky has now had four consecutive years in which more than one in every four children lives in poverty, which is consistently higher than the national average. It also reports that more than two in every five Kentucky children live in a high-poverty area.

The report says, " A family's earnings and its poverty status, the level of poverty in its neighborhood and the affordability of housing can all affect how a child grows, learns and ultimately succeeds as an adult."

Boone, Oldham and Spencer counties have the highest scores for economic security, while Lee, Martin and Wolfe have the lowest.

Economic security, based on scores for the four indicators in the report.

The results of the well-being of Kentucky's children around education are concerning.

More than half (51 percent) of Kentucky's children entering kindergarten are not adequately prepared for school and more than half  (51 percent) of its fourth graders are not proficient in reading and "therefore not on the path to high school graduation," according to the report. The study also found that over half (55 percent) of Kentucky eighth graders are not proficient in math and that one in seven Kentucky high school students did not graduate on time.

Oldham and Lyon counties "stand apart" at the top of the  education county comparison, with Clinton, Knox, Menifee and Clay counties ranking last.

Education, based on scores for the four indicators in the report. 

Family and community indicators in the report found that Kentucky is not putting as many youth in jail as in previous years; nearly one in five births were to moms without a high school degree; the number of children living in a single-parent home has grown to 37 percent from 35 percent; and over the course of 2013, over 12,700 children were placed in foster care due to abuse or neglect.

Oldham, Boone, Carlisle, Ballard and Spencer counties rank at the top of the family and community county comparisons, with Powell, Clay, Elliott, Owsley and Carroll counties ranked at the bottom.

Family and Community, based on scores for the four indicators in the report. 

The report recommends implementation of strong policies to combat children's exposure to adverse childhood experiences. "The best option for Kentucky is to find ways to prevent adverse childhood experiences. Ensuring safe, stable and nurturing environments will shield children from toxic stress and its deleterious effects," says the report.

Click here for the Annie E. Casey Foundation Kids Count Data Center, which includes current and historical data. Note that the indicators included in the 2014 rankings are different than those included in the 2013 County Data Book. Therefore, current rankings should not be compared to last year’s county rankings.

School nutrition beat keeps busy: Ketchup returns to Anderson County, more students eating at school in Allen County

School meal programs continue to make news, as schools, students and parents adjust to the latest round of federal guidelines to combat childhood obesity and make sure no child goes hungry.

The second and third Kentucky counties in the alphabetical list were two of the latest in the news.
In Allen County, expansion of a free-meals program means that almost all children are getting breakfast at school.

Following parental complaints in Anderson County, the schools are again offering ketchup, which had been removed because of its high salt content, Shelley Spillman reports for The Anderson News.

The problem, Food Service Director Ronnie Fields told Spillman, was the unavailability of low-sodium ketchup. All the cafeteria offerings had been configured with it, but there wasn't any available. Regular ketchup pushed the allowable sodium limits too high, so it was removed.

Signs were posted to explain, but this didn't set too well with the parents, who "flooded the Anderson County Schools' office and The Anderson News with questions," Spillman writes.

“They’re micromanaging our children,” Paul Coffey, who has grandchildren in the schools, told Spillman. “A parent knows what’s good for their child and ketchup is not going to hurt them.”

Low-sodium ketchup packets are 10 calories and contain 25 mg of sodium. Regular ketchup packets are 11 calories and 85 mg of sodium, Spillman reports.A teaspoon of salt has 2,300 mg. of sodium, according to the American Heart Association. It adds up quickly, with all the added salt in processed foods, so lunches and breakfasts for middle-school students are supposed to have less than 1,360 mg and 600 mg, respectively. Limits for elementary- and high-school students are slightly lower and higher, respectively.

“A lot people don’t realize how it’s this complicated to feed kids,” Fields told Spillman. There were rumors that the schools wouldn't let students bring their own lunches or condiments. “We’d never ban that,” Fields said. “Kids are always welcome to bring their own lunches and condiments.”

Meanwhile, Allen County reports "promising statistics" in after its elementary and middle schools joined the free-meal program offered by U.S. Department of Agriculture, Rachel Herrington reports for The Citizen-Times of Scottsville.

Of the 1,600 students enrolled in both centers, 95 percent are eating breakfast this year, compared to around 60 percent last year, Food Services Director Mary Hobdy told Herrington.

Hobdy said unclaimed breakfast food does not go to waste. Non-perishable foods are kept in elementary classrooms for students to eat during breaks, and are placed in the Family Resource Center for middle-school students who need extra food during the day. Leftover food is donated to the center's backpack program, which sends easy-to-prepare food home with needy kids on Fridays.

Students in Allen County are allowed to refuse meals if they have eaten breakfast or have brought their lunch.

Logan Co. schools work to keep kids and bus drivers hydrated during hot, humid days; here are tips for dealing with heat

With temperatures soaring into the high 90s and the heat index over 100, the new Logan County school superintendent made sure the students and bus drivers were well hydrated last week, O.J. Stapleton reports for the Russellville News Democrat & Leader.

Dr. Kevin Hub and other members of the central office staff delivered bottled water to all schools for students who would be riding buses in the extreme heat, Stapleton writes.

“I think it’s important to recognize that it’s hot and we do not have air conditioning on our school buses,” Hub told Stapleton. “That makes it hard on our drivers and students. This just falls under the category of ‘a good thing to do’ when it comes to taking care of our students and staff.” He said the gesture was appreciated by both the staff and students.

Signs and symptoms of heat exhaustion, according to the Centers for Disease Control and Prevention, are heavy sweating; weakness; cold pale clammy skin; fast, weak pulse; nausea or vomiting; and fainting. The CDC suggests that if someone has these symptoms they should be moved to a cooler location, lie down and loosen their clothing, apply wet, cool cloths to as much of the body as possible, be offered sips of water and seek medical attention immediately vomiting occurs and continues.

The CDC reports the signs and symptoms of heat stroke, a much more serious condition, as: body temperatures above 103 degree Fahrenheit; hot, red, dry or moist skin; rapid and strong pulse; and possible unconsciousness. These symptoms require immediate medical attention. Call 911 immediately, move the person to a cooler environment, reduce the person's body temperature with cool cloths or even a bath and do NOT give fluids.

Prevention is the best way to avoid these heat-related illnesses, Stapleton reports. He offers some suggestions below on how to protect yourself during these extreme temperatures.

Here are some suggestions to prevent heat stroke:

• Drink more fluids, regardless of your activity level.
• Avoid alcoholic beverages and high-sugar beverages as they can cause you to lose more body fluid.
• Don't wait until you are thirsty to drink.
• Seek the advice of your doctor if you have fluid restrictions or are on water pills.
• Avoid very cold drinks as they can cause stomach cramps.
• Stay indoors in an air-conditioned place if possible.
• Go to the mall or the library for some air-conditioned relief if you do not have home access.
• Seek a heat-relief shelter in your area. Contact your local health department for information.
• Fans do not prevent heat-related illness when the temperatures are in the high 90s.
• Take a cool shower or bath.
• Wear lightweight, light-colored, loose-fitting clothes.
• NEVER leave anyone in a closed, parked vehicle.

Every person is at risk of heat-related illnesses in these extreme temperatures, but some people are at greater risk and need to be checked on regularly, Stapleton writes. High risk adults should be checked on at least twice daily and monitored for signs of heat exhaustion or heat stroke. Infants and children need more frequent watching.

Those at high risk of heat-related illness are:

• Infants and young children
• People aged 65 or older
• People who are ill, especially with heart disease or high blood pressure.

Some advice for being outdoors in the heat:

• Limit your outdoor activities to the morning and evening hours.
• Minimize your outdoor exercise.
• Drink two to four glasses of cool, non-alcoholic fluids each hour if you exercise.
• Drink sports beverages to replace the salt and minerals you lose in sweat. Consult your doctor about the use of sports drinks if you are on a low-salt diet.
• Rest often in shady areas.
• Wear a wide-brimmed hat, sunglasses, and sunscreen.

W. Ky. elementaries use Baptist Health grants to join national program to fight childhood obesity; results encouraging

Two more West Kentucky schools have joined Project Fit America, a fitness program that targets childhood obesity, to help its students become more fit, reports The Paducah Sun.

East Calloway County and Calvert City elementary schools are the seventh and eighth schools in the area to win a $16,500 grant from Baptist Health Paducah for indoor and outdoor fitness equipment, teacher training and curriculum material, all included with the Project Fit America program.

"We believe as educators it is our responsibility to help our young population begin healthy lifestyles that will follow them into adulthood," Kathy Crouch, East Calloway principal, told the Sun.

Kentucky ranks eighth in child obesity, and U.S. adult obesity is expected to grow from 30 percent of the population now to 60 percent by 2030.

Benton Elementary, which joined the program only last year, has already documented improvement in students' fitness, showing a a 27 percent increase in cardiovascular endurance, 18 percent increase in upper body strength, 12 percent increase in abdominal strength and a 38 percent increase in students who could perform pull-ups.

Project Fit America is a national non-profit group that has worked with nearly 900 schools in 45 states to motivate students, parents and faculty to choose fitness over sedentary lifestyle habits. (Read More. This article is behind a pay wall.)

Fort Thomas joins other wealthy school districts in U.S. that have dropped federal school-lunch program

The wealthy Fort Thomas school district in Northern Kentucky is dropping out of the federal school-lunch program because "Kids didn't like their healthful lunches," Jessica Brown reports for The Cincinnati Enquirer.

"The 2,800-student district joins a small but growing number of school districts across the country – mostly wealthy districts who can afford to forfeit the money – who have dropped out of the federal program in the wake of stricter nutritional standards," Brown writes. "Schools said students don't like the unsalted potatoes, low-fat cheese or the mandatory fruits and vegetables. They throw food away or decide not to eat at all."

Forsaking federal funding will cost the district an estimated $260,000 a year, Brown reports. "Children who get free or reduced-price lunches – about 17 percent of the student body – will still get them at that price." (Read more)

UPDATE, Aug. 25: About 150 school districts nationwide have withdrawn from the federal program, Bloomberg BusinessWeek reports.

Leaders in health care and education meet on child obesity and what can be done about it, and not just in the schools

By Al Cross

Kentucky Health News

Children who are physically active are likely to be better learners, but not enough Kentucky schools seem to put that knowledge into practice, speakers suggested at last week's Kentucky Summit on Childhood Obesity and Physical Activity at the University of Kentucky.

Kentucky ranks eighth in child obesity, and nationally, adult obesity is expected to grow from 30 percent of the population now to 60 percent by 2030.

"Many of the adults who will be obese in 2030 are the children in Kentucky schools today," said Dr. Mary Lynne Capilouto, the wife of UK President Eli Caiplouto. The couple hosted an opening brunch for the conference, and at one small-group session.

The conference was an unusual gathering of people from education and health care, who don't discuss common interests enough, said Terry Brooks, executive director of Kentucky Youth Advocates, which staffed the conference. "Our intent is to put together a guiding coalition . . . and make something happen in 2015-16."

That would probably include legislation, but "We can't legislate ourselves out of this problem," educator Leon Mooneyhan told the group. "We need to change the mindset of our society," with multifaceted solutions. Mooneyhan, a former superintendent in Shelby County, is CEO of the Ohio Valley Educational Cooperative, which assists school districts.

He said each district needs a strong "wellness committee" to focus on health, nutrition and physical activity and promote such measures as integrating physical activity into the classroom and not using denial of recess as punishment for misbehavior. "We really need to focus at the elementary schools," he said. "That's where it starts."

The biggest obstacle may be the educational system itself.

An example of classroom-based physical activity,
from Dr. Heather Erwin's PowerPoint presentation

Some schools are reluctant to carve out time for physical activity because of pressure to spend time preparing students for annual achievement tests, but research shows that more physical-activity time "does not appear to to adversely impact academic performance," said Heather Erwin, Ph.D., a UK specialist in kinesiology, the study of human movement.

Erwin said some schools have started intensive math instruction lasting 90 minutes, and students could benefit from two of three physical-activity breaks in such a long classroom session. She said, "So many teachers will say after implementing physical activity, why haven't we been doing this all along?"

"If your butt is numb, your brain is, too," said Jamie Sparks, director of the School Health and Physical Education Network for the state Department of Education.

Sparks said it's unfortunate that some schools are using recess as extra study time before achievement tests. Stu Silberman, executive director of the Prichard Committee for Academic Excellence, said research has shown that students do better on achievement tests on days that they have physical activity.

"There is an achievement gap related to obesity," but many teachers don't see the connection, Silberman said. When students take part practical, in-class programs like those Erwin mentioned, "it becomes a habit for the rest of their lives. . . . Frankfort's not the answer on this.

Tom Shelton, who succeeded Silberman as superintendent in Fayette County, said asking teachers "to do one more thing is almost criminal," they are so busy, but nations such as India and China emphasize physical activity, and "It's amazing to me that we're going the other way. . . . We know for a fact that healthy students are better learners."

Shelton said "Poverty is the number-one barrier to student achievement," and part of that is "lack of good food options."

The face of poverty has changed to one of obesity, said David Jones Jr., a member of the Jefferson County school board and a Louisville venture capitalist. Poor people often eat poor food and don't get enough exercise. "The problem is, we don't know how to eat. We don't know how to deal with calorie-rich environments," Jones said.

Jones was among those who said the solution to child obesity lies in the community at large, not just in its schools.

"It has to be parents and schools and the community and legislators," said Susan Zepeda, president of the Foundation for a Healthy Kentucky, which funded the conference. "This challenge is about nutrition policies, physical-activity policies and building our environment with health in mind."

July is Minority Mental Health Month; experts discuss mental-health complications among African Americans

By Melissa Landon
Kentucky Health News

July is Minority Mental Health Month. KET's Renee Shaw interviewed Sycarah Fisher, associate professor in the College of Education at the University of Kentucky, and Shambra Mulder, an assistant professor in the School of Education at Kentucky State University, about challenges and differences professionals face in providing care for African Americans with mental health conditions. The show is available online and airing on KET's secondary channels.

"Getting the right diagnosis and treatment for mental health issues are difficult tasks, and can be even more challenging for ethnic and racial minority groups," Shaw said at the beginning of the interview on her weekly show, "Connections."

Fisher said mental illness is particularly stigmatized in African American communities and other ethnic or racial groups, perhaps because some "feel like getting help, especially from medical professionals, makes [them] weak, and [they're] expected to be strong and be able to take care of [themselves]."

Mulder agreed, adding that "The church and spirituality play a big role in the African American community," so those who seek medical help might be seen as lacking the faith to be healed. It may also have to do with the lack of minorities working in the field, she said. Research shows that African-Americans are more inclined to seek or stay in therapy if they have a minority therapist.

Fisher discussed ways more minorities might be recruited to the field. She called that "a very, very big task," noting that it can be uncomfortable to be the only African American in a program. Even the students who do make it into Ph.D. programs have more difficulty graduating, she said. Many programs are seeking grants to bring in minority psychologists.

Mulder added that if people haven't seen or heard of many black psychologists, they might think it's really difficult or might not think they couldn't do it. Shaw clarified that they weren't saying a doctor must be black to understand a black patient, it's just that mental health is a sensitive issue that people are sometimes uncomfortable discussing.

Fisher said it's important for people, especially African Americans, to talk about their disorders and treatments and how it is helping so that others will feel comfortable seeking medical attention that they need. Mulder said that even taking medication can be stigmatized.

Adding to the problem is that racial and ethnic minorities are more often misdiagnosed. Fisher "A lot of measures that are used to identify different types of behavior disorders aren't normed on African American samples," Fisher said. "We're taking and giving measures to African-American individuals, but yet when we're comparing them to different cultural groups."

Mulder agreed, adding that some people may not want to be forthcoming about their symptoms. If they will not accurately explain what they're dealing with, it's difficult to make the correct diagnosis. Shaw pointed out that this and other factors can lead to delayed treatment, which can have serious consequences. Fisher said, "The earlier you intervene, the better your outcomes are going to be. . . . The longer you wait, the more severe the problem behaviors are going to get."

The experts also discussed diagnosis of children. Shaw asked how professionals perceive the difference between a child who has a mental health issues and a child who is being abused or something similar. Fisher said environmental factors must be addressed, and Mulder said, "The behavior might be age appropriate, but the environment might not be age-appropriate," such as asking kindergartners to sit for a long time.

Shaw said people may wonder what schools can do to help. Fisher said a school psychologist's job is to make sure the student can function in the school environment. They may not have enough time to talk with the students and provide all the help they need, so they can "rally the troops" and "connect our services with the services they're receiving in the community."

Mulder noted that although it's important for school psychologists to make sure students are diagnosed so they can get the help they need, doctors are supposed to notice the early symptoms in young children. Later on, teachers may notice something is amiss but usually only if it is externalized behavior. Parental input is also important although they often don't have sufficient knowledge of what symptoms would be. Schools are moving to a more preventative approach, Fisher said. Teachers will report things that disrupt the classroom and miss the internalized behaviors.

Click here to watch the show.

Time on the tummy is important for infants' muscle development

Today's infants are spending too much time on their backs or in sitting devices, which is causing an increase in head and neck deformities and slowing down their motor development, Susan Effgen, a physical therapy professor at the University of Kentucky, writes for the Lexington Herald-Leader.

This is easily remedied by making sure infants spend most of their waking hours on their tummies, even during the first few weeks of life, Effgen suggests.

The American Academy of Pediatrics recommends that infants should sleep on their backs because it significantly reduces the chance of sudden infant death syndrome (SIDS).
While most parents may know that, any are not aware of how important it is for infants to spend time on their bellies, Effgen writes.

Time on their bellies allows them to learn to move and explore their environment, Effgen writes. You can encourage your infant when they are on their tummies by having them to lift up their heads and look around, giving them objects to reach for and encouraging them to prop up on their elbows or hands, These activities help to build strong back and neck muscles needed later for sitting, crawling, walking and talking.

If your infant doesn't like tummy time, Effgen suggest parents lie on their back and place the infant on their belly to let them practice for several days until they are used to this position. Eventually, practice tummy time together on a baby-proofed floor with fun, appropriate objects placed at their eye level.

HANDS program provides support and information to 12,000 Ky. parents to help them raise healthy, happy children

A Kentucky health-care program that focuses on families who are pregnant or expecting a baby currently supports around 12,000 households in an effort to promote better outcomes for these children, Don Weber reports for "Pure Politics" on cn|2, a service of TimeWarner Cable.

The Health Access Nurturing Development Services program, commonly called HANDS, has expanded its services to not only provide services for first-time families, but also help parents who have other children.

The program is designed to provide intensive support to families through home visits using a structured curriculum, Weber reports. Specialists talk to the parents in home visits about the importance of bonding with their child before birth, developmental stages of the child, and its specific needs—such as clothing, food and furniture—and safety issues. The specialist also provides a weekly sounding board for questions and concerns of often-stressed parents of newborns.

"When we come to visit with you, not only do we want to have fun, but we want to be able to share information with you about your baby's development, about pregnancy, just about new research that is coming out," HANDS specialist Amber Green told Weber. "But what we don't want to do is tell you the how-tos and the what-fors. We just want to share with you information about during pregnancy, maybe your child's development, what maybe you can expect around milestones; but we are there to do it in a way that you can choose what information works best for your baby."

The four goals of the outreach program, which Kentucky finances with money from the states' 1998 settlement with tobacco manufacturers, are:

• Providing positive pregnancy outcomes
• Optimal child growth and development
• Allowing children to live in healthy, safe homes
• Helping families make decisions that enhance long term independence over meeting short term or immediate needs.

Clark County is the "biggest user per capita" in Kentucky, serving more than 4,900 families through over 57,000 visits since the programs inception in 1999, Weber reports.

Health advocates recommend teaching children benefits of healthy food, even raw, to adapt to school-meal guidelines

Health advocates say that teaching people, especially children, about nutrition and the value of new federal guidelines for school meals can help improve Kentucky's health, Jacqueline Pitts reports for "Pure Politics" on cn|2, a news service of TimeWarner Cable.

Some schools have thrown away food because the students do not like the new, healthier meals and don't eat them. "The problem is the kids are saying they don't want this. You are trying to force them to eat things they don't want, and they go elsewhere," U.S. Rep. Hal Rogers, R-Somerset, said last month at a subcommittee meeting of the House Appropriations Committee, which he chairs and which approved a one-year waiver from the rules for schools losing money on meals.

Susan Zepeda

Foundation for a Healthy Kentucky President Susan Zepeda told Pitts that more education about nutrition needs is needed so students and parents will understand why healthier meals are so important. "If we saw kids throwing out the toothbrushes after we taught them how to brush and floss, we wouldn't stop teaching them how to brush and floss in schools," Zepeda said. "Sometimes as grownups and parents we have to nudge the children we are responsible for in a healthier direction."

Zepeda said that when she was young, she thought all vegetables were soft and mushy and didn't taste good because her mother used a pressure cooker, but when she started picking corn, tomatoes and peas, she found that raw vegetables tasted delicious. She said young Kentuckians should be taught to appreciate the "natural wonderful tastes of the foods we grow right here in Kentucky."

Rep. Leslie Combs

State Rep. Leslie Combs, D-Pikeville, who recently had a heart attack, told Pitts she is looking for ways to deal with the state's health issues and believes access to fast food and lack of physical activity play a significant role, especially in Eastern Kentucky, where several health issues connect.

"I think we need to work a lot on our role and in our capacity with our region to say 'we got to get this obesity rate down," Combs said. "That is huge because that ties itself to the high rate of diabetes that we've got. We still have a lot of smokers in our region, and this is a direct correlation between the health issues we've got, and the obesity brings itself into the heart issues." (Read more)

Kentucky school nutritionists meet amid some opposition to federal school-lunch guidelines aimed at curbing child obesity

Kentucky schools are working to adjust to the federal nutrition requirements for school lunches, but are facing some opposition from students, parents and some school nutritionists. The U.S. Department of Agriculture guidelines, aimed at curbing childhood obesity, require schools to include a fruit and vegetable with every meal, to switch to 100 percent whole grains by next year, to impose age-based restrictions on calorie and sodium intake, and to serve 1-percent-fat milk. Now the School Nutrition Association, which recently started getting half its money from major food companies, and other groups are supporting legislation to offer a one-year waiver to schools losing money on meal programs.

School nutritionists from all over Kentucky, which ranks high in child obesity, are encouraging students to eat healthier food throughout the school day. "About 700 school cooks, managers and administrators are meeting for a statewide conference this week in Lexington," reports Stu Johnson of WEKU-FM and Kentucky Public Radio. from a meeting of the Kentucky School Nutrition Association.

KSNA President Sabrina Jewell told Johnson that many students in the upper grades are not eating the newfangled meals, and some are even leaving campus to eat elsewhere. Federal funding is based on participation, "so, if they don't eat, then we don't have the money to run our programs. General school taxes and all, they don't pay for school nutrition. We're paid off of the meals that we serve."

However, Jewell said elementary-school children are adapting better to the new standards than middle and high schoolers. The switch "is just taking a little longer than we anticipated," she said. (Read more)

Russell Co. school board plans to make all campuses tobacco-free, renews free-lunch-for-all plan after breaking even

School districts in Kentucky often deal with health issues. The Russell County Board of Education dealt with two important ones, tobacco use and school lunch, in its meeting last week.

State officials are pushing to get schools to make their campuses tobacco-free as a way of discouraging smoking, since Kentucky has the highest percentage of smokers in the nation and ranks near the top in youth smoking.

The Russell County school board heard first reading of a policy that would ban use of tobacco products on all school campuses at any time, including events such as outdoor athletic contests. "Board Member Gerald Murray indicated that those who attended the meeting were for the complete ban, and wanted the public informed that if they had concerns, either for or against the ban, they need to attend the next board meeting to be heard," The Times Journal of Russell Springs reports. "The next reading and vote will be at a special called meeting on June 30."

June 30 was the original deadline for school districts to decide whether to participate in the federal program that makes free meals available to every student in school districts with certain levels of poverty and public assistance.

The board voted to stay in the program after Nutrition Director Susan Melton reported "the program has resulted in a 73 percent breakfast participation rate, an increase of 28 percent compared to 2012-2013 school year, and nearly double the state breakfast participation rate of 39 percent," the Times Journal reports. "The lunch participation rate was 90 percent over the last school year, up eight percent from 2012-2013."

The newspaper notes that the district has to pay only 6 percent of the cost, compared to 20 percent in the normal program, which charges some students regular or reduced prices for meals based on their family income. Some school districts have not joined the program, saying they might lose money on it, and Russell County feared likewise, but Melton said it "has been essentially 'break even' for the county" and has benefits; research has shown that hungry children are less able to learn.

“We went into this last year understanding we may lose $12,000 to $15,000,” Board Member Steve Kerr said. “But we all agreed that if we did lose that it was still well worth it. And with it being a break even situation you couldn't ask for anything better than that. And with the way it looks for the coming school year, I'm extremely pleased with it. Our students are the ones who benefit so that makes everything worth it.”

The state Department of Education expects about 100 of Kentucky's 173 public school districts to participate during the coming school year in a federal program that makes free meals available to all children in a school if at least 40 percent of its students already qualify for free meals through federal programs, Valarie Honeycutt Spears reports of the Lexington Herald-Leader reports.

How to keep kids safe from traumatic brain injuries this summer

About 1.7 million people in the U.S. suffer a traumatic brain injury each year, and nearly half a million children under 15 visit an emergency room for TBI. A brain injury is traumatic if it disrupts the normal function of the brain.

Dr. Michael Egnor, vice-chairman of neurology at New York's Stony Brook University Hospital and director of pediatric neurosurgery at Stony Brook Children's Hospital, provides ideas for how parents can help protect their children from brain injuries this summer.

Families are going on more bike rides, but not everyone knows that bicycle accidents are most likely to happen within five blocks of home. "Make sure your child wears a helmet every time he or she rides a bicycle, scooter or skateboard," Egnor said. "We're seeing the most head injuries right now in skateboarding, especially in young teens, who might think it's just not cool to wear a helmet."

Each year more than 200,000 children suffer from injuries on playgrounds in the U.S., according to the U.S. Consumer Product Safety Commission. The main cause is falls. Egnor suggested looking for shredded mulch, pea gravel, crushed stone and other loose surfaces and being extra careful on asphalt and concrete.

Parents with older children and teens should be aware of possible diving accidents. "In about 50 percent of cases of catastrophic injuries, alcohol or drugs is involved," Egnor said. "Ensure that responsible adults supervise pool parties and other events where swimming and diving are involved."

Egnor also warned of concussions during summer sports. He said, "The few serious injuries we treat from organized sports are usually accidents that probably could not have been prevented," he said, while many of the concussions he treats are mild because many sports require helmets.

Dealing with serious injuries quickly is key, Egnor said. "The full extent of the injuries may not appear immediately." (Read more)