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Carolina Journal News Reports

Child-Obesity Mandates Sought By Task Force

Legislative proposals would dictate day-care menus, BMI screenings

Jun. 14th, 2010
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RALEIGH — Some members of the General Assembly want to climb on the national anti-obesity bandwagon by mandating food types and exercise in day care centers and obesity screenings in schools, but others say the proposed measures are just another intrusion of government between parents and their children.

Whole-fat milk and many juice drinks could become illegal in North Carolina’s preschools and day care centers if the General Assembly’s Task Force on Childhood Obesity gets its way.

Additionally, children on public assistance who have high body mass index scores would be forced to undergo screening annually with an eye to making them lose weight, under measures being considered by the legislature.

The task force presented these recommendations to the General Assembly in April as two of 11 legislative proposals for tackling childhood obesity. Lawmakers now are toying with the ideas in legislative committees.

Rep. Jennifer Weiss, D-Wake, said she sponsored House Bill 1726 because nearly 75 percent of children ages 2 to 6 are in some form of child care and “there is evidence that child care attendance contributes to childhood obesity.”

Weiss said the task force chose the nutrition standards because they were “low-hanging fruit” that would “go a long way in reducing the intake of sugar, fat, and empty calories” but would “not be difficult for child care centers to implement.”

Rep. Marilyn Avila, R-Wake — who sits on the Commerce, Small Business, and Entrepreneurship Committee, which will review the bill next — questioned whether anti-obesity mandates should be the concern of state government.

“This is just another insidious sort of intrusion into parents’ ability to raise their children the way they want to,” Avila said.

She also expressed concern about the science behind the nutritional mandates. She said that when her children were young, her pediatrician advised serving them whole milk because of the nutrients and the vitamin D, but now whole milk is considered unhealthy.

“We’ve seen dozens of cases where supposed scientific research was used [to make laws] and lo and behold, in no time at all, new scientific research came out and said you’re doing more damage than good,” she said.

Avila called the exercise and nap requirements commonsense, and said child care providers didn’t need a mandate to recognize that young children become unruly when they don’t spend enough time outdoors.

H.B. 1726, now before Avila’s committee, would have the state mandate menus and exercise time at every child care center in the state, including in-home centers with as few as three children.

If passed, H.B. 1726 would require child care centers to provide:

• Reduced fat milk (skim or 1 percent)

• No more than four to six ounces of juice per day

• No sugar-sweetened beverages

• A rest period after lunch

• An out-of-doors period (20 to 30 minutes of exercise for half-day children and 60 minutes for those in centers for a full day)

The rules would apply not only to institutional preschools and day care centers, but also to in-home child care providers — defined as anyone caring for more than two children for pay.

Sen. Bill Purcell, D-Anson, a sponsor of a separate measure, Senate Bill 1286, said the rules would be difficult to enforce, but that he imagined most child care providers would comply.

When asked if the health department would inspect child care providers’ homes for the forbidden foods, Purcell replied:

“I mean, obviously, if they thought [somebody wasn’t] abiding by the rule they would do something about it. But, I mean, nobody’s going to jail over this.”

Purcell said day care centers often serve high-calorie and high-fat content foods to cut back on costs.

“Surely at home people feed their kids the wrong stuff, too, but it’s easier in a child care center to give them all macaroni and cheese than something healthier,” he said.

Avila said it’s up to parents, not the state, to determine the suitability of individual day care centers for their children. She said that when her children were young she investigated her child care options fully before deciding on a small, in-home day care.

She said she knew what her children were fed and what activities they were engaged in. “I had a very close relationship with the ladies that worked with my kids over the years,” she said.

“Can’t we just assume, God forbid, that parents maybe know best, and they’re concerned enough to question what’s being done at these places?” Avila asked.

Scott Bullock, a senior attorney with the Institute for Justice in Washington, D.C., said the bill sounded like it was full of “classic nanny-state provisions” that infringed upon day care providers’ economic liberty and parents’ rights to raise their children as they saw fit.

“This is the state interjecting itself into a matter that should be between parents and those they entrust their children to,” Bullock said.

He said parents are perfectly capable of negotiating menu items and dietary restrictions for their children.

“It’s sort of this assumption that parents aren’t responsible or that they cannot make decisions on their own,” he said.

He wondered into what personal areas of life the attitude that “government knows best” would intrude next: “If we can do this in day care centers, why shouldn’t it be mandated in the home?”

BMI screening

S.B. 1286, now before the House and Senate health committees, would require all children receiving Medicaid or participating in the Health Choice for Children Program to undergo BMI screening; the Department of Health and Human Services would use this data to work with other government agencies “to improve the health of children.”

Although the Senate version of the bill focuses on screening children receiving Medicaid, the House version makes it a goal to reduce BMI levels in all children.

Lawmakers haven’t decided whether to administer the screenings to all children in schools or only to children on Medicaid in doctors’ offices.

When Arkansas conducted BMI screenings on school children, under the administration of Republican Gov. Mike Huckabee, some students refused to participate and some parents threatened to sue, upset that schools were embarrassing their children and “calling them fat.”

The Arkansas program cost the state an estimated $1 million in the first year, not including costs to local districts and schools. Some principals complained the program was an “unfunded mandate” that added to the burden of overworked school nurses and support staff.

Purcell said the immediate goal is to screen children enrolled in Medicaid or the Health Choice for Children Program. He said the General Assembly might require providers enrolled in Community Care of North Carolina — a public–private partnership between the state and nonprofit community healthcare networks — to implement the screenings.

He said keeping kids’ weight under control was the government’s business “if for no other reason because it’s a terrific cost to the taxpayers to pay for the consequences of obesity.”

He said the state spends “millions of dollars a year” on diabetes, heart disease, and other obesity-related diseases.

Additional ideas

Other task force recommendations include:

• Appropriating $5 million to transfer children from the reduced-lunch program to the free-lunch program

• Spending $12 million to “retrofit” school cafeterias and train cafeteria workers to “present fresh fruit and vegetables in a manner that invites kids to select and eat”

• Spending $15 million in federal funds to encourage children to walk to school by building safer and more “walkable” sidewalks

Sara Burrows is an associate editor of Carolina Journal.