Flunking Lunch

By Jodie Morse

If it's late November, then it's time for Turkey Day at Little Woods Elementary School in New Orleans, La. Each fall, for decades, students have dined on the same spread of turkey, Creole gravy, corn-bread dressing and sweet-potato pie. But this week they will add a few new rituals to their holiday meal. Some will poke and prod their turkey meat or smell it to check for rancidity; others plan to pass on the lunch altogether. Most everyone will try to banish the memory of last year's Turkey Day, which ended in a mass pilgrimage to the school nurse.

In all, about 100 students and teachers fell ill with various symptoms of vomiting, abdominal cramps and bloody diarrhea; a handful were rushed to the hospital. The culprit? Clostridium perfringens, a bacterium that resides in the intestines of animals but is usually killed when meat is properly prepared. In a report titled "An Uninvited Guest at Turkey Day," state inspectors found that Little Woods' cooks did not monitor the temperature of the turkeys as they cooked. The officials also noted some other uninvited guests: an infestation of cockroaches in the kitchen. "It's bad enough that we have to think about safety when we send our kids to school," says Neketa Lacayo, who still quizzes her daughter Naiah McGruder, 9, nightly about what she eats in the school cafeteria. "When this happened, I wondered, Was [her lunch] something else I had to worry about?"

Yes, parents, the worry list is now a little longer. Large-scale outbreaks of food poisoning from school meals have risen on average 10% each year, from 25 outbreaks in 1990 to 50 in 1999, sickening a total of 16,000 children across the country with everything from salmonella to hepatitis A, according to a report released by the U.S. General Accounting Office (GAO) last spring. While undoubtedly unpleasant, most of those illnesses ran their course in a few days.

School lunches are also drawing scrutiny for posing long-term hazards to children's health. At a time when childhood obesity is skyrocketing--there has been an almost threefold jump in the number of overweight teens since the 1970s--some school cafeterias look little different from food courts at the local mall. Many serve burgers and pizzas rife with full-fat meats and cheeses or simply turn the prep work over to franchises like Burger King and Papa John's, which have a burgeoning side business in catering school meals. "If nothing changes, a generation will be having heart bypasses by the time they're 25," says Kelly Brownell, director of Yale University's Center for Eating and Weight Disorders. "The school cafeteria is a toxic food environment."

That may be overstating the situation, but what is clear is that the cleanup is under way. Lawmakers in a dozen states have introduced bills to ban the sale of junk food in schools. Some districts have gone organic, while others bake fries and skin chicken. Anti-tobacco lawyers, who gave advice for a suit against McDonald's filed by a group of obese New York teens (see box), are threatening similarly aggressive actions against a school board near you. Congress is gearing up to take a hard look at school meals when it reauthorizes the $6.4 billion government-funded school-lunch program at the start of next year. The same three questions are on all of their plates: How to make school lunches safer? How to make them more wholesome? Trickiest of all, how to make children believe healthier meals can also make them happy?

The Cockroach Special

Let's put the problem in perspective: despite the percentage increase in the number of incidents, major food-poisoning outbreaks occurred in just 300 schools nationwide during the 1990s. So the chances of your child falling prey to a massive, Turkey Day--scale illness are still minuscule. But that doesn't mean you can relax. "Full outbreaks are just the tip of the tip of an iceberg," says Paul Mead, of the Centers for Disease Control and Prevention's food-borne--and diarrheal-diseases branch. The vast majority of food-borne illnesses strike only a handful of children at a time, and symptoms are seldom reported to the school or a doctor, much less the CDC. But once infected, children are at much higher risk than healthy adults for developing complications.

In its report to Congress last spring, the GAO detailed a "patchwork structure" of school-food--safety regulations encumbered by red tape. The Food and Drug Administration and three separate agencies within the U.S. Department of Agriculture (USDA) share authority over school lunches. Yet none has the power to recall tainted foods. The ineptness of this bureaucracy was on display last month after 1.8 million lbs. of Wampler Foods turkey meat linked to listeria were distributed to schools as part of the National School Lunch Program. It took five days for officials to tell the Cumberland Valley School District in Mechanicsburg, Pa., that the Wampler turkey slices it had continued to serve at its salad bars were part of the recall.

By the end of this year the USDA intends to announce a plan allowing schools to purchase meat that has been irradiated. The process, which involves blasting meat with low-level radiation to kill bacteria like listeria, has its opponents, who claim it also kills nutrients. But serving meats spoiled during processing are only part of the food-borne--illness problem. The much more common causes are poor preparation in the cafeteria and poor hygiene among children, who often forget to wash their hands before picking at the salad bar. Many districts are following the lead of New Orleans, which after the Turkey Day incident required cafeteria workers to take refresher courses in food safety and several times a day test the temperature of dishes they serve. But all students would be well advised to follow their peers at Little Woods and look before they eat. Washing their hands first would not hurt either.

Big Mac=Big $$$

The National School Lunch Program was born of good intentions. In 1946, after World War II draft boards rejected legions of feeble, underfed men, the government began reimbursing schools for lunches, allowing the poorest students to dine for free. The USDA monitors the program, ensuring schools meet certain calorie and nutrition standards.

Today, however, economics drives school nutrition. At best, schools break even on the 27 million federally subsidized meals they serve each day, with most receiving a paltry $2.14 for each free meal, hardly enough to pay for equipment, labor, fresh produce or the relatively pricey ingredients needed for low-fat cooking. Consequently, while school meals meet most of the government's nutritional requirements, fewer than 20% stay within the limits for saturated fat.

The real money--and calories--are in a la carte, branded items, which schools often mark up 50% to 100%, and sodas from vending machines. Consider the Northside Independent School District in San Antonio, Texas, which managed to entice students and their pocketbooks into the cafeteria by offering Chick-fil-A, Subway and Papa John's products. While Northside's federal lunches sell for $1.75, a single 7-in. slice of Papa John's goes for $2, more than twice what the district pays to get it.

Nationally, 20% of schools sell branded foods, and nearly all senior high schools operate vending machines. Beyond simply subsidizing the government meals, those dollars buoy cash-strapped schools in other ways, funding field trips and buying sports equipment. They also lure kids away from healthier options. In one study by the Children's Nutrition Research Center at Baylor College of Medicine, students in schools with snack foods consumed 50% less fruit, juice and vegetables.

Despite the current momentum, legislation to restrict junk food has faltered at the state level. But reforms are taking off in individual districts like Los Angeles, which voted in August to ban sodas by 2004, and Philadelphia, which rejected a $43 million exclusive contract with Coca-Cola.

Dollars aren't the only obstacle. The state of Illinois last spring tried to crack down on schools in Oak Park that order in lunch from McDonald's, Domino's, Subway, KFC or Tasty Dog once or twice a week as part of a lucrative fund raiser sponsored by the Parent Teacher Organization (PTO). But parents fought the state for a special waiver; in exchange, they made some minimal concessions, such as serving pretzels instead of chips alongside the hot dogs. "You could make it a little more health conscious if you skipped the fries and put an apple [with the KFC]," says Candy French, an Oak Park PTO council co-president. Says Patty Jacobs, another PTO co-president: "A nutritious lunch is a lost cause."

Broccoli Gets a Boost

Serving healthy food is one thing. Getting kids to eat--and like--it is another. Schools are doing everything from extending the standard 20-minute lunch period to giving students real silverware, all in an effort to make dining a more agreeable experience.

Even more ambitious thinking has led to a boom in cooking classes in schools. These updated versions of home ec teach children who have been weaned on fast food about grains and vegetables they may never have encountered at home. Alice Waters, the chef of Chez Panisse, the celebrated restaurant in Berkeley, Calif., that builds its menus around seasonal ingredients, has launched an "edible school yard," where students learn to plant, harvest and cook organic fruits and vegetables.

In the CookShop program, running this semester in three elementary schools in New York City, students prepare a different healthy dish each week--most recently, fried rice with green beans, red peppers, mushrooms and more--and exchange letters with local farmers. "This is different from the fried rice I've had before," said a beaming Jose Gonzalez, 8, at P.S. 38 in East Harlem during a CookShop session last week. "Normally it doesn't have all these vegetables." The lesson seems to be sinking in: students in the CookShop program are more likely to pick healthier meals at the cafeteria. "It's not about vitamins and why you shouldn't eat fat," says the program's manager Lisa Kingery. "It's about cooking and tasting your own creation, and then we have them suckered into eating broccoli."

Another canny strategy: let them think they are eating junk. When the West Orange--Cove school district in southeast Texas started wrapping its part-vegetable-protein, part-beef "burgers" in foil marked CHEESEBURGER, sales tripled. Even some of the fast-food chains are getting in on the act. Kids who order Little Caesars from their school cafeteria are now buying a slimmed-down slice with part-skim mozzarella and fewer rounds of pepperoni. Frito-Lay this fall began delivering Baked Doritos to schools, and in January it will launch Cheetos Reduced Fat snacks, which contain 50% less fat and were developed especially for schools.

Students and administrators have at least one thing in common when it comes to nutrition: both care deeply about the bottom line. An intriguing study by Simone French, an associate professor in the University of Minnesota's department of epidemiology, found that when a sample of high school cafeterias in her state halved the prices of fresh fruits and vegetables, purchases of baby carrots doubled; apples, bananas and oranges saw a fourfold surge. In Santa Monica, Calif., similar market forces are at play in 16 schools that offer children a choice of an all-you-can-eat farmer's-market salad bar. In the hot-meal line, it's one trip only. At the lunch bell, students race for greens and blanched broccoli. Says Tracie Thomas, the district's interim food-services director: "Instead of going to McDonald's, our students want to go to the farmer's market." --With reporting by Amanda Bower/New York, Harlene Ellin/Chicago, Jeanne McDowell/Los Angeles and Maggie Sieger/New Orleans

With reporting by Amanda Bower/New York, Harlene Ellin/Chicago, Jeanne McDowell/Los Angeles and Maggie Sieger/New Orleans