There are 32 million reasons why the United States Department of Agriculture’s new school meal standards [PDF] are good news. That’s the number of children who participate in the National School Breakfast and Lunch programs in the U.S. and who will soon be served far more nutritious — and hopefully delicious — school meals.

Announced by First Lady Michelle Obama, who was instrumental in getting the new rules written by ensuring that the Healthy, Hunger-Free Kids Act passed in 2010, the updated meal standards are a huge improvement, in spite of last minute meddling by Congress. The standards are based on 2009 Institute of Medicine (IOM) recommendations and they include:

• Doubling the amount of fruits and vegetables offered;
• Increasing the variety of vegetables served to include dark greens, red/orange, and legumes;
• Increasing offerings of whole grain-rich foods — half the grains must be whole grain-rich by July and all must be whole grain-rich by start of the school year in 2014;
• Offering only fat-free or low-fat milk varieties (flavored must be fat-free);
• Limiting calories based on the age of children being served, to ensure proper portion size; and
• Reducing the amounts of saturated fat, trans fats, and sodium.

The total cost of the Healthy Hunger-Free Kids Act will be $3.2 billion over five years (down from $6.8 billion in the USDA’s proposed rule). Since it does cost more to serve healthier meals, the increased costs have been covered by program changes and funding provisions such as:

• Eliminating the meat/meat substitute requirement at breakfast;
• Lengthening the timeline for adding fruit to breakfast;
• Providing an additional 6-cent federal reimbursement per meal for lunches that meet the new standards;
• Ensuring that a la carte offerings are no longer subsidized by school meals (in some schools, this means that a la carte food prices will rise); and
• Allowing students to opt for smaller servings of fruits and vegetables to help eliminate “plate waste.”

Margo Wootan, director of nutrition policy for the Center for Science in the Public Interest, who has led the fight to improve school food over the past decade, was happy with the final standards. “These are the first-ever school meal standards for whole grains, trans fat, and sodium,” said Wootan. “The only disappointments I have are the ones Congress forced on the USDA — continuing to count pizza as a vegetable and allowing French fries to be served every day.”

So what does this all mean for America’s children?

As a long-time school food reformer who has watched countless children consume high-calorie, low-nutrition school meals that I wouldn’t serve to my dog, I believe that this is a giant step forward. Just the fact that every student who purchases a school lunch will soon have to take a fruit and/or vegetable as a component of their meal is revolutionary. And in one fell swoop, the USDA has eliminated full fat and 2 percent milk from school meals — high-fat beverages that our increasingly overweight children don’t need. The USDA has provided a sample before and after elementary school menu.

Next on the horizon, thanks to the Healthy, Hunger-Free Kids Act, is the USDA proposed rule for school a la carte or competitive foods, scheduled to be released in the next few months. If Congress doesn’t meddle again and the USDA proposes science-based standards for these foods sold outside the meal programs, our nation’s schools could become places where mostly healthy choices reign. What a refreshing thought — that our schools could actually model the nutrition habits that our government recommends in the Dietary Guidelines — rather than continually contradicting them and undermining parents.

But a la carte/competitive foods like sugary drinks, chips, ice cream, and candy are big business for Big Food and Beverage. So expect more deep-pocketed lobbying of Congress by their friends in the food industry in an attempt to maintain the status quo (e.g., their profits) at the expense of our children’s health.

Photo: roadsidepictures

So just how significant is the McDonald’s announcement? And how should the health community react? Before I discuss this, let’s clarify a few points:

1. McDonald’s, one of the largest and most successful corporations in the world, is only interested in the health of its customers as it relates to its own bottom line.
2. The Happy Meal changes are the result of unrelenting pressure exerted by child health advocates including bills passed in San Francisco and Santa Clara County that set nutrition standards for kids’ fast food meals sold with toys, as well as a lawsuit from the Center for Science in the Public Interest.
3. Even with apple slices, a smaller French fry portion, and reduced sodium, the Happy Meal is still not a healthy meal.

So how should health advocates react when fast food behemoth and industry leader McDonald’s blinks? Should we praise this step forward, even if it’s a small step? Here’s how I think we should handle this type of announcement:

First, let’s pat ourselves on the back for a job well done. Concern about childhood obesity and unhealthy fast food are at an all-time high thanks to food reformers’ efforts. The fact that the first lady has made childhood obesity her signature issue is testament to the growing success of the healthy food movement. And now, a multinational corporation that made its fortune selling unhealthy junk food is touting nutritional improvements in an attempt to mend its image, maintain market share, and stave off public health policy that would regulate what it can sell and advertise to kids. This is progress.

Second, we should acknowledge these positive changes, even if we feel they are inadequate. Whether McDonald’s initiated the change in order to preempt policy or entice health conscious families back to the golden arches isn’t the point; we’re constantly criticizing McDonald’s and other fast food chains so it’s only fair that we acknowledge positive changes. And by acknowledgment, I mean just that — let’s save the effusive praise for when McDonald’s makes its Happy Meal the truly healthy meal our kids deserve. I thought that the first lady’s muted and measured comments — she called McDonald’s plan “positive steps” toward her Let’s Move! goal of ending childhood obesity — set the tone perfectly. Ms. Obama also added that she “looks forward” to the company’s “efforts in the years to come.” That’s a diplomatic way of saying you’re going to have to do a lot better.

Finally, let’s keep up the pressure on McDonald’s by continuing to highlight the shortcomings of the Happy Meal. If McDonald’s had seen fit to include a non-fried vegetable and a whole wheat bun for the hamburger, and had made low-fat plain milk the default beverage rather than soda, this would have been a momentous announcement. Health advocates will not rest until McDonald’s and other fast food restaurants have made meaningful changes (via either internal or external policy change) including a truly healthy kids’ meal and an agreement to end to marketing to children.

Jan Fields, the president of McDonald’s USA, said of the new Happy Meal: “McDonald’s will always try to do the right thing, and we know we can help make a difference in our communities.” I think McDonald’s will continue to do the right thing — but only if health advocates hold their feet to the fire. Kindling, anyone?

Put ‘em up, Pepsi.

The world of public health and its funders can be very genteel. When a policy like the soda tax fails to get enacted due to strong, well-financed opposition from industry, public health advocates want more science. They often believe that the new data collected, the indisputable conclusions drawn, or the attendant policy recommendations will finally convince policymakers and the public to take action. But, as Ross pointed out, if you think you are in a policy debate and the other side thinks it is in a fight, you are not going to come out too well. And so far in this food fight, public health is pretty bruised and battered.

The reality is, that when up against deep-pocketed, no-holds-barred opponents, like Big Food, Big Beverage, and Big Agriculture, public health’s focus on science and evidence is easily trumped by money and messaging. If public health advocates don’t start rolling up their sleeves and using some of the same tactics used by industry, progress in this fight to create a safe, healthy, sustainable food system is going to move more slowly than a teenager asked to clean his room. Science and “being right” are no substitute for a strong, strategic, and powerful movement. Public health groups and their funders must find ways to pool resources and utilize costly professional advocacy marketing, PR, and grassroots movement development. Sweeping policy change can only be driven by a powerful professional messaging campaign and a grassroots movement.

Industry hires the top messaging agencies and consultants, and devotes big money to framing their messages and imposing that frame on us. Witness the millions (certainly well over $100 million) Coke, Pepsi, Dr. Pepper/Snapple, et al., have spent on a nationwide campaign to fight soda taxes. In New York state alone, the soft drink industry spent nearly $13 million in just the first six months of 2010 to successfully fend off a penny per ounce soda tax. What did that money buy? A slick, professional ad campaign that was created by the same advocacy marketing firm that brought us the infamous “Harry and Louise.” And what were public health professionals doing to convince legislators and the public that a soda tax was necessary for the health of consumers? They were distributing fact sheets filled with meticulously researched statistics and dozens of studies that have identified sugary drinks as a leading cause of our obesity epidemic — ammunition which fell flat compared to Big Beverage’s professional and misleading messaging campaign.

Studies and evidence get steamrollered by marketing, messaging, and deft public relations. While good science should be the basis of any public health campaign, it can’t be the only strategy. Ross’ fine speech should act as a wake-up call to the entire public health community and our funders. I propose that a public health conference called “How to Fight Industry at Its Own Game” be organized in order to change the way public health advocates, professionals, and their funders view their responsibilities and teach them some of the tactics they need to win. We must fight fire with fire. Let’s light the match!