Government diet plan for girls

The U.S. Department of Health and Human Services has an obesity prevention program for tween girls and their parents to teach them to adopt healthy eating and lifestyle habits. Called BodyWorks, this program is the most powerful demonstration to date of how far astray from soundness public advice for “healthy eating” has become. When you see the reality of this eating plan in action, you’ll fear for our young girls.

Few consumers have probably ever heard of this program, even though it’s now being taught by 1,700 government-accredited Bodywork instructors across 43 states. The BodyWorks program was advertised in a Reuters Heath article yesterday. Before we look more closely at what the program teaches girls and their parents, here’s the media’s brief overview:

U.S. program targets obesity at grassroots level

A new program developed by the U.S. government is tackling the obesity epidemic by helping "tween" girls and their parents make small but important changes to build a healthier lifestyle. The Department of Health and Human Services' (HHS) Office on Women's Health launched BodyWorks in 2006 by training instructors in the hopes that they would bring the program home to their communities. All materials are provided free, but communities must find the resources to pay trainers and a place to offer the program...

Girls 9 to 13 years old who are overweight or obese are referred to BodyWorks through their pediatrician, or by word of mouth. Parents and caregivers attend 10 weekly 90-minute sessions, and girls are expected to show up for at least three. The goal is to give parents and caregivers "hands-on tools to make small behavior changes to prevent obesity and help maintain a healthier weight"...

The goal is not for girls to lose weight, Jones and Richter say, but for families as a whole to begin making healthier choices at the grocery store, to become more active and to spend less time in sedentary activities like watching TV or playing computer games...

This is an obesity myth-driven program. Preteen and teen girls whose heights and weights place their BMIs above the 85^th percentile are targeted. In accordance with popular stereotypes, their size indicates they must have unhealthy diets and lifestyles and warrant education on how to eat right and exercise. But, far from the claims made in the news, this program isn’t teaching girls to make small changes, nor can it claim to not be about weight loss.

The BodyWorks program includes an instructional manual for girls, one for their parents, and a large recipe book to enable parents to put the healthy eating guidelines into action. We’ll look at each of these manuals.

For girls

The instruction book for girls — called BodyWorks 4 Teens: Eat right, move more, feel great — teaches them what it means to be “a healthy teen girl.” They define this as being “physically and mentally fit.” The opening chapter is on “healthy foods.” To eat healthfully, the girls are given this Daily Eating Plan:

A teen girl needs each day: 2 cups fruits, 2 ½ cups vegetables, 3 cups fat-free or low-fat dairy, 3 ounces whole grains, 5 ½ ounces protein. Limit fats, sugars and salt.

This is what girls are being taught “healthy eating” means.

Do you see a the missing food groups and major ingredients? Nowhere are girls told that even by the government’s weight-focused 2005 Dietary Guidelines, they need about one-third of their calories to come from fat, and that low-fat eating is not recommended for growing young people. They aren’t told that there is no nutritional guide that they should or need to limit sugars or salts, or fear these foods. Nowhere in the book is it mentioned that active girls their age need 2,400 calories a day — and we can be certain that, among the talk in this manual of portion control, monitoring and controlling what they eat to be a “healthy weight,” girls are counting calories. [These issues have been covered extensively at JFS; using the Google search tool on the sidebar, you can find posts corresponding to any questions.]

The Q&A section on how nutrition affects their health offers a string of diet speak and misinformation. The answers are provided by dietician, Jessica Donze-Black, R.D., MPH. [Disclosures below.*] Teen girls are told that if they’re worried about acne, it’s a good idea to “drink plenty of water, eat lots of fruits and vegetables and limit excess fat.” Foods can make you feel lazy if you eat too much, Donze-Black says. To avoid overeating, the girls are told, “one trick to avoid eating too much is to eat slowly.”

[Of course, acne is not caused by food, as the American Academy of Dermatologists points out. That’s one of the oldest myths, but disproven long ago. There is no evidence that greasy foods or any food causes acne, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the NIH. The C.S. Mott Children’s Hospital offers a webpage on acne for teens and reassures them that acne is not caused by their diet or anything they’re doing wrong. Young people with acne “do not have to avoid eating fried foods, chocolate or any other food,” they tell teens.]

BodyWork’s instructions to girls on how to eat “healthy” and live a healthy lifestyle are indistinguishable from weight loss advice found in any diet book. Essential to a healthy lifestyle, the girls are told to keep a food and exercise diary: “Write things down as soon as possible. Write down everything you eat, even if it’s just one cookie. Be honest. Includes drinks. Write down how you were feeling.” Addressing emotional eating is said to help them figure out their moods and other issues that made them want to eat. They are also told they should drink plenty of fluids and be sure to eat 19 grams of fiber every day because it will lower their risk for heart disease.

When eating out, the girls are advised to limit fried foods and order the garden salads with low-fat dressings, always pick the low-fat choices, get the smallest serving or sandwich on the menu, avoid mayonnaise and use mustard or ketchup because they have less fat, order water or fat-free/low-fat milk to drink, and “try pizza without cheese.”

And we wonder why so many young women today have no idea how to eat normally and have come to believe they are eating “healthy,” when they are really dieting. What must certainly add to their confusion, the girls in the BodyWorks toolkit are also told that “dieting is not the answer,” and to avoid going on very-low calorie diets, eliminating food groups or skipping meals. BodyWorks is not a diet, the girls are told. This is "healthy eating."

Food mustn’t be seen as tasty or tempting. For some reason, food stylists’ techniques for making food look good enough to eat in photography, and to enable the props to withstand hours under hot camera lights, is a key part of “media literacy.” Food that looks good is somehow bad. Think about that one. [Was it a coincidence, then, that the photo accompanying the beef recipes in the accompanying recipe book was gray and unappetizing?]

Exercise can help you keep a healthy weight, the book says, and the girls should try to exercise for one hour on most days. “Vigorous active is best for getting and staying fit.” Vigorous was described as so intense you’re “sweating, breathing hard and can’t talk or sing.” And add resistance exercises 2 or more days a week.

The book closed with this reminder: “A healthy mind = A healthy body.”

Parental manual

The longer version of the book for parents — BodyWorks Body Basics: A toolkit for healthy girls and strong women — has “7 simple steps to healthy living.” This government program tells parents how their families should live to have a trim and fit family. The steps families are to follow are:

1. Decide to live a healthy lifestyle — make a commitment to healthy eating and physical activity. This tells families that too many teens are “overweight” or “obese” and at risk for serious health problems of old age, that teens are more sedentary and watch too much TV, and that they eat too much junk. It tells parents that a healthy weight is determined by children’s BMI. An entire section is devoted to “weight and emotions” reinforcing the belief that emotional eating leads females to overeat and get fat.

2. See where you are now — by recording eating and activity habits. Girls are to keep food and exercise journals and turn them into their parents weekly for review. This should continue until the parents have seen positive changes.

3. Understand healthy eating. It repeats the diet plan given girls in more detail; gives meal suggestions and portion control measures; heightens concerns about bad fats and hidden fats and sugars; suggests parents eat out less often and check the menu first for choices that are low in sugar, fat and salt; and instructs them to have family meals each night. The accompanying recipe book puts healthy eating into action.

4. Recognize the benefits of physical activity, especially of vigorous-intensity. Recommended sports activities and exercises are ranked according to their intensity. This section also tells parents that fits kids have higher school grades; remember that one?

5. Set goals and plan. To effect change, in addition to the girls’ daily food and activity journals, the family should hang a weekly planner on an erase-board to write down meals and physical activities the family is to do each week.

6. Shop, cook and eat together. Parents are told how to shop to limit salt, calories, sugar, and fats; with a focus on fresh produce, dried beans and grains, and eliminating packaged foods and snacks.

7. Support a healthy lifestyle for your family. Parents are encouraged to change the home environment to support healthy eating and regular physical activity, as well as become active in changing schools and communities. For resources, they are referred to Center for Science in the Public Interest (CSPI) and Food Trust, a key “obesity-fighting grantee” of Robert Wood Johnson Foundation that created the School Nutrition Policy Initiative.

These steps are all with an eye towards achieving a “healthy weight” for their girls. Parents are told to teach healthy eating habits and “help your child learn to control her own eating.” A “healthy weight” can be achieved, according to BodyWorks, by also stepping up physical activity and limiting and monitoring television time. [Which, of course, have all been proven ineffective in childhood obesity prevention programs.]

Healthy eating in action

The 132-page recipe and menu book, BodyWorks Healthy Recipes, will vanish any remaining beliefs that “healthy eating” being taught to young people and families is healthful or nourishing. It IS dieting. In fact, this eating plan is the most extreme, punitive and restrictive diet I’ve seen published for healthy, growing girls.

Contained in this book are a large number of recipes choices for every meal of the day, including dessert. Most are inclusive one-dish meals and nowhere are parents advised to fill out meals with breads or other foods. This book supposedly demonstrates healthy eating in action, not only for girls 9 to 13 years of age, but for the whole family.

Breakfast recipes include those for cereals, egg white omelets, austere fruit dishes, French toast and pancakes, with an average 226.50 calories and 4.3 grams of fat per serving. Among 63 servings represented in the recipe choices, they contain a total of 5 tablespoons oil and 3 whole eggs.

Lunch recipes offer a range of vegetable salads, sandwiches and soups. Each serving averages 0.25 teaspoon oil and 0.02 teaspoon salt. Lunches average 227.25 calories and 8.2 grams of total fat per serving.

Dinner is an enormous collection of vegetable-intensive recipes dishes that are equally ascetic, with a mere 1 ½ teaspoons salt total for 191 servings and 0.07 tablespoon of oil per serving. The dinner recipes average 264.2 calories and 2.18 grams of total fat per serving.

The “healthy desserts” are fruit-based, averaging 1 teaspoon added sugar per serving. Desserts average 184.5 calories per servings, with 2.69 grams total fat.

Even if the girls are allowed dessert, a full day following this “healthy” meal plan would provide them with 902.45 calories — about one-third (37.6%) of the daily calories needed by girls this age and activity level, according the USDA/ARS Children’s Nutritional Research Center at Baylor, used by the Dietary Guidelines.

Equally troubling, even if the girls are allowed dessert every day, this “healthy” eating plan provides a total of 17.37 grams of fat each day, about 7% total fat, based on their daily calorie requirements. This is about one-fourth of the total fat they need each day. Remember, even according to the Dietary Guidelines, children this age need 25-35% of their calories to come from fat. The total fat in a day’s worth of these “healthy” meals is less than the saturated fat advised by the government for adults with heart disease.

Not only is this extreme diet plan nutritionally unsupportable, it has no credible medical evidence of effectiveness for improving the health of growing children or for preventing obesity. Worse, by all evidence, the messages it teaches and food fears it reinforces, put young women at risk for physical and emotional harm.

Yet this program is being promoted as “healthy eating” by our government, targeting young girls and their families, and paid for by us.

This program’s “healthy eating” messages are the same as those popularly believed by many young people today and the same ones being widely taught in schools and through childhood obesity programs. Young people would be much healthier without such “nutrition” education at all.

© 2008 Sandy Szwarc

* Not disclosed in the BodyWorks literature, Ms Donze-Black is the Executive Director of the Campaign to End Obesity, a coalition of leading obesity stakeholder organizations and individuals, including Johnson & Johnson, NIKE, Inc., American Heart Association, Discovery Health, CSPI, Partnership for Prevention, Sanofi-Aventis, Shaping America's Health, Trust for America's Health and others. [These will all be familiar to JFS readers.] She was also the lead contact for National Alliance for Nutrition and Activity’s (NANA) policy papers for School Nutrition Standards and “Obesity and other diet-related diseases in children,” which said unhealthy eating habits, inactivity and obesity in children are the root causes for two-thirds of deaths in the United States from heart disease, cancer, stroke and diabetes. NANA is the key lobbying group for more than 300 groups, working to promote government policies and programs for healthy eating and activity. Its nutrition initiatives were founded and coordinated by Margo Wootan at CSPI, who is also on the Steering Committee and co-chair of the Policy Subcommittee for the National 5-A-Day Partnership.

BodyWorks is a project of various obesity, bariatric, health and wellness, and fitness partners.