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Nutrition & Product Information
Calcium Summit II
Mapping Out an Agenda for Action: Seeking New Solutions
Moderator: Jean Ragalie, R.D.
Executive Vice President, Public and Industry Relations
National Dairy Council
The first Calcium Summit in 1999 focused on increasing awareness of the calcium deficiency problem. National Dairy Council undertook an awareness-building campaign, reaching out to youth with messages about the number of servings of milk and milk products to consume each day. An education effort, in partnership with the National Medical Association, focused on reaching African American youth, specifically teaching the value of calcium-rich milk and combating myths about lactose intolerance.
Moving from awareness to action, this session addressed ways to shape messages to effectively reach and motivate America's youth and how the school environment, particularly the availability of milk, can help children meet their calcium recommendations.
Breaking Through to Generation "Why": Finding Messages that Motivate
Janet Helm, M.S., R.D.
Senior Vice President, Food and Nutrition Weber Shandwick
Today's teenagers, which number more than 30 million, are the fastest growing segment of the U.S. population. They clearly live in a world very different than their parents did. Although today's teens conceptually think "good health" is desirable, they do not recognize either the immediate or long-term benefits of a healthy lifestyle, including consuming an adequate intake of calcium-rich foods such as milk to protect their bones.
The challenge ahead is not one of knowledge dissemination, but of motivating and sustaining changed behaviors to improve children¹s dietary patterns and calcium intake.
Messages to motivate teens to improve their dietary behaviors must be targeted and based on research. For example, research demonstrates that the importance of various motivating factors to increase milk intake (e.g., support growth, increase sports performance, prevent osteoporosis) differs between girls and boys. Research also identifies opportunities at home, school, and in the community to motivate teens to make dietary changes to improve their calcium status.
Marketing principles to apply when planning education programs to effectively reach and teach teens include knowing your audience and their needs, giving them credit (i.e., be honest), being where they are (e.g., reach teens through the Internet, magazines, radio, concerts, etc), and remembering to show them the "why."
Making Changes in the School Environment: Milk in School Nutrition Programs
Rachel K. Johnson, Ph.D., M.P.H., R.D.
Professor of Nutrition and Acting Dean College of Agriculture and Life Sciences The University of Vermont
Changes in children's beverage consumption patterns over the past two decades, specifically the decrease in milk consumption and increase in other beverages such as soft drinks, fruit drinks, and fruit juices, contribute to their low calcium intakes. Research demonstrates that children who consume milk (all types) at the noon meal have the highest daily intakes of critical shortfall nutrients, including calcium (31). In fact, milk appears to serve as a marker for diets that are higher in these problem nutrients (32). Soft drinks displace consumption of more nutrient-dense beverages in children's diets, leading to increased intake of total energy and low intakes of essential nutrients such as calcium (33). Higher energy intakes associated with soft drink consumption may be contributing to the nation¹s epidemic of childhood obesity (34).
School nutrition programs face incredible challenges to maintain the nutritional integrity of their programs. Competitive foods (e.g., chips, soft drinks, candy) are widely available in school a la carte lines and snack bars (35-37). In addition, many schools have signed lucrative, exclusive "pouring rights" contracts with beverage companies. These contracts specify what products are stocked in vending machines and require schools to sell only their specific brand of beverage. Profits, rather than children¹s health, may become the primary focus of selling these foods in schools.
Offering school children nutritious beverages such as flavored milks may be a solution to the calcium crisis (38). Initial trials with milk vending machines in middle and high schools show promising results, with vending machines selling out on a daily basis and chocolate milk being a preferred flavor (39). Legislation has been passed in some states such as California and introduced in other states such as Vermont to limit children¹s access to competitive foods and beverages in schools.
Breakthrough Innovations: Lessons Learned From Other Initiatives
Moderator: Susan T. Borra, R.D.
President, The American Dietetic Association, Senior Vice President and Director of Nutrition, International Food Information Council
- The American Dietetic Association (ADA) and its members play an important role in helping America's youth improve their dietary choices and calcium intakes. Through its spokesperson program, ADA works with print, broadcast, and electronic media to provide information about the health benefits of milk and calcium to millions of readers, viewers, and listeners. In addition to media outreach, ADA connects directly with consumers and health professionals through its web site, www.eatright.org , which includes numerous calcium-related resources. For National Nutrition Month 2002, ADA's web site included a consumer-friendly fact sheet in English and Spanish on how to obtain sufficient calcium to build strong bones and teeth. ADA, through the Journal of The American Dietetic Association, provides health professionals with peer-reviewed scientific articles on calcium and strategies to increase calcium intake. The following highlights innovative initiatives by other organizations to improve the calcium status of children and adolescents.
- American School Food Service Association. Melanie Konarik, M.S., S.F.N.S., Director of Child Nutrition in Spring Independent School District in Houston, Texas and Chairperson for the American School Food Service Association ( www.asfsa.org ) , described innovations in her school district to increase students' milk intake. Today's students want quick, easy, "grab and go," great tasting foods and beverages. Offering students a variety of flavored milks (e.g., chocolate, strawberry, "orange dream"), particularly in milk vending machines, increased milk sales at elementary, middle, and high schools. Other means to increase students' milk and calcium intake are "cool" appealing milk containers such as the resealable, single serve plastic bottles, promotional materials (e.g., inflatable cows, posters) in cafeterias, and new products. Another innovative way to help educate students about nutrition and calcium is through a web site developed by the child nutrition department in the school district.
- Milk Processor Education Program. Kurt Graetzer, Chief Executive Officer of the Milk Processor Education Program (MilkPEP) , highlighted some of the approaches taken through MilkPEP's "got milk?"® Milk Mustache Campaign, a multifaceted education program to increase milk consumption among children and teens. The "got milk?"® campaign is based on extensive research indicating that to be effective, messages for kids must provide new and meaningful information; educate not lecture; and be engaging and "as cool" as possible. Some of the approaches taken in the "got milk?"® program include advertising using celebrities as role models for good nutrition; the yearly 100 city Milk Mustache Mobile Tour, which last year profiled chocolate milk; the "Mad About Milk" photo contest in partnership with Seventeen Magazine; the SAMMY ("Scholar Athlete Milk Mustache of the Year") awards in partnership with USA Today; and the "got milk?"® 3-v-3 Soccer Shootout Program. To emphasize milk's important role in athletic performance, MilkPEP has partnered with Disney to make milk the official sports training fuel of the "Wide World of Sports" in Orlando, Florida, and with the National Basketball Association (NBA) to sponsor the NBA Rookie Program. Through its web site, www.whymilk.com , MilkPEP provides children and teens with information, links, and interactive games to improve milk's image. In addition to marketing and education programs to reposition milk as a contemporary beverage, significant strides have been made in making milk more convenient and available, such as offering flavored milks in school vending machines.
- National Institute of Child Health and Human Development. John McGrath, Ph.D., Chief of the Public Information and Communications Branch of the National Institute of Child Health and Human Development (NICHD) , discussed the NICHD's "Milk Matters" public education campaign. This campaign is built on three fundamental principles: a consensus of the science, collaboration with partners, and communication with target audiences. The goals of the "Milk Matters" campaign are to increase awareness (e.g., that calcium is critical for building strong bones and a healthy body and that milk is an excellent source of calcium), knowledge (e.g., that osteoporosis prevention begins in childhood), and attitudes. Campaign tactics involve identifying target audiences, establishing strategic alliances with other organizations, and developing materials to support program outreach. NICHD's web site (www.nichd.nih.gov/milkmatters/milk.cfm) includes information on its publications and materials, as well as summaries of research projects.
- National Osteoporosis Foundation Youth Programs. Ronald H. White, M.S.T., Assistant Executive Director of Education, Research, and Community Affairs, National Osteoporosis Foundation (NOF) , shared some of the NOF's efforts to educate children and teens about bone health. For years, the NOF has been involved with organizations to conduct market research to better understand preteen and adolescent girls' bone health issues. Also, the NOF has advocated for federal education programs and funding in this area. In addition, NOF education initiatives include an education kit, called the Bone Basics Series, which contains bone health information for children and teens ( www.nof.org ). The NOF has partnered with the NIH Osteoporosis and Related Bone Disease's National Resource Center, which the NOF operates through a grant from NIH, to develop and provide materials related to bone health. These include fact sheets on peak bone mass and the skeletal risk of over-training, and a forthcoming parents' guide on children and their bone health. The Center and the National Alliance for Hispanic Health have collaborated on the "Hispanic Girls Pilot" project to develop a culturally- and age-appropriate model program to teach Hispanic girls about osteoporosis prevention. Participation in a theater production, which includes bone health messages in the script, is the strategy used to reach Hispanic girls and their families. Assessment of this program reveals that knowledge about bone health and interest in adopting healthy bone behaviors increased among all girls, especially younger girls. A resource kit available in Spanish and English is being developed to help other organizations implement this model theater program in their communities.
- Office on Women's Health, U.S. Department of Health and Human Services. Saralyn Mark, M.D. Senior Medical Advisor to the Office on Women's Health within the U.S. Department of Health and Human Services and the National Aeronautics Administration (NASA), discussed the National Bone Health Campaign (NBHC) , "Powerful Bones, Powerful Girls." The goal of this multi-year national campaign is to help girls 9 to 12 years old establish lifelong healthy habits, especially increased calcium consumption and physical activity to build and maintain strong bones. The campaign is a unique public/nonprofit partnership among the Centers for Disease Control and Prevention, the Department of Health and Human Service's Office on Women's Health, and the National Osteoporosis Foundation. The NBHC tag line, "Powerful Bones, Powerful Girls," and the messages and materials featuring Carla (a spokes-character whose name means strong in German) are based on extensive research involving girls and their parents of all racial and ethnic backgrounds across the U.S. This integrated marketing and communication campaign includes paid print and radio advertising for girls and parents; a part in Radio Disney's Live World eight-city tour in 2001; a web site for girls (www.cdc.powerfulbones); a calendar for girls to track their calcium and physical activity, with their parents' input; parent-oriented web content; and collaboration with the Girl Scouts of the USA. Some of the next steps are to promote the campaign and the web site through media outreach to print and online outlets; distribute materials to state health departments and other organizations; enhance the web site with new features, games, and information to keep it exciting; and look for opportunities for future collaborations.
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