Celebrities may have helped shape anti-vaccine opinions during Covid-19 pandemic, study finds | CNN



CNN
 — 

Covid-19 vaccines are known to be safe and effective, and they’re available for free, but many Americans in the US refuse to get them – and a recent study suggests that celebrities may share some of the blame for people’s mistrust.

Celebrities have long tried to positively influence public health, studies show, but during the Covid-19 pandemic, they also seemed to have a large influence on spreading misinformation.

Decades ago, in the 1950s, people could see stars like Elvis Presley, Dick Van Dyke and Ella Fitzgerald in TV ads that encouraged polio vaccination. This celebrity influence boosted the country’s general vaccination efforts, and vaccination nearly eliminated the deadly disease.

In 2021, US officials used celebrities in TV ads to encourage more people to get vaccinated against Covid-19. Big names like lifestyle guru Martha Stewart, singer Charlie Puth and even Senate Minority Leader Mitchell McConnell showed up in spots that had billions of ad impressions.

The world isn’t restricted to only three TV networks any more, so celebrities like actress Hilary Duff, actor Dwayne “The Rock” Johnson, singer Dolly Parton and even Big Bird also used their enormous presence on Instagram and Twitter to promote a pro Covid-19 vaccine message.

But social media also became a vehicle for celebrities to cast doubt about the safety and effectiveness of the vaccine and even to spread disinformation about Covid.

Their negative messages seemed to find an audience.

For their study, published in the journal BMJ Health & Care Informatics, researchers examined nearly 13 million tweets between January 2020 and March 2022 about Covid-19 and vaccines. They designed a natural language model to determine the sentiment of each tweet and compared them with tweets that also mentioned people in the public eye.

The stars they picked to analyze included people who had shared skepticism about the vaccines, who had Covid-related tweets that were identified as misinformation or who retweeted misinformation about Covid.

They included rapper Nicki Minaj, football player Aaron Rodgers, tennis player Novak Djokovic, singer Eric Clapton, Sen. Rand Paul, former President Donald Trump, Sen. Ted Cruz, Florida Gov. Ron DeSantis, TV host Tucker Carlson and commentator Joe Rogan.

The researchers found 45,255 tweets from 34,407 unique authors talking about Covid-19 vaccine-related issues. Those tweets generated a total of 16.32 million likes. The tweets from these influencers, overall, were more negative about the vaccine than positive, the study found. These tweets were specifically more related to antivaccine controversy, rather than news about vaccine development, the study said.

The highest number of negative comments was associated with Rodgers and Minaj. Clapton had “very few” positive tweets, the study said, and that may have had an influence, but he also caught flak for it from the public.

The most-liked tweet that mentioned Clapton and the vaccine said, “Strongly disagree with [EC] … take on Covid and the vaccine and disgusted by his previous white supremacist comments. But if you reference the death of his son to criticize him, you are an ignorant scumbag.”

Trump and Cruz were found to have the most substantial impact within this group, with combined likes totaling more than 122,000.

They too came in for criticism on the topic, with many users wondering whether these politicians were qualified to have opinions about the vaccines. The study said the most-liked tweet mentioning Cruz was, “I called Ted Cruz’s office asking to make an appointment to talk with the Senator about my blood pressure. They told me that the Senator was not qualified to give medical advice and that I should call my doctor. So I asked them to stop advising about vaccines.”

The most-liked tweet associated with Rogan was an antivaxx statement: “I love how the same people who don’t want us to listen to Joe Rogan, Aaron Rodgers about the covid vaccine, want us to listen to Big Bird & Elmo.”

Posts shared by news anchors and politicians seemed to have the most influence in terms of the most tweets and retweets, the study found.

“Our findings suggest that the presence of consistent patterns of emotional content co-occurring with messaging shared by those persons in the public eye that we’ve mentioned, influenced public opinion and largely stimulated online public discourse, for the at least over the course of the first two years of the Covid pandemic,” said study co-author Brianna White, a research coordinator in the Population Health Intelligence lab at the University of Tennessee Health Science Center – Oak Ridge National Laboratory Center for Biomedical Informatics.

“We also argue that obviously as the risk of severe negative health outcomes increase with the failure to comply with health protective behavior recommendations, that our findings suggest that polarized messages from societal elite may downplay those severe negative health outcome risks.”

The study doesn’t get into exactly why celebrity tweets would have such an impact on people’s attitudes about the vaccine. Dr. Ellen Selkie, who has conducted research on influence at the intersection of social media, celebrity and public health outcomes, said celebrities are influential because they attract a lot of attention.

“I think part of the influence that media have on behavior has to do with the amount of exposure. Just in general, the volume of content that is focused on a specific topic or on a specific sort of interpretation of that topic – in this case misinformation – the repeated exposure to any given thing is going to increase the likelihood that it’s going to have an effect,” said Selkie, who was not involved in the new research. She is an adolescent health pediatrician and researcher with UW Health Kids and an assistant professor of pediatrics at the University of Wisconsin School of Medicine and Public Health.

Just as people listen to a friend’s thoughts, they’ll listen to a celebrity whom they tend to like or identify with because they trust their opinion.

“With fandoms, in terms of the relationship between musical artists and actors and their fans, there is this sort of mutual love that fans and artists have for each other, which sort of can approximate that sense that they’re looking out for each other,” Selkie said.

She said she would be interested to see research on the influence of celebrities who tweeted positive messages about the Covid-19 vaccine.

The authors of the study hope public health leaders will use the findings right away.

“We argue this threat to population health should create a sense of urgency and warrants public health response to identify, develop and implement innovative mitigation strategies,” the study says.

Exposure to large amounts of this misinformation can have a lasting impact and work against the public’s best interest when it comes to their health.

“As populations grow to trust the influential nature of celebrity activity on social platforms, followers are disarmed and open to persuasion when faced with false information, creating opportunities for dissemination and rapid spread of misinformation and disinformation,” the study says.



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President Carter is on hospice care, but what is it? Our medical analyst explains | CNN



CNN
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On Saturday, the Carter Center announced that former US President Jimmy Carter will be receiving hospice care at his home in Georgia.

“After a series of short hospital stays, former US President Jimmy Carter today decided to spend his remaining time at home with his family and receive hospice care instead of additional medical intervention,” according to the statement. “He has the full support of his family and his medical team.”

The 98-year-old Carter is the oldest living US president in history. He has survived metastatic brain cancer and faced a number of health scares, including brain surgery following a fall in 2019.

As Carter opted for hospice care, CNN Medical Analyst Dr. Leana Wen and I thought that many people might be unfamiliar with hospice care beyond a vague understanding that some people receive it toward the end of life. There can be benefits and blessings for the person receiving the care and their loved ones, but there are also some common misconceptions about what it involves.

I asked Dr. Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health, to guide us through some questions.

CNN: What is hospice care and who qualifies for it?

Dr. Leana Wen: Hospice care is a type of specialty medical care for people near the end of their lives that focuses on maximizing comfort for the patient and support for the patient and their family. That includes reducing physical pain and tending to the psychological, emotional and spiritual needs of the patient and the family.

Generally, to qualify for hospice care, the patient must have an incurable medical condition with an anticipated life expectancy of less than six months. The types of medical conditions that patients have include end-stage cancer, advanced dementia, heart failure and chronic obstructive pulmonary disease.

CNN: Where do patients receive hospice care and who provides it?

Wen: Hospice care is an approach to medical care, not a specific place, so it can be provided in a number of different settings. The choice of settings is up to the patient and family. Providers are an interdisciplinary team of physicians, nurses, home health aides, pharmacists and others who will tend to the patient no matter what setting they choose.

Many patients opt to receive hospice care in their homes, where they can be in familiar surroundings. The hospice team helps to provide equipment, supplies and staff to assist the family to care for their loved one. They provide regular home visits and are generally available around the clock for concerns as they come up.

Hospice can also be delivered in a nursing home or at the hospital. In addition, there are specialized hospice centers.

CNN: What are some common misconceptions of hospice care?

Wen: There is a misconception that hospice care is “giving up” on medical care. Actually, hospice care is a specific type of compassionate medical care for patients in the last stages of incurable disease to live as fully and comfortably as they can. A primary aim of hospice care is to manage the patient’s symptoms so that the patient’s last days can be spent with their loved ones, with dignity and the highest quality possible.

A second misconception is that once a patient enters hospice care, they can no longer receive any medical treatment. This is not true. Patients receive medicines to help their symptoms and alleviate their pain. They and their families can also choose to leave hospice at any point and resume, say, active treatment for their cancer.

I’ve also heard people say that hospice care is only for people with a few days to live. This is also not the case. Often, patients don’t begin hospice care soon enough to take full advantage of the help it offers. Beginning it earlier may help provide months — rather than days — of quality time with loved ones.

CNN: What are the benefits and blessings of this type of care?

Wen: In modern medicine, the tendency is to approach diseases as something to be cured. Unfortunately, this is not always possible. The patient may choose not to continue certain treatments that cause severe pain when there is slim chance for a cure. When there is limited time left to live, that patient may wish to minimize suffering and to prioritize spending the remaining time with their loved ones.

I know the benefits and blessings of hospice care firsthand. My mother was diagnosed with metastatic breast cancer in her 40s. She fought her cancer valiantly, undergoing multiple rounds of surgery, radiation and chemotherapy for eight years. Unfortunately, she had multiple recurrences.

During the final recurrence, it became clear that a cure was not possible and that she had limited time — as it turns out, weeks — to live. She opted to enter hospice care, with the aim to spend her final days at home, rather than in the hospital, and with the aim of alleviating her pain and suffering rather going through yet another round of chemotherapy. I understood and supported her decision, and it was important to me and my family to give her what she wanted, which was the highest quality of life with the least amount of suffering.

CNN: Does insurance cover hospice care?

Wen: Most hospice patients are eligible for Medicare, which provides for hospice care through Medicare Hospital Benefit. Medicaid also pays for hospice care in many states, and many private insurers will cover it. For patients who don’t have insurance, there are some community programs that offer sliding scale coverage or free care.

CNN: What’s the difference between hospice and palliative care?

Wen: There are physicians, nurses and other medical professionals who specialize in hospice and palliative medicine; these are very much complementary and related fields of medicine that share a similar philosophy.

Palliative care, like hospice care, also prioritizes easing suffering, improving the quality for the patient, and delivering that care in a way that centers the patient and family. But differently from hospice care, the patient doesn’t have to forgo curative treatment – palliative care can be provided together with curative treatment. Over time, if it becomes apparent that the patient is likely to die within six months, palliative care can transition over to hospice care.

Both hospice and palliative care are important specialty medical services that are underutilized, and can offer much support and comfort to many more patients and families.

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Fetterman’s hospitalization: What is clinical depression? | CNN

Editor’s Note: If you or someone you know is struggling with mental health, please call the Suicide & Crisis Lifeline at 988 to connect with a trained counselor or visit 988lifeline.org.



CNN
 — 

Democratic Sen. John Fetterman of Pennsylvania voluntarily checked himself into a hospital on Thursday “to receive treatment for clinical depression,” according to a statement by Adam Jentleson, his chief of staff.

“While John has experienced depression on and off during his life, it only became severe in recent weeks,” Jentleson wrote.

In May, during his campaign, Fetterman suffered a stroke as he faced off against Republican Mehmet Oz for the Senate seat.

“After what he’s been through in the past year, there’s probably no one who wanted to talk about his own health less than John. I’m so proud of him for asking for help and getting the care he needs,” his wife, Gisele Barreto Fetterman, tweeted.

“I think it’s fantastic that Sen. Fetterman was working with a provider that recommended he get a higher level of care, and that he was able to access services quickly,” said Kristen Carpenter, chief psychologist in the department of psychiatry and behavioral health at Ohio State University College of Medicine.

“Many patients struggle and suffer with these symptoms for a long time before seeking or getting the help they need,” she added. “At a minimum, you can have relief faster when you’re linked for care.”

Depression after a major illness such as stroke is not uncommon, according to the American Stroke Association.

“After a stroke there are biochemical changes within the brain structure which might put him more at risk for depression,” said stress management expert Dr. Cynthia Ackrill, a fellow at the American Institute of Stress.

“After you’ve had a stroke, it takes more work to do what you did before,” Ackrill added. “So you’re more tired and more stressed, and we know that chronic exposure to the cortisol that comes from stress puts you more at risk for depression.”

No one knows the exact cause for depression, and why it is worse in some people than others, according to the US Centers for Disease Control and Prevention.

“It may be caused by a combination of genetic, biological, environmental, and psychological factors,” the CDC noted.

Having a family member with depression raises the risk; so do traumatic experiences such as physical abuse or sexual assault, financial problems and a major life change, such as losing a loved one, the CDC said.

Depression is also more common after having a heart attack or being diagnosed with cancer or chronic pain, and people with anxiety disorders are more likely to suffer from depression, too, the CDC said. Substance abuse, such as alcoholism, is also linked to depressive symptoms.

Feelings of depression can be a side effect of many medications, including common ones such as beta blockers used to treat high blood pressure, some proton pump inhibitors used to treat acid reflux, steroids used for inflammation and pain, hormonal contraceptives and more. A 2018 study found over 37% of US adults used medications that might lead to depression.

Symptoms of depression include an ongoing sad, anxious or vacant mood, along with “feelings of hopelessness, pessimism, guilt, worthlessness or helplessness,” according to the American Stroke Association.

Other symptoms include fatigue and decreased energy; less interest or pleasure in daily activities, including sex; changes in appetite and weight; trouble with memory, concentration, planning and decision-making; sleep changes, such as insomnia or oversleeping; and thoughts of death or suicide.

Read more: Inside the depressed mind — fighting yourself in a world with no color

Depression can be mild, moderate or severe. Clinical depression, also called major depressive disorder, is the more severe form of depression.

To be diagnosed with clinical depression “an individual must have five depression symptoms every day, nearly all day, for at least 2 weeks,” according to the National Institute on Mental Health.

“One of the symptoms must be a depressed mood or a loss of interest or pleasure in almost all activities. Children and adolescents may be irritable rather than sad,” the institute noted.

“We all experience times of sadness, or lack of interest in things we usually enjoy, or other sorts of depressive symptoms,” Ohio State’s Carpenter said. “However, when someone slips into a major depressive episode that means those symptoms are present daily, for most of the day, and they are functionally impairing — meaning they inhibit one’s ability to work, to interface with their families and loved ones, and to engage in the usual activities of living.”

There are a number of treatments for depression, including antidepressant medications, psychological therapy or a combination of both. Antidepressants typically take between four to eight weeks to work, and it’s not uncommon to try a variety of medications before finding the best for that individual, Carpenter said.

“There are higher levels of care like hospitalization, which provides services available all day to help get you on your recovery journey faster.”

If depression fails to respond to first-line treatments, providers may suggest other medications such as esketamine, Carpenter said. Delivered as a nasal spray by doctors, esketamine is a newer US Food and Drug Administration-approved medication for treatment-resistant depression.

“It often acts rapidly — typically within a couple of hours — to relieve depression symptoms,” according to the National Institute on Mental Health.

“If you have what we refer to as a treatment-resistant depression, we may use things like TMS — transcranial magnetic stimulation — and we still use ECT, or electroconvulsive therapy. So there really is a large compendium of therapies available,” Carpenter said.

“The key is getting care. The vast majority of people will have their symptoms remit with proper treatment through psychotherapy and/or medication.”



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Pathological lying could finally be getting attention as a mental disorder | CNN



CNN
 — 

When Timothy Levine set out to write a book about deception in 2016, he wanted to include a chapter on one of its most extreme forms: pathological lying.

“I just couldn’t find any good research base on this,” said Levine, chair of the Department of Communication Studies at the University of Alabama at Birmingham.

Now, it seems it’s the only thing anyone wants to talk to him about.

“Santos has brought more reporters to me in the last couple of weeks than probably in the last year,” Levine said.

Santos, of course, is US Rep. George Santos, a Republican from Long Island who was recently elected to represent New York’s third congressional district.

In the months since his election, key claims from Santos’ biography – including where he earned his college degree, his employment at Citigroup and Goldman Sachs, an animal rescue group he says he founded and his Jewish religious affiliation – have withered under the scrutiny of reporters and fact-checkers. Now, he says, he doesn’t have a college degree; he wasn’t employed by Citigroup or Goldman Sachs; and the IRS has no record of his animal rescue group. He also says he never claimed to be Jewish, but rather he was “Jew-ish.”

Santos defended himself in media interviews in December, saying that the discrepancies were the result of résumé padding and poor word choices but that he was not a criminal or a fraud.

It’s not clear what is driving Santos’ statements.

But the story has given professionals who study lying in its most extreme forms a rare moment to raise awareness about lying as a mental disorder – one they say has been largely neglected by doctors and therapists.

“It is rare to find a public figure who lies so frequently in such verifiable ways,” says Christian Hart, a psychologist who directs the Human Deception Laboratory at Texas Woman’s University.

Psychiatrists have recognized pathological lying as a mental affliction since the late 1800s, yet experts say it has never been given serious attention, funding or real study. It doesn’t have its own diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, or DSM, the bible of psychiatry. Instead, it is recognized as a feature of other diagnoses, like personality disorders.

As a result, there’s no evidence-based way to treat it, even though many pathological liars say they want help to stop.

The standard approach to treating lying relies on techniques borrowed from cognitive behavioral therapy, which emphasizes understanding and changing thinking patterns. But no one is sure that this is the most effective way to help.

We don’t know necessarily what’s the most effective treatment,” said Drew Curtis, an associate professor of psychology at Angelo State University in Texas who studies pathological lying.

Curtis had someone offer to drive across the country to see him for treatment, which he says he wasn’t able to offer.

“So that’s the heartbreaking side of it for me, as a clinician: people that are wanting to help and can’t have the help,” Curtis said.

Longtime collaborators Curtis and Hart recently published a study laying out evidence to support the inclusion of pathological lying as a standalone diagnosis in the DSM.

Over the years, Hart said, almost 20 people have proposed definitions of pathological lying, but there’s very little overlap between them: “The only truly common feature is that these people lie a lot.”

The first thing to know about pathological or compulsive lying is that it is rare, Levine says. His studies show that most people tell the truth most of the time.

“These really prolific liars are pretty unusual,” said Levine, whose book about deception, “Duped,” was published in 2019.

Which isn’t to say that lying isn’t common. Most people lie sometimes, even daily. In his studies, people lied up to twice a day, on average.

Levine himself regularly lies at the grocery store when workers ask whether he found everything he was looking for. Since the Covid-19 pandemic began, that answer is almost always no, but he says yes anyway.

One of his students worked in a retail clothing store and regularly lied to people who were trying on clothes. Another – a receptionist – lied to cover for a doctor who was always running late.

That’s all pretty normal, Levine said. He believes that honesty is our default mode of communication simply because people have to be honest with each other to work effectively in big groups, something humans do uniquely well in the animal kingdom.

But sticking to the facts isn’t easy for everyone.

In their studies, Hart and Curtis have found that most people tell an average of about one lie a day. That’s pretty normal. Then there are people who lie a lot: about 10 lies a day, on average.

Hart and Curtis call prolific or especially consequential liars – someone like Bernie Madoff, who dupes and defrauds investors, for example – “Big Liars,” which is also the title of their recent book.

Big lying is pretty unusual. Pathological lying is even more rare than that.

Hart thinks he’s only ever interacted with two people that met the classical case study description of pathological lying.

“It was dizzying,” Hart says.

When people start to lie so much that they can’t stop or that it begins to hurt them or people around them, that’s when it becomes abnormal and may need treatment.

“It’s more the clinical category of people who tell excessive amounts of lies that impairs their functioning, causes distress, and poses some risk to themselves or others,” Curtis said, sharing the working definition of pathological lying that he and Hart hope will eventually be included in the DSM.

“What we found, examining all the cases, is that the lying appears to be somewhat compulsive,” Hart said. “That is, they’re lying in situations when a reasonable person probably wouldn’t lie, and it seems like even to their own detriment in many cases.

“It tends to cause dysfunction in their lives,” Hart said, including social, relationship and employment problems.

On some level, pathological liars know they’re lying. When confronted with their lies, they’ll typically admit to their dishonesty.

Lying can also be a feature of other disorders, but Hart says that when they assessed people who met the criteria for pathological lying, they found something interesting.

“It turned out that the majority of them don’t have another psychological disorder. And so it seems like lying is their principal problem,” he said, lending weight to the idea that it deserves to be its own diagnosis.

The American Psychiatric Association, or APA, publishes the DSM and regularly reviews proposals for new diagnoses. Curtis says he has been gathering evidence and is in the process of filling out the paperwork the APA requires to consider whether pathological lying should be a new diagnosis.

As for whether certain professions seem to attract people who lie more than average, Hart says that’s a complicated question.

It’s not that people who lie a lot tend to gravitate to certain jobs. Rather, certain jobs – like sales, for example – probably reward the ability to lie smoothly, and so these professions may be more likely to have a higher concentration of people who lie more than average.

“The evidence we have suggests that politicians aren’t by their nature any more dishonest than the typical person,” Hart said. “However, when people go into politics, there’s pretty good evidence that the most successful politicians are the ones that are more willing to bend the truth” and so they may be the ones more likely to be re-elected.

Only time will tell, how the situation may play out for Santos.

So far, he has resisted calls to step down, saying he intends to serve his term in Congress. This week, though, Santos announced he would step down from any committee assignments while the investigations are ongoing.

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Proposed changes to school lunches aim to reduce sugar and sodium, but flavored milk stays | CNN



CNN
 — 

If new US Department of Agriculture school food guidelines stand as proposed, chocolate milk is in, but for the first time ever, at least some added sugars will be out – and sodium levels will be reduced gradually.

Agriculture Secretary Tom Vilsack publicly announced the changes on Friday.

“The purpose of this is to improve the health and welfare of our children. And I think everybody who comes to this issue shares that goal and hopefully, collectively, we can make sure it happens,” Vilsack told CNN in an interview Thursday ahead of the announcement.

The federally assisted school meal program provides nutritionally balanced meals at school at low or no-cost.

More than 15.3 million kids every day get breakfast at school in the US and 29.6 million get a school lunch, Vilsack said. The numbers were higher earlier in the pandemic, when meals were offered free to all children regardless of their family’s income, but in June, Congress did not extend the Covid-19 pandemic waivers that had expanded the program.

While school meals are paid for by local and federal funding, the standards for what goes on a kids’ cafeteria tray are set by the USDA. The agency’s job is to make sure any meal served at school is nutritious and falls in line with the US Dietary Guidelines.

Flavored milk with “reasonable limits on added sugars” would be allowed under the proposal. Vilsack said school meal administrators tell the USDA that kids just won’t drink much no-fat skim milk or unflavored milk. “That’s not what they get at home,” Vilsack said. “We want to encourage kids to drink milk because there are there’s tremendous nutritional value in milk.”

However, the proposed standards would limit added sugar in certain high-sugar products like prepackaged muffins, yogurt, and cereal. Eventually, the guidelines would then limit added sugars across the weekly menu.

The standards would reduce sodium limits, but that would happen gradually over several school years.

“The [US Food and Drug Administration] provided some insight and direction by suggesting that it is easier for people to accept and adopt to reduced sodium if you do it over a period of time in small increments,” Vilsack said.

A gradual reduction would also give industry time to reformulate their products, said Dr. Lauren Au, an assistant professor at UC Davis’ Department of Nutrition who studies the effectiveness of school nutrition programs.

The guidelines would also place a bigger emphasis on whole grains, but still leave options open for an occasional non-whole grain product.

“Maybe a biscuit can be instituted for a little variety, or grits can be provided where that may make sense from a geographic standpoint. You are sensitive to cultural demands and needs,” Vilsack said.

The proposed rule would also strengthen the Buy American requirements encouraging schools to use more locally grown food.

The USDA will invest $100 million in the Healthy Meals Incentives initiative which offers farm-to-school grants and grants to buy equipment. In the 1980s, schools around the country tore out kitchens and bought prepackaged processed food. To make more nutritious meals, schools have had to rebuild or update kitchens.

“A lot of schools have outdated ovens, freezers, fridges, and that puts limitations on how they can prepare food, so grants that have helped with equipment have been really successful,” Au said.

The money would also reward schools that do a good job providing nutritious meals. Grants would also be aimed at small and rural districts and training.

Vilsack said the USDA created these proposed standards after the USDA received thousands of comments and held 50 listening sessions with parents, school food administrators, the food industry, public health and nutrition experts.

“Establishing these standards are difficult because you have to follow the science you have to follow the dietary guidelines, but you also have to understand that they need to be implemented in the real world which is which is which is tough,” Vilsack said in an interview with CNN.

Real world circumstances are tough already with the higher cost of food, staff shortages and supply chain problems.

Au hasn’t seen all of the proposed policies, but she said what she has seen look good.

“It’s a step forward in terms of promoting healthy nutrition in schools,” Au said. The reduction of added sugar, she added is a big deal.

“Reducing added sugars for this age range is so important,” AU said.

Megan Lott, deputy director for the Robert Wood Johnson Foundation program Healthy Eating Research, said that the policies seem to be heading in the right direction.

“There are a couple of things we would probably like to see strengthened, but it also seems like there are plans to do that over time,” Lott said.

The sugar standard is a good start, she said, but she’d prefer the proposal instead say that no more than 10% of calories should come from added sugars across the meal plan.

“But we recognize that schools might need a little bit of time for implementation,” Lott said.

Lott had also hoped they would take flavored milk off the menu. Research shows that schools that have gotten rid of flavored milk show a drop in milk consumption for a year or two, but milk sales eventually rebound.

School food has become a proverbial hot potato.

After decades of bipartisan support for school meals, the program has been politicized in about the last 10 years Lott says, meaning there is bound to be some pushback.

Friday’s proposed changes would be the first large scale reform of school meal standards since President Barack Obama signed the 2010 Healthy, Hunger-Free Kids Act into law.

The law that went into effect in 2012, championed by first lady Michelle Obama, really did improve US kids’ diet, studies show. The law raised the minimum standards and required schools to serve more whole grains, fruit, vegetables, and fat-free and/or low-fat milk more frequently and serve fewer starchy vegetables and foods high in trans fat and sodium.

Meals that were eaten by students – not just served to students and then tossed into garbage cans – were much healthier and had better overall nutritional quality, the study showed. Students who didn’t participate in the national program did not see an improvement in their diets.

Despite the program’s success, in 2018, the Trump administration announced a proposal to roll back many of the policies in the name of “flexibility,” including ones that involved sodium and whole grains. Trump’s policy would essentially create a loophole letting schools sell more burgers, pizza and french fries and reduce the fruit and vegetables sold. A federal court struck down the rule in April 2020.

During the pandemic, some of the polices were relaxed, like for whole grains, because it was difficult to find products, Lott said.

Studies show kids who eat meals at school ate more fruits, vegetables, whole grains and dairy, compared with those who ate at school less frequently.

Better nutrition can help prevent obesity. About 20% of the US population ages 2 to 19 live with obesity, which can cause kids to have high blood pressure, breathing problems and type 2 diabetes, and lead to lifelong health problems, according to the US Centers for Disease Control and Prevention.

Hungry kids have a hard time paying attention in class. Students who ate healthy meals at school scored better on end-of-year academic tests, studies have shown.

The new standards are just a proposal. The USDA will ask for additional feedback.

Vilsack is hopeful the standards will incentivize more schools to offer more healthy options.

“In terms of future of this program,” Vilsack said, “we want to see more and more school districts push themselves not only to meet the standards, but in some cases to exceed them.”

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