"It's tough to get the kids to eat, period," said Stephanie Holzman, food service coordinator for the district. "Especially the younger kids."

Holzman has been with the district for 12 years and is continually challenged to devise plans and ideas to feed the children healthy meals.

Childhood obesity is a problem that has been sweeping the nation for almost two decades and it is an increasingly large problem in Arizona.

Though obesity can be genetic, that cause is very uncommon. The majority of cases result from poor diet and exercise habits.

"If you consume more calories than you burn with activity and so forth, you store your extra calories as fat and gain weight," said Tracey Kurtzman, an assistant professor of clinical pediatrics at the University of Arizona.

Holzman tries to make her menus as healthy as possible based on her annual budget. Tombstone High School students are offered fresh fruit every day.

"A lot of times, you can find some fresh fruit that isn't that much more expensive than the canned fruit," Holzman said. "I even allow the high school students to grab as much fruit as they want because of its nutritional value."

The two elementary schools in the district can only afford to have fresh fruit some days. The district also recently added more frozen vegetables and fruit to avoid the high sodium content found in canned counterparts, Holzman said.

The younger children, however, tend to be a bit more picky.

"Sometimes we have to allow small things like ranch dressing or a little bit of brown sugar here and there to entice the smaller children to eat the healthier meals," Holzman said. "I'll sacrifice a bit of nutrition to get them to at least eat at all."

Getting the children to eat full portions of their food is a constant struggle among many schools. It's important to have all the food groups represented in school meals.

Holzman hopes to someday have recess moved after lunch for the elementary schools, which would allow children to concentrate more on eating and their appetite, as opposed to fun activities.

Monday morning, the children at Huachuca Elementary School were served oatmeal with brown sugar, dried cherries, a muffin, and their choice of milk or juice. Most of the kids ate the muffin and threw the oatmeal in the trash.

Holzman tries to ensure all meals are under 30 percent fat and never fried. The major health implication of poor nutrition is Type 2 diabetes.

"We are having to send these children to hormone specialists and getting them special medications," Kurtzman said.

Type 2 diabetes is more common in places like Arizona than other areas of the country because of the large American Indian and Hispanic population.

American Indians and Hispanics are more genetically predisposed to develop Type 2 diabetes, Kurtzman said.

The district used to have a company make and analyze its menus, but due to budget cuts Holzman now creates the menu herself with a menu analysis system she recently purchased.

After creating a wellness policy for the district in 2005, Holzman received a grant to purchase learning materials for children regarding healthy food choices. Unfortunately, she hasn't found the time to devote herself to the project as much as she would like.

Two years ago, Walter J. Meyer Elementary stopped serving food due to a study conducted by Holzman that found the district could lose approximately $15,000 a year if it continued serving breakfast and lunch.

In the meantime, the children have been bussed to Tombstone High School for meals. However, the parents and staff recently voiced a need for the district to reinstate meals at the elementary school.

Holzman had to think outside of the box in light of the budget cuts Arizona schools are facing. Since last Monday, she and staff have been transporting food from the high school and serving it to the elementary students.

At first, the staff was very willing to help, but now a food services staff member must be in charge of serving.

"Though we're stretched thin, we're trying our best to accommodate the children and get them fed," she said.

The differences between childhood and adult obesity are not fully known.
"If you look at this as a problem that we have only been paying attention to for the past 10 years, we don't really know how these children are affected as adults, because they are just now entering adulthood," Kurtzman said.

She believes that the community needs to do a better job to educate families and school systems about obesity in children. There are also many programs that help obese children gain a healthy lifestyle, but unfortunately, the few programs that were in southern Arizona have been shut down due to lack of funding.

"With the state of the state budget, more and more cuts are being made to programs like this," Kurtzman said. "The more we cut in those areas, the more we do a disservice to our nation in the next few decades in terms of health."