Junior Holli Newman sets her tray of nachos and a caramel roll on the table in the Bismarck High School cafeteria. Like most of her friends at the table, she bought her lunch from the a la carte line. Only one of the five people at her table bought a lunch from the hot lunch line.

It's the first day of school, and so far the only changes the students are noticing are the drink offerings and the size of the cookies.

"The cookies are smaller. Usually they are that big," Newman said, holding her hands apart in a circular shape to demonstrate. "They're really good."

The smaller cookies are only one change that comes from new wellness policies that are required by the federal government. As students and teachers headed to school this week, they no longer could drink soda or sports drinks in Bismarck Public Schools. Only juice, milk or water is sold. Also, food items sold in vending machines and a la carte lines at lunch must meet nutrition standards. The policies are a response to the national rise in obesity in children.

Have a carrot and chew on this: Most North Dakota teens are not at risk of being overweight, according to a national survey. More students' waistlines, however, are inching toward becoming overweight.

"Even though it's not a major increase, it's tripled since the '80s," nutritionist Karen Ehrens said. "If we keep doing what we're doing, it will continue."

Overweight teens account for 11 percent of North Dakota teens, and another 13 percent of North Dakota teens are at risk of being overweight, according to statistics from the 2005 Youth Risk Behavior Survey. The percentage has increased from 11.7 percent at risk and 7.2 percent being overweight in the 1999 Youth Risk Behavior Survey results for North Dakota.

Nationally, the percentage of youth who are overweight has tripled among 12- to 19-year-olds and more than doubled among 6- to 11-year-olds, according to the Centers for Disease Control's Healthy America Report. Overweight teens increased from 5 percent during 1976-80 to 16 percent during 1999-2002, and overweight children increased from 6.5 percent to 15.8 percent during the same time periods, according to the report.

Although more children are becoming overweight, three-quarters of North Dakota teens are within a healthy weight. Still, the federal government is requiring school districts to crack down on unhealthy foods and beverages in schools and require more physical activity to curtail the increasing national trend in childhood obesity.

"Wellness policies don't just target overweight kids. … It's trying to stop it from getting any worse, so we don't have any more kids getting overweight," Ehrens said.

All schools that participate in the national school lunch program, including private and parochial schools, must have a wellness policy in place for this school year.

Not all school district policies ban the sale of junk food and sodas. In Mandan Public Schools, students and staff won't see any changes in food and drink offerings because of the wellness policies. The Mandan School Board approved a policy that has not defined nutrition standards or specified amounts of physical activity. The policy calls for food items to be nutritional.

The Bismarck nutrition standards include only selling 100 percent fruit juice, skim or 1 percent milk, a la carte and vending machine items with 35 percent or less total fat and 30 grams or less of carbohydrates.

The first day of school, students noticed the rows of flavored waters and fat free milk in beverage coolers and vending machines.

"I bought one (soda) every day, one or two," last year, junior Lindsey Throndset said.

Some students used the sodas as a way to jump-start their day. Now they have to think of alternatives, unless they buy soda elsewhere.

Throndset figures she'll go to a gas station to get her caffeine fix.

"I need my caffeine," she said.

Newman, who drank a Mountain Dew during Demonettes morning practices, figures she'll switch to gum. Junior Isaac Schmidt figures he'll get soda or candy from the gas station if he needs a pick-me-up, he said.

The lack of soda doesn't bother all students.

"I just drink water," junior Alicia Martel said. "I'm not a big pop drinker."

The Bismarck School District worked with its vending machine contractors to supply items that meet the policies. There will be some of the nixed items sold because the district already had them on hand, Assistant Superintendent Rick Buresh said.

"It's not costing us any more money, but we are anticipating a modest decrease in revenue and consumption," he said.

The district's most popular selling beverage, however, is water, Buresh said.

The Bismarck School District began working on its policy two years ago at the request of local physicians and nutritionists. It created a health council, which created the policy the district put in place for this school year.

"This came later and added energy to what we already started," Buresh said.

The policies are not a cure-all for obesity, but as prevention for those who are not overweight and to curtail weight gain in those who are overweight.

"I don't think it's going to be as big an event as some people think it's going to be," Buresh said.

Student reaction to the policy is mixed.

"I don't really like it because if people wanted to choose their own food, it's (available) off campus and they can get it anyway," Newman said.

It's a good idea for younger children, Throndset said.

"It teaches them to do it," she said.

Throndset ate fries for lunch Thursday. She said she knows it's not a healthy choice.

"It's quick and easy," she said.

Martel supports the wellness policies, and she said the food choices are healthier versions of what was available last year.

"I think they should (choose the foods) because it's big right now," Martel said. "You read about it in the paper, about the little kids who are obese. It's sad."

Schools, however, only provide one of three meals a day. Its impact on a child's eating habits is negligible compared to the parents' eating habits.

"A lot of parents come from a dieting mentality," nutritionist Kelly Fisher said.

But such a mentality for children could cause insecurity with food, she said.

Getting teens to eat healthy starts by offering healthy choices at home and starting healthy eating habits when they are young. Fisher recommends parents introduce different foods and not punish children for not eating new foods. Parents might need to make a new food 10 to 12 times before a child will eat it, she said.

"You have to think of eating beyond now," she said. "Do you want to get them to eat broccoli at this meal or like it beyond this meal?"

Assuming a child doesn't like a new food after one or two tries could be a mistake, and if a child doesn't like a food now, the child could like it when they're older, she said.

Starting these kinds of habits as children are the basis for teens to adopt healthy eating habits when they start making their own food choices, Ehrens said.

"If they have a good foundation," it helps, Ehrens said. "Of course they will choose food that is fast and tastes good."

Getting to a healthy weight involves proper nutrition and getting enough physical activity.

Health officials, parents and others are concerned about the rise in numbers of youth who are at risk of becoming overweight or who are overweight because of the other health problems that are associated with being overweight. The biggest concern is diabetes.

Diabetes among North Dakota children remained fairly constant from 1996 to 2002 at 3.1 children per 1,000 children, but then increased to 3.2 children per 1,000 children in 2003, according to data from Blue Cross Blue Shield, which the North Dakota Department of Health uses to track diabetes in children.

But anecdotal evidence from physicians shows obesity and its related ills could be more grave than the statistics bear out.

"The anecdotal information we hear from physicians is that they are seeing a lot more overweight and obesity in their practices," Sherri Paxon, program director of the diabetes prevention and control program with the North Dakota Department of Health, wrote in an e-mail. "Part of the difficulty in proving it data-wise is that the number of kids in (North Dakota) is pretty small and the kids in the BCBS database only covers about 40 percent of the kids in the state."

The wellness policies are required under the reauthorization of the national school lunch act and are part of the HealthierUS initiative. The youth risk-behavior survey is part of a separate health initiative, the Healthy People 2010. The survey is the primary source of data to measure 15 Healthy People 2010 objectives and three leading health indicators, according to the report on the national survey results.

The wellness policies also address how much physical activity students should get through physical education classes and recess.

Although teens who are overweight or at risk of being overweight account for about a quarter of North Dakota teens, almost half of teens are trying to lose weight and a third see themselves as overweight, according to the youth risk-behavior survey results. About 60 percent of students tried to lose weight by exercising, according to the survey.

"It's not about 'lose this much weight,' but healthier habits," Fisher said.

She's seen children as young as first and second grade ask each other if they are fat, she said.

Ultimately, youth should try to maintain a healthy weight to prevent increased risk of obesity-related diseases such as diabetes, according to the CDC.

A healthy weight is within the fifth to 85th percentile for weight and height. The median weight and height for a 16-year-old boy is 132 pounds and 5 feet 8 and half inches. A girl's median weight and height for 16 years old is 118 pounds at 5 feet 4 inches. Overweight at the same height is 184 pounds for boys and 172 pounds for girls.

Some students know what it takes to be healthy.

"Pop and cookies at lunch can't be blamed" for obesity, Schmidt said. "It's them going home and sitting and not going to places like the (YMCA) and working out. Food cannot be blamed for everything."

(Reach reporter Sara Kincaid at 250-8251 or sara.kincaid@;bismarcktribune.com.)