This is what happens when a school swaps french fries for quinoa

In Quito, about 70% of the deaths are caused by non-communicable diseases like hypertension and diabetes. Obesity is a primary risk factor, and here – like just about everywhere in the world – we suffer from rising rates of childhood obesity.

Almost 27% of school-age children are either overweight or obese in Ecuador, compared with 31% in the US. The same risk factors apply in both countries, and everywhere else around the world: more processed foods, high in calories from sugar and fat but low in nutrients; more sweetened beverages and sodas; less fruit and vegetables; and less exercise.

Children who are overweight or obese are more likely to become adults with the same weight problems. And being overweight or obese increases the risk of type 2 diabetes, high blood pressure, heart attacks, some forms of cancer, and other non-communicable diseases.

The trend is also worsening, with more than 672 million people who qualify as obese – that’s more than one out of every eight adults in the world. Here in Ecuador, chronic non-communicable diseases (NCDs) cost the federal government $4.3 billion annually.

In both Ecuador, and the US – and again, most everywhere else – poverty and a subsequent lack of affordable food plays a significant role in the obesity crisis. The most recent United Nations report on nutrition highlights how economic inequities feed these health disparities: “The higher cost of nutritious foods, the stress of living with food insecurity and physiological adaptations to food restriction help explain why food insecure families may have a higher risk of overweight and obesity.”

That is why, in Quito, we’re working to tackle this crisis in the one place where we know we can reach the children – in school. As part of Bloomberg Philanthropies’ Partnership for Healthy Cities, the Pilas con las Vitaminas pilot program is now providing healthy meals in school food kiosks in six districts, while a healthy eating curriculum is being taught in classrooms. At the same time, we are working in communities to help everyone understand the importance of healthier nutrition, so that the nutrition lessons taught and modeled in the classroom are brought home to families.

What does this look like from a student’s perspective? Out goes the American fast foods, the French fries, hamburgers, and pizza. Instead, the meals available to students will be more traditional and healthier fare – foods made from chochos (high-protein beans), quinoa, amaranth, green plantain and corn. Our schools will provide more fruit and vegetables and less fat, salt and sugar.

The kiosks selling the healthier foods have been rebranded with colorful images and a marketing plan that will adjust for the seasons and holidays. The students have been suspicious of these changes, but our educational community – teachers, school administrators and staff – have embraced this new direction and are working with families to make it successful.

Remarkably, the cost of the new programme has been minimal. The roll out and marketing of the new menu choices and the healthier options represented only about 20% of our school food budget for the first year, and we anticipate cost savings as the programme becomes better established.

We will assess how this pilot project works at the end of the school year, but we have already observed success elsewhere in the world. In the US, a chef from one of the world’s finest restaurants created and delivered a healthy menu for 3,300 students in New London, Connecticut, and is now increasing the scope of operations in a pilot program in New York City’s least wealthy borough, the Bronx.

In London, UK, there is a movement to bring more chefs into school cafeterias and avoid pre-packaged nuggets and chips. There is even a new law, effective in 2019, that will ban new fast-food restaurants from opening within quarter of a mile of any primary or secondary school.

One aspect that catches our eye is how healthy eating translates into healthy test scores. Researchers looking at schools in the state of California saw that while student scores increased when healthy meals were served, the score increases were up to 40% larger for students coming from less wealthy families – the ones most likely to need the school lunches in the first place.

But the hard data on school lunches and childhood obesity remains front and centre in our efforts. In Japan, serving healthy school lunches was found to lower obesity rates and even increase student height. Earlier research in Tokyo established the importance of these meals in keeping students from impoverished communities well fed and thriving.

Like all mayors around the world, I want to see my constituents healthy and thriving. But local governments cannot do all of the work on their own. We need to partner with regional and national governments in promoting healthy lifestyles, from reining in misleading advertisements to creating agricultural policies that help farmers produce more nutritious foods.

Through the school lunch initiative, we have now acquired a more complete picture of our children’s well-being. As we continue to develop new strategies that limit the risk factors of non-communicable diseases, our experience reminds us that everyone should have the means to grow up healthy and happy.