WASHINGTON - It's back-to-school time and for many, that means back-to-packing-lunch time.

   "Unfortunately, many lunchboxes are overloaded with fat, sugar and salt and are missing fruit, vegetables and whole grains," said Margo Wootan, senior scientist at the Center for Science in the Public Interest (CSPI). "But since a handful of foods do most of the damage to children's diets and health, a handful of changes can go a long way toward improving them."

   What's in a child's lunch is important because it's in childhood that eating habits are formed and heart disease, obesity, osteoporosis and other diseases begin to develop. Fatty build-ups - the beginnings of clogged arteries - are seen in the arteries of children as young as ten years old. Obesity rates in children have doubled in the last decade.

CSPI suggests ten easy tips to give your child's lunchbox (or your lunch) a nutrition makeover:

1. Encourage your child to choose 1% or fat-free milk . "Milk is by far the largest source of saturated fat in children's diets," said Wootan. "Choosing 1% or fat-free milk instead of whole or 2% milk is an important strategy for keeping children's hearts healthy and arteries clear."
2. Leave the cheese off sandwiches, unless it's low-fat or fat-free cheese . Though cheese provides calcium, it is the second leading source of artery-clogging saturated fat in kids' diets. Healthier sources of calcium include lower-fat cheese, fat-free and 1% milk, low-fat yogurt and calcium-fortified orange juice.
3. Switch from ham, bologna, salami, pastrami or corned beef, and other fatty luncheon meats to low-fat alternatives . Wootan noted that supermarkets sell many good tasting, low-fat or fat-free brands of turkey breast, chicken breast, ham, bologna and roast beef.
4. Include at least one serving of fruit in every lunch . Try buying a few new types of fruit each week to let your child discover new favorites and to give her more choices. In addition to apples, oranges or bananas, try pears, sliced melon, cups of applesauce, grapes or pineapple (fresh or canned in its own juice). Try serving fruit in different ways -- whole, cut into slices, cubed or with a yogurt dipping sauce.
5. Sneak vegetables - like lettuce or slices of cucumber, tomato, green pepper, roasted peppers, zucchini or sweet onion - onto sandwiches . Eating fruits and vegetables reduces your child's chances of heart disease, cancer, blindness and stroke later in life. Putting veggies on a sandwich is one way to get more into your child's diet.
6. Use whole grain bread instead of white bread for sandwiches . Choose breads that list "whole wheat" as the first ingredient. If the main flour listed on the label is "wheat" or "unbleached wheat flour," the product is not whole grain. Most multi-grain, rye, oatmeal and pumpernickel breads in the U.S. are not whole grain.
7. Limit cookies, snack cakes, doughnuts, brownies and other sweet baked goods . Sweet baked goods are the second leading source of sugar and the fourth leading source of saturated fat in Americans' diets. Low-fat baked goods can help cut heart-damaging saturated fat from your child's diet, but even fat-free sweets can crowd out healthier foods like fruit.
8. Pack baked chips, pretzels, Cheerios, bread sticks or low-fat crackers instead of potato, corn, tortilla or other chips made with oil or Olean . Avoid fat-free Max chips and Procter and Gamble's Fat Free Pringles. They are made with Olean (olestra), a fat substitute that can cause abdominal cramping and diarrhea and can rob your body of carotenoids and other phytochemicals that may lower the risk of cancer. Also beware of Bugles, which are fried in heavily saturated coconut oil. One ounce has as much artery-clogging fat as a McDonald's Quarter Pounder.
9. If you pack juice, make sure it's 100% juice . All fruit drinks are required to list the "% juice" on the label. "Watch out for juice drinks like Sunny Delight, Hi-C, Fruitopia and Capri Sun. With no more than 10% juice, they're soft drinks masquerading as juice," said Wootan.
10. Don't send Lunchables . Oscar Mayer's Lunchables that come with a treat and a drink get two-thirds of their calories from fat and sugar. Making your own healthy alternative is as easy as packing low-fat crackers, low-fat lunch meat, a piece of fruit and a box of 100% juice in your child's lunch box (at the very least, use the lower-fat Lunchables).