Advertisement

Eating School Meals Daily Is Associated with Healthier Dietary Intakes: The Healthy Communities Study

Published:March 17, 2018DOI:https://doi.org/10.1016/j.jand.2018.01.010

      Abstract

      Background

      Research on the association between school meal consumption and overall dietary intake post-Healthy Hunger-Free Kids Act implementation is limited.

      Objective

      This study examines the association between frequency of participating in the National School Lunch and School Breakfast Programs and children’s dietary intakes.

      Design

      The Healthy Communities Study was a cross-sectional observational study conducted between 2013 and 2015.

      Participants and setting

      US children aged 4 to 15 years (n=5,106) were included.

      Main outcome measures

      Dietary measures were assessed using the National Health and Nutrition Examination Survey Dietary Screener Questionnaire. Dietary intake included fruit and vegetables, fiber, whole grains, dairy, calcium, total added sugar, sugar-sweetened beverages, and energy-dense foods of minimal nutritional value.

      Statistical analysis

      Multivariate statistical models assessed associations between frequency of eating school breakfast or lunch (every day vs not every day) and dietary intake, adjusting for child- and community-level covariates.

      Results

      Children who ate school breakfast every day compared with children who ate 0 to 4 days/wk, reported consuming more fruits and vegetables (0.1 cup/day, 95% CI: 0.01, 0.1), dietary fiber (0.4 g/day, 95% CI: 0.2, 0.7), whole grains (0.1 oz/day, 95% CI: 0.05, 0.1), dairy (0.1 cup/day, 95% CI: 0.05, 0.1), and calcium (34.5 mg/day, 95% CI: 19.1, 49.9). Children who ate school lunch every day, compared with those who ate less frequently, consumed more dairy (0.1 cup/day, 95% CI: 0.1, 0.2) and calcium (32.4 mg/day, 95% CI: 18.1, 46.6). No significant associations were observed between school meal consumption and energy-dense nutrient-poor foods or added sugars.

      Conclusions

      Eating school breakfast and school lunch every day by US schoolchildren was associated with modestly healthier dietary intakes. These findings suggest potential nutritional benefits of regularly consuming school meals.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. US Department of Agriculture. National School Lunch Program: Participation and lunches served. http://www.fns.usda.gov/sites/default/files/pd/slsummar.pdf. 2016. Accessed January 20, 2016.

      2. US Department of Agriculture. School Breakfast Program participation and meals served. http://www.fns.usda.gov/sites/default/files/pd/sbsummar.pdf. 2016. Accessed January 20, 2016.

      3. National Center for Education Statistics. Public School Enrollment. https://nces.ed.gov/programs/coe/pdf/Indicator_CGA/COE_CGA_2013_01.pdf. 2013. Accessed July 6, 2017.

      4. US Department of Agriculture. School Breakfast Program participation and meals served. https://www.fns.usda.gov/sites/default/files/pd/sbsummar.pdf. 2017. Accessed July 6, 2017.

        • Institute of Medicine
        Committee on Nutrition Standards for Foods in Schools. Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth.
        The National Acadamies Press, Washington, DC2007
        • Gordon A.R.
        • Cohen R.
        • Crepinsek M.K.
        • Fox M.K.
        • Hall J.
        • Zeidman E.
        The third School Nutrition Dietary Assessment Study: background and study design.
        J Am Diet Assoc. 2009; 109: S20-S30
      5. US Department of Agriculture (USDA). School Meals: Healthy Hunger-Free Kids Act. http://www.fns.usda.gov/school-meals/healthy-hunger-free-kids-act. 2014. Accessed April 2, 2015.

      6. US Department of Agriculture and US Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th ed. https://health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. 2010. Accessed February 7, 2018.

        • Au L.E.
        • Rosen N.J.
        • Fenton K.
        • Hecht K.
        • Ritchie L.D.
        Eating school lunch is associated with higher diet quality among elementary school students.
        J Acad Nutr Diet. 2016; 116: 1817-1824
        • Clark M.A.
        • Fox M.K.
        Nutritional Quality of the Diets of US Public School Children and the Role of the School Meal Programs.
        J Am Diet Assoc. 2009; 109: S44-S56
        • Hanson K.L.
        • Olson C.M.
        School meals participation and weekday dietary quality were associated after controlling for weekend eating among U.S. school children aged 6 to 17 years.
        J Nutr. 2013; 143: 714-721
        • Cohen J.F.
        • Rimm E.B.
        • Austin S.B.
        • Hyatt R.R.
        • Kraak V.I.
        • Economos C.D.
        A food service intervention improves whole grain access at lunch in rural elementary schools.
        J Sch Health. 2014; 84: 212-219
        • Robinson-O’Brien R.
        • Burgess-Champoux T.
        • Haines J.
        • Hannan P.J.
        • Neumark-Sztainer D.
        Associations between school meals offered through the National School Lunch Program and the School Breakfast Program and fruit and vegetable intake among ethnically diverse, low-income children.
        J Sch Health. 2010; 80: 487-492
        • Condon E.M.
        • Crepinsek M.K.
        • Fox M.K.
        School meals: Types of foods offered to and consumed by children at lunch and breakfast.
        J Am Diet Assoc. 2009; 109: S67-S78
        • Gleason P.M.
        • Suitor C.W.
        Eating at school: How the national school lunch program affects children’s diets.
        Am J Agric Econ. 2003; 85: 1047-1061
        • Campbell B.L.
        • Nayga R.M.
        • Park J.L.
        • Silva A.
        Does the National School Lunch Program improve children’s dietary outcomes?.
        Am J Agric Econ. 2011; 93: 1099-1130
        • Bhattacharya J.
        • Currie J.
        • Haider S.
        Poverty, food insecurity, and nutritional outcomes in children and adults.
        J Health Econ. 2004; 23: 839-862
        • Cohen J.F.
        • Richardson S.
        • Parker E.
        • Catalano P.J.
        • Rimm E.B.
        Impact of the new U.S. Department of Agriculture school meal standards on food selection, consumption, and waste.
        Am J Prev Med. 2014; 46: 388-394
        • Schwartz M.B.
        • Henderson K.E.
        • Read M.
        • Danna N.
        • Ickovics J.R.
        New school meal regulations increase fruit consumption and do not increase total plate waste.
        Child Obes. 2015; 11: 242-247
        • Miech R.A.
        • Kumanyika S.K.
        • Stettler N.
        • Link B.G.
        • Phelan J.C.
        • Chang V.W.
        Trends in the association of poverty with overweight among US adolescents, 1971-2004.
        JAMA. 2006; 295: 2385-2393
        • Gordon-Larsen P.
        • Adair L.S.
        • Popkin B.M.
        The relationship of ethnicity, socioeconomic factors, and overweight in U.S. adolescents.
        Obes Res. 2003; 11: 121-129
        • John L.V.
        • Gregoriou M.
        • Pate R.R.
        • et al.
        Operational implementation of the Healthy Communities Study: How communities shape children’s health.
        Am J Prev Med. 2015; 49: 631-635
        • Strauss W.J.
        • Sroka C.J.
        • Frongillo E.A.
        • et al.
        Statistical design features of the Healthy Communities Study.
        Am J Prev Med. 2015; 49: 624-630
        • Ritchie L.D.
        • Wakimoto P.
        • Woodward-Lopez G.
        • et al.
        The Healthy Communities Study nutrition assessments: Child diet and the school nutrition environment.
        Am J Prev Med. 2015; 49: 647-652
        • Fox M.K.
        • Dodd A.H.
        • Wilson A.
        • Gleason P.M.
        Association between school food environment and practices and body mass index of US public school children.
        J Am Diet Assoc. 2009; 109: S108-S117
      7. National Cancer Institute. Dietary Screener Questionnaire in NHANES 2009-2010. http://appliedresearch.cancer.gov/nhanes/dietscreen/. 2014. Accessed August 1, 2017.

        • Tibshirani R.
        Regression shrinkage and selection via the lasso.
        J R Stat Soc. 1996; 58: 267-288
      8. SAS [computer program]. Version 9.4. Cary, NC: SAS Institute Inc; 2013.

        • Potamites E.
        • Gordon A.
        Children’s Food Security and Intakes from School Meals.
        Mathematica Policy Research, Inc, Princeton, NJ2010
      9. US Census Bureau. Selected Characteristics of Households by Total Money Income. https://www.census.gov/data/tables/time-series/demo/income-poverty/cps-hinc/hinc-01.2014.html. 2017. Accessed September 26, 2017.

        • Centers for Disease Control
        2000 CDC Growth Charts for the United States: Methods and Development.
        DHHS, Washington, DC2002
        • Wang Y.
        Disparities in pediatric obesity in the United States.
        Adv Nutr. 2011; 2: 23-31
      10. Centers for Disease Control. National Center for Health Statistics. NHANES 2009-2010. https://wwwn.cdc.gov/nchs/nhanes/ContinuousNhanes/Default.aspx?BeginYear=2009. 2009. Accessed September 26, 2017.

      11. US Department of Agriculture, Food and Nutrition Service, Office of Research and Analysis, School Nutrition Dietary Assessment Study IV, Summary of Findings. https://fns-prod.azureedge.net/sites/default/files/SNDA-IV_Findings_0.pdf. 2012. Accessed February 7, 2018.

        • Rose D.
        • Hutchinson P.L.
        • Bodor J.N.
        • et al.
        Neighborhood food environments and body mass index: the importance of in-store contents.
        Am J Prev Med. 2009; 37: 214-219
        • Swinburn B.A.
        • Caterson I.
        • Seidell J.C.
        • James W.P.
        Diet, nutrition and the prevention of excess weight gain and obesity.
        Public Health Nutr. 2004; 7: 123-146
      12. US Department of Health and Human Services and US Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. 2015. http://health.gov/dietaryguidelines/2015/guidelines/. Accessed February 7, 2018.

      13. US Department of Agriculture, Food and Nutrition Service, Office of Analysis, Nutrition and Evaluation, Children’s Diets in the Mid-1990s: Dietary Intake and Its Relationship with School Meal Participation, CN01-CD1. https://fns-prod.azureedge.net/sites/default/files/ChilDiet.pdf. 2001. Accessed February 7, 2018.

      14. US Department of Agriculture, Food and Nutrition Service, Office of Research, Nutrition and Analysis, School Nutrition Dietary Assessment Study-III: Vol. II: Student Participation and Dietary Intakes. https://fns-prod.azureedge.net/sites/default/files/SNDAIII-Vol2.pdf. 2007. Accessed February 7, 2018.

      Biography

      L. E. Au is an assistant researcher, Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley.

      Biography

      K. Gurzo is a data analyst, Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley.

      Biography

      W. Gosliner is a project scientist, Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley.

      Biography

      K. L. Webb is a researcher, Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley.

      Biography

      P. B. Crawford is a senior research director and cooperative extension specialist, Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley.

      Biography

      L. D. Ritchie is director and cooperative extension specialist, Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley.