Abstract
Background
Implementation of updated nutrition standards for school meals began during school
year (SY) 2012-2013. The standards were designed to improve the nutritional quality
of the meals and their consistency with the Dietary Guidelines for Americans.
Objective
To assess the nutritional quality of school lunches and breakfasts after the updated
standards were in place and compare it with the nutritional quality of the meals before
the updated standards.
Design
School menu data were used from two cross-sectional, nationally representative studies
of schools participating in the National School Lunch Program during SY 2014-2015
(School Nutrition and Meal Cost Study) and SY 2009-2010 (fourth School Nutrition Dietary
Assessment Study).
Participants/setting
The analysis used 1 week of school menu data from 1,206 schools at lunch and 1,110
schools at breakfast for SY 2014-2015, and 884 schools at lunch and 802 schools at
breakfast for SY 2009-2010.
Outcome measures
Healthy Eating Index 2010 scores were estimated.
Statistical analyses
Descriptive analyses were conducted to estimate mean Healthy Eating Index 2010 total
and component scores for school meals. Scores are expressed as a percentage of maximum
possible scores. Two-tailed t tests were used to assess differences in scores before and after updated standards
were in place.
Results
Total Healthy Eating Index 2010 scores for school lunches and breakfasts increased
significantly after the updated standards. Between SY 2009-2010 and SY 2014-2015,
the total score for school lunches increased from 58% of the maximum score to 82%,
and the total score for school breakfasts increased from 50% to 71% (P<0.05). For both meals, component scores increased by more than 20 percentage points
for whole grains, refined grains, and empty calories, as well as for greens and beans
for lunches and whole fruit and sodium for breakfasts.
Conclusions
The updated nutrition standards for schools meals significantly improved the nutritional
quality of the meals and their consistency with the Dietary Guidelines for Americans.
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 accessOne-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 DieteticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- School Lunch Program fact sheet.https://fns-prod.azureedge.net/sites/default/files/resource-files/NSLPFactSheet.pdfDate accessed: July 11, 2019
- School Breakfast Program fact sheet.https://fns-prod.azureedge.net/sites/default/files/resource-files/SBPfactsheet.pdfDate accessed: July 11, 2019
- National level annual summary tables: FY 1969-2019, National School Lunch: Participation and lunches served.https://fns-prod.azureedge.net/sites/default/files/pd/slsummar.pdfDate accessed: February 26, 2019
- National level annual summary tables: FY 1969-2019, School Breakfast Program: participation and meals served.https://fns-prod.azureedge.net/sites/default/files/pd/sbsummar.pdfDate accessed: February 26, 2019
- Healthy, Hunger-Free Kids Act of 2010.(Published 2010. Accessed July 11, 2019)
Final rule: Nutrition standards in the National School Lunch and School Breakfast programs. 77 Federal Register 4088-4167. 2012. Codifed at 7 CFR §210.
- Dietary Guidelines for Americans 2010. 7th edition.(Published December 2010. Accessed July 11, 2019)
- School meals: Building blocks for healthy children.National Academies Press, Washington, DC2010
- School lunch quality following healthy, hunger-free kids act implementation.J Child Nutr Manag. 2016; 40: 1-11
- Effect of the Healthy Hunger-Free Kids Act on the nutritional quality of meals selected by students and school lunch participation rates.JAMA Pediatr. 2016; 170e153918
- Changes in foods selected and consumed after implementation of the new National School Lunch Program meal patterns in southeast Texas.Prev Med Rep. 2015; 2: 440-443
- Impact of the new US Department of Agriculture school meal standards on food selection, consumption, and waste.Am J Prev Med. 2014; 46: 388-394
- Improvements and disparities in types of foods and milk beverages offered in elementary school lunches, 2006-2007 to 2013-2014.Prev Chronic Dis. 2016; 13: 150395
- Nutrient content of school meals before and after implementation of nutrition recommendations in five school districts across two US counties.Prev Med. 2014; 67: S21-S27
- School lunch before and after implementation of the Healthy Hunger-Free Kids Act.J Child Nutr Manag. 2014; 38: 1-12
- Impact of the National School Lunch Program on fruit and vegetable selection in northeastern elementary schoolchildren, 2012-2013.Public Health Rep. 2015; 130: 453-457
- School lunch entrées before and after implementation of the Healthy, Hunger-Free Kids Act of 2010.J Acad Nutr Diet. 2019; 119: 490-499
- Investigating the relationship between food pairings and plate waste from elementary school lunches.Food Nutr Sci. 2015; 6: 1029-1044
- School nutrition and meal cost study: Study design, sampling, and data collection.https://fns-prod.azureedge.net/sites/default/files/resource-files/SNMCS-Methods-Report_0.pdfDate accessed: July 11, 2019
- School Nutrition and Meal Cost Study, final report volume 1: School meal program operations and school nutrition environments.https://fns-prod.azureedge.net/sites/default/files/resource-files/SNMCS-Volume1.pdfDate accessed: July 11, 2019
- School Nutrition and Meal Cost Study, final report volume 2: Nutritional characteristics of school meals.https://fns-prod.azureedge.net/sites/default/files/resource-files/SNMCS-Volume2.pdfDate accessed: July 11, 2019
- School Nutrition and Meal Cost Study, final report volume 3: School meal costs and revenues.https://fns-prod.azureedge.net/sites/default/files/resource-files/SNMCS-Volume3.pdfDate accessed: July 11, 2019
- School Nutrition and Meal Cost Study, final report volume 4: Student participation, satisfaction, plate waste, and dietary intakes.https://fns-prod.azureedge.net/sites/default/files/resource-files/SNMCS-Volume4.pdfDate accessed: July 11, 2019
- USDA food and nutrient database for dietary studies 2011-2012.(Published 2014. Accessed July 11, 2019)
- Food patterns equivalents database 2011-2012.(Published 2014. Accessed July 11, 2019)
- Food patterns equivalents ingredients database 2011-2012.(Published 2014. Accessed July 11, 2019)
- School Nutrition Dietary Assessment Study–IV: Volume I: School foodservice operations, school environments, and meals offered and served.https://fns-prod.azureedge.net/sites/default/files/SNDA-IV_Vol1Pt1_0.pdfDate accessed: July 11, 2019
- Update of the Healthy Eating Index: HEI-2010.J Acad Nutr Diet. 2013; 113: 569-580
- Update of the Healthy Eating Index: HEI-2015.J Acad Nutr Diet. 2018; 118: 1591-1602
- Healthy Eating Index—beyond the score.J Acad Nutr Diet. 2017; 117: 519-521
- Applications of the Healthy Eating Index for surveillance, epidemiology and intervention research: Considerations and caveats.J Acad Nutr Diet. 2018; 118: 1603-1621
- US Department of Agriculture, Center for Nutrition Policy and Promotion. Healthy Eating Index-2010. CNPP Fact Sheet No. 2.(Published February 2013. Accessed November 22, 2019)
- Healthy Eating Index: Choosing a method and SAS code website.(Published 2017. Accessed November 3, 2016)
- SAS [computer program]. SAS Institute Inc,
Cary, NC2014Version: Version 9.4
- HEI-2010 total and component scores for children, adults, and older adults during 2011-2012.https://www.cnpp.usda.gov/sites/default/files/HEI-2010-During-2011-2012-Oct21-2016.pdfDate accessed: February 26, 2019
- Breakfast in America: 2001-2002.https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/DBrief/1_Breakfast_2001_2002.pdfDate accessed: February 26, 2019
National School Lunch Program and School Breakfast Program: School Meals Initiative for Healthy Children: Final rule. 60 Federal Register 14292. 1995. Codifed at 7 CFR §210, 220.
- Strategies for successful implementation of the Healthy, Hunger-Free Kids Act: Sodium.https://fns-prod.azureedge.net/sites/default/files/ops/HHFKA-Sodium.pdfDate accessed: February 26, 2019
- Strategies for successful implementation of the Healthy, Hunger-Free Kids Act: Whole grains.https://fns-prod.azureedge.net/sites/default/files/ops/HHFKA-WholeGrains.pdfDate accessed: February 26, 2019
- Successes and challenges in school meal reform: Qualitative insights from food service directors.J Sch Health. 2017; 87: 608-615
US Department of Agriculture, Food and Nutrition Service. Child nutrition programs: Flexibilities for milk, whole grains, and sodium requirements. 83 Federal Register 63775-63794. 2018. Codifed at 7 CFR §210, 215, 220, 226.
- 2015-2020 Dietary Guidelines for Americans. 8th ed.(Published December 2015. Accessed July 11, 2019)
Biography
E. C. Gearan is a senior researcher and deputy director of nutrition policy research, Mathematica, Cambridge, MA.
Biography
M. K. Fox is senior fellow and director of nutrition policy research, Mathematica, Cambridge, MA.
Article info
Publication history
Published online: January 13, 2020
Accepted:
October 22,
2019
Received:
May 15,
2019
Footnotes
AUTHOR CONTRIBUTIONS E. C. Gearan conducted the analyses with technical guidance from M. K. Fox. E. C. Gearan wrote the first draft of the manuscript with contributions from M. K. Fox. Both authors reviewed and commented on subsequent drafts of the manuscript.
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT The studies were funded by the Food and Nutrition Service of the US Department of Agriculture.
Identification
Copyright
© 2020 by the Academy of Nutrition and Dietetics.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Documented Success and Future Potential of the Healthy, Hunger-Free Kids ActJournal of the Academy of Nutrition and DieteticsVol. 120Issue 3
- PreviewThe Healthy, Hunger-Free Kids Act (HHFKA) of 2010 required the US Department of Agriculture (USDA) to create updated school meal and competitive food standards that aligned with the concurrent (2010) version of the Dietary Guidelines for Americans.1 The resulting regulations significantly strengthened the nutrition standards for school breakfast and lunch,2 and introduced new nutrition standards for foods sold outside of the school meal program during the school day (ie, Smart Snacks in School).
- Full-Text
- Preview
