School meals more nutritious, thanks to revised standards


Millions of children across the US have benefitted from more nutritious school meals as a result of the Healthy Hungry-Free Kids Act, according to a new study published in JAMA Pediatrics.

Passed into law in 2010, the Healthy Hungry-Free Kids Act (HHFKA) enabled the US Department of Agriculture (USDA) to update the nationalnutrition standards for the National School Lunch Program and the School Breakfast Program for the first time in 30 years, bringing school meals in line with the 2010 Dietary Guidelines for Americans.

Coming into effect in 2012, the updated standards increased the availability and portion sizes of fruits, vegetables and whole grains in schools, requiring students to choose at least one portion of fruits and/or vegetables daily.

The key aim of the revised standards was to increase the nutritional quality of school meals in order to improve children’s health and reduce the burden of childhood obesity in the US; obesity has more than doubled in children and quadrupled in adolescents in the country over the past 30 years.

Previous studies have shown that the HHFKA has increased children’s fruit selection and vegetable consumption; one study of more than 1,000 students reported by Medical News Today last year found that the updated standards had boosted children’s vegetable consumption from 24.9% to 41.1%.

For this latest study, Donna B. Johnson, from the University of Washington Nutritional Sciences Program in Seattle, and colleagues set out to assess the nutritional quality of foods selected by students both before and after the HHFKA came into play, as well as meal participation rates of students.

“Because the National School Lunch Program reaches more than 31 million students each day in 99% of US public schools and 83% of private schools, the new standards have the potential to significantly and consistently affect the nutritional health of children,” note the authors.

HHFKA has improved kids’ nutrition without affecting meal participation

The team calculated the mean adequacy ratio (MAR) and energy density of 1,741,630 school lunches served in three middle schools and three high schools in the US from 2011 – 1 year before HHFKA was implemented – until 2014. The daily meal participation rates in these schools were also monitored.

Levels of calciumvitamin C, vitamin A, iron, fiber and protein in school meals were used to calculate MAR.

Researchers found the MAR of school meals increased between 2011-2014, from an average of 58.7 before HHFKA implementation to 75.6 after. There was also a reduction in energy density of schools meals, reducing from 1.65 prior to HHFKA to 1.44 after; lower energy density indicates lower calories per gram of food.

While some legislators and school administrators have voiced concerns about how the HHFKA might negatively impact school meal participation rates, the team found there was little difference; 47% of students consumed school meals prior to HHFKA, compared with 46% after.

Commenting on their findings, the researchers say:

“These results contribute to the evidence that significant improvement in the nutrition environments in schools is associated with the enactment and implementation of the new US Department of Agriculture meal standards, with corresponding improvement of student selection of nutritious foods, without negatively affecting meal participation.”

HHFKA ‘an example of an effective food policy action’

While Johnson and colleagues say these findings are consistent with other studies that show the HHFKA has increased the nutritional quality of school meals, they stress that their study has overcome a number of limitations of previous research.

Fast facts about childhood obesity

  • In the US, the rate of obesity for children aged 6-11 increased from 7% in 1980 to almost 18% in 2012
  • Among adolescents aged 12-19 years, obesity increased from 5% to almost 21% between 1980-2012
  • In 2012, more than a third of children and adolescents in the US were overweight or obese.

“Unlike other studies, our study included high schools and had the strength of longitudinal food selection data that spanned 31 months and more than 1.7 million reimbursable meals,” they note.

Their research was subject to limitations, however. For example, the study only included middle and high schools from one urban district, so their findings may not be generalizable to elementary schools and those in rural areas.

Additionally, the study only included data on school meals chosen by students rather than data on food consumption. “However, the new standards include increases in portions and variety of fruits and vegetables, and the MAR calculation used in this study included nutrients that would be affected by key nutrients provided by these foods,” they explain.

Overall, the researchers conclude that the revised USDA standards “are an example of an effective food policy action,” and their results “support the ongoing implementation of the HHFKA and maintenance of strong nutrition standards during its reauthorization.”

In an accompanying editorial, Erin R. Hager, PhD, of the University of Maryland School of Medicine, and Lindsey Turner, PhD, of Boise State University, say that while it is clear the updated USDA standards are making progress in terms of improving child nutrition, that progress is at risk of being hampered.

“We encourage policymakers to consider the hard evidence rather than anecdotal reports when evaluating the impact of policy changes,” they add. “On the fifth anniversary of this landmark legislation, it is worth celebrating the successes of the HHFKA, rather than abandoning the recent progress made in keeping our nation’s children healthy.”

Last month, MNT reported on a study that concluded eating a good breakfast is associated with better educational attainment.

Written by Honor Whiteman



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