School nutrition standards

There is strong evidence that nutrition standards for school meals increase healthy food consumption and improve school food environments (Durao 2023, Micha 2018, Mansfield 2017, Jaime 2009). Nutrition standards that focus on competitive foods can decrease unhealthy food consumption, increase the availability and consumption of healthier alternatives, and may modestly improve student dietary intake (Micha 2018, Woodward-Lopez 2010, Snelling 2009, Schwartz 2009). Strengthening nutrition standards for competitive foods may increase effects on the school food environment and student nutrition (Woodward-Lopez 2010).

School nutrition standards reduce unhealthy food consumption, reduce excess calorie intake (Durao 2023, Pineda 2021, Micha 2018), increase purchases of healthy and neutral foods such as fruits and vegetables (Jaime 2009, Snelling 2009), and decrease fat consumption (Jaime 2009). Nutrition standards can also reduce sugar sweetened beverage intake (Micha 2018, Cochrane-von Philipsborn 2019). Assessments of the Healthy, Hunger-Free Kids Act (HHFKA) of 2010 indicate that strengthened school lunch nutrition standards decrease consumption of fat and added sugars, increase fruit and vegetable consumption, reduce plate waste (especially vegetables and entrees), and do not change milk consumption (Jia 2020, Schwartz 2015, Cohen 2014a). The HHFKA is also associated with improved dietary quality of lunch for students from families with low, middle, and high incomes (Kinderknecht 2020).

Children who live in states with stronger nutrition standards have a lower risk of obesity than those who live in states with weaker standards (Pineda 2021). School nutrition standards can have positive effects on weight outcomes for boys and may decrease the prevalence of obesity and overweight in children (Jia 2020, Vericker 2019). Healthier school lunches can improve academic outcomes (NBER-Anderson 2017). Policies that improve nutrition and make school food options healthier do not discourage National School Lunch Program (NSLP) participation and many school districts (e.g., Los Angeles Unified, Dallas, Cincinnati Public Schools, Kentucky Daviess County, and El Monte City) report increased NSLP participation following implementation of new school lunch standards under HHFKA (Hecht 2023, USDA-HHFKA implementation 2014). Stronger local school nutrition standards can also be encouraged through state wellness policy requirement laws, which are associated with more comprehensive local wellness policies, more wellness practices implemented, and more improvements to school food environments (Chriqui 2021).

Experts suggest that school nutrition standards could be modified to reduce climate change in addition to promoting health and that these modifications may also reduce food costs (Poole 2020). School nutrition standards that increase fresh fruit and vegetable consumption and reduce food waste may reduce fossil fuel energy used to produce, process, and transport food (Ringling 2020, FAO-Food waste, Hic 2016, CCAFS-Campbell 2012). Such initiatives may also reduce the energy intensity of an individual’s diet if more plant-based foods are consumed in place of animal products (Ringling 2020, Hamerschlag 2017).

Commonly reported barriers for school nutrition standards include costs of policy-compliant foods, decreasing revenue, proximity of unhealthy food vendors, and limited policy knowledge or negative attitudes towards change. Sufficient funding, effective and clear policy communication, and positive attitudes of stakeholders are associated with successful nutrition standard implementation (Ronto 2020). Including nutrition standards in district wellness policies is associated with district food purchasing specifications in rural areas (Piekarz-Porter 2020). Careful implementation of nutrition standards is necessary to maintain reductions in food insecurity realized historically through the NSLP (Gundersen 2015).

Most schools participating in the NSLP are expected to operate food service as a financially self-sustaining nonprofit enterprise, yet federal reimbursement rates often do not fully cover the cost of providing meals (Kappan-Gaddis 2020, Mathematica-Fox 2019). In most cases, implementing nutrition standards has not been shown to decrease school revenue, and in some cases, such standards have been shown to increase revenue (CDC-Nutrition standards, Long 2013). An examination of California’s nutrition standards for competitive foods suggests that such policies can be revenue-neutral; decreases in à la carte revenue losses were generally offset by increased meal program participation (Woodward-Lopez 2010). Experts suggest that school nutrition standards for competitive foods are likely to save more in future health care costs than what they cost to implement (Gortmaker 2015).

There is some evidence that school nutrition standards have the potential to decrease disparities in weight outcomes between children from families with low incomes and those from families with higher incomes (Richardson 2022, Kenney 2020). Families with lower incomes often lack access to affordable healthy food and are more likely to experience food insecurity (USDA-ERS Coleman-Jensen 2021). Children who experience food insecurity consume more of their daily energy from school meals than children who do not experience food insecurity (Forrestal 2021). Assessments of the Healthy, Hunger Free Kids Act (HHFKA) of 2010 find that school nutrition standards decreased risks of obesity for children living in poverty (Kenney 2020). In California, combined federal and state nutrition standards are associated with halting increasing disparity trends between Black or Hispanic children and white children; in some cases, disparities were slightly decreased (Sanchez-Vaznaugh 2021).

Overall, foods served at school are higher quality and more nutritious than foods served outside of school (Forrestal 2021, Gearan 2020), particularly after the HHFKA updated nutrition standards and improved child diet quality (Liu 2021a). However, experts suggest that nutrition standards alone will not eliminate disparities in health outcomes (Sanchez-Vaznaugh 2021). Nutrition standard flexibilities may be associated with more free and reduced-price meal participation (Russell 2023a); however, experts warn that nutrition standard flexibilities undermine standards and may limit improvements in nutrition quality and child obesity rates (Kogan 2019, Schwartz 2019).

Research suggests that rural schools may have fewer policies that support healthy eating and have less healthy food environments than those in urban and suburban areas (Caspi 2015, Nanney 2013). Schools in rural areas often experience challenges in recruiting food service professionals along with limited resources; rural schools can participate in food purchasing co-ops, use state technical assistance, and establish external partnerships to improve school food environments (Asada 2020).

Food sovereignty is the right of Native people to create food and agriculture systems that produce culturally relevant and healthy foods to nourish their community. Food sovereignty includes having decision-making authority over food system values and practices in addition to having food security or access to sufficient supplies of healthy food (Sicangu, USDA-Tribal food sovereignty). Some tribes have expressed interest in administering and managing their own school nutrition programs, which could allow tribal schools to offer more culturally appropriate foods (USDA-Garasky 2016). Research suggests that offering healthy, culturally relevant foods can increase participation in healthy school lunch programs (Wojcicki 2006).

Universal school meals are a suggested strategy to decrease disparities in healthy food consumption by removing economic, administrative, and language barriers for students and families (CG-Healthy school meals for all 2022). Universal school meals are associated with improved diet quality, food security, and academic performance (Cohen 2021b).

In the U.S., the first school meal programs were provided by private societies and child welfare associations in the 1800s and early 1900s (USDA-Gunderson 1971). Congress established the National School Lunch Program (NSLP) in 1946 to both reduce undernutrition in children and increase demand for domestic agriculture commodities (USDA-ERS Ralston 2008). In 1966 during the Civil Rights movement, the Child Nutrition Act created the first NSLP subsidies for children from families with low incomes (Thompson 2020a). The Reagan Administration made significant cuts to the NSLP budget in 1981. In response, the U.S. Department of Agriculture (USDA) broadened NSLP food categories to cut costs, such as reclassifying corn chips, doughnuts, and pies as “bread” (Gaddis 2019). At the same time, the USDA’s commodity distribution program for school lunch began shifting towards ready-to-heat-and-eat foods which are more heavily processed but are easier for schools to serve (Gaddis 2019). The NSLP declined in the 1980s and 1990s; by the early 2000s, NSLP participation was associated with increased obesity rates (Kogan 2019). The association between NSLP participation and obesity was eliminated after the Healthy, Hunger-Free Kids Act (HHFKA) was passed in 2010 which introduced stronger nutrition standards (Cohen 2021a, Kenney 2020). In 2018, the Trump Administration introduced school nutrition standard flexibilities that raised sodium limits and reduced requirements for whole grains (Kogan 2019). The USDA proposed updated standards in 2023 to limit added sugars and sodium, in addition to increasing whole grains (NPR-Bustillo 2023a).

School nutrition standards are often influenced by the commercial interests of corporations who sell school food (Gaddis 2019). Large companies or organizations in the food industry, such as the National Potato Council and the School Nutrition Association, have lobbied against healthier school food standards (Schwartz 2019). In the current U.S. policy context, food that is cheap for corporations to produce tends to be less nutritious, more calorie dense, and contains more chemical additives and preservatives than food that is more expensive. Food procurement policies that dictate schools must choose the lowest bid, rather than the healthiest one, may entrench cheaply made and less healthy food options (Gaddis 2019).

• What school nutrition or food procurement policies does your state or local school district have in place? How do those policies align with the federal nutrition standards?
• Who makes decisions about how nutrition standards are implemented in your school district? Whose input is considered in those decisions? Who should have a voice in ongoing school food decisions?
• How do school food environments compare across all schools in your community? Which schools need additional resources to support implementation of school nutrition standards and to improve their school food environment? How could local partnerships or collaborations help direct resources and support to those schools?

The National School Lunch Program (NSLP), guided by federal nutrition standards, provided 4.9 billion lunches in almost 100,000 schools across the country in fiscal year 2019. The COVID-19 pandemic temporarily changed school meal service opportunities and special programs were used to provide lunches or cash equivalents to students eligible for free and reduced price lunches. As of the 2021-2022 school year, federal legislation authorizes an additional 7 cents per meal payment for schools demonstrating that their meals meet the updated nutrition standards (USDA ERS-NSLP). Some states provide additional meal reimbursements or other funding to help schools meet the cost of providing meals (FRAC-School meals legislation 2023).

State government policies can encourage schools to adopt nutrition standards. Connecticut’s Healthy Food Certification program, for example, provides monetary incentives to districts which apply state nutrition standards to all foods sold to students (Long 2010). Eat Smart, the food service component in the Child and Adolescent Trial for Cardiovascular Health (CATCH); Fresh Choices (from Gimme 5), and Lunch Power are examples of successful school nutrition programs (Kramer-Atwood 2002). The Centers for Disease Control and Prevention (CDC) suggests schools can use the Whole School, Whole Community, Whole Child (WSCC) model to evaluate school food environments (CDC-School nutrition 2019).

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