IGNITING an expected firestorm of controversy, the U.S. Department of Agriculture last year embarked on a regulatory adventure to improve the nutritional content of school lunch menus across the country.
While some parents and lawmakers balked at the notion, new research reported by the American Medical Assn. suggests that stricter school meal nutrition standards are associated with better weight status among students.
Published in the journal JAMA Pediatrics, a publication of the Journal of the American Medical Association, the study looked at the incidence of obesity among students who received free or reduced-price lunches compared with students who did not eat school lunches.
Specifically, University of Illinois at Chicago health policy researcher Daniel Taber examined 4,870 students in 40 states using data collected as part of a nationally representative sample of students who enrolled in kindergarten in the fall of 1998.
According to Taber's research, in states where school meal standards exceeded those set by USDA, the difference in obesity prevalence between students who received school lunches and those who did not was 12.3 percentage points smaller than in those states that did not exceed USDA standards.
"In states that did not exceed USDA standards, students who obtained free or reduced-price lunches were almost twice as likely to be obese than students who did not obtain school lunches (26.0% and 13.9%, respectively), whereas the disparity between groups was markedly reduced in states that exceeded USDA standards (21.1% and 17.4%, respectively," the report explains.
Researchers said there was little evidence to support the notion that students compensated for stricter meal standards by buying sweets, salty snacks or added-sugar beverages from school vending machines, for example, or from other sources, including fast-food restaurants.
The report says evidence suggests that ongoing changes to school meal standards have the potential to reduce obesity, particularly among students who are eligible for free/reduced-price lunches, but the authors did acknowledge the need for additional research on the subject.
Taber is currently studying whether economic and environmental characteristics in the community modify the effects of school-based policies in an effort to analyze whether such characteristics contribute to racial and ethnic disparities in weight status and policy effectiveness.
Ultimately, the study will analyze the impact policy initiatives in different sectors have on diet, weight status and racial/ethnic disparities in weight status among adolescents.
Eat your veggies
In a separate study published earlier this year in the American Journal of Preventative Medicine, Taber and his colleagues reported that teens in states requiring schools to offer fruits and vegetables as part of the meal program consumed more fruits and vegetables than those living in states with no such policies.
Comparing students in California and Mississippi, which do set specific requirements for serving fruits and vegetables, with 25 other states that have no such standards, the study found that students who were offered more fruits and vegetables did, in fact, eat more fruits and vegetables.
The difference, they found, was most pronounced among teens in California and Mississippi who regularly ate school meals and had only unhealthy snacks — such as cookies, chips and cake — available at home: They ate an average of 0.45 more cups of fruit and 0.61 more cups of vegetables per day than students in the other states.
"This study suggests that schools can help level the playing field for families who can't afford or don't have access to healthy foods," Taber said. "We found that strong laws — those that give specific requirements for improving school meals — have the potential to help teens eat more fruits and vegetables, especially when they're not getting those foods at home."
Not surprisingly, the authors also found that teens ate more fruits and vegetables when such foods were available at home. Specifically, teens who never had access to fruits or vegetables at home consumed about 0.98 cups of fruits and vegetables per day, while those who always had access consumed about 2.83 cups per day.
Perhaps further highlighting the role school meals play in childhood nutrition, the study concluded that, overall, teens were not eating enough fruits or vegetables to meet the recommendations of the federal Dietary Guidelines for Americans. This was true among all of the students in the study. On average, teens consumed 1.2 cups of fruit and 0.9 cups of vegetables per day, compared with the recommended 1.5-2.0 cups of fruit and two to three cups of vegetables per day.