We've Made School Lunches Healthier - But Will Kids Eat Them?

by Jenn Woo, MD

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I have a very fond memory of the lunches I brought to school — turkey or PB&J on whole wheat, an apple, and carrot sticks — even if I was often envious of the kids who ate the fried foods typically served at school. You probably have your own unique memory, and a strong gut reaction, to the phrase “school lunch.”

School nutrition is an emotion-laden topic. Childhood obesity is at an all-time high. A 2008 Institute of Medicine panel found that schoolchildren consumed an excess of more than 500 calories per day from sugar and fat. On school days, children consume almost one-half of their total daily calories at school. Unhealthy school food environments have been linked to a higher risk for obesity. Knowing these facts, how can we give children the opportunity to eat more healthfully at school?

In 2010, Congress passed the Healthy, Hunger-Free Kids Act.  It revised school meal standards to meet the 2010 Dietary Guidelines for Americans. As a result, schools now must include at least one fruit or vegetable at each lunch, provide more whole grains and fewer refined grains, limit sodium, and follow recommended calorie ranges. These changes may help prevent more kids from becoming obese.

These changes, however, have been controversial. This is not surprising. Change can take time. And getting kids to eat new foods may take repeated exposures. Some have argued for relaxing healthier school meal standards, mainly citing “plate waste".  

Based on recent research, these early concerns may be overstated. Juliana Cohen and colleagues at Harvard School of Public Health found that the healthier school meal standards did not lead to more food waste at four low-income Massachusetts elementary and middle schools. Cohen’s team examined what more than 6000 children chose to put on their plates, then weighed the food remaining on their plates after they finished eating. The researchers had these measurements before and after the healthier school meal standards were implemented. What did they find? Children ate more of their entrée and vegetables and chose more fruit after the new standards were in place. This seems like a victory: less waste and healthier meals.

When my colleague Elsie Taveras and I heard that Congress might allow some schools to opt-out of healthier school meals, we wrote a perspective piece in The New England Journal of Medicine about the importance of updated standards. Since we published this piece, Congress passed an Omnibus Appropriations bill that did not allow schools to opt out of the healthier school meal standards, though it does relax whole grain requirements.

This battle is not over.  School nutrition programs are up for reauthorization by Congress this year. Reauthorization could lead to strengthening of the healthier standards, or it might mean additional rollbacks.

The current school meal standards provide a population-wide opportunity for children to put healthier foods on their plate at school. Most parents support the improved school meal standards, and parents who perceive higher nutritional quality of school meals are more likely to have their children participate in them.

It is time to move away from the debate over whether to improve the nutritional value of meals children eat at school, to a conversation about how to make healthier standards work. Don’t all children deserve the opportunity to eat healthfully at school?

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About the Author

Dr. Jennifer Woo Baidal is a physician in the Division of Gastroenterology and Nutrition and the Center for Nutrition at Boston Children's Hospital. Her research focuses on reduction of socioeconomic and racial/ethnic disparities in childhood obesity and its co-morbidities. Jennifer is from Los Angeles and is learning to speak French.