Improving school lunch programs for children and adolescents in the United States: The Healthy, Hunger- Free Kids Act of 2010 and the National School Breakfast Program
High nutrition standards can have long term positive effects, like influencing the kinds of foods youth prefer and creating healthy habits.
The study, published in JAMA Pediatrics, followed 14,121 US youths ages 5 to 18 from January 2005 to March 2020. The study did not include any data after widespread school shutdowns caused by the Covid-19 flu.
The Healthy, Hunger- Free Kids Act of 2010 reformed the School Lunch Program and the National School Breakfast Program, which provided meals to more than 30 million children. Half of the calories in a child’s day are spent on these meals.
According to the US Centers for Disease Control and Prevention, about 20% of children and adolescents ages 2 to 19 are obese, which can lead to lifelong health complications including high blood pressure, type 2 diabetes and breathing problems such as asthma and sleep apnea.
When you look at the large scale evaluations of population level, the effect on a single child at a time is a big deal for the broader picture.
The director of nutrition at Mass General for Children Hospital said the steps are at least in the right direction.
An editorial written by Fiechtner was published in the same journal and called for more action including limiting juices and promoting consumption of fruit in its whole form.
Fiechtner thinks that the National School Lunch Program is important and that it’s important because they know that obese people cost the healthcare system a lot of money in the long term.
The US Department of Agriculture has not finalized proposed updates to school nutrition standards. The hope is that the research will support movement to improve school meals.
“With continual efforts to make improvements, we hope that this means that public health practitioners and policymakers, no matter where they’re from, what their political views might be, or what their personal ideas are, this is something we can come together on because this is an actionable place where we can make a difference in our obesity epidemic, which has felt so just intractable and so difficult to overcome,” Chandran said. “Now, we can think of this not as a foregone conclusion, we can make a difference.”
It’s still unclear whether the program has started to turn the tide for the entire country or just the groups of kids studied. There are about 30 million children who get school lunches.
“You can impact their excess weight gain over the course of their childhood if you want to,” said Dr. Chandran. She led the study published Monday in the journal JAMA Pediatrics.
Children from low-income households have shown the effects of the federal law on their weight. The new study is the first to find lower BMI in kids across all income levels.
One way to think of the change is that for a 10-year-old boy with an elevated body-mass index, the decline would amount to a 1-pound weight loss, noted Dr. Lauren Fiechtner, director of nutrition at MassGeneral Hospital for Children in Boston, who wrote an editorial accompanying the study.
“This is important as even BMI flattening over time is likely important,” she said. As children grow, keeping their weight in check is one way to keep obesity under control.
A slight reduction in those measures does not tell us if the health, well-being, and concerns related to food security of children participating in the school breakfast or lunch program improved.