Healthy school lunch initiatives
Healthy school lunch initiatives modify the food environment during school lunch periods by increasing the convenience of healthy foods and providing many healthy, culturally appropriate options, especially fresh, whole foods and foods cooked from scratch. Healthy school lunch initiatives can focus on both school meal programs and competitive foods. Healthy school lunch initiatives can also modify school schedules by providing longer lunch periods and having recess before lunch. Districts or individual schools can implement healthy school lunch initiatives alongside federal, state, and local school nutrition standards.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased healthy food consumption
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Increased healthy food purchases
Improved dietary choices
Improved nutrition
Improved weight status
Increased academic achievement
Increased food security
Reduced emissions
What does the research say about effectiveness?
There is strong evidence that certain types of healthy school lunch initiatives increase healthy food consumption1, 2, 3, 4. These initiatives include offering more menu choices, adapting recipes to improve palatability or cultural appropriateness, providing pre-sliced fruits, rewarding students who try fruits and vegetables, limiting access to competitive foods, providing longer lunch periods, and having recess before lunch1.
Healthy school lunch initiatives consisting of multiple interventions are more effective than single interventions, such as offering more fruit and vegetable choices in addition to providing pre-sliced fruits1. Students consume more of their lunches if they have longer lunch periods1, 2, 5. Research suggests that 30-minute lunch periods can help ensure students have enough time to eat after waiting in the lunch line and could be combined with scheduling recess before lunch to create a calmer lunchroom environment1. Removing competitive foods can increase participation in healthier school meals6.
Nutrition education, taste tests, and Smarter Lunchroom techniques have inconsistent impacts on student meal consumption; however, decision-makers may still consider implementing these initiatives alongside strategies with stronger evidence1. Healthy school lunch initiatives that combine cafeteria environment improvements with classroom nutrition education can improve fruit and vegetable consumption and dietary choices more than nutrition education or cafeteria improvements alone1, 7. One study showed that Smarter Lunchroom marketing and nudging techniques resulted in increased school meal participation but did not decrease competitive food purchases by students6. Other nudging techniques may increase healthy meal choices initially but do not show persistent effects8.
Healthier school lunches can improve academic outcomes9 and appear to reduce absences related to illness10. Healthy school lunch initiatives have been associated with increased free National School Lunch Program (NSLP) participation11. Many school districts report increased NSLP participation following implementation of the Healthy, Hunger-Free Kids Act of 2010 (HHFKA)12, 13. Careful implementation of HHFKA and healthy school lunch initiatives is necessary to maintain gains in food security realized through the NSLP14.
Healthy school lunch initiatives can be combined with nutrition standards or physical activity programs to reduce or maintain rates of obesity or overweight status in students15. One program that combines scratch-cooked, less processed meals with physical activity coaching found that students consumed more fruits and vegetables16. Another study found that menu changes, new kitchen equipment, and food staff training is associated with increased fresh fruit and vegetable offerings17.
Experts suggest that students’ perceptions of barriers and facilitators of school lunches play a key role in healthy eating18. Long cafeteria lines, time constraints, lack of variety, and limited quantities of preferred foods can be challenges for students, while access to fresh foods can facilitate healthy eating18. Inadequate equipment, kitchen infrastructure, and staff training to support new cooking, food safety, equipment operation, and healthy food promotion responsibilities along with revisions to menu development and food purchasing processes can be challenges for healthy school lunch initiatives19.
Healthy school lunch initiatives may reduce food waste and increase cooking from scratch with fresh, seasonal produce, which may reduce emissions from fossil fuels used to produce, process, and transport food20, 21, 22, 23, 24. Such initiatives may also reduce the energy intensity of an individual’s diet if more plant-based foods are consumed in place of animal products20, 25.
Many aspects of healthy school lunch initiatives are low cost, easy to implement, and scalable, such as recess before lunch and pre-slicing1, 26. Cooking from scratch can also be cost-effective; lower food costs and higher labor costs often lead to small changes in total costs27.
How could this strategy advance health equity? This strategy is rated potential to decrease disparities: suggested by expert opinion.
Healthy school lunch initiatives are a suggested strategy to reduce disparities in healthy food consumption between children from families with low incomes and those from families with higher incomes1. Families with lower incomes often lack access to affordable healthy food and are more likely to experience food insecurity37. Children who experience food insecurity consume more of their daily energy from school meals than children who do not experience food insecurity38. Schools with two-thirds or more of students eligible for free and reduced-price lunch (FRPL) report more participation in healthy school lunch programs and less plate waste than schools with fewer students eligible for FRPL39. Overall, school foods are higher quality and more nutritious than non-school foods38, particularly after the Healthy, Hunger-Free Kids Act (HHFKA) updated nutrition standards in 2010 and improved child diet quality40.
Offering healthy, culturally relevant foods can increase participation in healthy school lunch programs11. A culturally sensitive approach is suggested to increase effectiveness of obesity prevention efforts such as healthy school lunch initiatives41. Universal school meals are a suggested strategy to increase healthy food consumption and remove economic, administrative, and language barriers for students and families42.
What is the relevant historical background?
In the U.S., the first school meal programs were provided by private societies and child welfare associations in the 1800s and early 1900s43. Congress established the National School Lunch Program (NSLP) in 1946 to both reduce undernutrition in children and increase demand for domestic agriculture commodities44. In 1966 during the Civil Rights movement, the Child Nutrition Act created the first NSLP subsidies for children from low-income families45. 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”46. 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 serve46. Participation in the NSLP declined slightly in the 1980s and 1990s47. Implementation of healthier school meals after the passage of the Healthy, Hunger-Free Kids Act (HHFKA) has been associated with reductions in obesity-related disparities among children in poverty1, 48. In 2018, the Trump Administration introduced school nutrition standard flexibilities that weakened the phased implementation of lower sodium limits and reduced requirements for whole grains49. The USDA announced updated standards in 2024 that will limit added sugars and sodium in school meals starting in the 2025-2026 school year50.
School nutrition standards are often influenced by the commercial interests of corporations who sell school food46. Large companies or organizations in the food industry, such as the National Potato Council and the School Nutrition Association, have lobbied against healthier school food51. 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 options46.
Equity Considerations
- Who decides whether to start or sustain healthy school lunch initiatives? Who should have a voice in ongoing school lunch decisions?
- What barriers or challenges to healthy eating do students experience in your lunchroom?
- What are the strengths of your school and community? How can you build on those strengths in the lunchroom?
- What funds are available for healthy school lunch initiatives? If healthy school lunch initiatives are low or no-cost, what other resources might they need to be successful?
Implementation Examples
School meal programs face higher food costs and staffing challenges as they return to regular meal service after the COVID-19 pandemic. During the pandemic, the U.S. Department of Agriculture (USDA) offered waivers that provided flexibility and additional funding28. As of 2023, many state legislatures are considering healthy school meals for all and 8 states have passed state-wide free school meal policies29, 30. More broadly in 2019, 40 states and Washington, D.C. proposed legislation and 16 states passed legislation to support school nutrition and healthy school lunches, including proposals to enhance farm to school programs, local procurement incentives, organic food purchasing, vegetarian lunch options, and school garden programs31. These state actions complement the nutrition standards outlined by the 2010 federal Healthy, Hunger-Free Kids Act (HHFKA). According to the USDA, over 90% of schools meet the HHFKA standards, and only 0.15% of schools have opted out of the National School Lunch Program following implementation12.
Many non-profit organizations support healthy school lunch initiatives. The Alliance for a Healthier Generation, for example, supports efforts in over 28,000 schools, touching every state32. Santa Barbara’s School Food Initiative features a Culinary Boot Camp and kitchen staff training to bring cooked from scratch lunches into Santa Barbara public schools33. In Massachusetts, Project Bread’s Chefs in Schools program helps school kitchen staff learn to prepare healthy meals and supports farm to school efforts34. Let’s Move Salad Bars to Schools has donated almost 6,000 salad bars to schools across the country35. In Colorado, The Lunch Box’s Rainbow Day program encourages students to eat from the salad bars in their school lunchrooms36.
Implementation Resources
‡ Resources with a focus on equity.
USDA-NSLP - U.S. Department of Agriculture (USDA). National School Lunch Program (NSLP).
SLI-Resources - School Lunch Initiative (SLI), Center for Ecoliteracy, The Edible Schoolyard Project. Resources.
AFHK-Smarter lunchrooms - Action for Healthy Kids (AFHK). The cafeteria: Serve up smarter lunchrooms.
The Lunch Box-Tools - The Lunch Box. Tools for school food change.
Pew-KSHFP - The Pew Charitable Trusts (Pew), Robert Wood Johnson Foundation. Kids' safe and healthful foods project (KSHFP).
CDC-School nutrition environment - Centers for Disease Control and Prevention (CDC). CDC healthy schools: School nutrition environment.
ChangeLab-Healthy food at schools - ChangeLab Solutions. Healthy food at schools: A webinar on how to provide healthier school food options.
UM-YES-Resources - University of Michigan (UM), School of Public Health. Youth Empowered Solutions (YES). Resources.
CSPI-School meals - Center for Science in the Public Interest (CSPI). Model school wellness policies: School meals.
MD DOE-Cafeteria toolkit - Maryland State Department of Education (MD DOE), University of Maryland-Extension. Project ReFresh: Cafeteria toolkit. Team Nutrition; 2010.
ISU-Food and sustainability resources - Iowa State University (ISU), Sustainable Food Processing Alliance. Online resources for food and sustainability.
CDC-Healthy school meals parent guide - Centers for Disease Control and Prevention (CDC). Healthy school meals: How can you help? Ideas for parents.
USDA-FRPL access‡ - U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS). Ensuring access to free and reduced-price school meals for low-income students. 2016.
Footnotes
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1 Cohen 2021a - Cohen JFW, Hecht AA, Hager ER, et al. Strategies to improve school meal consumption: A systematic review. Nutrients. 2021;13(10):3520.
2 Graziose 2018 - Graziose MM, Ang IYH. Factors related to fruit and vegetable consumption at lunch among elementary students: A scoping review. Preventing Chronic Disease. 2018;15:170373.
3 Driessen 2014 - Driessen CE, Cameron AJ, Thornton LE, Lai SK, Barnett LM. Effect of changes to the school food environment on eating behaviours and/or body weight in children: A systematic review. Obesity Reviews. 2014;15(12):968-982.
4 Williamson 2013 - Williamson DA, Han H, Johnson WD, Martin CK, Newton RL. Modification of the school cafeteria environment can impact childhood nutrition. Results from the Wise Mind and LA Health studies. Appetite. 2013;61(1):77–84
5 Burg 2021 - Burg X, Metcalfe JJ, Ellison B, Prescott MP. Effects of longer seated lunch time on food consumption and waste in elementary and middle school-age children: A randomized clinical trial. JAMA Network Open. 2021;4(6):e2114148.
6 Boehm 2020 - Boehm R, Read M, Henderson KE, Schwartz MB. Removing competitive foods v. nudging and marketing school meals: A pilot study in high-school cafeterias. Public Health Nutrition. 2020;23(2):366-373.
7 Song 2016 - Song HJ, Grutzmacher S, Munger AL. Project ReFresh: Testing the efficacy of a school-based classroom and cafeteria intervention in elementary school children. Journal of School Health. 2016;86(7):543-551.
8 Ozturk 2020 - Ozturk OD, Frongillo EA, Blake CE, McInnes MM, Turner-McGrievy G. Before the lunch line: Effectiveness of behavioral economic interventions for pre-commitment on elementary school children’s food choices. Journal of Economic Behavior and Organization. 2020;176:597-618.
9 NBER-Anderson 2017 - Anderson ML, Gallagher J, Ritchie ER. School lunch quality and academic performance. National Bureau of Economic Research (NBER). 2017: Working Paper 23218.
10 Belot 2011 - Belot M, James J. Healthy school meals and educational outcomes. Journal of Health Economics. 2011;30(3):489-504.
11 Wojcicki 2006 - Wojcicki JM, Heyman MB. Healthier choices and increased participation in a middle school lunch program: Effects of nutrition policy changes in San Francisco. American Journal of Public Health. 2006;96(9):1542-1547.
12 USDA-HHFKA implementation 2014 - U.S. Department of Agriculture (USDA). Fact sheet: Healthy, Hunger-Free Kids Act school meals implementation. Release No. 0098.14;2014.
13 Pew-School food 2012 - The Pew Charitable Trusts (Pew). School food success stories. 2012.
14 Gundersen 2015 - Gundersen C. Food assistance programs and child health. The Future of Children: Policies to Promote Child Health. The Woodrow Wilson School of Public and International Affairs at Princeton University, The Brookings Institution. 2015:25(1):91-109.
15 CG-Healthy school foods 2016 - The Guide to Community Preventive Services (The Community Guide). Obesity: Multicomponent interventions to increase availability of healthier foods and beverages in schools. 2016.
16 Koch 2021 - Koch PA, Wolf RL, Trent RJ, et al. Wellness in the schools: A lunch intervention increases fruit and vegetable consumption. Nutrients. 2021;13(9):1-11.
17 Behrens 2018 - Behrens TK, Liebert ML, Peterson HJ, et al. Changes in school food preparation methods result in healthier cafeteria lunches in elementary schools. American Journal of Preventive Medicine. 2018;54(5):S139-S144.
18 Payan 2017 - Payán DD, Sloane DC, Illum J, Farris T, Lewis LB. Perceived barriers and facilitators to healthy eating and school lunch meals among adolescents: A qualitative study. American Journal of Health Behavior. 2017;41(5):661-669.
19 Pew-Urahn 2013 - Urahn S, Olson E, Thomas K, et al. Serving healthy school meals despite challenges: Schools meet USDA meal requirements. The Pew Charitable Trusts (Pew), Robert Wood Johnson Foundation, Kids' Safe and Healthful Foods Project Report. 2013.
20 Ringling 2020 - Ringling KM, Marquart LF. Intersection of diet, health, and environment: Land grant universities’ role in creating platforms for sustainable food systems. Frontiers in Sustainable Food Systems. 2020;4(70).
21 FAO-Food waste - Food and Agriculture Organization of the United Nations (FAO). Food wastage footprint & climate change.
22 Hic 2016 - Hic C, Pradhan P, Rybski D, Kropp JP. Food surplus and its climate burdens. Environmental Science and Technology. 2016;50(8):4269-4277.
23 SSSA-McIvor 2017 - McIvor K. Soils in the city: Community gardens. Soil Science Society of America (SSSA). 2017.
24 CCAFS-Campbell 2012 - Campbell B. Is eating local good for the climate? Thinking beyond food miles. Research Program on Climate Change, Agriculture and Food Security (CCAFS), CGIAR Research Programs. 2012.
25 Hamerschlag 2017 - Hamerschlag K, Kraus-Polk J. Shrinking the carbon and water footprint of school food: A recipe for combating climate change. A pilot analysis of Oakland Unified School District's food programs. Friends of the Earth; 2017.
26 Wansink 2013 - Wansink B, Just DR, Hanks AS, Smith LE. Pre-sliced fruit in school cafeterias: Children's selection and intake. American Journal of Preventive Medicine. 2013;44(5):477-480.
27 Woodward-Lopez 2014 - Woodward-Lopez G, Kao J, Kiesel K, et al. Is scratch-cooking a cost-effective way to prepare healthy school meals with U.S. Department of Agriculture foods? Journal of the Academy of Nutrition and Dietetics. 2014;114(9):1349-1358.
28 NCSL-Katz 2023 - Katz E, Rockenback H. New state and federal policies expand access to free school meals. National Conference of State Legislatures (NCSL). 2023.
29 SNA-2023 legislation - School Nutrition Association (SNA). 2023 third-quarter state legislative report (January-August). 2023.
30 FRAC-Healthy school meals - Food Research and Action Center (FRAC). Healthy school meals for all.
31 SNA-2019 legislation - School Nutrition Association (SNA). 2019 state legislative summary: Year-end report.
32 AFHG-Lunch - Alliance for a Healthier Generation (AFHG). Breakfast and lunch.
33 Orfalea-School food - Orfalea Foundation. School food initiative.
34 Project Bread-Chefs in schools - Project Bread. Chefs in schools: Improving the quality of food for kids. East Boston, MA.
35 SB2S-Salad bar - Salad Bars to Schools (SB2S). Get a salad bar in your school.
36 The Lunch Box-Rainbow days - The Lunch Box. Lunchroom education: Rainbow days.
37 USDA-ERS Coleman-Jensen 2021 - Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household food security in the United States in 2020, ERR-298. U.S. Department of Agriculture (USDA), Economic Research Service (ERS). 2021.
38 Forrestal 2021 - Forrestal S, Potamites E, Guthrie J, Paxton N. Associations among food security, school meal participation, and students’ diet quality in the first school nutrition and meal cost study. Nutrients. 2021;13(2):307.
39 BTG-Terry-McElrath 2014 - Terry-McElrath YM, Turner L, Colabianchi N, et al. Student reactions during the first year of updated school lunch nutrition standards: A Bridging the Gap research brief. Ann Arbor, MI: Bridging the Gap (BTG) program, Institute for Social Research, University of Michigan. 2014.
40 Liu 2021a - Liu J, Micha R, Li Y, Mozaffarian D. Trends in food sources and diet quality among U.S. children and adults, 2003-2018. JAMA Network Open. 2021;4(4):e215262.
41 CDC-Health equity resources - Centers for Disease Control and Prevention (CDC). Health equity resource toolkit for state practitioners addressing obesity disparities.
42 CG-Healthy school meals for all 2022 - The Guide to Community Preventive Services (The Community Guide). Healthy school meals for all. 2022.
43 USDA-Gunderson 1971 - Gunderson, GW. History of the National School Lunch program. U.S. Department of Agriculture (USDA). 1971.
44 USDA-ERS Ralston 2008 - Ralston K, Newman C, Clauson A, Guthrie J, Buzby J. The National School Lunch program: Background, trends, and issues, ERR 61. U.S. Department of Agriculture (USDA), Economic Research Service (ERS). 2008.
45 Thompson 2020a - Thompson ED. Why nutritious meals matter in school. Phi Delta Kappan. 2020;102(1):34-37.
46 Gaddis 2019 - Gaddis JE. The labor of lunch: Why we need real food and real jobs in American public schools. Oakland: University of California Press; 2019.
47 USDA-Child nutrition data - U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS). Child nutrition tables.
48 Kenney 2020 - Kenney EL, Barrett JL, Bleich SN, et al. Impact of the Healthy, Hunger-Free Kids Act on obesity trends. Health Affairs. 2020;39(7):1122-1129.
49 Kogan 2019 - Kogan R. Rollback of nutrition standards not supported by evidence. Health Affairs Forefront. 2019.
50 USDA-School nutrition updates - U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS). School nutrition standard updates.
51 Schwartz 2019 - Schwartz MB, Brownell KD, Miller DL. Primer on U.S. food and nutrition policy and public health: Protect school nutrition standards. American Journal of Public Health. 2019;109(7):990-991.
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