School nutrition standards

Evidence Rating  
Scientifically Supported
Evidence rating: Scientifically Supported

Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.

Health Factors  
Decision Makers

School nutrition standards regulate the quality of food that can be sold to students on school grounds during the school day; such standards often focus on foods available during school meals and via the National School Lunch Program (NSLP). The Healthy, Hunger-Free Kids Act (HHFKA) of 2010 strengthened nutrition standards nationally, so that NSLP meals include more whole grains, fruits and vegetables, low-fat milk and dairy products, and less sodium and fat than previous years1. HHFKA sets minimum standards; states, local governments, and school districts can establish stronger, additional requirements for the nutritional content and availability of competitive foods. Competitive foods include any foods sold to students through à la carte options, vending machines, and other sources outside of federally reimbursable meals2.

Expected Beneficial Outcomes (Rated)

  • Increased healthy food consumption

  • Improved school food environment

Other Potential Beneficial Outcomes

  • Improved dietary choices

  • Improved nutrition

  • Reduced energy use

Evidence of Effectiveness

There is strong evidence that nutrition standards for school meals increase healthy food consumption, especially consumption of fruits and vegetables, and improve school food environments3, 4, 5, 6. 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 intake789. Strengthening nutrition standards for competitive foods may increase effects on the school food environment and student nutrition7.

Assessments of the Healthy, Hunger-Free Kids Act of 2010 (HHFKA) indicate that strengthened school lunch nutrition standards increase fruit and vegetable consumption, reduce plate waste (especially vegetables and entrees), and do not change milk consumption3, 4. Overall, reducing unhealthy food offerings has been shown to decrease students’ unhealthy food consumption9, increase purchases of healthy and neutral foods such as fruits and vegetables58, and decrease fat consumption5. Such standards can also reduce sugar sweetened beverage intake10.

Strong, comprehensive state laws that regulate nutrition content of competitive foods across grade levels may reduce increases in adolescent body mass index (BMI)11. Policies that improve nutrition and make school food options healthier do not discourage National School Lunch Program (NSLP) participation12; 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 HHFKA1314.

Following HHFKA implementation, schools with a majority of students (at least two-thirds) eligible for free and reduced-price lunch (FRPL) report more school lunch participation and less plate waste than schools with fewer students eligible for FRPL. Surveys also suggest that changes in plate waste vary, with the least waste reported at urban and suburban elementary and middle schools with a large proportion of students from lower income families15.

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 food16, 17, 18, 19, 20. Such initiatives may also reduce the energy intensity of an individual’s diet if more plant-based foods are consumed in place of animal products16, 21.

Inadequate equipment and kitchen infrastructure can challenge successful implementation of new school nutrition standards22, 23. Careful implementation of these standards is necessary to maintain reductions in food insecurity realized historically through the NSLP24.

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 revenue25, 26. 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 participation7.

Impact on Disparities

Likely to decrease disparities

Implementation Examples

As of 2013, 28 states and Washington DC have passed school nutrition legislation or authorized funding for school nutrition grants to improve the school food environment that complements the 2010 Healthy, Hunger-Free Kids Act (HHFKA)27. According to the USDA, over 90% of schools already meet the HHFKA standards, and only 0.15% of schools opted out of the NSLP following implementation13. Many states (38) also have policies with nutrition standards for competitive foods; however, on average these state policies meet only 4 of the 18 USDA provisions outlined for competitive foods in schools22, 28.

Using HHFKA’s nutrition standards, more public elementary schools offered school lunches with healthy foods in the 2013-14 school year than the 2006-07 school year. The portion of schools serving whole grains, for example, increased from 76% to 97%, those serving vegetables (other than potatoes) increased from 74% to 83%, fresh fruit from 61% to 80%, and the portion of schools with salad bars increased from 17% to 31%. Unhealthy foods also decreased during this time period. Just over half (53%) of elementary schools always offered fried potatoes (down from 73% in 2008-09); 37% of schools always offered higher-fat pizza (down from 70% in 2010-11), and 35% of schools always offered higher-fat milk (down from 79% in 2006-07)29.

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 students30. Eat Smart, the foodservice component in the Child and Adolescent Trial for Cardiovascular Health31; Fresh Choices (from Gimme 5), and Lunch Power are examples of successful school nutrition programs32.

Implementation Resources

USDA-Nutrition standards - US Department of Agriculture (USDA), Food and Nutrition Service (FNS). Nutrition standards for school meals.

USDA-SN training - US Department of Agriculture (USDA). Professional standards for school nutrition professionals: Training and resources.

CPSI-Nutrition policy - Center for Science in the Public Interest (CSPI). Nutrition policy.

CDC-School nutrition environment - Centers for Disease Control and Prevention (CDC). CDC healthy schools: School nutrition environment.

CDC MMWR-School health guidelines 2011 - National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Adolescent and School Health (DASH). School health guidelines to promote healthy eating and physical activity. Morbidity and Mortality Weekly Report (MMWR). 2011:60(RR-05):1-71.

RWJF-Healthy schools - Robert Wood Johnson Foundation (RWJF). Healthy school environments: Building a culture of health in US schools.

ISU-Food and sustainability resources - Iowa State University (ISU), Sustainable Food Processing Alliance. Online resources for food and sustainability.

Footnotes

* Journal subscription may be required for access.

1 USDA-HHFKA - US Department of Agriculture (USDA). School meals: Healthy, Hunger-Free Kids Act (HHFKA).

2 Federal Register-NSLP - Federal Register. National School Lunch Program (NSLP) and School Breakfast Program (SBP): Nutrition standards for all foods sold in school as required by the Healthy, Hunger-Free Kids Act of 2010.

3 Schwartz 2015 - Schwartz MB, Henderson KE, Read M, Danna N, Ickovics JR. New school meal regulations increase fruit consumption and do not increase total plate waste. Childhood Obesity. 2015;20(10):1-6.

4 Cohen 2014a* - Cohen JFW, Richardson S, Parker E, Catalano PJ, Rimm EB. Impact of the new US Department of Agriculture school meal standards on food selection, consumption, and waste. American Journal of Preventive Medicine. 2014;46(4):388-394.

5 Jaime 2009* - Jaime PC, Lock K. Do school based food and nutrition policies improve diet and reduce obesity? Preventive Medicine. 2009;48(1):45-53.

6 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

7 Woodward-Lopez 2010* - Woodward-Lopez G, Gosliner W, Samuels SE, et al. Lessons learned from evaluations of California’s statewide school nutrition standards. American Journal of Public Health. 2010;100(11):2137-45

8 Snelling 2009* - Snelling AM, Kennard T. The impact of nutrition standards on competitive food offerings and purchasing behaviors of high school students. Journal of School Health. 2009;79(11):541-6.

9 Schwartz 2009* - Schwartz MB, Novak SA, Fiore SS. The impact of removing snacks of low nutritional value from middle schools. Health Education & Behavior. 2009;36(6):999-1011.

10 Levy 2011 - Levy DT, Friend KB, Wang YC. A review of the literature on policies directed at the youth consumption of sugar sweetened beverages. Advances in Nutrition. 2011;2(2):182S-200S.

11 Taber 2012 - Taber DR, Chriqui JF, Perna FM, Powell LM, Chaloupka FJ. Weight status among adolescents in States that govern competitive food nutrition content. Pediatrics. 2012;130(3):437–44.

12 Ishdorj 2012 - Ishdorj A, Crepinsek MK, Jensen HH. Children’s consumption of fruits and vegetables: Do school environment and policies affect choice in school meals? Paper prepared for the AAEA/EAAE Conference on Food Environment: The Effects of Context on Food Choice. 2012.

13 USDA-HHFKA implementation 2014 - US Department of Agriculture (USDA). Fact sheet: Healthy, Hunger-Free Kids Act school meals implementation. Release No. 0098.14;2014.

14 Pew-School food 2012 - The Pew Charitable Trusts (Pew). School food success stories. 2012.

15 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 Program (BTG), Institute for Social Research, University of Michigan. 2014.

16 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).

17 FAO-Food waste - Food and Agriculture Organization of the United Nations (FAO). Food wastage footprint & climate change.

18 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.

19 SSSA-McIvor 2017 - McIvor K. Soils in the city: Community gardens. Soil Science Society of America (SSSA). 2017.

20 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.

21 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; February 2017.

22 TFAH-Levi 2014 - Levi J, Segal L, St. Lauren R, Rayburn J. The state of obesity: Better policies for a healthier America 2014. Washington, DC: Trust for America's Health (TFAH); 2014.

23 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.

24 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.

25 CDC-Nutrition standards - National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Implementing strong nutrition standards for schools: Financial implications. Atlanta: Centers for Disease Control and Prevention (CDC).

26 Long 2013* - Long MW, Luedicke J, Dorsey M, Fiore SS, Henderson KE. Impact of Connecticut legislation incentivizing elimination of unhealthy competitive foods on National School Lunch Program participation. American Journal of Public Health. 2013;103(7):e59-66.

27 NCSL Winterfeld 2014a - Winterfeld A. State actions to reduce and prevent childhood obesity in schools and communities: Summary and analysis of trends in legislation. National Conference of State Legislators (NCSL); 2014.

28 CDC-Competitive foods 2012 - Centers for Disease Control and Prevention (CDC). Competitive foods and beverages in US schools: A state policy analysis. Atlanta: US Department of Health and Human Services (US DHHS); 2012.

29 BTG-Turner 2015 - Turner L, Chaloupka F. Improvements in school lunches result in healthier options for millions of US children: Results from public elementary schools between 2006-07 and 2013-14. Chicago: Bridging the Gap Program (BTG), Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago; 2015.

30 Long 2010* - Long MW, Henderson KE, Schwartz MB. Evaluating the impact of a Connecticut program to reduce availability of unhealthy competitive food in schools. Journal of School Health. 2010;80(10):478-86.

31 CATCH - Coordinated Approach to Child Health (CATCH). What is CATCH?

32 Kramer-Atwood 2002* - Kramer-Atwood JL, Dwyer J, Hoelscher DM, et al. Fostering healthy food consumption in schools: Focusing on the challenges of competitive foods. Journal of the American Dietetic Association. 2002;102(9):1228-33.

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