Abstract
The Healthy, Hunger-Free Kids Act of 2010 strengthened nutrition standards for meals and beverages provided through the National School Lunch, Breakfast, and Smart Snacks Programs, affecting fifty million children daily at 99,000 schools. The legislation’s impact on childhood obesity is unknown. We tested whether the legislation was associated with reductions in child obesity risk over time using an interrupted time series design for 2003–18 among 173,013 youth in the National Survey of Children’s Health. We found no significant association between the legislation and childhood obesity trends overall. For children in poverty, however, the risk of obesity declined substantially each year after the act’s implementation, such that obesity prevalence would have been 47 percent higher in 2018 if there had been no legislation. These results suggest that the Healthy, Hunger-Free Kids Act’s science-based nutritional standards should be maintained to support healthy growth, especially among children living in poverty.
Highlights
Policies shaping what foods and beverages are available in schools, which reach about fifty million US children and adolescents, provide an important opportunity to improve health, for lower-income and minority children, who tend to have less access to healthy food[3] and poorer dietary quality[4,5] as well as a higher risk for obesity compared to other children.[6]
The nutritional guidelines for meals and snacks served through these programs were originally developed long before childhood obesity and diet-related chronic disease had become a major concern, so they did not address limits on food and beverages that advances in nutrition science had found to be linked with excess weight gain
After the HHFKA’s implementation for school meals and snacks, youth in poverty—who are vulnerable to obesity6—saw their odds of having obesity reduced by 9 percent annually; by 2018 their risk of obesity would have been 47 percent higher if there had been no legislation
Summary
The passage of the Healthy, Hunger-Free Kids Act (HHFKA) in 2010 established a suite of policies to improve the nutritional quality of food and beverages served to US children through an array of federal food assistance programs This included the National School Lunch Program, which affects thirty million students nationwide,[7] and the School Breakfast Program, which affects fourteen million students nationwide.[8] The National School Lunch Program began in 1946 and the School Breakfast Program, in 1996, to ensure that US children have access to nutritionally adequate meals during the school day.
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