Abstract
BackgroundFederal nutritional guidelines apply to school foods provided through the national school lunch and breakfast programs, but few federal regulations apply to other foods and drinks sold in schools (labeled "competitive foods"), which are often high in calories, fat and sugar. Competitive food policies among school districts are increasingly viewed as an important modifiable factor in the school nutrition environment, particularly to address rising rates of childhood overweight. Congress passed legislation in 2004 requiring all school districts to develop a Wellness Policy that includes nutrition guidelines for competitive foods starting in 2006–2007. In addition, the Institute of Medicine (IOM) recently published recommendations for schools to address childhood obesity.MethodsRepresentatives of school districts with the largest student enrollment in each state and D.C. (N = 51) were interviewed in October-November 2004 about each school district's nutrition policies on "competitive foods." District policies were examined and compared to the Institute of Medicine's recommendations for schools to address childhood obesity. Information about state competitive food policies was accessed via the Internet, and through state and district contacts.ResultsThe 51 districts accounted for 5.9 million students, representing 11% of US students. Nineteen of the 51 districts (39%) had competitive food policies beyond state or federal requirements. The majority of these district policies (79%) were adopted since 2002. School district policies varied in scope and requirements. Ten districts (53%) set different standards by grade level. Most district policies had criteria for food and beverage content (74%) and prohibited the sale of soda in all schools (63%); fewer policies restricted portion size of foods (53%) or beverages (47%). Restrictions more often applied to vending machines (95%), cafeteria à la carte (79%), and student stores (79%) than fundraising activities (47%). Most of the policies did not address more comprehensive approaches to the school nutrition environment, such as nutrition education (32%) or advertising to students (26%), nor did they include guidelines on physical education (11%). In addition, few policies addressed monitoring (32%) or consequences for non-compliance (11%). No policy restricted foods sold for after-school fundraising or required monitoring physical health indicators (e.g. BMI).ConclusionWhen compared to the Institute of Medicine's recommendations for schools' role in preventing obesity, none of the nutrition policies among each state's largest school district had addressed all the recommendations by 2004–2005. Nutritionists, nurses, pediatricians, parents, and others concerned about child health have an unprecedented opportunity to help shape and implement more comprehensive school district nutrition policies as part of the Congressional requirement for a "Wellness Policy" by 2006–2007.
Highlights
Snack foods and beverages high in sugar, fat and calories are widely available in schools [1,2,3], and children's intake of these foods has increased [4]
■ Establish nutritional standards for all "Competitive Foods" ■ Establish a minimum of 30 minutes of activity during school day ■ Enhance school health curricula ■ Ensure all school meals meet the Dietary Guidelines for Americans ■ Ensure schools are as advertising free as possible ■ Conduct annual assessments of student weight, height, BMI, and make data available to parents
While the United States Department of Agriculture (USDA) regulates the nutritional content of foods sold in the national school lunch and breakfast programs, federal guidelines for foods sold outside these programs are limited [5]
Summary
Snack foods and beverages high in sugar, fat and calories are widely available in schools [1,2,3], and children's intake of these foods has increased [4]. While the United States Department of Agriculture (USDA) regulates the nutritional content of foods sold in the national school lunch and breakfast programs, federal guidelines for foods sold outside these programs (labeled "competitive foods") are limited [5]. National agencies, including the Centers for Disease Control and Prevention (CDC) [16], the American Academy of Pediatrics (AAP) [19], and the Institute of Medicine (IOM) [20], have all published recommended changes to the school nutrition environment, competitive foods, as part of efforts to address childhood overweight. Federal nutritional guidelines apply to school foods provided through the national school lunch and breakfast programs, but few federal regulations apply to other foods and drinks sold in schools (labeled "competitive foods"), which are often high in calories, fat and sugar.
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