Elementary School Lunch Research Articles

Daily Saturated Fat and Sodium Content of Elementary School Meals in a Large Sample of 128 Geographically Diverse School Systems in the United States

BackgroundDespite federal regulations limiting saturated fat and sodium levels on a weekly average basis, daily nutrient content of school meals in the United States is not regulated, leading to potential large fluctuations and intake well in excess of dietary recommendations. ObjectiveTo assess the daily prevalence of potential public elementary school meal combinations that were high in saturated fat and sodium (using cutoffs based on the US Department of Agriculture weekly average reimbursable meal thresholds), and to identify saturated fat and sodium thresholds for entrées to limit full meals exceeding those cutoffs. DesignCross-sectional. Participants and settingFour weeks of publicly available public elementary school (kindergarten through grade five) breakfast and lunch menus with associated nutrition data were collected from a national stratified random sample of 128 school districts during fall 2019. Main outcome measuresPercent of meal combinations exceeding the saturated fat and Target 1 sodium thresholds were calculated, as well as thresholds for saturated fat and sodium levels in breakfast and lunch entrées. Statistical analysesDescriptive statistics and logistic regression were used to examine the odds of alignment with sodium and saturated fat US Department of Agriculture thresholds. ResultsThe prevalence of elementary breakfast and lunch meal combinations that were high in sodium was on average 11% and 12.4%, respectively, and for saturated fat was 10.6% and 34%, respectively. Entrées above certain thresholds (≥400 and ≥1,000 mg sodium and ≥4.5 and ≥6 g saturated fat for breakfast and lunch, respectively) had a higher odds of producing a reimbursable meal that was high in sodium and saturated fat. ConclusionsThere is widespread availability of high-saturated fat and sodium elementary school meal combinations on a daily basis. Daily thresholds, in addition to weekly nutrient thresholds, as well as limits on sodium and saturated fat for entrées, may therefore be needed to prevent daily excess intake of saturated fat and sodium among elementary students.

Hyper-palatable foods in elementary school lunches: Availability and contributing factors in a national sample of US public schools.

School cafeterias are a major point of influence for child nutrition. United States federal legislation requires the presence of important nutrients in school meals. However, legislation overlooks the potential presence of hyper-palatable foods in school lunches, a hypothesized factor that may influence children's eating behavior and obesity risk. The study sought to 1) quantify the prevalence of hyper-palatable foods (HPF) served in US elementary school lunches; and 2) determine whether food hyper-palatability varied based on school geographic region (East/Central/West), urbanicity (urban/micropolitan/rural), or meal item (entrée/side/fruit or vegetable). Lunch menu data (N = 18 menus; N = 1160 total foods) were collected from a sample of six states that represented geographic regions of the United States (Eastern/Central/Western; Northern/Southern) and that had variability in urbanicity (urban, micropolitan, and rural) within each state. A standardized definition from Fazzino et al (2019) was used to identify HPF in lunch menus. HPF comprised almost half of foods in school lunches (M = 47%; SD = 5%). Compared to fruit/vegetable items, entrées were >23 times more likely to be hyper-palatable and side dishes were >13 times more likely to be hyper-palatable (p values < .001). Geographic region and urbanicity were not significantly associated with food item hyper-palatability (p values >.05). The majority of entrée and side items contained meat/meat alternatives and/or grains and likely aligned with the US federal reimbursable meal components of meat/meat alternatives and/or grains. HPF comprised almost half of foods offered in elementary school lunches. Entrées and side items were most likely to be hyper-palatable. US school lunches may be a key point of regular exposure to HPF among young children, a risk factor that may elevate child obesity risk. Public policy regulating HPF in school meals may be needed to protect children's health.

Estimated 24-hour urinary sodium excretion and sodium-to-potassium ratio among Japanese elementary school teachers and school lunch cooks

ABSTRACT Background:Dietary salt intake is largely responsible for increase in blood pressure that is commonly seen with aging. In our previous study carried out in 2015, we calculated the 24-hour urinary sodium excretion and sodium-to-potassium (Na/K) ratio among elementary school children. In the present study, we aimed to examine the same items among the school children’s teachers and lunch cooks.Methods:Of 153 recruited participants, urine samples were collected from 129 subjects (84.3%), and 124 subjects (81.0%; 37 male teachers, 65 female teachers, and 22 female cooks) whose dietary habits were confirmed were included in the final study analysis.Results: The median estimated 24-hour urinary salt excretion (g/day) was 8.2 in male teachers, 7.4 in female teachers, and 8.9 in cooks. The median urinary Na/K ratio (mEq/mEq) was 4.1 in male teachers, 3.6 in female teachers, and 4.0 in cooks. In both male and female teachers and cooks, no association was found between urinary salt excretion or urinary Na/K ratio and an awareness of the need to restrict salt intake. The proportion of subjects with both a urinary salt excretion and Na/K ratio above the median was high in male teachers and cooks, whereas the proportion of subjects who scored below the median in both tests was high in female teachers.Conclusion:It should be considered that elementary school teachers and cooks who have been provided with the results of their own salt excretion could realize the importance of reducing salt consumption from early childhood and the continuous salt intake reduction education for children.

Diet quality and household income level among students: 2014 National Health and Nutrition Survey Japan.

Although higher diet quality is related to higher socioeconomic status among adults, it is unclear whether this result could be generalized to children. Elementary and junior high school lunch programs may contribute to the reduction of socioeconomic disparities in diet quality. We examined the association between diet quality and household income level in school children in Japan according to age subgroups. This cross-sectional study was conducted in 866 household members (435 men and 431 women) aged 6-18 years old from the 2014 National Health and Nutrition Survey, Japan. Dietary intake was assessed by 1 day semi-weighted household dietary record, and the Japanese Food Guide Spinning Top scores (range 0-70) were calculated. The household income was assessed by low, middle, and high. Associations between diet quality and household income levels were examined by age subgroups (6-14 years and 15-18 years), i.e., those with and without school lunch programs RESULTS: Higher dietary scores were observed in those with higher household income in the 15-18 year-olds; the multivariate adjusted mean (95% CI) of diet score was 44.3 (39.0-49.7), 48.8 (47.1-50.6), 51.6 (49.7-53.4) in children with the lowest household income level through the highest, respectively (P for trend = 0.003). However, there were no significant associations among those who were 6-14 years old. Our findings suggest that school lunch program in elementary and junior high schools might help to reduce socioeconomic disparities in diet quality. The development of healthy food environment in high schools without school lunch programs, should also be considered.

Variability in Dietary Quality of Elementary School Lunch Menus with Changes in National School Lunch Program Nutrition Standards.

ABSTRACTNational School Lunch Program (NSLP) standards recently changed significantly. The Healthy, Hunger-Free Kids Act (HHFKA) presumably improved the dietary quality (DQ) of meals, whereas Child Nutrition Program (CNP) Flexibilities appear to decrease DQ. This variability has not been quantified. Our objective was to determine differences in DQ between elementary school lunch menus meeting NSLP standards: School Meal Initiative (SMI), HHFKA, CNP Flexibilities, and evidence-based best practices (BP). A base menu was portioned per NSLP standards and analyzed for nutrient content and DQ. Statistical analyses included 1-factor ANOVA, Kruskal–Wallis, and Dunnett's test. The BP menu had higher whole fruit and whole grain Healthy Eating Index scores than SMI (Ps < 0.0083). The BP and HHFKA menus had higher refined grain and added sugars scores than SMI (Ps < 0.0083). The SMI menu had lower total vegetable and saturated fat scores than all menus (Ps < 0.0083). This study informs policy toward improving standards, positively affecting child health and academic performance through higher-DQ lunches.

Comparing Diet Quality of School Meals versus Food Brought from Home.

Purpose: Consuming nutritious food is essential to learning. The purpose of this research was to determine the diet quality of elementary school lunches, both those in meal programs and those bringing food from home, in urban and rural locations in Saskatchewan.Methods: Using a School Food Checklist and digital photography we compared food group servings and diet quality in 3 school types: urban schools with a meal program and urban and rural schools without a meal program. The total sample was 773 students.Results: Only 55% of students brought the minimum number of servings for grain products and meat and alternatives, with fewer bringing the minimum for vegetables and fruit (25.6%-34.9%), whole grains (24.1%), and milk and alternatives (14.1%). Students bringing food from home had significantly more calories in their lunches from minimally nutritious foods. Students in meal programs had the highest diet quality scores using the Healthy Eating Index adapted for school hours.Conclusions: The diet quality of elementary students' lunches needs improvement, although students in meal programs have healthier diets. Interventions targeting what children eat at school should focus on increasing the number of students meeting recommendations for healthy foods while decreasing minimally nutritious foods brought to school.

Variability in Dietary Quality of an Elementary School Lunch Menu with Changes in National School Lunch Program Nutrition Standards

Abstract Objectives There have been numerous changes to the National School Lunch Program (NSLP) nutrition standards over the past 10 years. The Healthy Hunger-Free Kids Act (HHFKA, 2010) presumably improved dietary quality (DQ) of reimbursable school meals from previous standards, while Child Nutrition Program Flexibilities (CNP Flexibilities, 2017) appear to decrease DQ. However, this variability in DQ has not been quantified. Thus, the purpose of this study was to determine differences in nutrient content and DQ between elementary school lunch menus meeting recent NSLP nutrition standards, School Meal Initiatives (SMI, 1995), HHFKA (2012), and CNP Flexibilities (2017), as well as with evidence-based school lunch best practices implemented (BP). Methods A base menu, deemed typical by expert opinion, was portioned per three versions of NSLP nutrition standards (SMI, HHFKA, CNP Flexibilities) and BP for elementary schoolchildren, and analyzed for nutrient content and DQ using ESHA Food Processor and The Healthy Eating Index (HEI) 2015. Statistical analyses included one-way ANOVA, Kruskal-Wallis, and Dunnett's test. The level of significance was set at P &amp;lt; 0.0083. Results The BP menu had significantly higher whole fruit (317%) and whole grain (669%) HEI scores than the SMI menu. The BP and HHFKA menus had higher refined grain (156%) and added sugar (2%) HEI scores than the SMI menu. The SMI menu had lower total vegetable (49-50%) and saturated fat (43-51%) HEI scores compared to all other menus. Results were significant (ps &amp;lt; 0.0083). Conclusions This study provides important information for guiding future policy towards further improving NSLP nutrition standards in their mission to provide healthy food to children, combatting malnutrition and obesity. Continuing to improve NSLP policy has the potential to impact the health, academic performance, and future of US children through higher DQ school lunches. Funding Sources None.

Everyone deserves quiche: French school lunch programmes and national culture in a globalized world

Globalization poses many challenges for national cultural unity, especially in Europe. Some doubt whether national cultures will be able to survive, but there are many counter-trends pushing to maintain national cultural unity. I analyse the dual trends of global diversity and maintaining unity through an everyday manifestation of French culture: elementary school lunches. French school lunch programmes are part of the nation-building process because they are designed to teach students how to eat, which is especially important in France where the art of gastronomy is a key source of identity and pride. I analyse cultural influences on over 11,000 school lunch menu items from eight municipalities across two French regions. I also conduct in-depth face-to-face interviews with the people who design and approve school lunch menus. My inquiry is guided by three key questions. First, to what extent are foreign influences included? Second, does openness to foreign influences vary across different parts of France? Finally, how are foreign cultures represented? My results suggest that foreign cultures are deployed to nationalize difference. The limited foreign influences that appear in school lunches are strategically chosen to appeal to and to educate students, but in a way that reinforces the centrality of traditional French cultural norms. This article contributes to our understanding of the tension between national culture and a globalizing world.

Survey of a Japanese Elementary School Lunch Program Menu Planning, Quality Control, and Nutrition Management: A Case Study

Survey of a Japanese Elementary School Lunch Program Menu Planning, Quality Control, and Nutrition Management: A Case Study

The Application of Optimal Defaults to Improve Elementary School Lunch Selections: Proof of Concept.

In this study, we applied behavioral economics to optimize elementary school lunch choices via parent-driven decisions. Specifically, this experiment tested an optimal defaults paradigm, examining whether strategically manipulating the health value of a default menu could be co-opted to improve school-based lunch selections. The design was a randomized comparison of optimal versus suboptimal (standard) default lunch menus for all first-graders in a school district for a period of 1 week. We hypothesized that making the default lunch option healthier, while providing parents the opportunity to access and choose from the standard school menu for their child, would yield more frequent selection of healthier items than when the default option was suboptimal. Overall, 127 (93%) first-grade children's families participated. Among those families randomized to receive the nutritionally optimized default menu, all but one remained with these options; of those parents randomized to the standard menu (suboptimal default), all parents remained with these options (Χ2 = 123.06, df = 1, p < .001). The mere positioning of choices, without restricting options, significantly affected which menu items the children received during the test period. Results are proof of concept for a strategy to increase health-promoting school lunch content, procedures, and policies.

Improvements and Disparities in Types of Foods and Milk Beverages Offered in Elementary School Lunches, 2006-2007 to 2013-2014.

IntroductionChildren consume much of their daily energy intake at school. School district policies, state laws, and national policies, such as revisions to the US Department of Agriculture’s school meals standards, may affect the types of foods and beverages offered in school lunches over time.MethodsThis study evaluated changes and disparities in school lunch characteristics from 2006–2007 to 2013–2014. Data were obtained from annual cross-sectional surveys at 4,630 public elementary schools participating in the National School Lunch Program. Multivariate logistic regressions were conducted to examine lunch characteristics.ResultsThe percentage of schools regularly offering healthful items such as vegetables (other than potatoes), fresh fruit, salad bars, whole grains, and more healthful pizzas increased significantly from 2006–2007 to 2013–2014, and the percentage of schools offering less healthful items such as fried potatoes, regular pizza, and high-fat milks decreased significantly. Nevertheless, disparities were evident in 2013–2014. Schools in the West were significantly more likely to offer salad bars than were schools in the Northeast, Midwest, or South (adjusted prevalence: West, 66.3%; Northeast, 22.3%; Midwest, 20.8%; South, 18.3%). Majority-black or majority-Latino schools were significantly less likely to offer fresh fruit than were predominantly white schools (adjusted prevalence: majority black, 61.3%; majority Latino, 73.0%; predominantly white, 87.8%). Schools with low socioeconomic status were significantly less likely to offer salads regularly than were schools with middle or high socioeconomic status (adjusted prevalence: low, 38.5%; middle, 47.4%; high, 59.3%).ConclusionMuch progress has been made in improving the quality of school lunches in US public elementary schools, but additional opportunities for improvement remain.

Nutrient Density and the Cost of Vegetables from Elementary School Lunches.

Vegetables are the major source of the dietary fiber, magnesium, potassium, and vitamins A and C that are crucial in the diets of children. This study assessed the nutrient content of vegetables offered through the National School Lunch Program and examined the relation between the overall nutrient density of vegetable subgroups and the costs of nutrients offered and wasted before and after the changes in school meal standards. Using data collected from 3 elementary schools before and after the changes in school meal standards, we found that vegetable plate waste increased from 52% to 58%. Plate waste for starchy vegetables, exclusive of potatoes, was relatively high compared with other subgroups; however, plate waste for white potatoes was the lowest among any type of vegetable. Energy density; cost per 100 g, per serving, and per 100 kcal; and percentage daily value were calculated and used to estimate nutrient density value and nutrient density per dollar. Cost per 100 kcal was highest for red/orange vegetables followed by dark green vegetables; however, nutrient density for red/orange vegetables was the highest in the group and provided the most nutrients per dollar compared with other subgroups. Given that many vegetables are less energy dense, measuring vegetable costs per 100 g and per serving by accounting for nutrient density perhaps is a better way of calculating the cost of vegetables in school meals.

School Resources and Engagement in Technical Assistance Programs Is Associated with Higher Prevalence of Salad Bars in Elementary School Lunches in the United States

BackgroundSalad bars have been promoted as a strategy for increasing fruit and vegetable consumption in schools. ObjectiveTo examine school-level resources and programs associated with the presence of salad bars in elementary schools and to assess whether there were differential changes in salad bar prevalence based on school-level resources and programs before and after the new US Department of Agriculture schools meals standards were proposed (January 2011) and implemented (July 2012). DesignRepeated cross-sectional design. Data were collected annually between 2006-2007 and 2013. SettingNationally representative sample of 3,956 elementary schools participating in the National School Lunch Program. School personnel (ie, administrators and foodservice staff) provided data using a mail-back survey. MeasuresPresence of salad bars in school was the primary outcome variable. School-level programs and resources were investigated as independent variables. Statistical analysisWeighted logistic regression analyses examined associations between dependent and independent variables controlling for school demographic characteristics. ResultsPrevalence of salad bars increased significantly from 17.1% in 2006-2007 to 29.6% in 2012-2013. The prevalence of salad bars was significantly higher among schools that participated in the Team Nutrition program (odds ratio [OR] 1.37, 95% CI 1.10 to 1.70), the Fresh Fruit and Vegetable Program (OR 1.48, 95% CI 1.13 to 1.95), a Farm to School program (OR 1.77, 95% CI 1.36 to 2.33), and where school meals were provided by a foodservice management company (OR 1.46, 95% CI 1.08 to 1.97). No association was found for schools with full-service kitchen, school gardens, those offering nutrition education, or those with dietitians/nutritionists on staff. ConclusionsPrevalence of salad bars increased significantly after the US Department of Agriculture school meal guidelines were proposed and implemented. It is likely that schools are using salad bars to offer a variety of fruits and vegetables to students, and schools with greater numbers of school-level resources and programs are better positioned for having salad bars.

Effect of Food Habits and Perceived Food Quality on Satisfaction with Elementary School Lunch in Gyeonggi Province

Effect of Food Habits and Perceived Food Quality on Satisfaction with Elementary School Lunch in Gyeonggi Province

Effect of Food Habits and Perceived Food Quality on Satisfaction with Elementary School Lunch in Gyeonggi Province

The provincial education office considers providing school lunch as a foodservice and intends to improve consumer satisfaction. This study investigates the effect of student food habits and perceived food quality on satisfaction with school lunch based on Oliver’s expectancy disconfirmation theory. We test the moderating effect of student gender and school conditions, such as the location of the school, job positon of the nutrition teacher, renovating kitchen and food distributing place. Questionnaires were collected from 240 sixth graders in the eight elementary schools in Gyeonggi province from August to September 2014. Excluding inadequate questionnaires, 208 were analyzed. PLS (Partial Least Square) and bootstrap t-tests were conducted for this study. The results showed food habits affected satisfaction directly (p<0.01). The perceived food quality of the school lunch service mediated this relationship in part (p<0.01). Moderating effects identified were gender (p<0.1), nutrition teacher’s position(p<0.05), and renovating kitchen (p<0.1), but not location of school or distributing place. The study revealed the importance of student food habits and perceived food quality, which had an influence on satisfaction. We make a distinction between the concepts of satisfaction and quality so as to improve student satisfaction. When it comes to offering education program about food habits, the schools with old-fashion kitchen is given priority to than renovating one.

Using Media to Improve Fruit and Vegetable Consumption in Elementary School Lunch Programs

Using Media to Improve Fruit and Vegetable Consumption in Elementary School Lunch Programs

Study on Recognition, Acceptance, and Satisfaction of Dessert Menus on Elementary School Food Services in Seoul Province

The purpose of this study was to evaluate perception, acceptance and satisfaction of dessert menu in elementary school children. Five hundred students (246 male, 254 female) were recruited at the elementary schools in Seoul. The results show that dessert menus of elementary school lunches are needed to satisfy diverse acceptance and preference levels of children. For dessert items chocolate milk among beverage items, peaches among fruits, chocolate cookies among cookies, piece cake among breads and honey rice cake among rice cakes presented high acceptance scores. Furthermore, fruits, ice creams, juices and cookies were the most liked food items. Taste and health of desserts were important factors in perception of dessert. Rice cake (48.6%), a Korean traditional food, was the most preferred food item, followed by tea punch (31.2%), Korean cracker (10.0%) and Shanja (4.0%). Taste (51.4%) was considered as the most important factor for improvement of dessert, and increasing variety of dessert items (43.4%) was considered as the most important factor affecting demand of dessert. It is suggested that continuous update of school dessert menus is needed to meet consumers’ demands and health aspects. Furthermore, Korean traditional desserts might be the key for improving satisfaction in desserts in elementary school lunches.

Using Media to Improve Fruit and Vegetable Consumption in Elementary School Lunch Programs

Using Media to Improve Fruit and Vegetable Consumption in Elementary School Lunch Programs

Increasing portion sizes of fruits and vegetables in an elementary school lunch program can increase fruit and vegetable consumption

Increasing portion size can increase children's consumption of food. The goal of this study was to determine whether increasing the portion sizes of fruits and vegetables in an elementary school cafeteria environment would increase children's consumption of them. We measured each child's consumption of the fruit and vegetables served in a cafeteria line on a control day (normal cafeteria procedures) and on two intervention days. When we increased the portion size of 3 of the 4 fruits and vegetables by about 50%, children who took those foods increased their consumption of them. Although this was an effective strategy for increasing fruit and vegetable consumption among students who took those foods, many children chose not to take any fruits or vegetables. Further efforts are needed to increase children's selection and consumption of fruits and vegetables in an environment of competing foods of higher palatability.

Elementary school lunch categorisation and correlations with dietitian recommendations.

Numerous interventions have been designed to impact children's diet in the elementary school setting. One popular strategy is to label foods in the elementary cafeteria as more or less healthy. An example is the Coordinated Approach To Child Health (CATCH) labels of 'go', 'slow', or 'whoa' foods. In many respects, this has been successful, as food purveyors have responded by offering more healthy versions of popular foods (e.g. hamburgers with a high soy content) in an effort to avoid the less healthy, 'whoa' label. While this provides an obvious benefit to children's dietary choices and overall risk of obesity, it may have the unintended consequence of not setting up youth to make healthy choices in the environment outside of schools where these foods have not been altered. In response, the current study was designed to compare school labels and registered dietitian (RD) recommendations of common elementary lunch options. In the spring of 2010, 28 RDs provided their recommendation of 'generally healthy, choose often'; 'generally less healthy, choose less often'; and 'generally unhealthy, choose rarely' for 48 common school lunch options. RDs were not told how schools categorised each selection. Kappa analyses were used to determine agreement between school labels and RD recommendations. Results indicate some disagreement between school labels and RD recommendations, with higher fat/calorie entrées showing greater discrepancies. Given these inconsistencies, nutrition education in schools should be designed to help children and their parents understand how foods offered in school may differ from those outside the school environment.