Meal Standards Research Articles

Incremental implementation concept for healthy eating habits in German school with kiosk

PurposeSchool kiosk offerings play a crucial role in the dietary behavior of students. The importance of healthy meals in schools is emphasized again and again, but there is a lack of practical implementation and literature data on kiosk offers and acceptance. This study aimed to analyze the reasons and improve the situation.Design/methodology/approachIndividual nutrition knowledge and behavior as well as purchasing behavior at a typical kiosk scenario at schools were collected. Based on the outcome, a concept for improving the school kiosk offerings according to the quality standard of the German Nutrition Society was developed. Many obstacles and challenges had to be overcome in the transition to healthier offerings and their implementation. In the course of these changes, the creation of a new feel-good cafeteria lounge was deemed necessary and finally realized.FindingsA large percentage of the school kiosk offerings did not meet the desires of the school community. Opportunities to improve the school kiosk service were identified. The skillful planning of structural changes towards healthy food offers and warm meals on two weekdays made it possible to implement the official nutrition standards for healthier meals at school kiosks, despite long-term challenges for food providers.Originality/valueAfter a critical analysis of the reasons for the lack of politically desired standards for healthier meals at school kiosks, a new implementation culture is presented and was successfully applied to overcome barriers and challenges through an incremental-dynamic concept strategy with iterative cooperation between the actors of food service providers, school administration, school management, teachers and students.

Evaluation of health and economic effects of United States school meal standards consistent with the 2020–2025 dietary guidelines for Americans

BackgroundThe current school meal nutrition standards, established in 2010, are not fully aligned with the 2020–2025 Dietary Guideline for Americans (DGA). This study evaluates the potential short-term and long-term health and economic benefits of strengthening the school meal standards on added sugars, sodium, and whole grains to be aligned with current guidelines. MethodsWe used comparative risk assessment frameworks based on nationally representative data incorporating current demographics, dietary habits, and risk factors of United States children aged 5–18 y from 3 cycles of the National Health and Nutrition Examination Survey (2013–2018). To estimate short-term impact, the model incorporated estimated dietary changes owing to potential new DGA-aligned school meal nutrition standards and the effect of these changes on childhood body mass index (in kg/m2) and blood pressure. To estimate long-term impact, the model further incorporated data on the sustainability of childhood dietary changes into adulthood, and on demographics and risk factors of United States adults, diet-disease associations, and disease-specific national mortality. ResultsIn a best-case scenario assuming full school compliance, implementing new DGA-aligned nutritional standards would lower elementary children’s BMI by an average 0.14 (95% UI: 0.08–0.20) kg/m2 and systolic blood pressure by 0.13 (95% UI: 0.06–0.19) (95% mm Hg. Later in life, the new standards were estimated to prevent 10,600 [95% uncertainty interval (UI): 4820–16,800) annual deaths from cardiovascular disease (CVD), diabetes, and cancer in adulthood; and save 355,000 (95% UI: 175,000–538,000) disability-adjusted life years and $19.3 (95% UI: 9.35–30.3) B in direct and indirect medical costs each year. Accounting for plausible (incomplete) school compliance, implementation would save an estimated 9110 (95% UI: 2740–15,100) deaths, 302,000 (95% UI: 120,000–479,000) disability-adjusted life years, and $15.9 (95% UI: 4.54–27.2) B in healthcare-related costs per year in later adulthood. ConclusionsStronger school meal nutrition standards on added sugars, sodium, and whole grains aligned with the 2020–2025 DGA recommendations may improve diet, childhood health, and future adult burdens of CVD, diabetes, cancer, and associated economic costs.

P29-046-23 Evaluation of Health and Economic Effects of U.S. School Meal Standards Consistent With the 2020-2025 Dietary Guidelines for Americans

P29-046-23 Evaluation of Health and Economic Effects of U.S. School Meal Standards Consistent With the 2020-2025 Dietary Guidelines for Americans

Comparison of foods and beverages served and consumed in Child and Adult Care Food Program-participating childcare centres to national guidelines.

The federal Child and Adult Care Food Program (CACFP) sets minimum nutrition and portion size standards for meals served in participating childcare programs. CACFP has been associated with more nutritious meals served. It is unclear, however, whether CACFP results in children's dietary intake being aligned with national recommendations. We assess whether children's dietary intake in CACFP-participating childcare centres meets benchmarks set by the Dietary Guidelines for Americans (DGA). This is a cross-sectional study. We used direct observation to estimate quantities of foods/beverages served and consumed per child. Mean amounts served per child per day were compared with CACFP portion size requirements for each component (fruits, vegetables, milk and meat/meat alternate). Mean amounts of foods/beverages consumed were compared with DGA recommendations (energy content, fruits, vegetables, whole/refined grains, dairy, protein and added sugars). One sample t-tests evaluated if quantities served and consumed were different from CACFP and DGA standards, respectively. Six CACFP-participating childcare centres. 2-5 year-old children attending childcare. We observed forty-six children across 166 child meals. Most meals served met CACFP nutrition standards. Compared with CACFP portion size standards, children were served more grains at breakfast and lunch; more fruits/vegetables at lunch but less at breakfast and snack and less dairy at all eating occasions. Compared with DGA recommendations, children under-consumed every food/beverage category except grains during at least one eating occasion. Children were served quantities of foods/beverages mostly consistent with CACFP portion size requirements, but had sub-optimal intake relative to DGA. More research is needed to help children consume healthy diets in childcare.

Prevalence of Double Burden of Malnutrition and Associated Factors of Weight Gain among Schoolchildren in Taza, Eastern Morocco

Background: Obesity and overweight are characterized by an excessive accumulation of fat present in the body. Worldwide more than 340 million children between the ages of five and nineteen were overweight or obese in 2016. Very few studies have focused on the prevalence of the double burden of malnutrition, namely obesity, and underweight, in the Moroccan context. Methods: The research was a cross-sectional study based on a selfadministered questionnaire which distributed to 462 adolescents in the presence of a dietician who was also responsible for anthropometric measurements and clinical examination. Results: The prevalence of underweight was 11.4%, overweight was estimated at 7.3%, and obesity at 1.7%. The Odds ratio analysis revealed that the number of people sharing the same household has a strong influence on weight gain, as adolescents who share their home with only 2 people are 61 times more likely to gain weight than adolescents who live with 3 or more people in the same household (OR 61.11 CI 18.96;196.97). Type of residence was also found to be a risk factor for weight gain; adolescents living in urban areas were 6 times more likely to gain weight than those living in rural areas (OR= 6.11 CI: 1.39; 26.82). Adolescents who do not consume fast food are less likely to gain weight (Odds Ration less than 1 (OR=0.014 CI: 0.003;0.063). Regular strenuous physical activity was also a protective factor against weight gain (OR=0.278 CI: 0.080;0.969). Conclusion: The double burden of malnutrition characterized by the coexistence of obesity and underweight is a reality in Taza. It is therefore urgent to take community action, such as promoting healthy food choices by taxing unhealthy foods, implementing obligatory standards for meals in canteens and school catering, increasing daily physical activity in schools, as well as fighting against obesogenic environments. Early intervention is necessary because moderate overweight in childhood is associated with a significant increase in the risk of type 2 diabetes and cardiovascular disease in later adulthood.

A Systematic Review and Meta-Analysis of Fruit and Vegetable Waste From School Lunch

ObjectivesTo synthesize findings from studies that assessed fruit and vegetable (F&V) plate waste from school lunches to i) estimate the level of waste, ii) determine whether there is a difference in F&V waste pre- and post- implementation of the new National School Lunch Program’s (NSLP) meal standards, and iii) identify factors associated with plate waste. MethodsThe systematic review followed the Cochrane Collaboration Guidelines, USDA’s Nutrition Evidence Library (NEL) Bias Assessment, and USDA NEL Conclusion Statement Evaluation Criteria. Meta-analysis of selection and percentage of waste was performed in STATA-16. Thirty-two studies were included in the systematic review and thirty in meta-analysis. ResultsThe estimated mean percentage of students that selected fruits and vegetables were 61% (95% CI: 50%-72%, n = 14), and 48% (95% CI: 37%-59%, n = 14), respectively. The percentage of students who selected fruits increased significantly after the implementation of the new standards. This increase was consistent across all the studies and ranged from 5% to 24%. Fruit waste was estimated to be 39.5% (95% CI: 33.8%–44.5%) and vegetables waste was 50.5% (95% CI: 42.5%–57.4%). No significant differences were found between pre- and post-implementation for fruit or vegetable waste. Child related factors, such as age, gender, and ethnicity/race, were not statistically significant to explain the aggregate waste across studies. Only few studies on plate waste explored the effect of preferences or attitudes, preparation methods, availability of competitive food, and time devoted to eating on F&V waste. However, no relationships could be established beyond the descriptions provided in the original studies. ConclusionsThe change in NSLP meal standards has had a positive effect in increasing the number of students selecting fruits. Further research is warranted to improve the overall F&V selection and reduce waste, especially for dark green vegetables, to maximize the nutritional impact of the NSLP. Funding SourcesUSDA/ARS; The Alliance for Potato Research and Education.

Gender Differences in Nutritional Quality and Consumption of Lunches Brought from Home to School.

Gender difference in the lunches brought from home to school and the amount consumed by elementary and intermediate school students were examined using data collected from 12 schools in Texas. The amount and nutritional quality of food items brought and consumed was evaluated, by comparing the results to the 2012 school meal standards, and Dietary Reference Intakes (DRIs). Almost all lunches brought from home contained grain and meat/meat alternatives, and the amount brought and consumed exceeded the NSLP standards. The majority of students did not bring fruits, vegetables, and whole grain foods, but those who brought consumed most of what they brought. Among elementary school students, only 9% of boys and 14% of girls brought vegetables and the amount brought and consumed did not meet the standards. Although carbohydrate and protein consumption were adequate for boys and girls, the intakes of micronutrients and fiber did not meet the requirements across both genders at both school levels. Overall, lunches brought from home were not well balanced and did not meet NSLP standards and DRIs. It is imperative to identify strategies to improve the nutritional quality of lunches brought from home considering gender difference in food choice and educating parents and children on what is a healthy well-balanced lunch.

State and Local Healthy Kids’ Meal Laws in the United States: A Review and Content Analysis

BackgroundTo address unhealthy restaurant food intake among children, localities and states are passing healthy restaurant kids’ meal laws. However, there is limited knowledge of what these policies require and how they compare with expert and industry nutrition standards. ObjectivesThe aim of this study was to develop a research instrument to evaluate healthy kids’ meal laws and assess their alignment with expert and industry nutrition standards. DesignThe study team conducted a content analysis of healthy kids’ meal laws passed between January 2010 and August 2020 in the United States. Using a structured codebook, two researchers abstracted policy elements and implementation language from laws, regulations, fiscal notes, and policy notes. Nutritional criteria for kids’ beverages and meals were compared with existing expert and industry nutrition standards for meals and beverages. Main outcome measuresMeasures included law characteristics, implementation characteristics, enforcement characteristics, definitions of key terms, and nutritional requirements for meals and default beverage options and alignment with expert and industry nutrition standards. Statistical analyses performedInterrater reliability of the coding tool was estimated using the Cohen kappa statistic, and researchers calculated descriptive statistics of policy elements. ResultsTwenty laws were identified. Eighteen were healthy default beverage policies, two were toy restriction policies, and one was a nutrition standards policy. The nutrition standards, default beverage offerings, and implementation characteristics varied by location. No law met the expert nutrition standards for kids’ meals or beverages. ConclusionsThe variations in policy specifications may influence how restaurants implement the policies, and, consequently, the policies’ influences on children’s consumption. Future policies could use expert nutrition standards to inform the standards set for kids’ meals and specify supports for implementation.

Training Preferences of School Food Service Staff Vary by Role in the School Nutrition Program.

Professional development has been identified as a critical component for school nutrition professionals (SNPs) to successfully implement school meal standards in the United States. However, training needs may vary based on different factors. This study examined (1) the topics of highest priority for SNPs; (2) preferred learning methods; (3) where and when trainings should be conducted; and (4) whether responses differ according to important factors including position type, school locale (urban vs. rural), or job experience. Participants completed surveys that included questions on demographics and preferences for learning methods and training topics (n = 492). Descriptive statistics characterized survey responses. Chi square tests assessed differences in learning method and training topic preferences by participant role, locale, and job experience; Cramer’s V assessed the strength of association for each chi square result. Qualitative responses to open-ended questions were analyzed using an inductive thematic analysis method. Nearly all training topic preferences were significantly different (p < 0.001 using Bonferroni method) when stratified by role. Significant differences were also observed for school locale and years of experience, but to a lesser degree. There was less variation in learning method preferences across staff role. Qualitative results (n = 93) identified three key themes related to training needs: role-specific trainings, innovative learning methods, and geographic access. The combination of quantitative and qualitative analysis indicate that professional development for SNPs should mostly be conducted in-person, be easily accessible, and include hands-on activities. Further, training should be tailored by job role and address situational barriers unique to the geographic area.

Analyzing the Association between Student Weight Status and School Meal Participation: Evidence from the School Nutrition and Meal Cost Study.

Childhood obesity remains a pressing public health concern. Children consume a substantial amount of their caloric intake while in school, making the passage of the Healthy Hunger-Free Kids Act (HHFKA) in 2010 and the subsequent improvements to the school meal standards a key policy change. Using data from the School Nutrition and Meal Cost Study, this paper seeks to re-examine the association between students’ (N = 1963) weight status and participation in the National School Lunch Program (NSLP) and School Breakfast Program (SBP) since the implementation of these policy changes to determine whether, and how, this relationship has changed. After controlling for a wide array of student characteristics and school-level fixed effects, findings from the multivariate regression analyses indicate that usual participation in the school meal programs has no clear association with students’ weight status, which contradicts findings from earlier studies conducted prior to the passage of the HHFKA. These findings are discussed in relation to changes in the demographic composition of usual NSLP participants over time.

Availability of Lower-Sodium School Lunches and the Association with Selection and Consumption among Elementary and Middle School Students

BackgroundDuring 2010, the US Department of Agriculture updated the school meals standards, including three progressively decreasing sodium targets. The Target 1 standards went into effect in 2014, but during 2018, the US Department of Agriculture delayed the Target 2 standards until 2024 and eliminated the Target 3 standards citing concerns regarding the availability and acceptability of lower-sodium foods. In addition, there are currently no sugar standards, and it is unknown whether sugar is substituted for salt in lower-sodium school foods. ObjectiveTo examine the availability, selection, and consumption of school lunches already in alignment with the Target 2 and 3 sodium levels and the association between sodium and sugar. DesignAn observational cafeteria-based study conducted during fall 2018. Participants and settingStudents (n = 1985) in grades three through eight attending 13 elementary/kindergarten through eighth-grade schools in a large, urban school district in New England. Main outcome measuresAvailability, selection, and consumption were examined using plate waste methodology. Statistical analyses performedMixed-model analysis of variance accounting for student demographic characteristics with schools/students as a random effect (students nested within schools) were used to examine differences in availability, selection, and consumption. Linear regression was used to examine the association between sodium and sugar in the school foods. ResultsThe majority of meals selected (87%) and consumed (98%) were already in alignment with the Target 2 standards. There were significant inverse associations between sodium levels and consumption; each 100-mg increase in sodium was associated with a decrease in consumption by 2% for entrées (P = 0.002) and 5% for vegetables (P = 0.01). When examining the association between sodium and sugar, each 10-mg reduction in sodium was associated with 1-g increase in sugar among entrées (P < 0.0001), whereas there was a significant positive association between sodium and sugar with vegetables and condiments. ConclusionsThis study provides some evidence that schools may already have the ability to provide lower-sodium meals that are acceptable to students, and therefore the recent rollbacks to the sodium standards may be unwarranted. Study findings suggest that the US Department of Agriculture should take under consideration policies that would limit added sugar for school meals as sugar may be substituted for salt.

Did the New School Meal Standards Improve the Overall Quality of Children's Diets?

AbstractSchool meal programs represent the second largest form of food assistance in the United States. Schools receive federal reimbursements, totaling $17 billion in 2018, provided they meet certain nutritional standards. The Healthy Hunger‐Free Kids Act (HHFKA) updated these standards beginning with 2012–2013 school year. We document the impact of consuming school‐prepared food, rather than home‐prepared food, on diet quality pre‐ and postpolicy reform. Pre‐HHFKA, school food increased dietary quality for relatively disadvantaged children, with null‐to‐negative effects among all other students. Post‐HHFKA, significant improvements are observed across the entire distribution of dietary quality, mainly driven by older, higher‐income students.

Addressing Equity in Rural Schools: Opportunities and Challenges for School Meal Standards Implementation.

Few studies examine why rural public schools have weaker policies and practices related to school nutrition environments compared to their urban counterparts. It is important to understand this disparity because federal school meal standards aim for children to access health-promoting nutrition environments. In this study, we identify challenges and opportunities for the implementation of school meal standards in rural high schools. We interviewed 38 rural school professionals from 22 high schools across 7 states. School professionals included food service directors, principals, school nurses, and teachers. Team coding in Atlas.ti Qualitative Data Analysis software v8 and principles of comparative analysis were employed to generate themes related to challenges and opportunities. Overall, school professionals described improvements with implementation experiences and student acceptance over time. Key challenges included the negative influences of home and community food environments and limited staff size and capacity. Key opportunities involved joining co-ops to enhance purchasing power, leveraging state technical assistance, and forming external partnerships. This study offers insights from a broad range of rural school professionals' implementation experiences. The findings can inform governments and technical assistance agencies working with rural schools and school districts to facilitate implementation and sustainability of initiatives.

Participation Trends for Full Price Meals in the National School Lunch Program

AbstractParticipation in USDA's National School Lunch Program has declined since 2011, driven by fewer full‐price lunch purchases among students not eligible for free or reduced‐price meals. Potential explanations include meal price increases for paying students and updated nutrition standards for meals following implementation of the Healthy Hunger‐Free Child Act, as well as macroeconomic factors. Longitudinal analyses of full‐price lunch participation at the state and local levels indicate household income and employment trends were significantly associated with participation trends, but lunch price increases and challenges some localities experienced implementing new nutrition standards may have played a role as well.

Voluntary Kids' Meal Beverage Standards: Are They Sufficient to Ensure Healthier Restaurant Practices and Consumer Choices?

Many quick-service restaurants (QSRs) instituted voluntary kids’ meal default beverage standards (standards) between 2013 to 2017. Little is known about impacts of standards on QSR drive-through practices and on customer choices. This study assessed differences in restaurant practices including kids’ meal beverages shown on menu boards, offered by cashiers, and selected by customers in QSRs with and without voluntary standards. Observations (n = 111) and customer surveys (n = 84) were conducted in 2018 at QSRs with standards (n = 70) and without (n = 41) in low-income California, U.S. neighborhoods. Kids’ meal beverages on menu boards (n = 149) and offered by cashiers (n = 185) at QSRs with and without standards were analyzed using multilevel logistic regression. Significantly more menu boards at QSRs with standards (n = 103) vs. without (n = 46) featured only milk, water or unsweetened juice (65.1% vs. 4.4%; p < 0.001). Most cashiers at QSRs with standards and QSRs without (53.1%, 62.5%) asked what drink the data collector wanted rather than first offering default beverages. A small sample of customer interviews found that customers at QSRs with standards most commonly ordered juice (37.0%); at QSRs without standards, soda (45.5%). Although menu boards showed healthier kids’ meal beverages at QSRs with standards than without, cashier behavior was inconsistent. Results suggest additional measures (legislation, implementation support, enforcement) may be needed to ensure optimal implementation.

Impact Of The Healthy, Hunger-Free Kids Act On Obesity Trends.

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.

Implementing the New Child and Adult Care Food Program's Nutrition Standards in Boston.

In 2017, the US Department of Agriculture’s Child and Adult Care Food Program’s (CACFP’s) nutrition standards were updated to improve nutrition and meal quality while remaining feasible for child care providers to implement. We conducted a pre–post study of 13 family child care home (FCCH) providers in Boston, Massachusetts, to compare reported opportunities for training and technical assistance and knowledge of new nutrition standards before the effective date of the updates (October 1, 2017) and 1 year later. The McNemar test was used to test for differences in provider responses. Few FCCH providers received training or technical assistance or had knowledge of most new standards at baseline or at follow-up; however, provider-reported knowledge of the whole-grain standard improved over time (from 6 providers to 12 providers) (P = .03). One year post implementation, FCCH providers still needed additional training, technical assistance, or other support to meet the new nutrition standards for meals served to children.

The harmonizing effect of Smart Snacks on the association between state snack laws and high school students' fruit and vegetable consumption, United States—2005–2017

Despite national guidelines recommending daily fruit and vegetable (FV) consumption, intake of FV among adolescents is low. Over the past 10–15 years, state and federal laws have reduced the availability of junk foods in schools. This study examined the association between state snack laws and high school (HS) student FV consumption. The overall sample included 99,785 HS students (outcome samples ranged from 96,209-97,328) included in the Youth Risk Behavior Survey (YRBS). National Cancer Institute Classification of Laws Associated with School Students' data for 2004–2016 were lagged on to 2005–2017 YRBS data. Separate analyses examined the state law-youth FV consumption relationship pre- and post-federal Smart Snacks standards (effective school year 2014–2015). Analyses were conducted between 2018 and 2020.Overall, state laws were associated with any vegetable, salad, and other vegetable consumption. The relationship between state laws and vegetable consumption primarily occurred pre-Smart Snacks. Pre-Smart Snacks, state laws were associated with higher odds of youth consumption of any vegetable, salad, carrots, and other vegetables (all compared to students in states without snack laws). The only association post-Smart Snacks was between strong state laws and salads.This study illustrates the important role that standards restricting the availability of junk foods in schools can have on increasing student vegetable consumption. Given current efforts to roll-back federal school meal standards, findings from this study illustrate how federal standards harmonized the patchwork of state laws that existed prior to Smart Snacks and the important role that consistent national standards can play in supporting student consumption of vegetables.

Updated Nutrition Standards Have Significantly Improved the Nutritional Quality of School Lunches and Breakfasts

BackgroundImplementation of updated nutrition standards for school meals began during school year (SY) 2012-2013. The standards were designed to improve the nutritional quality of the meals and their consistency with the Dietary Guidelines for Americans. ObjectiveTo assess the nutritional quality of school lunches and breakfasts after the updated standards were in place and compare it with the nutritional quality of the meals before the updated standards. DesignSchool menu data were used from two cross-sectional, nationally representative studies of schools participating in the National School Lunch Program during SY 2014-2015 (School Nutrition and Meal Cost Study) and SY 2009-2010 (fourth School Nutrition Dietary Assessment Study). Participants/settingThe analysis used 1 week of school menu data from 1,206 schools at lunch and 1,110 schools at breakfast for SY 2014-2015, and 884 schools at lunch and 802 schools at breakfast for SY 2009-2010. Outcome measuresHealthy Eating Index 2010 scores were estimated. Statistical analysesDescriptive analyses were conducted to estimate mean Healthy Eating Index 2010 total and component scores for school meals. Scores are expressed as a percentage of maximum possible scores. Two-tailed t tests were used to assess differences in scores before and after updated standards were in place. ResultsTotal Healthy Eating Index 2010 scores for school lunches and breakfasts increased significantly after the updated standards. Between SY 2009-2010 and SY 2014-2015, the total score for school lunches increased from 58% of the maximum score to 82%, and the total score for school breakfasts increased from 50% to 71% (P<0.05). For both meals, component scores increased by more than 20 percentage points for whole grains, refined grains, and empty calories, as well as for greens and beans for lunches and whole fruit and sodium for breakfasts. ConclusionsThe updated nutrition standards for schools meals significantly improved the nutritional quality of the meals and their consistency with the Dietary Guidelines for Americans.

Did the New School Meal Standards Improve the Overall Quality of Children’s Diets?

School meal programs represent the second largest form of food assistance in the United States. Schools receive federal reimbursements, totaling $17 billion in 2018, provided they meet certain nutritional standards. We document the impact of consuming school food, rather than home-prepared food, on diet quality as standards changed under the Healthy Hunger-Free Kids Act (HHFKA). Pre-HHFKA, school food increased dietary quality for relatively disadvantaged children, with null-to-negative effects among all other students. Post-HHFKA, we find large improvements across the board, mainly driven by older, higher-income students although younger, lower-income students also experienced non-trivial gains.