Assessment urges more veggies plus restrictions on unhealthy options
WEDNESDAY, March 4 (HealthDay News) -- Despite some improvements, U.S. school meal programs are still laden with unhealthy fat, salt and sugar, nutrition experts contend.
Students also have limited choices in foods available in vending machines, á la carte in cafeterias, at school stores and snack bars and for fund-raisers, they say in a series of articles in a supplement to the February issue of the Journal of the American Dietetic Association.
Echoing these sentiments, a Chicago chef brought to the White House to cook for the Obamas has said that too much of the food available at schools also is high in additives and preservatives.
Unhealthy eating at school, these food experts believe, is contributing to the surge in obesity rates among U.S. children. Obesity rates have more than doubled among infants and toddlers aged 2 to 5, quadrupled in children aged 6 to 11 and more than tripled among adolescents aged 12 to 19, according to an editorial in the journal.
The rising rates have health experts concerned about a nascent epidemic of obesity-related diseases, including cardiovascular disease and type 2 diabetes, in young people.
"Of course, school meals are only one part of the problem," said Anne R. Gordon, a senior researcher at Mathematica Policy Research in Princeton, N.J., and co-author of a paper on school lunches in the supplement. "Kids don't eat well throughout the day. But, we do find at least some evidence that in some of the schools that restrict the availability of sugar-sweetened beverages, you don't see the kids going and drinking more sugar-sweetened at other times of day. It really does decrease intake, so that's encouraging."
Gordon's paper described and assessed data from the third School Nutrition Dietary Assessment, sponsored by the U.S. Department of Agriculture and conducted by Mathematica, as well as findings from other studies that used the same data. The USDA-backed analysis covered both the National School Lunch Program, which provides subsidized meals to about 30 million children daily, and the School Breakfast Program, which provides meals to about 10 million children a day.
The lunch program began in 1946 to help ensure that U.S. children were receiving enough nutritious food. The breakfast program was institutionalized in 1975. Both offer free or low-cost meals to eligible students.
"It's very clear that USDA needs to update the standards of schools" related to nutrition, Gordon said. "They know what they're aiming for, but having standards is not enough."
"We need to explore other ways of making change, which could include items such as providing more training and technical assistance to schools, providing more funding for nutrition education," she said. "It also may be worth considering more laws or regulations to limit the availability of certain types of food, such as whole or 2 percent milk."
Mary Ford, a registered dietitian and professor in the School of Public Health at the University of Minnesota, and author of the journal editorial, urged such action.
"Schools need to do even more to reduce the availability of high-calorie, low-nutrient foods and make school meals more nutritious," she wrote. Foods available by choice to students -- in vending machines, á la carte and the like -- "should include only fruits, vegetables, whole grains and non-fat and low-fat dairy products," she wrote.
The editorial also suggested that the federal government withhold funding for meal programs from school systems that don't comply with stepped-up nutrition expectations.
Sam Kass, the chef who followed the Obamas to the White House, also has put the school lunch program under fire. According to a report in The New York Times in January, Cass attributes the nutritional shortcomings in school lunches, at least in part, to the use of donated surplus agricultural commodities that result from government subsidies.
"As a result, he says, meals served to students are low in vegetables and disproportionately high in fat, additives, preservatives and high-fructose corn syrup," the Times report said.
The School Nutrition Dietary Assessment included information from 398 public schools in 130 districts across the United States, including 2,314 students in first through 12th grade during the 2004-05 school year.
It found that more than 70 percent of the schools served meals that met the standards for critical nutrients such as protein, vitamins A and C, calcium and iron.
But a mere 6 to 7 percent of subsidized meals met all nutritional standards, the study found. Most had too much saturated fat or fat overall, and not enough calories.
About 42 percent of the schools surveyed offered no fresh fruits or raw vegetables in their lunch programs.
Fat tended to come from salad dressings, condiments and spreads, pizza products, peanut butter sandwiches and french fries. Saturated fat tended to come from pizza products, condiments and spreads, 2-percent milk, salad plates or salad bars and hamburgers or cheeseburgers.
Foods in vending machines and offered á la carte and in snack bars were most often high in calories and low in nutrients: candy, french fries, donuts, sweetened drinks and salty snacks.
The study found that low-income children fared worse, nutritionally, than those from higher-income homes, although school-lunch-program participants generally got more nutrients in their meals than kids responsible for their own lunches.
As for remedies, Gordon and the other researchers offered some. "Innovative preparation methods or improvements in the presentation of fruits and vegetables could make these items more appealing to children," they wrote. The study suggested that school cooks use whole-grain flours to prepare pizza crusts and mix whole-grain and regular pasta in pasta-based entrees and that school lunchrooms control the available portions of condiments such as ketchup, mustard and barbeque sauce to control sodium intake.
Gordon noted that schools have made progress in improving meal offerings, but more needs to be done.
"Part of it is getting kids to eat healthier foods, part of it is providing schools with more support," she said.
The USDA has more on the National School Lunch Program.
SOURCES: Anne R. Gordon, Ph.D., senior researcher, Mathematica Policy Research Inc., Princeton, N.J.; February 2009 Journal of the Dietetic Association; Jan. 29, 2009, The New York Times
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