Strict school meal standards associated with improved weight status among students

A study suggests that states with stricter school meal nutrition standards were associated with better weight status among students who received free or reduced-price lunches compared with students who did not eat school lunches, according to a report published Online First by JAMA Pediatrics, a JAMA Network publication.

The National School Lunch Program (NSLP) was started in 1946 to improve student nutrition by providing school lunches according to standards sets by the U.S. Department of Agriculture (USDA). However, the program has faced criticism that the lunches did not meet USDA nutrient-based standards, and the NSLP may be a missed opportunity to improve students' weight status and reduce the health consequences of obesity, the authors write in the study background.

Daniel R. Taber, Ph.D., of the University of Illinois at Chicago and colleagues conducted a study using a sample of 4,870 students in 40 states. Student data were obtained from the Early Childhood Longitudinal Study, Kindergarten Class, which began collecting data from a nationally representative sample of kindergarten students in fall 1998.

In states that exceeded USDA school meal standards, the difference in obesity prevalence between students who received free or reduced-price lunches and students who did not get lunches was 12.3 percentage points smaller compared with states that did not exceed USDA standards.

"In states that did not exceed USDA standards, students who obtained free/reduced-price lunches were almost twice as likely to be obese than students who did not obtain school lunches (26 percent and 13.9 percent, respectively), whereas the disparity between groups was markedly reduced in states that exceeded USDA standards (21.1 percent and 17.4 percent, respectively)," according to the study results.

Researchers also found that there was little evidence that students compensated for school meal laws by buying sweets, salty snacks or sugar-sweetened beverages from other school venues, such as vending machines, or from other sources, such as fast food restaurants.

"The evidence in this study suggests that ongoing changes to school meal standards have the potential to reduce obesity, particularly among students who are eligible for free/reduced-price lunches, though additional longitudinal research is needed to confirm this," the study concludes.

Editor's Note: Support for the research was provided by The Robert Wood Johnson Foundation and a grant from the National Heart, Lung and Blood Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: School Meals a Starting Point for Countering Childhood Obesity

In a related editorial, Marion Nestle, Ph.D., M.P.H., of New York University, writes: "In this issue of JAMA Pediatrics, Taber and colleagues provide important evidence to support the value of strong, far-reaching public health initiatives to counter childhood obesity."

"In short, the study found an association between more stringent school meal standards and more favorable weight status, especially among low-income students," Nestle continues.

'The study produced one other noteworthy result. Students did not compensate for the healthier school meals by buying more snacks or sodas on school premises," Nestle concludes.