The Impact of School Nutrition Standards on Childhood Obesity

 By Lauren Scott

Childhood obesity is on the rise. Obesity impairs health due to the accumulation of adipose tissue (Kumari et al., 2022). This is a concern because obesity is a public health issue, and children can also develop it as adults. “According to estimates from various studies, 200 million school children are either overweight or obese” (Kumari et al. 2022, p.1). Body Mass Index (BMI) above the 95th percentile is what determines if a child is obese or not (Kumari et al., 2022). When it comes to school children, school lunches affect obesity. The evaluation of school nutrition standards is pertinent to the role of childhood obesity. The National School Lunch Program is in elementary, middle school and high schools. In 2010, the Healthy, Hunger- Free Kids Act (HHFKA) required nutrition standards to be up to par with the Dietary Guidelines for Americans (DGAs) (Smith et al, 2024).  What we really want to know is whether or not the school nutrition standards impact childhood obesity. This can be determined by looking at the National Health and Nutrition Examination Survey (NHANES), the Healthy, Hunger-Free Kids Act (HHFKA) and universal free school meals. 

NHANES was conducted by the National Center for Health Statistics (NCHS) (Smith et al., 2024). This survey showed that obesity is unequally distributed among children that come from household incomes below 130% of poverty level (Smith et al., 2024). This survey also showed that during 2018-2020, the percentage of Hispanic children that were obese was 26%, the percentage of non-Hispanic Black children that were obese was 25%, and the percentage of non-Hispanic white children that were obese was 17% (Smith et al., 2024). If children came from household incomes below 130%, they can get a reduced price for lunch. 

Before the HHKFA was implemented, children being influenced by school diet had a mixed reaction (Smith et al., 2024). During this period, children ate candy and consumed sweetened beverages, for example. After HHFKA was implemented, school food quality increased among children of all races and income levels. From 2017- March 2020, the consumption of school food had associations with diet-quality that was positive among non-Hispanic Blacks, and Hispanics (Smith et al., 2024). 

One of the benefits of school lunches is the Universal free school meals. Universal free school meals targets those from low income families. There are multiple provisions that affect universal free school meals. They are Provisions 1,2,3 and the Community Eligibility Provision (CEP) (Cohen et al., 2021). CEP was enacted during the 2010 HHFKA.  A study in Japan showed that students in elementary and junior high schools who consumed mandatory lunches had a higher dietary quality (Cohen et al., 2021). Most of the studies conducted showed a positive relationship with food security, academic performance and diet quality (Cohen et al., 2021). In a study conducted in Norway, in 2017, by IlløKken et al., an intervention was conducted in elementary schools providing free lunches for students. The study showed an increase in consumption of fruits (Cohen et al., 2021). The overall studies conducted showed that food security improved during universal free school meal provisions (Cohen et al., 2021). Looking at NHANES, HHFKA, and universal school meals shows that the consumption of healthier school meals increased the consumption of healthier items such as fruits and vegetables. For the children from low socioeconomic backgrounds, NHANES showed that obesity is more prevalent in these children. The percentage of Hispanic children that were obese was the highest among other races (Smith et al., 2024). These children are able to get a reduced price for lunch, which gives them access to fresher items at a lower cost. Studies have shown that school food quality among Hispanics and non-Hispanic Blacks improved after the HHFKA was implemented (Smith et al., 2024). This improved their quality of diet. Finally, free school lunches, also known as Universal Free school meals, also had higher quality meals and improved the quality of their diets (Cohen et al., 2021). Overall, higher quality food leads to a positive relationship between food and academic performance (Cohen et al., 2021). 

References 

Cohen JFW, Hecht AA, McLoughlin GM, Turner L, Schwartz MB. Universal School Meals and Associations with Student Participation, Attendance, Academic Performance, Diet Quality, Food Security, and Body Mass Index: A Systematic Review. Nutrients. 2021 Mar 11;13(3):911. doi: 10.3390/nu13030911. PMID: 33799780; PMCID: PMC8000006.

Kumari, S., Shukla, S., & Acharya, S. (2022). Childhood Obesity: Prevalence and Prevention in Modern society. Cureus. https://doi.org/10.7759/cureus.31640

Smith, T.A.et al., (2024). School Meal Nutrition Standards Reduce Disparities Across Income and Race/Ethnicity American Journal of Preventive Medicine, Volume 67, Issue 2, 249 - 257