Society of Behavioral Medicine position statement: retain school meal standards and healthy school lunches

Society of Behavioral Medicine position statement: retain school meal standards and healthy... Abstract In 2010, the Healthy, Hunger-Free Kids Act (HHFKA) altered nutrition standards in the U.S. National School Lunch Program in an attempt to promote healthy eating and improve children’s overall health. However, it was reported that these nutrition standard changes were leading to lower consumption of meals and an increase in plate waste. Initial research was unable to validate these reports. Despite these unsubstantiated claims, the U.S. Department of Agriculture released a proposal to roll back some of the nutritional standards implemented by the HHFKA in 2017. An exploration of the current literature uncovered several new studies that further support the updated meal standards outlined in the HHFKA. Identifying and reviewing these studies was the aim of the current brief. Several new studies found that the implementation of the HHFKA standards led to healthier meals, increased fruit consumption, lower plate waste, and reductions in sodium and calories from saturated fats, to name a few. Given the continued evidence that the HHFKA standards improve dietary quality of school meals, policymakers, schools, and stakeholders are urged to continue to support the retention of the new meal standards. Implications Practice: The changes implemented as a result of the Healthy, Hunger-Free Kids Act (HHFKA) have improved the dietary quality of school meals and have not increased plate waste. Policy: Policymakers should continue to support the retention of school meal standards and healthful lunches through reauthorization of the HHFKA. Research: Future research should be aimed at identifying strategies to further increase the consumption of healthful foods and further decrease plate waste in school lunchrooms. The Society of Behavioral Medicine continues to support the retention of U.S. school meal standard changes to promote healthy eating among school-aged children. INTRODUCTION The Society of Behavioral Medicine (SBM) released a health policy brief in March 2015 supporting retention of the revised nutrition standards in the U.S. National School Lunch Program set by the Healthy, Hunger-Free Kids Act (HHFKA) of 2010 to promote healthy eating and improve the overall health of children [1]. After initial implementation, opponents to the policy—such as food service personnel, parents, and members of Congress—reported that the changes resulted in lower consumption of school meals and increased plate waste. Initial evidence did not support these claims. In fact, several studies showed intake of healthy food options actually increased and there were no significant changes in plate waste [2, 3] In November 2017, the U.S. Department of Agriculture (USDA) released a proposal to roll back some of the nutritional standards implemented by the HHFKA. Specifically, they are proposing to allow schools to offer 1% flavored milk, serve grains that are not whole, and delay the next level of sodium reductions [4]. SBM opposes this proposal given that, since the initial implementation of the HHFKA, there have been several new studies that provide further evidence in support of the school lunch changes. We briefly review these studies below. New studies • Schwartz, Henderson, Read, Danna, and Ickovics [3] collected data before and after the implementation of the HHFKA at 12 kindergartens through eighth-grade schools in an urban school district in Connecticut. Results indicated the implementation of the HHFKA led to: Healthier meals and less plate waste, Increased fruit selection and consumption, with no increase in fruit waste, More students selecting the revised entrées and less wasting of foods, and Decreased vegetable plate waste. (Fewer students selected vegetables, but students who did select vegetables were eating more of the portion and wasting less.) • The USDA [5] conducted semistructured telephone interviews of nine school food service directors. Questions focused specifically on challenges faced during the initial implementation of HHFKA, strategies developed to cope with these challenges, and plate waste perceptions. Directors reported that plate waste initially increased following implementation of the HHFKA. However, they were able to reduce fruit and milk waste to pre-HHFKA levels during the 2013–2014 school year. Strategies for reducing plate waste included: o Involving students in meal planning and taste tests, o Offering healthful foods versus just serving them, o Providing more menu choices, o Serving familiar flavors, o Serving ready-to-eat fresh fruit, o Scheduling recess before lunch, o Inviting staff and teachers to sit with students at meals, o Encouraging students to save food for snacks, and o Allowing school cafeterias to donate intact, unserved foods to local food banks. • Bergman, Englund, Taylor, Watkins, Schepman, and Rushing [6] compared student food consumption before versus after HHFKA implementation among a sample of more than 1,000 second- to fifth-graders. Results showed significant reductions in sodium and calories from saturated fats, and an increase in fiber. However, the amount of calcium-containing items selected and consumed decreased. Authors noted the decrease in calcium might be due to reducing saturated fat, which may have led to reductions in consumption of foods high in fat and calcium (like cheese). • There is also emerging evidence that school lunch plate waste can be reduced by: o Slicing fresh fruit rather than leaving it whole [7], o Holding recess before lunch [8], and o Scheduling lunch for at least 25-min periods [9]. Recommendations New evidence continues to confirm that changes implemented as a result of the HHFKA have improved the dietary quality of school meals without increasing plate waste. SBM urges policymakers to 1. Continue to support the retention of school meal standards and healthful lunches through reauthorization of the HHFKA. 2. Oppose the USDA’s proposal to roll back school meal nutrition standards. 3. Continue to support other federal funding initiatives in support of healthful school lunches. SBM urges schools and stakeholders to 1. Continue to support traditional and innovative nutrition education formats (e.g., farm tours, urban farming, demonstration kitchens) among children of all ages, encourage consumption of healthful foods, and make small environmental changes in lunchrooms/cafeterias to promote accessibility and attractiveness of healthful foods to help make these foods more normative as recommended in our 2015 statement [1]. 2. Use the following strategies to reduce plate waste: • Involve students in meal planning and taste tests, • Offer healthful foods versus just serving them, • Provide more menu choices, • Serve familiar flavors, • Serve ready-to-eat (sliced) fresh fruit, • Invite staff and teachers to sit with students at meals, • Schedule recess prior to lunch, • Allow 25 min or more for lunch sessions, and • Encourage students to save food for snacks. Compliance with Ethical Standards Conflict of Interests: Joanna Buscemi, Angela Odoms-Young, Amy L. Yaroch, Laura L. Hayman, Bernardo Loiacono, Annie Herman, and Marian L. Fitzgibbon declare that they have no conflicts of interest. Ethical Approval: This manuscript does not contain any studies with human participants performed by any of the authors. This manuscript does not contain any studies with animals performed by any of the authors. Informed Consent: This manuscript is a brief, and therefore informed consent was not required. Acknowledgments This manuscript was not supported by grant funding. References 1. Buscemi J, Odoms-Young A, Yaroch AL, Hayman LL, Robertson TP, Fitzgibbon ML. Society of Behavioral Medicine (SBM) position statement: SBM supports retaining healthy school lunch policies. Transl Behav Med . 2015; 5( 3): 357– 359. Google Scholar CrossRef Search ADS PubMed  2. Cohen JF, Richardson S, Parker E, Catalano PJ, Rimm EB. Impact of the new U.S. Department of Agriculture school meal standards on food selection, consumption, and waste. Am J Prev Med . 2014; 46( 4): 388– 394. Google Scholar CrossRef Search ADS PubMed  3. Schwartz MB, Henderson KE, Read M, Danna N, Ickovics JR. New school meal regulations increase fruit consumption and do not increase total plate waste. Child Obes . 2015; 11( 3): 242– 247. Google Scholar CrossRef Search ADS PubMed  4. Department of Agriculture. 2017. Interim Rule: https://www.federalregister.gov/documents/2017/11/30/2017–25799/child-nutrition-programs-flexibilities-for-milk-whole-grains-and-sodium-requirements. Accessed 15 November 2017. 5. USDA. 2016. HHFKA Implementation Research Brief: Plate waste. USDA Food and Nutrition Service, 1– 7. https://fns-prod.azureedge.net/sites/default/files/ops/HHFKA-PlateWaste.pdf. Accessed 15 November 2017. 6. Bergman EA, Englund T, Taylor KW, Watkins T, Schepman S, Rushing K. 2014. School lunch before and after implementation of the Healthy Hunger-Free Kids Act. Journal of Child Nutrition & Management . 38( 2): 1– 12. 7. Handforth KM, Gilboy MB, Harris JH, Melia N. 2016. Fruit and vegetable plate waste among students in a suburban school district participating in the National School Lunch Program. The Journal of Child Nutrition & Management . 40( 1): 1– 12. 8. Price J, Just DR. Lunch, recess and nutrition: responding to time incentives in the cafeteria. Prev Med . 2015; 71: 27– 30. Google Scholar CrossRef Search ADS PubMed  9. Cohen JF, Jahn JL, Richardson S, Cluggish SA, Parker E, Rimm EB. Amount of time to eat lunch is associated with children’s selection and consumption of school meal entrée, fruits, vegetables, and milk. J Acad Nutr Diet . 2016; 116( 1): 123– 128. Google Scholar CrossRef Search ADS PubMed  © Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Translational Behavioral Medicine Oxford University Press

Society of Behavioral Medicine position statement: retain school meal standards and healthy school lunches

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© Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Abstract

Abstract In 2010, the Healthy, Hunger-Free Kids Act (HHFKA) altered nutrition standards in the U.S. National School Lunch Program in an attempt to promote healthy eating and improve children’s overall health. However, it was reported that these nutrition standard changes were leading to lower consumption of meals and an increase in plate waste. Initial research was unable to validate these reports. Despite these unsubstantiated claims, the U.S. Department of Agriculture released a proposal to roll back some of the nutritional standards implemented by the HHFKA in 2017. An exploration of the current literature uncovered several new studies that further support the updated meal standards outlined in the HHFKA. Identifying and reviewing these studies was the aim of the current brief. Several new studies found that the implementation of the HHFKA standards led to healthier meals, increased fruit consumption, lower plate waste, and reductions in sodium and calories from saturated fats, to name a few. Given the continued evidence that the HHFKA standards improve dietary quality of school meals, policymakers, schools, and stakeholders are urged to continue to support the retention of the new meal standards. Implications Practice: The changes implemented as a result of the Healthy, Hunger-Free Kids Act (HHFKA) have improved the dietary quality of school meals and have not increased plate waste. Policy: Policymakers should continue to support the retention of school meal standards and healthful lunches through reauthorization of the HHFKA. Research: Future research should be aimed at identifying strategies to further increase the consumption of healthful foods and further decrease plate waste in school lunchrooms. The Society of Behavioral Medicine continues to support the retention of U.S. school meal standard changes to promote healthy eating among school-aged children. INTRODUCTION The Society of Behavioral Medicine (SBM) released a health policy brief in March 2015 supporting retention of the revised nutrition standards in the U.S. National School Lunch Program set by the Healthy, Hunger-Free Kids Act (HHFKA) of 2010 to promote healthy eating and improve the overall health of children [1]. After initial implementation, opponents to the policy—such as food service personnel, parents, and members of Congress—reported that the changes resulted in lower consumption of school meals and increased plate waste. Initial evidence did not support these claims. In fact, several studies showed intake of healthy food options actually increased and there were no significant changes in plate waste [2, 3] In November 2017, the U.S. Department of Agriculture (USDA) released a proposal to roll back some of the nutritional standards implemented by the HHFKA. Specifically, they are proposing to allow schools to offer 1% flavored milk, serve grains that are not whole, and delay the next level of sodium reductions [4]. SBM opposes this proposal given that, since the initial implementation of the HHFKA, there have been several new studies that provide further evidence in support of the school lunch changes. We briefly review these studies below. New studies • Schwartz, Henderson, Read, Danna, and Ickovics [3] collected data before and after the implementation of the HHFKA at 12 kindergartens through eighth-grade schools in an urban school district in Connecticut. Results indicated the implementation of the HHFKA led to: Healthier meals and less plate waste, Increased fruit selection and consumption, with no increase in fruit waste, More students selecting the revised entrées and less wasting of foods, and Decreased vegetable plate waste. (Fewer students selected vegetables, but students who did select vegetables were eating more of the portion and wasting less.) • The USDA [5] conducted semistructured telephone interviews of nine school food service directors. Questions focused specifically on challenges faced during the initial implementation of HHFKA, strategies developed to cope with these challenges, and plate waste perceptions. Directors reported that plate waste initially increased following implementation of the HHFKA. However, they were able to reduce fruit and milk waste to pre-HHFKA levels during the 2013–2014 school year. Strategies for reducing plate waste included: o Involving students in meal planning and taste tests, o Offering healthful foods versus just serving them, o Providing more menu choices, o Serving familiar flavors, o Serving ready-to-eat fresh fruit, o Scheduling recess before lunch, o Inviting staff and teachers to sit with students at meals, o Encouraging students to save food for snacks, and o Allowing school cafeterias to donate intact, unserved foods to local food banks. • Bergman, Englund, Taylor, Watkins, Schepman, and Rushing [6] compared student food consumption before versus after HHFKA implementation among a sample of more than 1,000 second- to fifth-graders. Results showed significant reductions in sodium and calories from saturated fats, and an increase in fiber. However, the amount of calcium-containing items selected and consumed decreased. Authors noted the decrease in calcium might be due to reducing saturated fat, which may have led to reductions in consumption of foods high in fat and calcium (like cheese). • There is also emerging evidence that school lunch plate waste can be reduced by: o Slicing fresh fruit rather than leaving it whole [7], o Holding recess before lunch [8], and o Scheduling lunch for at least 25-min periods [9]. Recommendations New evidence continues to confirm that changes implemented as a result of the HHFKA have improved the dietary quality of school meals without increasing plate waste. SBM urges policymakers to 1. Continue to support the retention of school meal standards and healthful lunches through reauthorization of the HHFKA. 2. Oppose the USDA’s proposal to roll back school meal nutrition standards. 3. Continue to support other federal funding initiatives in support of healthful school lunches. SBM urges schools and stakeholders to 1. Continue to support traditional and innovative nutrition education formats (e.g., farm tours, urban farming, demonstration kitchens) among children of all ages, encourage consumption of healthful foods, and make small environmental changes in lunchrooms/cafeterias to promote accessibility and attractiveness of healthful foods to help make these foods more normative as recommended in our 2015 statement [1]. 2. Use the following strategies to reduce plate waste: • Involve students in meal planning and taste tests, • Offer healthful foods versus just serving them, • Provide more menu choices, • Serve familiar flavors, • Serve ready-to-eat (sliced) fresh fruit, • Invite staff and teachers to sit with students at meals, • Schedule recess prior to lunch, • Allow 25 min or more for lunch sessions, and • Encourage students to save food for snacks. Compliance with Ethical Standards Conflict of Interests: Joanna Buscemi, Angela Odoms-Young, Amy L. Yaroch, Laura L. Hayman, Bernardo Loiacono, Annie Herman, and Marian L. Fitzgibbon declare that they have no conflicts of interest. Ethical Approval: This manuscript does not contain any studies with human participants performed by any of the authors. This manuscript does not contain any studies with animals performed by any of the authors. Informed Consent: This manuscript is a brief, and therefore informed consent was not required. Acknowledgments This manuscript was not supported by grant funding. References 1. Buscemi J, Odoms-Young A, Yaroch AL, Hayman LL, Robertson TP, Fitzgibbon ML. Society of Behavioral Medicine (SBM) position statement: SBM supports retaining healthy school lunch policies. Transl Behav Med . 2015; 5( 3): 357– 359. Google Scholar CrossRef Search ADS PubMed  2. Cohen JF, Richardson S, Parker E, Catalano PJ, Rimm EB. Impact of the new U.S. Department of Agriculture school meal standards on food selection, consumption, and waste. Am J Prev Med . 2014; 46( 4): 388– 394. Google Scholar CrossRef Search ADS PubMed  3. Schwartz MB, Henderson KE, Read M, Danna N, Ickovics JR. New school meal regulations increase fruit consumption and do not increase total plate waste. Child Obes . 2015; 11( 3): 242– 247. Google Scholar CrossRef Search ADS PubMed  4. Department of Agriculture. 2017. Interim Rule: https://www.federalregister.gov/documents/2017/11/30/2017–25799/child-nutrition-programs-flexibilities-for-milk-whole-grains-and-sodium-requirements. Accessed 15 November 2017. 5. USDA. 2016. HHFKA Implementation Research Brief: Plate waste. USDA Food and Nutrition Service, 1– 7. https://fns-prod.azureedge.net/sites/default/files/ops/HHFKA-PlateWaste.pdf. Accessed 15 November 2017. 6. Bergman EA, Englund T, Taylor KW, Watkins T, Schepman S, Rushing K. 2014. School lunch before and after implementation of the Healthy Hunger-Free Kids Act. Journal of Child Nutrition & Management . 38( 2): 1– 12. 7. Handforth KM, Gilboy MB, Harris JH, Melia N. 2016. Fruit and vegetable plate waste among students in a suburban school district participating in the National School Lunch Program. The Journal of Child Nutrition & Management . 40( 1): 1– 12. 8. Price J, Just DR. Lunch, recess and nutrition: responding to time incentives in the cafeteria. Prev Med . 2015; 71: 27– 30. Google Scholar CrossRef Search ADS PubMed  9. Cohen JF, Jahn JL, Richardson S, Cluggish SA, Parker E, Rimm EB. Amount of time to eat lunch is associated with children’s selection and consumption of school meal entrée, fruits, vegetables, and milk. J Acad Nutr Diet . 2016; 116( 1): 123– 128. Google Scholar CrossRef Search ADS PubMed  © Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)

Journal

Translational Behavioral MedicineOxford University Press

Published: Apr 13, 2018

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