USDA School Breakfast and Lunch Programs: National Prevalence of Sodium and Saturated Fat Exposure and the Impacts of School Kitchen Infrastructure on School Meal Selection and Consumption

Abstract

Subsidized meals provided through the National School Breakfast and Lunch programs, which are administered by the U.S. Department of Agriculture (USDA), provide nearly 30 million Federally subsidized lunches and 15 million Federally subsidized breakfasts to children each school day. These programs can play a significant role in overall childhood dietary quality, as students who participate in both the SBP and NSLP may consume as much as fifty percent or more of their daily calories at school. Because childhood is a critical time to set food preferences school meals are also powerful intervention points to promote healthy dietary patterns that can help lower diet-related disease posed by excess saturated fat, and sodium consumption and limited fresh fruit and vegetable intake across the life course. The passage of the Healthy Hunger Free Kids Act (HHFKA) in 2010 provided USDA with the for first opportunity in 30 years to make significant nutrition reforms to the SBP and NSLP. Since its implementation in 2012, the HHFKA’s updated nutrition regulations have placed caps on the saturated fat content of school meals, detailed a phased decrease in sodium content, and mandated increased offerings of fruits and vegetables to students. These improved guidelines have not only been shown to increase consumption of fruits and vegetables, but also provide students with more nutritious meals than those typically brought from home.

Despite these documented improvements, many school districts nationally continue to struggle to fully realize the intended benefits of the nutrition regulations on student dietary quality, namely excess saturated fat and sodium intake coupled with vegetable consumption below recommended levels. This dissertation employs three unique data sets collected by the author to investigate these issues. Chapter 1 utilizes a nationally representative sample of publicly available school menus from the 2018/19 school year to examine the daily prevalence of meal combinations that exceed USDA saturated fat and sodium guidelines. Chapter 2 utilizes direct observation plate waste data to examine differences in meal selection and consumption between students in schools serving pre-packaged meals and students who receive fresh meals prepared on-site in school kitchens. Lastly, Chapter 3 utilizes pre/post intervention plate waste data to examine the impacts on selection and consumption of a school kitchen renovation where students transitioned from being offered pre-packaged meals to meals prepared on-site halfway through the school year. Collectively, these works can help inform evidence-based continuous improvements to how we regulate and administer USDA school meal programs to best support child dietary health.