Improving Child Health through School Meals and Wellness Policies

In the US, childhood obesity affects approximately 18.5% of children 2 to 19 years of age.¹ With over 31 million children participating in the National School Lunch Program, most of whom get their daily meals at school, it is important to realize the vital role schools play in the overall wellbeing of children.² Thus, any legislation that would positively impact the health outcomes of school-aged children should be supported. 

The Healthy, Hunger-Free Kids Act of 2010 allowed the United States Department of Agriculture (USDA) to reform child nutrition programs for the first time in over thirty years. These changes came in the forms of increased funding for school meals (mainly school breakfast and lunch programs), as well as increased access to healthy meals and snacks for low-income children with a focus on reducing childhood obesity.^1,3  

In addition, the Healthy, Hunger-Free Kids Act of 2010 established basic standards for school wellness policies, created local farm-to-school networks, expanded access to drinking water, improved nutritional quality of commodity foods and improved the nutritional standards at child care settings as well.^3-6  These are just a few of the many positive changes brought about with this legislation.  Elements of program monitoring were also implemented to ensure the integrity of the process and the validity of the outcomes.  In turn, school districts were audited every three years to ensure compliance with nutrition standards.  Food service providers were provided with trainings and technical assistance. Schools were required to inform parents about the nutritional quality of the meals their children were consuming.^3-6  In summary, the Healthy, Hunger-Free Act of 2010 focused on improving the nutritional quality of foods and beverages consumed in schools, with the goal of reducing obesity, while increasing healthy food access to students and ensuring compliance with policies. 

The question begging to be asked is, “Did it work?” One study published in Health Affairs in July 2020 that examined responses from 173,013 youth from the National Survey of Children’s Health over a 15 year period indicated that “the passage of the Healthy, Hunger-Free Kids Act and implementation of its changes to school meals and snacks—currently affecting children in more than 99,000 schools across the US—was associated with significantly decreased risk of obesity for the estimated 5.9 million US children ages 10–17 in poverty.”¹ For example, the authors point out that without the passage of this legislation, obesity prevalence among youth in poverty would have been 47% higher in 2018, suggesting that the continuation of this legislation is important for the healthy growth of children living in poverty. In addition, there have been a few studies showing that the quality of foods offered to students had improved with the passing of the Healthy, Hunger-Free Kids Act of 2010. To better understand the impact of this landmark legislation, however, more studies are needed to examine the effects of improved quality of food on student choices and how that can be linked to obesity rates. With a better understanding and with evidence-based approach, policy makers in the US should continue to develop ways to improve our children’s health through school meals and wellness policies.

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References:

1. https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00133
2. https://www.fns.usda.gov/nslp/nslp-fact-sheet
3. https://www.fns.usda.gov/pl-111-296
4. https://www.federalregister.gov/documents/2016/07/29/2016-17230/local-school-wellness-policy-implementation-under-the-healthy-hunger-free-kids-act-of-2010#:~:text=Final%20rule.%20SUMMARY%3A%20This%20final%20rule%20requires%20all,of%20the%20Healthy%2C%20Hunger-Free%20Kids%20Act%20of%202010.
5. https://www.cde.ca.gov/ls/nu/he/wellness.asp
6. https://obamawhitehouse.archives.gov/sites/default/files/Child_Nutrition_Fact_Sheet_12_10_10.pdf