With childhood obesity at an all-time high in the United States, medical professionals agree that improving U.S. children's eating habits is crucial. And school is the natural place to start, with the National School Lunch Program and the School Breakfast Program serving more than 40 million children each school day. (The two programs provide meals in 83% of all schools in the United States—and 99% of public schools.) But the current standards by which their nutritional value is determined are out of sync with the Dietary Guidelines for Americans established in 2005 by the Department of Health and Human Services and the U.S. Department of Agriculture (USDA).
In response to this (and a push from Congress), the USDA asked the Institute of Medicine (IOM) to develop recommendations for an update to the 1995 Nutrition Standards and Meal Requirements that currently govern school meals. "The programs that nourish so many American schoolchildren need to reflect the latest child health and nutrition science given the extent to which dietary habits shape lifelong health," said committee chairwoman Virginia A. Stallings, in a National Academies press release (http://bit.ly/1Zi9ne). "Since the school meal programs were last updated, we've gained greater understanding of children's nutritional needs and the dietary factors that contribute to obesity, heart disease, and other chronic health problems."
Children's diets need to change. The changes reflect an effort to address significant deficiencies-in the average American student's diet. In developing the recommendations, the IOM committee-looked at reported food and nutrient intakes of nationally representative groups of schoolchildren, as well as related health concerns. Daily intakes of fruit were found to be low across the board, as were intakes of green and orange vegetables and legumes. Whole grain consumption was found to be very low, although intakes of refined grain products exceeded recommended levels. Starchy vegetables represented a disproportionate amount of children's total vegetable intake (with fried potatoes and potato chips accounting for about 22% of the total).
"Many students eat two out of their three meals every day in school," said Linda Davis-Alldritt, president-elect of the National Association of School Nurses in-an interview with AJN. "If these recommendations are implemented, the likelihood of improving children's health is very high."
The program will face challenges, however, not only because implementation costs will be high, but also because students will have to be persuaded to accept the changes. Realizing that the program won't be successful unless the students actually participate and consume the food, the IOM has recommended a series of strategies, including student involvement, nutrition education, parent and community involvement, and training of food service staff, to promote the changes.
"It can't happen in isolation," said Davis-Alldritt. "The cafeteria can be offering great food, but if no one is eating it, the program won't go anyplace. Nutrition by itself is important, but to really improve children's health, you need health education and physical activity, too. It's important to have a whole team at school providing these services for kids."
To read the IOM report online, go to http://bit.ly/4FLRmH.