Melissa A. Clark

Nutritional Quality of the Diets of US Public School Children and the Role of the School Meal Programs

BACKGROUND Good nutrition is essential to healthy childhood. Because the school meal programs--the National School Lunch Program and the School Breakfast Program--are so widely available, they are in a unique position to influence the nutritional quality of childrens diets. OBJECTIVE This article assesses the nutritional quality of the diets of US public school children and explores the relationship between childrens participation in the school meal programs and the nutritional quality of their diets. DESIGN Data were collected as part of the third School Nutrition Dietary Assessment Study (SNDA-III), a nationally representative study fielded during school year 2004-2005. Data on childrens dietary intakes were collected through in-person 24-hour dietary recalls. Nutritional quality of childrens diets was assessed by estimating the prevalence of inadequate and excessive intakes of energy and nutrients. SUBJECTS/SETTING The analysis is based on a nationally representative sample of 2,314 children in grades 1 through 12 from 287 public schools. STATISTICAL ANALYSES PERFORMED Nutrient adequacy and excess were assessed by comparing usual nutrient intake distributions to Dietary Reference Intakes and the Dietary Guidelines for Americans 2005. Propensity score matching was used to examine the relationship between school meal program participation and the prevalence of inadequate and excessive intakes. RESULTS The majority of public school children in the United States had nutritionally adequate diets, but 80% had excessive intakes of saturated fat and 92% had excessive intakes of sodium. School meal program participation was associated with reduced prevalence of nutrient inadequacy but with increased prevalence of excessive sodium intakes. CONCLUSIONS School meal programs play an important role in the nutritional adequacy of childrens diets. However, the association between program participation and excessive sodium intakes, along with the high prevalence of excessive saturated fat intakes among all students, suggest areas for improvement in the meals these programs provide.

The third School Nutrition Dietary Assessment Study: summary and implications.

Bringing school meals in line with the 2005 Dietary Guidelines will involve more than changing nutrient standards and revising menu planning regulations. SNDA-III provides evidence that, despite the hard work of many individuals, schools, and organizations, SMI goals were not fully achieved. Strategies are needed to enhance the ability of schools to offer healthier meals.