Abstract
The Kids' Safe and Healthful Foods Project is a joint collaboration of The Pew Charitable Trusts and the Robert Wood Johnson Foundation. They came together very specifically with a focus on the school nutrition environment. This is one issue where the two organizations really thought they could work collaboratively toward some very specific goals.
Those goals are, basically, making sure that the food and beverages sold to students in schools are safe and healthy. That may sound nonspecific, but it translates into some fairly specific efforts. We have been focused on making sure that the USDA issues science-based standards for both the school meals as well as the rest of the school food environment—including what is technically called “competitive foods,” which is food sold in vending machines, it is the à la carte line in the cafeteria, and food sold in school stores. And, ultimately, making sure that USDA policies translate into action at the state and local level.
We have also looked at making sure that schools get what they need in order to execute the policies. One of the areas that we identified as a challenge was related to kitchen equipment, infrastructure, and training, which are the backbone pieces of school nutrition programs. We are actively working on analyzing that need as well as figuring out ways to address it.
The Kids' Safe and Healthful Foods Project conducts rigorous peer-reviewed research as well as compiles lessons learned from those involved in day-to-day school food operations. We then use our data to communicate to policy makers, including the USDA. It is our desire that they use our research to write and implement policy that is well informed by both the science and real-world situations.
We work with a diverse group of stakeholders to fully gauge what needs to happen to make sure all students have access to healthy food. We listen to a lot of people who are working in schools around the country so that we can learn from their experiences. We then apply those experiences to help other schools move forward productively. We share a lot of that information with the USDA and the other decision makers in the pipeline.
Exactly, and so we have. We wanted to know what parents and voters thought about food sold in schools, so we conducted public opinion polling. Our findings were very informative. 1 Overwhelmingly, parents and, in fact, most voters, want nutrition standards for snack foods and beverages. There was good reason to move forward. We also conducted a health impact assessment that allowed us to take an in-depth look at the consequences of updating national nutrition standards for snack foods and beverages. 2 We found that the right standards could help students maintain a healthy weight and help schools increase food service revenue. These two pieces of research allowed us to educate the public and policy makers on how to improve school foods.
Our data on the financial impact of competitive food standards proved helpful to the USDA as they were writing the proposed regulations. Our data showed that when looking at schools that have implemented strong snack and à la carte food standards, they actually tend to break even or even increase revenue over time because of shifting students from buying snack foods to purchasing the school meals. A lot of that work was cited in writing on the original policy and then, ultimately, will also help inform guidance for implementation.
The USDA has recently issued an interim final rule. 3 Given the current school food environment, this rule will certainly raise the bar for many schools around the country.
One of the reports we conducted was titled, Out of Balance: A Look at Snack Foods in Secondary Schools across the States, and it looked at the current landscape of snack food environments in secondary schools across the country. 4 What the report showed was a remarkable amount of variability. In some states, the vast majority of schools do not sell fruits and vegetables in school stores, snack bars, or vending machines. And in far too many instances, students have tremendous access to less-healthy items like salty chips, brownies, chocolate, and fruity candies.
Raising that bar starts with minimum national standards on what schools can sell. States and localities have a great amount of local control in terms of specifically what they sell, if they sell anything. Schools will just have to meet minimum standards that are in line with current science so that no matter where kids go to school, they will not be inundated with less-healthy snacks. We want to make sure that the available choices are healthy choices.
The USDA standards are good in terms of reducing serving sizes and limiting kids' access to fatty or salty food and sugar-sweetened beverages. The rules set reasonable calorie caps on snack food items and on entrée items, and limit the amount of saturated fat, trans fat, and sodium in snack foods. A lot of this is right in line with commitments that some in the industry have already made based on the changes they see as necessary.
The bottom line is that these are really solid standards. They are evidence based, but practical. Schools can definitely implement them as shown by thousands of schools already ahead of the curve and implementing healthier snack standards of their own volition. We know these changes are important. A recent study found that children and teens in states with strong laws restricting the sale of less-healthy snack foods and beverages in school gained less weight over a 3-year period than those living in states without similar policies. 5 For those schools that have not yet made these changes or may not know exactly how to realign their product portfolio to be healthier, there are many good examples out there. 6
Our window into this was when the federal government released the American Recovery and Reinvestment Act funding, which included $100 million for school food service equipment upgrades. In the limited time that that money was available, more than $630 million in requests from the states were received. So clearly, there is a big need.
While we are set to delve more into this issue later in 2013, I can say from our exploratory conversations with various stakeholders that the need is really varied. In some places, a small amount of resources would make a big difference. If a school had, for instance, sectionizers and slicers that would help them cut vegetables and fruits in a more efficient manner, they could greatly reduce labor time and serve sliced fruit and vegetables. This has been shown to increase children's consumption of fruits and vegetables. 7
That is a relatively small investment in any one school, but, multiply that by all of the schools in a district or given other budget priorities, it is sometimes tough to do.
Another thing that schools often talk about is salad bars; if they can install the type of salad bars that are low enough and of the right-sized components so that young kids can use them, it really does tend to increase how many vegetables kids take and consume. Young people like the idea of self-selection and they are willing to try different things when given the opportunity.
On the other side of the equation, a lot of schools are still trying to get away from deep-fat fryers, which they have counted on as a preparation method for a long time. With some of the foods they serve, if something like a Combi oven can be put in—a relatively high-tech oven that cooks using three cooking modes: convection, steam, and combination—products can taste and look so much better.
Updated equipment can help schools make food that looks appetizing such that kids are more likely to eat it—from baked sweet potato fries to broccoli that is freshly steamed. Having that level of equipment installed can make a real difference in terms of what schools put on the menu, how efficiently it can be made, and what the kids actually consume. That is why having the proper tools is critically important.
The reality is that there is a spectrum of things schools need. For some schools, a very small amount of resources could make a big difference. For other schools, it is a matter of trying to access larger pots of financial resources. Funding kitchen improvements is an area we are exploring with federal policy makers, state leaders, and members of the philanthropic community.
What kids eat at school matters. They get a significant amount of their nutrition during the school day and, for many, they are getting up to half of their daily calories at school.
By improving the school nutrition environment, we are improving the overall nutrition environment for children, regardless of what is happening outside of the school day. Especially during today's challenging budgetary times, during which we have seen the numbers of students qualifying for free and reduced-price lunches increasing, we know students are dependent on those school meals.
The greater the exposure to healthy foods during the school day, the more likely they are to have optimal nutrition, regardless of where they are on the socioeconomic spectrum or where they are geographically. The school nutrition environment is a major opportunity to address food access for children across the country.
There are a number of groups that do a lot of tracking in the school nutrition environment, a couple of whom are also funded by the Robert Wood Johnson Foundation (RWJF). For instance, Bridging the Gap is a research group that has published a large, broad spectrum of research that does a lot of evaluation of nutrition policies, wellness policies, and what is happening in the schools at the school level, at the district level, and at the state level. We are able to look at a lot of the outcomes of their work in order to assess the trends.
Similarly, Healthy Eating Research, which is another RWJF initiative, has done a lot of in-depth research into the impact of changes in the school nutrition environment and what that means for policy and practice. For instance, in 2012, the group published a research review on the influence of competitive food and beverage policies on children's diets and childhood obesity. 8
The Kids' Safe and Healthful Foods Project has helped to answer two major questions regarding the outcomes of school nutrition policy: What will the financial impact be on schools, and what will the health impact be on kids? We've found that the financial impact on schools, interestingly enough, can be neutral or even positive when you look at the net overall. If students do not have less-healthy snack or à la carte foods as options, they are more likely to buy healthy meals. And when students buy meals, the school gets the money the student gives them as well as reimbursement from the USDA. So it is better for the school, financially, to serve meals than it is to serve snacks.
On the student health side, the evidence is very clear that if what is served in schools is healthier, given the number of kids who buy food during the day, the potential to have an impact on their risk of developing obesity and associated chronic diseases is significant. If we know that the financial impact and health impact can be positive, then it is clear that the school nutrition environment is an area that we can and do need to address.
This really is a democratic process at every step, and we encourage people to be involved in it. One of the easiest ways to play a role is to submit comments when the USDA or another agency issues proposed rules regarding school nutrition or other issues of interest. The agencies genuinely read all of the comments submitted, and there is definite value when those in the academic arena submit relevant research and analysis.
Another role that everyone can play is to communicate with others in their community via “letters to the editor” or op-eds that help to explain the importance of the issue or opportunities for action.
Finally, everyone can play a role in their local schools. As many schools will be looking to improve their nutrition environments to get in line with the updated snack food standards, now is a great time to get involved at the local level.
—Jamie Devereaux, Features Editor
For more information on the Kids' Safe and Healthful Foods Project, visit HealthySchoolFoodsNow.org.