Published Online: October 26, 2009
Published in Print: October 28, 2009, as Report Calls for Upgrade to School Meal Programs

Institute of Medicine Calls for Upgrade to School Meals

Institute of Medicine Recommends Cap on Calories

School meals should include more fruits, vegetables, and whole grains and less sodium, and schools should put a “caloric cap” on meals, an Institute of Medicine report recommended last week.

Commissioned by the U.S. Department of Agriculture, which runs the national school lunch and breakfast programs, the report aims to align school meals with the latest dietary guidelines for Americans, last updated in 2005.

“We’ve made great strides in improving the sophistication and accuracy that are used to assess and define children’s nutritional needs,” said Mary Kay Fox, a senior researcher at Mathematica Policy Research, a Princeton, N.J.-based firm that specializes in education, health-care, nutrition, and early-childhood issues. She was a committee member for the Institute of Medicine team that worked on the report.

The Washington-based institute is an independent, nonprofit organization that provides information to policymakers and the public about health and science policy.

In addition to increased amounts of fruits and vegetables at both breakfast and lunch, the report recommends that students have a wider variety to choose from, with an emphasis on green leafy vegetables, orange vegetables, and legumes, as opposed to starchy vegetables such as potatoes. No more than half the fruit that schools provide should be given in the form of juice, it says.

Whole Grains

While schools now are encouraged to incorporate whole grains into meals, the new recommendations would require that at least half the grains in each school meal be whole, as opposed to refined.

The committee recommends setting, for the first time, a calorie limit on school meals. Lunches should not exceed 650 calories for students in grades K-5, 700 for students in grades 6-8, and 850 for students in grades 9-12, the panel says. Breakfast should not exceed 500, 550, and 600 calories for those grade levels, respectively.

The report also focuses on cutting down the amount of sodium in each meal. The committee recommends gradually decreasing the sodium level from the current average of about 1,600 milligrams for a high school lunch to 740 milligrams over the next 10 years.

For middle school lunches, the amount of sodium should be capped at 710 milligrams, while elementary lunches should contain no more than 640 milligrams, the report says.

Sandy Spero, the supervisor of food services for the 135,000-student San Diego Unified School District, said cutting back on the amount of sodium in meals will be the most challenging of the recommendations.

“That one is probably the most concerning in terms of student acceptability,” she said, adding that the 10-year time frame “is good for giving the industry time to gear up and come up with those products.”

The report also calls for schools to serve 1 percent and skim milk only, as opposed to whole milk or 2 percent; those changes could help keep the amount of saturated fat in each meal below the 10 percent requirement.

The National School Lunch Program is available in 99 percent of public schools and served about 30.6 million children in 2007. The School Breakfast Program is available in 85 percent of public schools and served 10.1 million children in 2007.

Up for Reauthorization

Both programs are up for reauthorization by Congress this year, which makes the report timely, Ms. Fox said, although school districts could choose to begin incorporating the guidelines into meal planning immediately, without legislative or regulatory action.

While the recommendations are welcome, congressional support is needed to implement them, said Dora Rivas, the president of the School Nutrition Association, a 55,000-member professional organization of school meal providers, and the executive director of food and child nutrition services for the 160,000-student Dallas Independent School District.

“School nutrition programs, long underfunded and pressured by rising costs, will need more than just ‘building blocks’ to improve on our success,” she said in a statement. “Congress needs to provide the mortar through higher federal reimbursement rates for school meals.”

The report acknowledges that more nutritious meals could cost more, and says districts should not be expected to absorb the higher cost on their own. It calls for federal reimbursement to be increased to help schools reach the new recommendations. Money should also be set aside to help train food-service operators, the report suggests.

“These recommendations are very realistic and very thoughtful,” said Melanie Konarik, the director of child-nutrition services for the 36,000-student Spring Independent School District in Houston. “The issue will be whether we can afford it, because right now, school districts are struggling just to educate our children.”

Vol. 29, Issue 09, Page 9

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