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

Mathematica Policy Research, Inc, PO Box 2393, Princeton, NJ 08543, USA.
Journal of the American Dietetic Association (Impact Factor: 3.92). 02/2009; 109(2 Suppl):S44-56. DOI: 10.1016/j.jada.2008.10.060
Source: PubMed


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 children's diets.
This article assesses the nutritional quality of the diets of US public school children and explores the relationship between children's participation in the school meal programs and the nutritional quality of their diets.
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 children's dietary intakes were collected through in-person 24-hour dietary recalls. Nutritional quality of children's diets was assessed by estimating the prevalence of inadequate and excessive intakes of energy and nutrients.
The analysis is based on a nationally representative sample of 2,314 children in grades 1 through 12 from 287 public schools.
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.
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.
School meal programs play an important role in the nutritional adequacy of children's 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.

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    • "More students responded that school meal was saltier than home-made meal in the order of high, middle, and elementary schools. It has been reported that school meal program participation was associated with increased prevalence of excessive sodium intakes [19]. On average, school meal participants consumed roughly 200 mg more sodium at lunch than matched non-participants did, which was statistically significant and observed for all elementary, middle, and high schools. "
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    • "Despite these relatively lax standards, two-thirds of school lunches exceed the maximum amount of fat and saturated fat (Crepinsek et al. 2009), and 99% of all school meals fail to meet the federal requirements due an excess of saturated fat (Burghardt et al. 1995). As a result, 80% of students who participate in school food programs have excess saturated fat intake, and 92% of students consume excess sodium (Clark & Fox 2009). "
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