New school meal requirements: More harm than good?

New federal regulations requiring school meals to contain more whole grains, less saturated fat and more fruits and vegetables, while perhaps improving some aspects of the food being served at schools across the United States, may also be perpetuating eating habits linked to obesity, diabetes and other diet-related diseases, an analysis by Johns Hopkins Bloomberg School of Public Health researchers has found.

The reasons: Based on analysis of school meals and the new requirements, the whole grains served are mostly processed, which means they are converted into sugar when digested, and many of the required foods, like fruit and milk, contain added sugar because many schools opt to serve canned fruit, fruit juice, and flavored milk. The new requirements do not limit the amount of added sugar in school meals. The researchers are recommending that the requirements be expanded to limit added sugars and processed foods and to ensure carbohydrate quality.

The findings will be presented in a poster at the APHA Conference on Nov. 18.

School meals can account for more than 50 percent of a student's daily caloric intake, and over 30 million children participate in school breakfast and lunch programs. Childhood and adolescent obesity rates have more than tripled since 1970.

"The low-fat craze in the last two decades has caused Americans to transition to a high carb, low fat diet," notes Sadie Barr, a student in a joint MPH-MBA program at Johns Hopkins University's Bloomberg School of Public Health and the Carey Business School. "This has been strongly linked to obesity, diabetes and other diet-related diseases, in large part because the majority of the carbs we have been eating are processed. School lunches, even with these new regulations, still largely reflect this diet."

Congress passed the Healthy, Hungry-Free Kids Act (HHFKA) in 2010. It requires school meals (breakfast and lunch) to consist of 51 percent whole grains, increases the amount of fruits and vegetables offered to students, restricts saturated fats to less than 10 percent of meal calories, imposes calorie restrictions and only allows skim or 1 percent milk to be served (only skim milk is allowed to be flavored). (HHFKA also restricts salt, but this was not addressed in this paper.) The goal was to provide nutritious food that promoted healthful eating.

In 2004, the U.S Department of Agriculture instituted a voluntary program, the Healthier U.S. School Challenge, for elementary school lunches, which used many of the same menu guidelines outlined in the HHFKA. Breakfast was added in 2012. HHFKA is based in large part on the Healthier U.S. School Challenge, but extends to all grade levels.

For their study, "Challenging School Food Policy: Why New Nutrition Standards for School Meals are at Odds with Nutritional Science," researchers did two things: Analyzed the new regulations in the context of nutrition science, and compared the new regulations to what was being served in the 2009-10 school year. They also looked at the smaller group of schools that had already implemented the healthier food guidelines.

The lunches at schools where the Healthier U.S. School Challenge had already been implemented contained over 54 percent carbohydrates, which was actually slightly higher than schools that were not participating in the initiative. The majority of carbohydrates were processed. Researchers say the Healthier U.S. School Challenge menus should look very similar to what schools are now serving under the new regulations.

"The one thing I found shocking," notes Barr, "is that the HHFKA regulation requirements make no mention of carbohydrates. The word 'fat' is mentioned perhaps hundreds of times. But the word 'carbohydrate' is not mentioned once. They didn't recognize that primary macronutrient. Requiring grains served to be at least 51 percent whole is a step in the right direction, but isn't enough to ensure that the meals served will be more whole and less processed, which would be more advantageous to health."

The researchers, in addition to recommending that HHFKA be expanded to limit added sugars, curtail the amount of processed carbohydrates and increase whole grain and whole food products, are recommending that an independent panel of experts be convened to reevaluate the saturated fat and calorie restriction. This would help insure that processed carbohydrates are not replacing saturated fats, Barr says.