Brown Bag or Cafeteria Tray, Kids Don’t Eat Healthy School Lunch

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Schoolchildren aren’t exactly gobbling up the healthy lunches they were meant to eat under a national nutrition program, two new studies suggest.

Students purchasing school lunch only select a fruit or vegetable about half the time, and even then, the majority of them don’t eat even a single bite, according to research from the Johns Hopkins Bloomberg School of Public Health.

Kids who bring lunch from home aren’t faring any better. Those brown bags are packed with significantly fewer fruits and vegetables, plus more salt and sugar, than school-provided lunches, according to a team from Baylor College of Medicine.

The studies highlight the gaps in the Healthy Hunger-Free Kids Act, a reauthorization of the Child Nutrition Act, passed by Congress in 2010 with new provisions to raise government-subsidized lunches to higher nutrition standards. Notable changes in schools across the country include new minimum and maximum calorie counts and increased servings of fruits, veggies and whole grains.

“So many children in our country may eat as many as two of their meals a day in the schools,” said Susan Gross, a nutritionist and dietitian at Johns Hopkins in Baltimore who led the first study. “And if that’s two-thirds of their consumption, we should make it as healthy as possible.”

The National School Lunch Program, or NSLP, served 5.1 billion midday meals last year, while the School Breakfast Program delivered 2.2 billion meals. The U.S. Department of Agriculture administers the lunch program with the participation of more than 100,000 public and nonprofit private schools, along with child-care institutions. In exchange for serving meals that meet government requirements, the schools get subsidies and food from the USDA.

Single Bite?

“There’s been a lot of emphasis on menus and what kind of food is being offered to the kids,” Gross said. There hasn’t been as much attention on whether children are eating those foods or what foods are brought from home, she said.

The Hopkins study, presented last week at the American Public Health Association’s Annual Meeting, observed 274 6- to 8-year-olds in New York City public schools as they selected what to eat in the lunchroom. Only 58 percent chose a fruit and 59 percent chose a vegetable, and just 24 percent of those who opted for vegetables ate even a single bite.

Eating Environment

The researchers also found a major influence on how much healthy food children ate: the cafeteria environment. Children were more likely to eat healthy foods when it was quieter in the cafeteria; when the food was cut up into smaller pieces like apple slices; when lunch periods were longer; and when teachers were eating lunch in the same cafeteria.

“We saw a big jump in consumption if these factors were controlled, and they aren’t expensive things to control for,” Gross said.

Additionally, parents can encourage their children to pick and eat healthy options by reviewing school menus ahead of time, Gross said.

Regulations from the Healthy Hunger-Free Kids Act are making a big difference in government-funded meals, but they don’t address lunches brought from home.

“This component of the school food environment is basically avoided by public health policy and rarely addressed by investigators,” said Virginia Stallings, a nutrition pediatrician at the Children’s Hospital of Philadelphia, in an editorial.

Home-Lunch Study

The Baylor study, published online yesterday by JAMA Pediatrics, examined lunches of 337 students, kindergarten through eighth grade, in a Houston area school district. Lunches brought from home contained almost double the amount of sodium as government meal program lunches, 40 percent less fruit and 88 percent fewer vegetables. Additionally, 90 percent of packed lunches included desserts, chips or sweetened beverages -- not permitted in school lunch program meals -- and students almost always entirely consumed them.

Parents can improve packed lunches by planning and making lunch with their children.

“It’s an opportune time for parents to talk about what’s healthy and what kinds of food you should be eating, not just putting in foods they want to have,” said Karen Cullen, a professor of pediatrics and nutrition at Baylor who led the study.

Of course, it can be difficult to convince children to eat healthy options, all three researchers said. For healthy meal and snack ideas, Cullen recommends the USDA’s Choose My Plate website.

“One of the most important things for kids is exposure. We know it takes 10 to 20 times for a child to adapt to the taste of a new food,” Stallings said in an interview. “Parents have to not give up.”

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