Quality Nutrition in Schools
GOAL: To help children and adolescents maintain healthy weights by increasing access to nutritious food in schools, incorporating nutrition education into school curricula and limiting access to unhealthy food.
Quality Nutrition in Schools
1. Ensure That Students Have Appealing, Healthy Food and Beverage Choices In Schools
The Issues and the Research: The school food environment can have a large impact on the dietary intake of children and adolescents—up to 50 percent of total daily energy intake can be consumed at school. The U.S. Department of Agriculture (USDA) provides meals to children in about 95 percent of public schools and many private schools throughout the nation through the National School Lunch Program and the School Breakfast Program. USDA sets nutrition standards for these school meal programs, but has less authority to set nutrition standards for sold à la carte, in school stores and in vending machines. Although most schools that sell competitive foods offer some nutritious food and beverage options, less nutritious alternatives also have been commonly available. For example, in one study, 70 percent of the beverage options available in vending machines were high in sugar, only 12 percent of the beverage slots were for water, and only 5 percent were for milk.1 Excluding à la carte items, another study found that 22% of schoolchildren consumed competitive items in a representative school day, with the highest consumption rates in high schools. Children who ate competitive items consumed significantly more sugar–and much less dietary fiber, B vitamins and iron.2 Studies have shown promotion strategies can increase students’ purchases of fruits, vegetables and low-fat foods.3,4,5,6 A single study that evaluated a policy requiring school snack bars to offer only individual portions of foods and beverages also demonstrated that changes in school food policies could reduce consumption of empty calories and potentially reduce excess weight gain over time.7
At the time of this toolkit update (January 2011), the USDA is in the process of strengthening the current school nutrition standards as mandated by law in the Healthy, Hunger-Free Kids Act of 2010.
Potential Stakeholders
Policy-makers
Federal, state and local elected and appointed officials (e.g., federal and state legislators; city, county, township and other local level policy-makers)
School officials (e.g., state boards of education, local school boards and school administrators)
Other Government and Community Stakeholders
School food vendors
Nonprofit organizations such as the Alliance for a Healthier Generation and Action for Healthy Kids
Teachers and cafeteria workers
Parents and students
Policy and Program Options
Healthy school food and nutrition legislation
State legislatures can support bills and amendments that improve access to and the quality of school meals. State boards of education can consider adopting comprehensive statewide nutrition standards for foods in schools. They can provide sample policy language, including key nutrition requirements, which can be incorporated into school wellness policies (see the National Association of State Boards of Education’s model policies to encourage healthy eating). Any proposed policies should strive to build upon the strengthened school nutrition standards set by the U.S. Department of Agriculture.
Strong local wellness policies
State boards of education, local school districts and individual schools can enforce strong that ensure healthy school food environments by limiting low-nutrient, energy-dense foods in vending machines, à la carte lines, school stores and during school celebrations, as well as by offering healthy snacks. These policies also can encourage fundraisers and classroom rewards that are healthy or do not involve food. Policies can address the availability of healthy foods for school meals and before- and after-school programs, and incorporate cafeteria staff training. Districts can use the Dietary Guidelines for Americans or the Institute of Medicine Nutrition Standards for Foods in Schools as guides for developing nutrition standards for in schools. There are many examples of states that have set standards for or beverages served or sold at school that are stricter than federal requirements.
Vending policies
School and school district officials can adopt vending machine policies that either prohibit the sale of unhealthy foods and beverages in school facilities or restrict vending machine sales to healthy snacks.
Nutrition education
School officials can use nutrition education through experiential learning curricula, such as school gardens and farm-to-school programs, as well as other educational components that can encourage parents to introduce and provide nutrient-rich foods to children.
Getting Started
- School district officials can review their district’s and monitor and evaluate its implementation
- School district officials can review their food service and food and beverage vendor contracts, and work with their vendors to offer healthier options.
- Policy-makers at all levels can champion state, district or school policies that prohibit the sale or distribution of high-fat, high-sugar snacks during school celebrations, before or during mealtimes and as fundraisers.
- Local government and school officials can partner with universities to provide assistance in implementing and evaluating local wellness policies. For example, local health departments and school districts can work with public health professors to recruit students interested in evaluating such policies.
- State policy-makers can provide funding to schools for experiential nutrition education and for investing in improvements to school food services, such as oil-free cooking equipment.
- School district officials and state boards of education can develop policies encouraging cafeterias to display healthy side items and snacks at eye level on shelves and positioned near the point of purchase. Additionally, they can request that cafeterias move less healthy options to the back of food displays.
- School district officials can encourage individual schools to work with parents and extracurricular groups to implement healthy fundraisers.
- School district officials can convene a school wellness committee to develop an action plan to meet measurable goals related to nutritious foods and health education. They can invite local chefs and nutrition and health experts to serve on the committee.
Resources
Action for Healthy Kids, Wellness Policy Tool
This tool helps schools create a local wellness policy that meets their districts’ unique goals for nutrition and physical activity, and helps them put the policy into action to positively impact students’ health and lifelong choices. Action for Healthy Kids is composed of more than 50 national organizations and government agencies representing education, health, fitness and nutrition.
www.actionforhealthykids.org/wellnesstool/index.php
Alliance for a Healthier Generation, Healthy Schools
The Healthy Schools program provides information and resources to increase opportunities for students to exercise and eat healthier foods in schools. It also provides resources for teachers and staff to become healthy role models. The Alliance is a partnership between the American Heart Association and the William J. Clinton Foundation to fight childhood obesity. The Healthy Schools program receives funding from the Robert Wood Johnson Foundation.
www.healthiergeneration.org/schools.aspx
Center for Science in the Public Interest, Model State School Foods Policy Legislation
This model state legislation addresses issues of vending, à la carte, fundraising and other school foods sold outside of meals.
http://www.cspinet.org/nutritionpolicy/school_food_legislation2.pdf
Center for Science in the Public Interest, State School Food Report Card 2007, A State-by-State Evaluation of Food Policies in Schools
This document ranks states by their policies governing the nutritional quality of foods sold through their school’s meal plan and also through vending machines, fundraisers and à la carte options.
www.cspinet.org/2007schoolreport.pdf
Center for Science in the Public Interest, Sample Vending Contract
This vending contract between the Dallas Independent School District and the North Texas Coca-Cola Bottling Company can serve as a model for other districts interested in taking the same action.
http://cspinet.org/new/pdf/soda_contract.pdf
Center for Science in the Public Interest, Sweet Deals: School Fundraising Can Be Healthy and Profitable
This report proposes alternative, creative and healthier fundraising options for students. Some proposed fundraisers include book fairs, non-food product sales, sale of school-related items, car washes and auctions. These healthier options for fundraisers can be, in many cases, equally, if not more, profitable.
www.cspinet.org/schoolfundraising.pdf
Coordinated Approach to Child Health (CATCH)
This Web site provides information about CATCH, an evidence-based Coordinated School Health Program designed to promote physical activity and healthy food choices, and prevent tobacco use in elementary school-aged children. It provides resources, tips and training.
www.catchinfo.org
Council of State Governments, School Wellness Policies
This legislator policy brief brief provides information on the need for legislator intervention in school wellness policies. For example, legislators may demand accountability from schools and help schools identify funding sources.
www.healthystates.csg.org/NR/rdonlyres/C87EB28D-B2F6-4399-B1BD-BC5617940019/0/SchoolWellnessPoliciesFINAL.pdf
Council of State Governments, Using School Nutrition to Address Obesity, Talking Points
School food policies vary widely, and many schools allow the sale of unhealthy items, such as chips and cookies. Legislators can work with food and beverage companies to find healthy snack alternatives and also can offer financial incentives to improve the availability of produce and high-quality foods in schools. These talking points outline the ways in which legislators can become involved.
www.healthystates.csg.org/NR/rdonlyres/290CC6D9-D67D-4D3B-B350-0A453699E9A1/0/SchoolWellnessSources.pdf
Institute Of Medicine, Nutrition Standards for Foods in Schools
This report explores the sale of competitive foods and analyzes their content, nutritional value and ability to generate revenue.
http://iom.edu/CMS/3788/30181/42502.aspx
National Alliance for Nutrition and Activity, Model School Wellness Policies
These model school wellness policies call for school officials to form health councils, set standards for food and beverage sales, teach and encourage healthy eating and physical activity, provide students with physical activity opportunities and evaluate the success of their programs.
www.schoolwellnesspolicies.org
National Policy & Legal Analysis Network to Prevent Childhood Obesity, Developing a Healthy Beverage Vending Agreement
The Model Healthy Beverages Vending Agreement is a tool that provides guidance for school administrators negotiating vending machine contracts, encouraging tactics shown to result in the best possible outcomes for students. The model vending policy advises schools to aggressively negotiate strong vending contracts in order to achieve three primary goals: to ensure that their wellness policies are fully implemented; to hold vendors legally accountable for their promises to provide healthy snacks; and to maximize the school’s profits.
http://www.nplanonline.org/nplan/products/developing-healthy-beverage-vending-agreement
National Association of State Boards of Education (NASBE), Model Policies to Encourage Healthy Eating
This site provides research-based best practice model policy language on various school health topics. The model polices were developed by NASBE in partnership with the Centers for Disease Control and Prevention’s Division of Adolescent and School Health and other school policy experts. States, districts and schools can adopt these model policies or adapt them to local circumstances.
http://nasbe.org/index.php?option=com_content&view=article&id=122:policies-to-encourage-healthy-eating&catid=78:model-policies&Itemid=372
National Association of State Boards of Education, Fit, Healthy, and Ready to Learn, A School Health Policy Guide
This guide is intended to help schools create policies that promote health and prevent obesity and other chronic diseases. It calls for schools to teach students health literacy skills and encourages staff to model healthy behaviors. This guide also stresses the importance of health education courses taught by well-qualified staff.
http://nasbe.org/index.php?option=com_content&view=article&id=396:fit-healthy-and-ready-to-learn-a-school-health-policy-guide&catid=53:shs-resources&Itemid=372
National School Boards Association, Addressing School Wellness Policies 101 and Healthy Eating 101
The Addressing School Wellness Policies document provides background information on the prevalence of student obesity, guidance and policy-development tools, highlights of wellness policies in several states and additional external resources about wellness policies. Healthy Eating 101 provides resources on nutrition and healthy eating policies in schools.
www.nsba.org/MainMenu/SchoolHealth/101Packets/Wellness-101_1.aspx
www.nsba.org/MainMenu/SchoolHealth/101Packets/HealthyEating101.aspx
Public Health Policy Institute, Mapping School Food: A Policy Guide
This report provides a decision-making tool, an adapted Potter Box, to review and analyze school food dilemmas. It provides sample applications of the Potter Box for policy-makers with differing levels of influence.
http://www.phaionline.org/wp-content/uploads/2007/11/mappingschoolfood.pdf
U.S. Department of Agriculture (USDA), Dietary Guidelines for Americans
The Dietary Guidelines for Americans has been published jointly by the U.S. Department of Health and Human Services and the USDA every five years since 1980. The guidelines provide authoritative advice for people two years and older about how good dietary habits can promote health and reduce risk for major chronic diseases. They serve as the basis for federal food and nutrition education programs. The most recent dietary guidelines were published in 2005 and remain current until the 2010 guidelines are published.
http://www.cnpp.usda.gov/dietaryguidelines.htm
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2. Support Farm-to-School and School Garden Programs
The Issues and the Research: A growing number of states and school districts are turning to farm-to-school programs to increase the quality and availability of fresh, healthy foods for their students. This program has been in existence in the United States for nearly a decade, and as of March 2009, more than 2,050 farm-to-school programs were in existence in more than 40 states.8 School garden programs are another way to connect youth with fresh, healthy foods. A study in Tucson, Ariz., found that children who participated in their school garden program improved their perceptions of healthy foods, and in fact, had placed a high intrinsic value on the vegetables they had grown.9 According to another study, after students completed their gardening program, their perceptions of vegetables significantly improved, as did their preferences for fruits and vegetables—no such improvements were evident in the control group.10
Potential Stakeholders
Policy-makers
State and local elected and appointed officials
School officials (e.g., state boards of education, local school boards and school administrators)
Other Government and Community Stakeholders
State and local agriculture departments
Parks and recreation officials
Local government extension agents
Local farmers, businesses and chefs
Nonprofit and federal programs, such as FarmtoSchool.org
College and university agriculture and public health departments
School or community gardens
Parents, teachers and students
Policy and Program Options
Farm-to-school programs
State and school district officials can develop policies and programs that support farm-to-school programs. Farm-to-school programs encourage schools to use locally grown produce for school cafeteria meals, thereby improving nutrition while also providing lifelong lessons in health and nutrition. These programs also support local farmers and therefore can be beneficial to local economies, particularly in rural areas.
School gardens
School officials can create edible school gardens that integrate gardening and fresh seasonal cooking into curricula, culture and food programs. In addition to the health benefits, edible school gardens involve students in all aspects of farming the garden— including preparing, serving and eating the food.
Getting Started
- State legislatures can fund pilot projects to implement farm-to-school programs and target schools with large numbers of vulnerable students.
- tate and local agriculture departments can partner with local farmers or farming organizations, nearby universities and colleges, nonprofit organizations and the national Farm-to-School organization to develop a program.
- School officials, including boards of education, can convene teachers from various disciplines to develop a curriculum that incorporates math, science, nutrition, physical education and other subjects into school garden activities. For example, students can develop and perform taste tests on food from the garden.
- School officials and community representatives can develop a team to support food service directors implementing farm-to-school activities.
- School officials can invite representatives from the farming community to serve on the school wellness committee. They can integrate locally grown foods into school food programs.
Resources
Community Food Security Coalition (CFSC)
CFSC is an organization of social and economic justice, environmental, nutrition, sustainable agriculture, community development, labor, anti-poverty, anti-hunger and other groups. They provide a variety of training and technical assistance programs for community food projects, support the development of farm-to-school and farm-to-college initiatives, advocate for federal policies to support community food security initiatives and provide networking and educational resources.
www.foodsecurity.org
Farm to School
This Web site provides pertinent resources about the farm-to-school program broken down by state, including guides, reports and implementation strategies. It also includes state and local policy recommendations aimed at fixing current school meal programs to incorporate fruits and vegetables from local farms.
www.farmtoschool.org
www.farmtoschool.org/policies.php
Let’s Move, Chefs Move to Schools
This program connects schools with chefs who are willing to partner with schools to work with teachers, parents, schools nutritionists, and administrators to help educate kids about food and nutrition.
http://www.letsmove.gov/chefs-move-schools
National Gardening Association, Kidgardening.org
This Web site provides extensive educational and funding resources about how to establish school and youth gardens.
www.kidsgardening.org
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3. Implement a Standards-Based Health Education Program Taught by Teachers Certified in Health Education
The Issues and the Research: Health education in school can encourage healthy behaviors that can last a lifetime, especially when it is combined with moderate-to-vigorous physical activity. When asked which standards need to be addressed in the school curriculum, 74 percent of Americans felt health was “definitely necessary.”11 In fact, health standards received the highest overall rating in the same survey.12
Potential Stakeholders
Policy-makers
State and local elected and appointed officials
School officials (e.g., state boards of education, local school boards and school administrators)
Other Government and Community Stakeholders
County and city health officials
Parents, teachers and students
Policy and Program Options
Health education course
School district officials and state boards of education can incorporate a comprehensive K to 12 health education course that includes lessons about nutrition and physical activity. According to the Centers for Disease Control and Prevention’s Coordinated Health Program, school health curricula should address the physical, mental, emotional and social dimensions of health. In addition, they should “motivate and assist students to maintain and improve their health, prevent disease, and reduce health-related risk behaviors,” while also allowing students to increase their “health-related knowledge, attitudes, skills and practices.”13
Nutrition education component
State boards of education can include nutrition education as a component of a comprehensive health core requirement in the school curriculum and adopt high-quality statewide standards.
Teacher training and development in health education
State policy-makers can require that health education teachers are adequately prepared by adopting high-quality certification standards for teachers. School officials can ensure that teachers receive ongoing professional support and development.
Health throughout the day
School district officials can encourage the integration of health education into other subjects.
Getting Started
- School districts can establish a partnership between the school wellness committee and the local health department to ensure school curricula meet state and national health education standards and the Centers for Disease Control and Prevention’s characteristics of effective health education.
- School wellness committees can use the Health Education Curriculum Analysis Tool to review a current or new health education curricula to determine if it aligns with state or national standards and criteria for effectiveness.
- School district officials can ensure health teachers have access to resources and support (local, national and Web-based) to develop and teach the curriculum.
Resources
Centers for Disease Control and Prevention (CDC), Health Education Curriculum Analysis Tool (HECAT)
The CDC’s HECAT allows schools to evaluate and revise health education curricula based on 14 different criteria. HECAT is based on the guidelines and recommendations set by the National Health Education Standards and the CDC’s Characteristics of Effective Health Education Curricula. The tools are customizable based on the needs of a particular school or district.
www.cdc.gov/HealthyYouth/HECAT/index.htm
www.cdc.gov/HealthyYouth/SHER/characteristics/index.htm
The Food Studies Institute, Food is Elementary
Food is Elementary is an interactive experience that educates students about the relationship between food choices and disease prevention while encouraging students’ creativity. It involves the entire community in school meals, murals and garden projects.
http://www.foodstudies.org/
National Association of State Boards of Education, Fit, Healthy, and Ready to Learn, A School Health Policy Guide
This guide is intended to help schools create policies that promote health and prevent obesity and other chronic diseases. It calls for schools to teach students health literacy skills and encourages staff to model healthy behaviors. This guide also stresses the importance of health education courses taught by well-qualified staff.
http://nasbe.org/index.php?option=com_content&view=article&id=122:policies-to-encourage-healthy-eating&catid=78:model-policies&Itemid=372
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1 Dispensing Junk: How School Vending Undermines Efforts to Feed Children Well. Washington, D.C.: Center for Science in the Public Interest, 2004. Available at www.cspinet.org/new/pdf/dispensing_junk.pdf.
2 Kalarala M, Keast D, and Hoerr S.” Schoolchildren’s Consumption of Competitive Foods and Beverages, Excluding à la Carte.” Journal of School Health. 80(9):429-435, September 2010.
3 French S, Story M, Fulkerson JA and Hannan P. “An environmental intervention to promote lower fat food choices in secondary schools: Outcomes from the TACOS study.” American Journal of Public Health.94:1507-1512, 2004
4 French S, Jeffery R, Story M, et al. “Pricing and promotion effects on low-fat vending snack purchases: the CHIPS Study.” American Journal of Public Health. 91(1):112-117, 2001.
5 French S, Jeffery R, Story M, Hannan P, Snyder MP. “A pricing strategy to promote low-fat snack choices through vending machines.” American Journal of Public Health, 87(5):849-851, 1997.
6 Sallis J, McKenzie T, Conway T, et al. “Environmental Interventions for Eating and Physical Activity: A Randomized Controlled Trial in Middle Schools.” American Journal of Preventive Medicine. 24:209-217, October 2003.
7 Cullen K and Thompson D. “Texas School Food Policy Changes Related to Middle School à la Carte/Snack Bar Foods: Potential Savings in Kilocalories.” Journal of the American Dietetic Association, 105(12):1952–1954, December 2005.
8 Farm to School. Statistics. Available at www.farmtoschool.org.
9 Cavaliere D. “How Zucchini Won Fifth-Grade Hearts.” Children Today, 16(3): 18-21, February 1987.
10 Ibid.
11 Marzano R, Kendall J and Cicchinelli L. “What Americans Believe Students Should Know: A Survey of U.S. Adults.” Aurora, Colo.: Mid-Continent Regional Educational Laboratory, January 1999. Available at www.mcrel.org/PDF/Standards/5987RR_WhatAmerBelieve.pdf.
12 Ibid.
13 Healthy Youth! Coordinated School Health Program. Centers for Disease Control and Prevention. Available at http://www.cdc.gov/healthyYouth/CSHP/.
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