School nutrition standards
School nutrition standards regulate the quality of food that can be sold to students on school grounds during the school day; such standards often focus on foods available during school meals and through the National School Lunch Program (NSLP). The Healthy, Hunger-Free Kids Act (HHFKA) of 2010 strengthened nutrition standards nationally so that NSLP meals include more whole grains, fruits and vegetables, low-fat milk and dairy products, and less sodium and fat than previous years. HHFKA sets minimum standards; states, local governments, and school districts can establish stronger, additional requirements for the nutritional content and availability of competitive foods. Competitive foods include any foods sold to students through à la carte options, vending machines, and other sources outside of federally reimbursable meals1.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased healthy food consumption
Improved school food environment
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Improved dietary choices
Improved nutrition
Reduced energy use
What does the research say about effectiveness?
There is strong evidence that nutrition standards for school meals increase healthy food consumption and improve school food environments2, 3, 4, 5. Nutrition standards that focus on competitive foods can decrease unhealthy food consumption, increase the availability and consumption of healthier alternatives, and may modestly improve student dietary intake3, 6, 7, 8. Strengthening nutrition standards for competitive foods may increase effects on the school food environment and student nutrition6.
School nutrition standards reduce unhealthy food consumption, reduce excess calorie intake2, 3, 9, increase purchases of healthy and neutral foods such as fruits and vegetables5, 7, and decrease fat consumption5. Nutrition standards can also reduce sugar sweetened beverage intake3, 10. Assessments of the Healthy, Hunger-Free Kids Act (HHFKA) of 2010 indicate that strengthened school lunch nutrition standards decrease consumption of fat and added sugars, increase fruit and vegetable consumption, reduce plate waste (especially vegetables and entrees), and do not change milk consumption11, 12, 13. The HHFKA is also associated with improved dietary quality of lunch for students from families with low, middle, and high incomes14.
Children who live in states with stronger nutrition standards have a lower risk of obesity than those who live in states with weaker standards9. School nutrition standards can have positive effects on weight outcomes for boys and may decrease the prevalence of obesity and overweight in children11, 15. Healthier school lunches can improve academic outcomes16. Policies that improve nutrition and make school food options healthier do not discourage National School Lunch Program (NSLP) participation and many school districts (e.g., Los Angeles Unified, Dallas, Cincinnati Public Schools, Kentucky Daviess County, and El Monte City) report increased NSLP participation following implementation of new school lunch standards under HHFKA17, 18. Stronger local school nutrition standards can also be encouraged through state wellness policy requirement laws, which are associated with more comprehensive local wellness policies, more wellness practices implemented, and more improvements to school food environments19.
Experts suggest that school nutrition standards could be modified to reduce climate change in addition to promoting health and that these modifications may also reduce food costs20. School nutrition standards that increase fresh fruit and vegetable consumption and reduce food waste may reduce fossil fuel energy used to produce, process, and transport food21, 22, 23, 24, 25. Such initiatives may also reduce the energy intensity of an individual’s diet if more plant-based foods are consumed in place of animal products21, 26.
Commonly reported barriers for school nutrition standards include costs of policy-compliant foods, decreasing revenue, proximity of unhealthy food vendors, and limited policy knowledge or negative attitudes towards change. Sufficient funding, effective and clear policy communication, and positive attitudes of stakeholders are associated with successful nutrition standard implementation27. Including nutrition standards in district wellness policies is associated with district food purchasing specifications in rural areas28. Careful implementation of nutrition standards is necessary to maintain reductions in food insecurity realized historically through the NSLP29.
Most schools participating in the NSLP are expected to operate food service as a financially self-sustaining nonprofit enterprise, yet federal reimbursement rates often do not fully cover the cost of providing meals30, 31. In most cases, implementing nutrition standards has not been shown to decrease school revenue, and in some cases, such standards have been shown to increase revenue32, 33. An examination of California’s nutrition standards for competitive foods suggests that such policies can be revenue-neutral; decreases in à la carte revenue losses were generally offset by increased meal program participation6. Experts suggest that school nutrition standards for competitive foods are likely to save more in future health care costs than what they cost to implement34.
How could this strategy advance health equity? This strategy is rated potential to decrease disparities: supported by some evidence.
There is some evidence that school nutrition standards have the potential to decrease disparities in weight outcomes between children from families with low incomes and those from families with higher incomes40, 41. Families with lower incomes often lack access to affordable healthy food and are more likely to experience food insecurity42. Children who experience food insecurity consume more of their daily energy from school meals than children who do not experience food insecurity43. Assessments of the Healthy, Hunger Free Kids Act (HHFKA) of 2010 find that school nutrition standards decreased risks of obesity for children living in poverty41. In California, combined federal and state nutrition standards are associated with halting increasing disparity trends between Black or Hispanic children and white children; in some cases, disparities were slightly decreased44.
Overall, foods served at school are higher quality and more nutritious than foods served outside of school43, 45, particularly after the HHFKA updated nutrition standards and improved child diet quality46. However, experts suggest that nutrition standards alone will not eliminate disparities in health outcomes44. Nutrition standard flexibilities may be associated with more free and reduced-price meal participation47; however, experts warn that nutrition standard flexibilities undermine standards and may limit improvements in nutrition quality and child obesity rates48, 49.
Research suggests that rural schools may have fewer policies that support healthy eating and have less healthy food environments than those in urban and suburban areas50, 51. Schools in rural areas often experience challenges in recruiting food service professionals along with limited resources; rural schools can participate in food purchasing co-ops, use state technical assistance, and establish external partnerships to improve school food environments52.
Food sovereignty is the right of Native people to create food and agriculture systems that produce culturally relevant and healthy foods to nourish their community. Food sovereignty includes having decision-making authority over food system values and practices in addition to having food security or access to sufficient supplies of healthy food53, 54. Some tribes have expressed interest in administering and managing their own school nutrition programs, which could allow tribal schools to offer more culturally appropriate foods55. Research suggests that offering healthy, culturally relevant foods can increase participation in healthy school lunch programs56.
Universal school meals are a suggested strategy to decrease disparities in healthy food consumption by removing economic, administrative, and language barriers for students and families57. Universal school meals are associated with improved diet quality, food security, and academic performance58.
What is the relevant historical background?
In the U.S., the first school meal programs were provided by private societies and child welfare associations in the 1800s and early 1900s59. Congress established the National School Lunch Program (NSLP) in 1946 to both reduce undernutrition in children and increase demand for domestic agriculture commodities60. In 1966 during the Civil Rights movement, the Child Nutrition Act created the first NSLP subsidies for children from families with low incomes61. The Reagan Administration made significant cuts to the NSLP budget in 1981. In response, the U.S. Department of Agriculture (USDA) broadened NSLP food categories to cut costs, such as reclassifying corn chips, doughnuts, and pies as “bread”62. At the same time, the USDA’s commodity distribution program for school lunch began shifting towards ready-to-heat-and-eat foods which are more heavily processed but are easier for schools to serve62. The NSLP declined in the 1980s and 1990s; by the early 2000s, NSLP participation was associated with increased obesity rates48. The association between NSLP participation and obesity was eliminated after the Healthy, Hunger-Free Kids Act (HHFKA) was passed in 2010 which introduced stronger nutrition standards41, 63. In 2018, the Trump Administration introduced school nutrition standard flexibilities that raised sodium limits and reduced requirements for whole grains48. The USDA proposed updated standards in 2023 to limit added sugars and sodium, in addition to increasing whole grains64.
School nutrition standards are often influenced by the commercial interests of corporations who sell school food62. Large companies or organizations in the food industry, such as the National Potato Council and the School Nutrition Association, have lobbied against healthier school food standards49. In the current U.S. policy context, food that is cheap for corporations to produce tends to be less nutritious, more calorie dense, and contains more chemical additives and preservatives than food that is more expensive. Food procurement policies that dictate schools must choose the lowest bid, rather than the healthiest one, may entrench cheaply made and less healthy food options62.
Equity Considerations
- What school nutrition or food procurement policies does your state or local school district have in place? How do those policies align with the federal nutrition standards?
- Who makes decisions about how nutrition standards are implemented in your school district? Whose input is considered in those decisions? Who should have a voice in ongoing school food decisions?
- How do school food environments compare across all schools in your community? Which schools need additional resources to support implementation of school nutrition standards and to improve their school food environment? How could local partnerships or collaborations help direct resources and support to those schools?
Implementation Examples
The National School Lunch Program (NSLP), guided by federal nutrition standards, provided 4.9 billion lunches in almost 100,000 schools across the country in fiscal year 2019. The COVID-19 pandemic temporarily changed school meal service opportunities and special programs were used to provide lunches or cash equivalents to students eligible for free and reduced price lunches. As of the 2021-2022 school year, federal legislation authorizes an additional 7 cents per meal payment for schools demonstrating that their meals meet the updated nutrition standards35. Some states provide additional meal reimbursements or other funding to help schools meet the cost of providing meals36.
State government policies can encourage schools to adopt nutrition standards. Connecticut’s Healthy Food Certification program, for example, provides monetary incentives to districts which apply state nutrition standards to all foods sold to students37. Eat Smart, the food service component in the Child and Adolescent Trial for Cardiovascular Health (CATCH); Fresh Choices (from Gimme 5), and Lunch Power are examples of successful school nutrition programs38. The Centers for Disease Control and Prevention (CDC) suggests schools can use the Whole School, Whole Community, Whole Child (WSCC) model to evaluate school food environments39.
Implementation Resources
‡ Resources with a focus on equity.
USDA-Nutrition standards - U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS). Nutrition standards for school meals.
USDA-SN training - U.S. Department of Agriculture (USDA). Professional standards for school nutrition professionals: Training and resources.
CPSI-Nutrition policy - Center for Science in the Public Interest (CSPI). Nutrition policy.
CDC-School nutrition environment - Centers for Disease Control and Prevention (CDC). CDC healthy schools: School nutrition environment.
CDC MMWR-School health guidelines 2011 - National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Adolescent and School Health (DASH). School health guidelines to promote healthy eating and physical activity. Morbidity and Mortality Weekly Report (MMWR). 2011:60(RR-05):1-71.
ISU-Food and sustainability resources - Iowa State University (ISU), Sustainable Food Processing Alliance. Online resources for food and sustainability.
Footnotes
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1 Federal Register-NSLP - Federal Register. National School Lunch Program (NSLP) and School Breakfast Program (SBP): Nutrition standards for all foods sold in school as required by the Healthy, Hunger-Free Kids Act of 2010. 2013.
2 Durao 2023 - Durao S, Wilkinson M, Davids EL, Gerritsen A, Kredo T. Effects of policies or interventions that influence the school food environment on children’s health and nonhealth outcomes: A systematic review. Nutrition Reviews. 2023;nuad059.
3 Micha 2018 - Micha R, Karageorgou D, Bakogianni I, et al. Effectiveness of school food environment policies on children’s dietary behaviors: A systematic review and meta-analysis. PLoS ONE. 2018;13(3):e0194555.
4 Mansfield 2017 - Mansfield JL, Savaiano DA. Effect of school wellness policies and the Healthy, Hunger-Free Kids Act on food-consumption behaviors of students, 2006-2016: A systematic review. Nutrition Reviews. 2017;75(7):533-552.
5 Jaime 2009 - Jaime PC, Lock K. Do school based food and nutrition policies improve diet and reduce obesity? Preventive Medicine. 2009;48(1):45-53.
6 Woodward-Lopez 2010 - Woodward-Lopez G, Gosliner W, Samuels SE, et al. Lessons learned from evaluations of California’s statewide school nutrition standards. American Journal of Public Health. 2010;100(11):2137-2145
7 Snelling 2009 - Snelling AM, Kennard T. The impact of nutrition standards on competitive food offerings and purchasing behaviors of high school students. Journal of School Health. 2009;79(11):541-546.
8 Schwartz 2009 - Schwartz MB, Novak SA, Fiore SS. The impact of removing snacks of low nutritional value from middle schools. Health Education & Behavior. 2009;36(6):999-1011.
9 Pineda 2021 - Pineda E, Bascunan J, Sassi F. Improving the school food environment for the prevention of childhood obesity: What works and what doesn’t. Obesity Reviews. 2021;22(2):e13176.
10 Cochrane-von Philipsborn 2019 - von Philipsborn P, Stratil JM, Burns J, et al. Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health. Cochrane Database of Systematic Reviews. 2019;(6):CD012292.
11 Jia 2020 - Jia J, Moore LL, Cabral H, Hanchate A, Larochelle MR. Changes to dietary and health outcomes following implementation of the 2012 updated U.S. Department of Agriculture school nutrition standards: Analysis using National Health and Nutrition Examination Survey, 2005-2016. Public Health Nutrition. 2020;23(16):3016-3024.
12 Schwartz 2015 - Schwartz MB, Henderson KE, Read M, Danna N, Ickovics JR. New school meal regulations increase fruit consumption and do not increase total plate waste. Childhood Obesity. 2015;20(10):1-6.
13 Cohen 2014a - Cohen JFW, Richardson S, Parker E, Catalano PJ, Rimm EB. Impact of the new U.S. Department of Agriculture school meal standards on food selection, consumption, and waste. American Journal of Preventive Medicine. 2014;46(4):388-394.
14 Kinderknecht 2020 - Kinderknecht K, Harris C, Jones-Smith J. Association of the healthy, hunger-free kids act with dietary quality among children in the U.S. National School Lunch Program. Journal of the American Medical Association. 2020;324(4):359-368.
15 Vericker 2019 - Vericker TC, Gearing ME, Kim SD. Updated nutrition standards for school meals associated with improved weight outcomes for boys in elementary school. Journal of School Health. 2019;89(11):907-915.
16 NBER-Anderson 2017 - Anderson ML, Gallagher J, Ritchie ER. School lunch quality and academic performance. National Bureau of Economic Research (NBER). 2017: Working Paper 23218.
17 Hecht 2023 - Hecht AA, Olarte DA, McLoughlin GM, Cohen JFW. Strategies to increase student participation in school meals in the United States: A systematic review. Journal of the Academy of Nutrition and Dietetics. 2023;123(7):1075-1096.
18 USDA-HHFKA implementation 2014 - U.S. Department of Agriculture (USDA). Fact sheet: Healthy, Hunger-Free Kids Act school meals implementation. Release No. 0098.14;2014.
19 Chriqui 2021 - Chriqui JF, Leider J, Turner L, Piekarz-Porter E, Schwartz MB. State wellness policy requirement laws matter for district wellness policy comprehensiveness and wellness policy implementation in the United States. Nutrients. 2021;13(1):188.
20 Poole 2020 - Poole MK, Musicus AA, Kenney EL. Alignment of U.S. school lunches with the EAT-Lancet healthy reference diet’s standards for planetary health. Health Affairs. 2020;39(12):2144-2152.
21 Ringling 2020 - Ringling KM, Marquart LF. Intersection of diet, health, and environment: Land grant universities’ role in creating platforms for sustainable food systems. Frontiers in Sustainable Food Systems. 2020;4(70).
22 FAO-Food waste - Food and Agriculture Organization of the United Nations (FAO). Food wastage footprint & climate change.
23 Hic 2016 - Hic C, Pradhan P, Rybski D, Kropp JP. Food surplus and its climate burdens. Environmental Science and Technology. 2016;50(8):4269-4277.
24 SSSA-McIvor 2017 - McIvor K. Soils in the city: Community gardens. Soil Science Society of America (SSSA). 2017.
25 CCAFS-Campbell 2012 - Campbell B. Is eating local good for the climate? Thinking beyond food miles. Research Program on Climate Change, Agriculture and Food Security (CCAFS), CGIAR Research Programs. 2012.
26 Hamerschlag 2017 - Hamerschlag K, Kraus-Polk J. Shrinking the carbon and water footprint of school food: A recipe for combating climate change. A pilot analysis of Oakland Unified School District's food programs. Friends of the Earth; 2017.
27 Ronto 2020 - Ronto R, Rathi N, Worsley A, et al. Enablers and barriers to implementation of and compliance with school-based healthy food and beverage policies: A systematic literature review and meta-synthesis. Public Health Nutrition. 2020;23(15):2840-2855.
28 Piekarz-Porter 2020 - Piekarz-Porter E, Leider J, Turner L, Chriqui JF. District wellness policy nutrition standards are associated with healthier district food procurement practices in the United States. Nutrients. 2020;12(11):3417.
29 Gundersen 2015 - Gundersen C. Food assistance programs and child health. The Future of Children: Policies to Promote Child Health. The Woodrow Wilson School of Public and International Affairs at Princeton University, The Brookings Institution. 2015:25(1):91-109.
30 Kappan-Gaddis 2020 - Gaddis JE. The big business of school meals. Kappan Magazine. 2020.
31 Mathematica-Fox 2019 - Fox MK, Gearan E. School nutrition and meal cost study (SNMCS): Summary of findings. Washington, D.C.: Mathematica Policy Research, Abt Associates; 2019.
32 CDC-Nutrition standards - National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Implementing strong nutrition standards for schools: Financial implications. Atlanta: Centers for Disease Control and Prevention (CDC).
33 Long 2013 - Long MW, Luedicke J, Dorsey M, Fiore SS, Henderson KE. Impact of Connecticut legislation incentivizing elimination of unhealthy competitive foods on National School Lunch Program participation. American Journal of Public Health. 2013;103(7):e59-66.
34 Gortmaker 2015 - Gortmaker SL, Wang YC, Long MW, et al. Three interventions that reduce childhood obesity are projected to save more than they cost to implement. Health Affairs. 2015;34(11):1932-1939.
35 USDA ERS-NSLP - U.S. Department of Agriculture (USDA), Economic Research Services (ERS). National School Lunch Program (NSLP). 2023.
36 FRAC-School meals legislation 2023 - Food Research and Action Center (FRAC). School meals legislation and funding by state. 2023.
37 Long 2010 - Long MW, Henderson KE, Schwartz MB. Evaluating the impact of a Connecticut program to reduce availability of unhealthy competitive food in schools. Journal of School Health. 2010;80(10):478-486.
38 Kramer-Atwood 2002 - Kramer-Atwood JL, Dwyer J, Hoelscher DM, et al. Fostering healthy food consumption in schools: Focusing on the challenges of competitive foods. Journal of the American Dietetic Association. 2002;102(9):1228-1233.
39 CDC-School nutrition 2019 - Centers for Disease Control and Prevention (CDC). Comprehensive framework for addressing the school nutrition environment and services. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.
40 Richardson 2022 - Richardson AS, Weden MM, Cabreros I, Datar A. Association of the Healthy, Hunger-Free Kids Act of 2010 with body mass trajectories of children in low-income families. JAMA Network Open. 2022;5(5):e2210480.
41 Kenney 2020 - Kenney EL, Barrett JL, Bleich SN, et al. Impact of the Healthy, Hunger-Free Kids Act on obesity trends. Health Affairs. 2020;39(7):1122-1129.
42 USDA-ERS Coleman-Jensen 2021 - Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household food security in the United States in 2020, ERR-298. U.S. Department of Agriculture (USDA), Economic Research Service (ERS). 2021.
43 Forrestal 2021 - Forrestal S, Potamites E, Guthrie J, Paxton N. Associations among food security, school meal participation, and students’ diet quality in the first school nutrition and meal cost study. Nutrients. 2021;13(2):307.
44 Sanchez-Vaznaugh 2021 - Sanchez-Vaznaugh EV, Matsuzaki M, Braveman P, et al. School nutrition laws in the U.S.: Do they influence obesity among youth in a racially/ethnically diverse state? International Journal of Obesity. 2021;45(11):2358-2368.
45 Gearan 2020 - Gearan EC, Monzella K, Jennings L, Fox MK. Differences in diet quality between school lunch by income and race. Nutrients. 2020;12(3891).
46 Liu 2021a - Liu J, Micha R, Li Y, Mozaffarian D. Trends in food sources and diet quality among U.S. children and adults, 2003-2018. JAMA Network Open. 2021;4(4):e215262.
47 Russell 2023a - Russell SM, Jabbari J, Farah Saliba L, et al. Implementation of flexibilities to the National School Lunch and Breakfast Programs and their impact on schools in Missouri. Nutrients. 2023;15(3):720.
48 Kogan 2019 - Kogan R. Rollback of nutrition standards not supported by evidence. Health Affairs Forefront. 2019.
49 Schwartz 2019 - Schwartz MB, Brownell KD, Miller DL. Primer on U.S. food and nutrition policy and public health: Protect school nutrition standards. American Journal of Public Health. 2019;109(7):990-991.
50 Caspi 2015 - Caspi CE, Davey C, Nelson TF, et al. Disparities persist in nutrition policies and practices in Minnesota secondary schools. Journal of the Academy of Nutrition and Dietetics. 2015;115(3):419-425.
51 Nanney 2013 - Nanney MS, Davey CS, Kubik MY. Rural disparities in the distribution of policies that support healthy eating in U.S. secondary schools. Journal of the Academy of Nutrition and Dietetics. 2013;113(8):1062-1068.
52 Asada 2020 - Asada Y, Mitric S, Chriqui JF. Addressing equity in rural schools: Opportunities and challenges for school meal standards implementation. Journal of School Health. 2020;90(10):779-786.
53 Sicangu - Sicangu Co. Sicangu food sovereignty initiative: Restoring our sacred connection to food. South Dakota.
54 USDA-Tribal food sovereignty - U.S. Department of Agriculture (USDA), Climate Hubs, Southwest Climate Hub. Tribal food sovereignty and climate change preparedness of tribal agriculture.
55 USDA-Garasky 2016 - Garasky S, Mbwana K, Chamberlain A, et al. Feasibility of Tribal administration of federal nutrition assistance programs. Alexandria: U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS), Office of Policy Support; 2016.
56 Wojcicki 2006 - Wojcicki JM, Heyman MB. Healthier choices and increased participation in a middle school lunch program: Effects of nutrition policy changes in San Francisco. American Journal of Public Health. 2006;96(9):1542-1547.
57 CG-Healthy school meals for all 2022 - The Guide to Community Preventive Services (The Community Guide). Healthy school meals for all. 2022.
58 Cohen 2021b - Cohen JFW, Hecht AA, McLoughlin GM, Turner L, Schwartz MB. Universal school meals and associations with student participation, attendance, academic performance, diet quality, food security, and body mass index: A systematic review. Nutrients. 2021;13(3):911.
59 USDA-Gunderson 1971 - Gunderson, GW. History of the National School Lunch program. U.S. Department of Agriculture (USDA). 1971.
60 USDA-ERS Ralston 2008 - Ralston K, Newman C, Clauson A, Guthrie J, Buzby J. The National School Lunch program: Background, trends, and issues, ERR 61. U.S. Department of Agriculture (USDA), Economic Research Service (ERS). 2008.
61 Thompson 2020a - Thompson ED. Why nutritious meals matter in school. Phi Delta Kappan. 2020;102(1):34-37.
62 Gaddis 2019 - Gaddis JE. The labor of lunch: Why we need real food and real jobs in American public schools. Oakland: University of California Press; 2019.
63 Cohen 2021a - Cohen JFW, Hecht AA, Hager ER, et al. Strategies to improve school meal consumption: A systematic review. Nutrients. 2021;13(10):3520.
64 NPR-Bustillo 2023a - Bustillo X. The USDA wants to limit added sugars and sodium in school meals. National Public Radio (NPR). 2023.
Related What Works for Health Strategies
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