Association for Public Policy Analysis & Management

A key concern for child health and development in the U.S. is the rapid increase in the prevalence of obesity among children.  Genetic, metabolic, behavioral, environmental, cultural and socioeconomic factors all play a role in excess adiposity.  However, with the rapid increase in the prevalence of obesity in the U.S. over a very short time period, it is clear that behavior and environment are important elements.  With children spending a significant amount of time each day in school, foods offered in school provide a viable policy lever for improving child nutrition and nutrition-related outcomes.

School lunches are provided through the National School Lunch Program (NSLP). In 2015, the federal government spent over $11.7 billion on the program and served lunches to over 30 million children daily. Lunches served contain about one-third of the Recommended Energy Allowance for the day, making NSLP is an important part of a child’s overall diet. Perhaps even more crucially, the majority of the children served by NSLP live in low-income households disproportionately affected by obesity.

As directed by the Healthy, Hunger-Free Kids Act of 2010, USDA instituted new nutrition standards for lunches served to school children. These standards reflect the most recent Dietary Guidelines for Americansand are designed to lead to improvements in meal quality and nutrition-related child outcomes. Given that child obesity is a critical public health issue and the new school meal standards pose a significant public investment in bettering child nutrition, it is important to assess the effects of the new standards on child weight outcomes.  To that end, this research has the following specific aims: 1) To examine whether the new school nutrition standards have affected elementary school children’s BMI and risk of obesity; and 2) To examine, in two specific contexts, whether or not school nutrition standards are being implemented as intended and to document the obstacles schools faced in implementing the new school nutrition standards.

This study employs a mixed methods approach.  A non-experimental design and secondary data are used to estimate the impact of the new nutrition standards on child BMI and weight status. Using nationally-representative data from the Early Childhood Longitudinal Studies—the 1998-1999 and 2010-2011 kindergarten cohorts—the goal of the quantitative analysis is to identify the factors that relate systematically to changes in BMI between the pre and post periods—and to assess the contribution of the NSLP nutrition standards. DDD models will be used to isolate the effect of the treatment on children consuming school meals, while controlling for possible biasing variables as well as time trends. Semi-structured key informant interviews provide descriptive evidence on the implementation of nutrition standards across school districts and on possible pathways through which nutritional standards may impact child weight.

The NSLP serves large numbers of children in households disproportionately affected by obesity, making the NSLP a powerful policy tool with the potential for reversing the obesity trend. Results from this study will help inform policymakers of the potential benefits of investing in improved diet quality for children.