IOM recommends new nutritional requirements for school meal programs

The National School Lunch Program and the School Breakfast Program should adopt a new set of nutrient targets and standards for menu planning, says a new report from the Institute of Medicine. The recommended targets and standards would update and improve the programs' abilities to meet children's nutritional needs and foster healthy eating habits. The report's recommendations will bring school meals in line with the latest Dietary Guidelines for Americans and Dietary Reference Intakes. They will limit sodium and the maximum number of calories, and encourage children to eat more fruits, vegetables, and whole grains. The programs' current nutrition standards and meal requirements are based on the 1995 Dietary Guidelines and the 1989 Recommended Dietary Allowances.

Implementation of the recommendations will likely raise the costs of providing school meals -- particularly breakfasts -- largely because of the increased amounts of fruits, vegetables, and whole-grain foods involved, stated the committee that wrote the report. A combination of higher federal meal reimbursement, capital investment, and additional money for training food service operators will be needed to make the necessary changes in school cafeterias.

"The programs that nourish so many American schoolchildren need to reflect the latest child health and nutrition science given the extent to which dietary habits shape lifelong health," said committee chair Virginia A. Stallings, Jean A. Cortner Endowed Chair in Pediatric Gastroenterology, Children's Hospital of Philadelphia. "Since the school meal programs were last updated, we've gained greater understanding of children's nutritional needs and the dietary factors that contribute to obesity, heart disease, and other chronic health problems. The changes recommended in this report are needed to assure parents that schools are providing healthful, satisfying meals."

The report updates the school meals programs' nutrition standards with a recommended set of nutrient targets that are higher for protein, vitamins, and minerals and lower for sodium. The committee also set maximum calorie levels for the first time. Lunches should not exceed 650 calories for students in grades K-five, 700 for children in grades six-eight, and 850 for those in grades nine-12. Breakfast calories should not exceed 500, 550, and 600 respectively for these grade groups.

To reduce the health risks associated with excessive salt intake, the sodium content of school meals should be gradually reduced over the next 10 years. For example, recent data show that a typical high school lunch contains around 1,600 milligrams of sodium. The report recommends that lunches for high school students should eventually contain no more than 740 milligrams. The committee recognized that consumers are less likely to detect incremental changes, and it is unrealistic to expect food preparers to make rapid, dramatic changes and still produce meals children would eat.

Schools should plan weekly menus around foods rather than a set of nutrients, the committee concluded. The report recommends new standards for the kinds and amounts of foods that should be part of menu planning that would largely achieve the nutrient targets. The main changes are the greater amounts and variety of vegetables and fruits that schools should offer, the replacement of a substantial amount of refined grain products with products rich in whole grains, and the replacement of whole or 2 percent milk with 1 percent or nonfat milk. Schools that allow students to decline individual items rather than take a whole meal should require them to take at least one serving of fruits or vegetables at each meal. The meal programs currently have no such requirements.

The amount of fruit offered in breakfasts should increase to 1 cup per day for all grades and in lunches should increase to 1 cup per day for students in grades nine-12. No more than half the fruit schools provide should be in the form of juice.

The amount of vegetables offered should increase to 3/4 cup per day for grades K-eight, and 1 cup per day for grades nine-12. Schools should offer starchy vegetables such as potatoes less often and provide at least 1/2 cup each of green leafy vegetables, orange vegetables, and legumes per week.

Schools should ensure that half or more of the grains and breads they provide are whole grain-rich, meaning they contain 50 percent or more whole grains. The U.S. Food and Drug Administration should require food manufacturers to label products with their whole-grain content to help food preparers ensure they are meeting the standards.

Students should be provided 1 cup of 1 percent or nonfat milk at breakfast and at lunch each day. This will help ensure schools meet requirements to keep the saturated fat content of meals below 10 percent of total calories.

The amount of meat or meat alternatives in lunches should be 2 ounces on most days for all grades, but schools should have the flexibility to provide greater amounts to students in higher grades. The amount of meat or meat alternatives in breakfasts should be 1 ounce per day for children in grades K-eight and 2 ounces on most days for high school students.

The National School Lunch Program is available in 99 percent of U.S. public schools and in 83 percent of private and public schools combined. The School Breakfast Program is available in 85 percent of public schools. About 30.6 million schoolchildren -- 60 percent -- participated daily in the school lunch program in fiscal year 2007, and 10.1 million children ate school breakfasts. Participating schools served about 5.1 billion lunches and 1.7 billion breakfasts that year.

Food and beverages are also available through a la carte service in cafeterias, school stores, snack bars, and vending machines in many schools. The IOM recommended nutrition standards for these products, which compete with school meals, in a 2008 report, NUTRITION STANDARDS FOR FOODS IN SCHOOLS.

Source: National Academy of Sciences