Investigating the historic long-term population health impact of the US National School Lunch Program

Abstract

Objective: The present research aimed to compare historic participation in the US National School Lunch Program (NSLP) during childhood and subsequent prevalence of overweight and obesity among adults at the population level. Design: Regression models examined cross-sectional, state-and age-based panel data constructed from multiple sources, including the Behavioural Risk Factor Surveillance System, US Congressional Record, US Census and the US Department of Agriculture. Models controlled for cohorts' racial/ethnic composition and state poverty rates. Subjects: Adult-age cohorts (18-34, 35-49, 50-64 and 18-64 years) by US state over a 25-year period (1984-2008). Setting: The cohorts' prevalence of overweight and obesity was compared with the cohorts' estimated NSLP participation during schooling (1925-2007 the NSLP began in 1946). Results: Among adults aged 18-64 years, a one percentage-point increase in estimated NSLP participation during schooling between 1925 and 2007 was significantly associated with a 0?29 percentage-point increase in the cohort's later prevalence of overweight and obesity. Analysis of narrower age cohorts and different schooling periods produced mixed results. Conclusions: The NSLP might have influenced population health historically. Longitudinal analysis of individuals from studies now underway will likely facilitate more robust conclusions about the NSLP's long-term health impact based on more recent experiences. Keywords Food policy Food assistance School nutrition ObesitySince 1946, the US National School Lunch Program (NSLP) has provided federal funding to states for school lunches and specified the general nutrition content of those lunches (1) . At least 94 % of schools now participate and over 200 billion NSLP lunches have been served (2,3) . Any child at a participating school can purchase an NSLP lunch, although the programme also plays a critical role in delivering food assistance to low-income children by providing means-tested reduced-and no-cost lunches. Unfortunately, US Department of Agriculture (USDA) assessments have indicated persistently high average sodium, fat, saturated fat and energy content in NSLP lunches (4)(5)(6) . In 2004-5, a nationwide assessment commissioned by the USDA estimated that just 4-7 % of schools complied with all NSLP nutrition standards (6) . In 2009-10, a subsequent assessment indicated overall nutrition improvements; however, under half of elementary schools and less than one-quarter of secondary schools at the time of the evaluation were serving lunches that would meet new energy ceilings (implemented in 2012) (7) .Such evidence has motivated extensive research into a link between school-based child nutrition programmes and child overweight and obesity, which has yielded mixed conclusions (8)(9)(10)(11)(12)(13)(14) . Notably, two recent studies (using the same data set, the Early Childhood Longitudinal Study) applied advanced econometric techniques to longitudinal, individual-level observational data and both concluded that school l...

Are school meals a viable and sustainable tool to improve the healthiness and sustainability of children´s diet and food consumption? A cross-national comparative perspective

“…Nevertheless, the impact of school food is not always positive. A unique study of the U.S. national school lunch program between 1946 and 2013 found that among the entire adult group of 18-64 year olds, school lunch consumption was related to an increased subsequent prevalence of overweight and obesity (Peterson, 2013). However, the effect was not consistent for all different age cohorts within the studied population, possibly owing to secular trends in eating habits and changing national nutrition policies that spanned both Phase I and II of school meal program development.…”

Childhood Obesity and Quality of Meals: The Saudi School Meal and Home Meal Study SSMHMS – A Cross Sectional Study

“…More than 28 million students participate in National School Lunch Program, where school meal at lunch time provided at least one-third of children requirement for energy, protein, vitamin C, vitamin A, iron and calcium. Children who receive lunch at school regularly have greater intake of fiber and several nutrients than children who have their lunch at home [22]. One study reported the difference between breakfast served at school and breakfast served at home, where the one served at school contain more calories and protein, whereas the one served at home contain more total fat, dietary cholesterol and sucrose [23].…”