School nutrition standards: The bottom line

Changing institutional practices within schools has been the focus of many efforts to support children to be active, eat healthfully and prevent obesity. California led the way in this regard by passing the first state wide school nutrition standards that applied to all grade levels. The primary barrier has been concerns regarding financial losses due to reduced food and beverage sales. The impact on student intake is also unknown. Three studies were conducted to assess the impact of these standards on the school food environment, student intake, and food and beverage sales as well as identify barriers and factors associated with success. Methods included observation and documentation of available foods and beverages, sales accounts and surveys of food service workers, and secondary analysis of student consumption data from the California Healthy Kids Survey at 99 elementary, middle and high schools. All data were collected pre and post implementation. Analyses were conducted to determine the significance of the changes. After the legislation went into effect schools increased their compliance with the legislation, student dietary intake improved modestly, and food service financial losses were usually offset by increased meal program participation. The results establish that implementing the legislation was both feasible and effective. Challenges remain and additional policies and actions are needed in order to obtain more substantive improvements in the school nutrition environment, student nutrition, and health.