Changing the school food environment: Evaluation of the nutritional content of a large local school district meal program

Introduction: School meals offer a unique opportunity to influence children's diets. Recently, the USDA based proposed guidelines for federal school-meal programs on the Institute of Medicine (IOM) nutrition report. Los Angeles Unified School District (LAUSD) is attempting early adoption of these recommendations for the 2011/2012 school year. We examined LAUSD's present meal content compared to the IOM recommendations and discussed the implications of the upcoming menu changes. Methods: Using a sample of meals offered in October 2010, a comparative analysis of the 2010/2011 menu and the IOM nutrition targets was conducted. Sample means and confidence intervals for food energy and sodium were calculated for four meal-categories: elementary-breakfast/lunch and secondary-breakfast/lunch. We also compared the preliminary 2011/2012 menu with the IOM food-based standards. Results: More calories were offered per meal in 2010/2011 than recommended by the IOM. Calories from all meal categories, except secondary-lunch, were above the upper-limit range by 63.8-240.6 calories (CIs: 36.5, 91.0; 185.7, 295.5, respectively). Sodium levels were also high, >300mg in all categories and >500mg for secondary-breakfast, than the IOM recommendations. The preliminary 2011/2012 menu includes sufficient fruit per meal, but inadequate vegetables in both secondary-lunch and elementary-lunch meal options.Discussion: Although proposed sodium recommendations will not be fully adopted until 10 years post-program implementation, levels will likely drop if fruit/vegetable options are increased in the new menu. Changing the school meal program is just one-step in the process of improving the food environment. Addressing sugar-sweetened beverages, competitive food sources, and healthy food promotion/signage are additional important strategies.