263802 Reducing sodium levels in the meals of a large urban school district meal program: Comparisons of menus for school years 2010-11 and 2011-12

Monday, October 29, 2012

Patricia L. Cummings, MPH , County of Los Angeles, Department of Public Health, Division of Chronic Disease & Injury Prevention, Los Angeles, CA
Lindsey Burbage, MPH , Division of Chronic Disease and Injury Prevention, County of Los Angeles Department of Public Health, Los Angeles, CA
Michelle Wood, MPP , Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA
Brenda Robles, MPH , Los Angeles Department of Public Health, RENEW LA County(Communities Putting Prevention to Work, Los Angeles, CA
Gloria Kim, MPH , Office of Senior Health, Los Angeles County Department of Public Health, Los Angeles, CA
Tony Kuo, MD, MSHS , County of Los Angeles, Department of Public Health, Office of Senior Health, Los Angeles, CA
Background: As part of the Sodium Reduction in Communities Program, the Los Angeles County Department of Public Health recently provided technical support to Los Angeles Unified School District (LAUSD) to impose stricter sodium limits on school meals. These 2011-12 changes included adoption of food-based nutrition standards based on 2009 Institute of Medicine (IOM) recommendations and the recent USDA school-meal-planning final rule. The present analysis examines sodium levels of the district's menus before and after changes. Purpose & Significance: High salt diets in children lead to raised blood pressure, which can increase the risk of heart disease and stroke in adulthood. Methods: We conducted a comparative analysis of the 2010-11 and 2011-12 school-year menus for sodium (mg) using October 2010 and October 2011 food offerings. Sample means and confidence intervals for sodium were calculated for four meal categories: elementary breakfast and lunch; secondary breakfast and lunch. The analysis was based on comparing levels to IOM and USDA nutrition standards. Results: Mean sodium levels in the meals of both menus (2010 and 2011) met the IOM 2-year targets with the exception of breakfast. Both breakfast menus contained higher sodium levels than expected, exceeding the targets by over 200mg in elementary and 400mg in secondary grade-level categories. Compared to the USDA requirements, the 2011 menu showed substantive improvements with all breakfast menu items meeting the federal guidelines; secondary-breakfast sodium dropped by 62.1% compared to the previous year. Conclusion: The gradual sodium reduction plan in LAUSD appears promising, affecting over 650,000+ meals/children per day.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
• List the current sodium levels in school meals offered by a large school district meal program for the school-year 2010-11 and 2011-12. • Compare the aforementioned school district’s primary- and secondary-school breakfast and lunch menus for the school-years 2010-2011 and 2011-12, as they relate to USDA and IOM guidelines. • Describe lessons learned from working with a large, urban school district to adopt and implement sodium reduction standards in the school meal program.

Keywords: School Health, Children's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of multiple research studies focusing on the epidemiology of food quality and food safety, including school-based nutrition and foodborne diseases. Among my scientific interests has been the development of strategies for preventing chronic diseases, such as obesity, cardiovascular disease, and stroke.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3407.0: Improving Student Healthy Eating and Healthy Weight