267244 Sodium Reduction in Communities Program: Lessons learned from reducing sodium content in school meals in Los Angeles County, California

Tuesday, October 30, 2012 : 5:30 PM - 5:50 PM

Patricia L. Cummings, MPH , Division of Chronic Disease & Injury Prevention, Los Angeles County Department of Public Health, 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 , Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 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
Introduction: A grantee of CDC's Sodium Reduction in Communities Program, the Los Angeles County Department of Public Health (DPH) launched its local sodium reduction initiative (LACSRI) in October 2010. A key objective of this initiative was to reduce the sodium content of school meals in the county, to levels consistent with the 2009 Institute of Medicine (IOM) recommendations. This presentation describes this complex process and the lessons learned from sodium reduction efforts in the Los Angeles Unified School District (LAUSD; > 650,000 students). Methods: In partnership with the district's Food Service Branch (FSB), sodium limits and a plan for further reductions were developed and adopted for the 2011-12 school-year menu. The process evaluation, including key informant interviews, a review of related school board policies/bulletins, and examination of FSB food production and menu analysis records, was conducted to monitor progress and to document lessons learned from this system-level procurement-intervention. Results: Mean sodium levels for lunch (elementary = 981.7mg; 95% CL 851.0-1,112.5 and secondary = 1,410.9mg; 95% CL 1,285.3-1,536.5) and breakfast (elementary/secondary = 402.7mg; 95% CL 235.5-569.9) were below the IOM 2-year targets. Achieving these levels, the FSB and DPH followed a complex, process-driven strategy that proactively addressed numerous challenges (e.g., student taste, lengthy policy adoption processes) and took advantage of facilitators (e.g., recruiting champions, training food service staff, cost concerns). Discussion: The support of the school board and early engagements with students and parents were among key factors that aided in the successful development, adoption, and implementation of the new menu.

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 laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe the process of developing, adopting, and implementing a food procurement intervention at the school district level. Identify and discuss key lessons learned from working with a large, urban school district to reduce sodium content in school meals.

Keywords: IOM, School 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 issues (e.g., foodborne illness). Among my scientific interests has been the development of strategies for preventing obesity, cardiovascular disease, and other chronic conditions impacted by food quality and food safety.
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.