What's On Your Kid's Lunch Tray?

Of all the public policy problems to have a surprisingly long shelf life, how to serve healthy food to schoolchildren is among the most surprising. Giving kids a balanced meal in the middle of the day while they go about the business of being educated seems like the kind of task our elected leaders would strive to get right without much fuss. Unfortunately, our nation hasn’t stuck the landing on this one yet, despite grappling with such complex questions as whether or not ketchup counts as a vegetable since I was eating school lunches in elementary school myself.

The ramifications of a loused-up lunch can be quite significant. Questions about nutrition and diet are invariably part of the history I take for every patient who comes to see me for a well-child exam, from a nursing newborn up through kids in college living on cheap ramen noodles. When I ask what comprises the meals for school-aged children, regarding lunch the answer is often “whatever they’re serving at school.” Parents can stock the pantry with healthy items for breakfast and dinner, but lunch is largely out of their hands. The school lunch program provides food for 31 million kids in this country [PDF], and for families who rely on these low-cost or free meals there may be little alternative.

When students are overweight or obese, well-balanced meals are especially important. Given that fully one third of American children and adolescents fall into this category, this is not a public health issue to be shrugged off. Obesity is often a very difficult problem to solve, one thatthe majority of my fellow pediatricians often feel ineffective in tackling. I can spend an entire patient visit talking with parents about giving their children good, nutritious meals, but if their kids are offered pizza a-go-go at school then all the advice I have to give will only go so far.

An even bigger concern is vending machines, which many schools around the country allowed into their halls due to bonuses paid from the companies that put them there. Some of my more honest patients will readily concede that they get all manner of junk food and soft drinks from the vending machines in their schools. The machines wouldn’t be there if students didn’t buy from them regularly, and as much as I encourage them to make healthier choices I don’t kid myself that this advice holds much sway when they’re feeding their dollars into the slot.

Thankfully, in 2010 the Healthy Hunger-Free Kids Act was passed, which mandated healthier school lunches [PDF] and which began taking effect in 2012. Perhaps not entirely surprisingly, not every kid was thrilled with these changes and some schools have dropped out of the federal school lunch program, citing a drop in the number of students buying the meals and a resultant loss of money. A generation that has gotten used to junk food being readily available in their schools is going to balk at having said junk food taken away.

The solution, of course, is not to throw up our hands and say, “oh, well. We tried” and discard the new standards. When parents describe the difficulty they have getting their kids to eat a good selection of fruits and vegetables, I don’t tell them to just cave in and let them subsist on Froot Loops. Unfortunately, this sort of defeatist measure was recently proposed in the House of Representatives. The GOP-backed bill would allow schools that have lost money on the new standards to get a waiver exempting them from it, essentially letting them serve the same old unhealthy meals as before.

This is a bad idea. Whatever the solution to assisting schools facing fiscal problems due to reduced consumption of school lunches, it isn’t to reverse the positive changes made to those meals. There is a compromise that has beenrecently adopted by the Senate Appropriations Committee, which relaxes a few of the requirements but doesn’t allow schools to opt out of the new standards entirely. That seems like a better alternative to me.

Further, the same legislation that mandated healthier lunches will be changing the snacks available in schools later this year, includingwhat’s sold in vending machines. Under the “Smart Snacks in School” guidelines, the Fritos and Mountain Dew a student could buy up until now will be replaced by items that adhere to standards regarding caloric content, sodium and other limits. I am entirely supportive of this change, though I wish the vending machines hadnever been allowed in the first place.

From kindergarten through their senior years, kids spend much of their waking life in school. The food they have access to there is a major factor in their overall health. With childhood obesity at epidemic proportions in this country, attending to the content of that food is of paramount importance. This may not be an easy change, but it’s an important one. Even if kids miss the junk food they could find in their cafeterias and the machines down the hall, getting rid of it is the right decision.

Like us on Facebook - Follow us on Twitter - Sign up for The Cheat Sheet Newsletter