Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/2/2010
Publication Date: 9/1/2010
Citation: Martin, C.K., Thomson, J.L., Leblanc, M.M., Stewart, T.M., Newton, R.L., Han, H., Sample, A., Champagne, C.M., Williamson, D.A. 2010. Children in school cafeterias select foods containing more saturated fat and energy than the Institute of Medicine recommendations. Journal of Nutrition. 140(9):1653-60. Interpretive Summary: Children spend approximately 180 days per year in school, and most receive breakfast or lunch from school cafeterias. The National School Lunch Program (NSLP), part of the USDA Food and Nutrition Service, provides reduced-cost or free lunches to over 30 million children per day. Hence, the school environment is very influential on children’s nutritional health, as noted by the Institute of Medicine (IOM). Using digital photography, we measured the lunch selection and consumption of 4th through 6th grade rural Louisiana school children. Our results indicate that the majority of children’s lunch choices are meeting the NSLP guidelines for energy, protein, carbohydrates, calcium, and iron; however, most children select too much fat and too few foods containing vitamins A and C. Additionally, the majority of children exceed the IOM recommended upper limits for energy and saturated fat. Over half the children met the IOM minimum recommendations for protein, calcium, iron, and vitamin A, but less than one fifth met the recommendation for vitamin C. Children’s consumption patterns differed by grade level, sex, race, and weight status (e.g. normal weight, overweight). Based on the results of this study, efforts are needed to improve the nutritional quality of children’s school meals.
Technical Abstract: In this study, we examined if children’s food selection met the School Meals Initiative (SMI) standards, and the recently released Institute of Medicine (IOM) recommendations. Mean food selection, plate waste, and food intake were also examined. Food intake of 2,049 4th-6th grade students were measured objectively at lunch with digital photography in 33 schools. The percent of children whose food selection met the SMI standards and IOM recommendations for energy (kJ), fat and saturated fat, calcium, iron, and vitamin A and C were calculated. The SMI standards provide lower limits for most nutrients; the IOM provides a range of values, including an upper limit, for many nutrients. Seventy seven percent of children’s energy selection met the SMI lower limit, but only 16% of children met the IOM’s recommended range, and 74% of children exceeded the upper limit. More than 70% of children exceeded the SMI and IOM’s saturated fat recommendations. Children selected (mean+SD) 3168+621 kJ, discarded 882+581 kJ, and consumed 2286+716 kJ. Children proportionally consumed more fat than selected and discarded more carbohydrate. Most children met SMI and IOM recommendations for protein, calcium, iron, and vitamin A. With few exceptions, energy selection was similar among groups of children, but plate waste differed significantly (P<.001), resulting in greater energy intake among boys compared to girls, Caucasians compared to African Americans, and heavier compared with lighter children. Children’s selection was high in recommendations differ, resulting in discrepant conclusions about the quality of children’s food selection. Children’s selection was high in saturated fat and, based on IOM criteria, included excess energy.