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Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth
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Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth
Index
A
Advertising and marketing
of competitive foods and beverages, 98–99
recommendations for Tier 2 products, 11, 136
After-school activities
concession stands, 84
recommendations for food and beverage availability, 11–12, 136–137
À la carte entrée items
availability in schools, 23, 79–80, 83
definition, 7
nutritional quality, 24
recommended nutrition standards, 7, 8, 129–130
regulation, 83
school revenue from, 93–94, 96
scope, 83
See also Competitive foods and beverages in schools
Alabama, 184–185
Alaska, 186–187
Alliance for a Healthier Generation, 114, 115, 257
Anorexia nervosa, 38–39
Arizona, 186–187
Arkansas, 186–189
Aspartame, 47
Atherosclerosis, 30, 33
Athletics. See Sports drinks
Availability of foods and beverages
competitive foods and beverages, 23, 79–80, 83
determinants of, in schools, 16
effect of competitive foods on student food intake, 85–86, 107
monitoring implementation of nutrition standards, 146–147
parental restrictions, 67
physical environment, 99–100
rationale for school regulation, 22–24
recommendations for after-school activities, 11–12, 136–137
recommendations for school day, 10–11, 134–136
B
Benchmark data, 20, 144, 145–146, 147–148
Beverages
Alliance for a Healthier Generation guidelines, 260–262
caffeine content, 9–10, 133–134
consumption patterns, 60–61
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consumption trends, 69
fortified, 41
industry efforts to improve nutritional value of, 114–115
nonnutritive sweeteners in, 8, 130–132
obesity and, 61
recommendations for school day availability, 10–11
regulatory trends, 111
sugar content, 6, 59–60, 127–128
Tier 1 classification, 123
Tier 2 classification, 124
See also Competitive foods and beverages in schools
Body mass index, 31, 60, 65
Bone health, 35–36, 56, 58, 60
Breakfast, 65–66, 70
Bulimia nervosa, 38–39
C
Caffeine
consumption patterns, 50
potential adverse effects, 9, 51–53, 134
recommended nutrition standards, 9–10, 133–134
sources, 50
stimulant effects, 50–51
Calcium, 36, 42, 56–58, 59–60
California, 190–193
Calorie intake
current standards for school meals, 25
discretionary calorie allowance, 63–65
low nutrient density foods, 62–65
nonnutritive sweeteners and, 8, 48–50
patterns and trends, 15, 23, 43–44, 60
snacks, 7, 67, 129
sugar, 58
from sugar-sweetened beverages, 60
weight gain and, 62
See also Intake, energy and nutrient
Cardiovascular disease, 33
Centers for Disease Control and Prevention, 1–2, 19, 87
Channel One, 98
Child Nutrition Act, 74, 104
Child Nutrition and WIC Reauthorization Act, 1, 16–19
Child Nutrition Labeling Program, 128
Child Nutrition Promotion and School Lunch Protection Act, 108
Cholesterol, 33, 62
trans fat effects, 4, 126
Civil Rights Act, 74
Colorado, 194–195
Competitive foods and beverages in schools
after-school sales, 11–12, 84, 136–137
Alliance for a Healthier Generation guidelines, 114, 115, 257–262
availability, 23, 79–80, 83
concerns, 16, 106–107
current nutritional characteristics, 16, 24
current regulation, 78–79, 109, 183–255
definition, 1, 16, 78
determinants of access and availability, 16
effects on student food intake, 85–86, 107
evolution of regulation, 104–105
financial effects of restricting, 96–97
foods used as reward or discipline, 11, 85, 135–136
goals, 14, 108, 119–120
marketing of, 11, 98–99, 136
national sales, 92–93
national school meals program and, 76–77, 79, 104, 107, 124
rationale for nutrition standards, 16, 23–24, 25–26, 107–108, 118
recommendations for after-school availability, 11–12, 136–137
recommended standards for nonnutritive food components, 8–10, 130–134
recommended standards for nutritive food components, 4–8, 126–130
recommended standards for school day availability, 10–11, 134–136
research needs, 1–2, 19
as school revenue source, 75, 77, 91–97, 104, 110, 148
sources, 1, 78, 83–85
two-tier classification, 3–4, 119, 120
Connecticut, 196–197
D
Dairy products
as calcium source, 56–58
displacement by sweetened beverages, 59–60
sugar content, 6–7, 59, 128–129
Tier 1 foods, 123
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Delaware, 198–199
Dental disease, 37–38
Diabetes, 34
Dietary Guidelines for Americans, 2, 16, 20, 24, 26, 54, 61, 88, 118–119, 121, 126, 139
current intake and consumption patterns and, 39–41
Dinner, 66
District of Columbia, 198–199
E
Eating disorders, 38–39
Elementary and Secondary Education Act, 74
Elementary school
after-school food and beverage availability, 11–12
availability of competitive foods, 23
competitive foods regulation, 110, 111
nutrition standards, 26–27, 183–255
open campus, 100
recommendations for after-school food and beverage availability, 136–137
F
Fast food consumption, 65
Fat
Alliance for a Healthier Generation guidelines, 260
consumption trends, 69–70
current intake, 15, 61
health effects, 4, 62, 126
recommended nutrition standards, 4, 126
Federal government
competitive foods regulation, 104–105, 107–108
current nutrition standards for school meals, 25, 78
food safety regulation and oversight, 46–47
implementation of recommended nutrition standards, 12–14, 138–139
school governance structure, 74
school system funding, 75
wellness program mandates, 1, 16–19, 108
Fiber, dietary, 42
Financial considerations
competitive foods as school revenue source, 75, 77, 91–96, 104, 148
cost of implementing recommended standards, 20, 139
effects of restricting competitive food sales, 96–97, 113
federal school meal program, 93
monitoring implementation of nutrition standards, 148
obstacles to competitive foods regulation, 110, 113
Florida, 198–199
Folate, 42
Food industry
efforts to improve nutritional value of school-available beverages and foods, 114–115
implementation of recommended nutrition standards, 13–14, 138–139, 146
product information and labeling, 14, 127, 128, 138–139
receptivity to regulation, 114
Food Marketing to Children and Youth: Threat or Opportunity, 26
Foods of Minimal Nutritional Value, 79, 104–105, 106, 108
Foods to be encouraged, 3
Fortification and supplementation, 41
Fruits
current consumption patterns, 53
sugar content, 6, 128
Tier 1 foods, 121–122
Fundraising activities, 12, 84–85, 137
G
Gender differences
dietary intake, 67–68
eating disorders, 38, 39
energy intake, 43
nutrient intake, 42, 43
obesity patterns, 32
Georgia, 200–201
Growth
energy balance and, 7, 29–30, 43
individual patterns, 30
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H
Hawaii, 200–203
Health
caffeine intake and, 9, 51–53, 134
current dietary guidelines, 2, 26, 39–41
diet and nutrition concerns, 1, 16, 29
fat intake and, 4, 62, 126
life-course approach, 30–31
normal growth, 30
nutrition linkage, 15, 16, 22, 24, 27, 29–39, 53
school role in children’s, 1, 15, 22–23, 25–26
sodium intake and, 7, 130
unhealthy weight control behaviors, 39
Healthful eating
goals of nutrition standards for competitive foods, 14, 108, 119, 126
student attitudes and beliefs, 86
students’ food choice behaviors, 67, 86
HealthierUS School Challenge, 56
Healthy People 2010, 88
High schools
availability of competitive foods, 23
competitive foods regulation, 110–111
nutrition standards, 26–27, 183–255
open campus, 100
physical education, 88–89
recommendations for after-school food and beverage availability, 8, 11–12, 136, 137
Hypertension, 33–34, 44, 51
I
Idaho, 202–203
Illinois, 204–207
Implementation of nutrition standards
benchmarks, 144, 145–146
changes in food availability for, 143–144
changes in food sources for, 144
costs, 20, 139
decisions and actions in, 143
expected benefits, 149
food industry role, 13–14, 138–139, 146
framework for, 141–142
key decision-makers in, 145
promoting awareness and understanding, 142–143
recommendations for, 12–14, 138–139
requirements for, 24–25, 145
success stories, 113–114
tracking and evaluation, 144–149
wellness program compliance, 108
Indiana, 208–209
Individuals with Disabilities Education Act, 74
Institute of Medicine, 1–2, 19
Intake, energy and nutrient, 15, 42–44
added sugar, 6, 58–59
age-related patterns, 70
basis for nutrition standards, 118
calcium, 56–58
competitive food availability and, 85–86
concerns, 15, 22, 42–43
current nutritional standards for school meals, 25, 78
data sources, 20, 71–72
demographic differences, 42, 43
dietary guidelines and, 39–41, 61
economic status and, 68–69
effects of parental restrictions, 67
energy requirements of children, 63–65
fast food consumption, 65
fat, 15, 61
fruits and vegetables, 53
gender differences, 67–68
low nutrient density foods, 62–65
meal patterns, 65–66, 70
monitoring implementation of nutrition standards, 147–148
nonnutritive food components, 45–53
portion size and, 71
race/ethnicity and, 69
requirements, 179–181
at school, 103, 106–107
school environment as factor in, 73, 99–101
snacks, 7, 66, 70–71
sources, 15–16
students’ food choice behaviors, 67
sweetened beverages, 59–61
trends over time, 69–71
whole-grain foods, 53–55
See also Calorie intake
Iron deficiency, 36–37, 42
J
Juices, 6, 12, 83, 106, 120, 123
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K
Kansas, 210–211
Kentucky, 212–213
L
Local food producers, 146
Louisiana, 214–217
Low nutrient density foods, 62–65
Lunch, 66
school lunch period, 99–100
M
Magnesium, 42
Maine, 218–219
Making It Happen! School Nutrition Success Stories, 97, 113–114
Marketing. See Advertising and marketing
Maryland, 218–219
Massachusetts, 218–219
Metabolic syndrome, 34–35
Michigan, 220–221
Middle schools
availability of competitive foods, 23
competitive foods regulation, 110–111
current state nutrition standards, 183–255
dietary intake patterns, 86
nutrition standards, 26–27
open campus, 100
recommendations for after-school food and beverage availability, 11–12
Minnesota, 220–221
Mississippi, 220–221
Missouri, 220–221
Monitoring outcomes of nutrition standards, 144–149
availability of foods and beverages, 146–147
benchmark data, 20, 144, 145–146, 147–148
dietary intake, 147–148
ease of implementation, 145–146
at local level, 145
programs for, 148–149
school finances, 148
at state and federal levels, 145
Montana, 222–223
Mortality
cardiovascular disease, 33
diet-related, 30
N
National School Lunch and Breakfast Programs, 2, 15–16, 22–23, 68–69, 73–74
administration, 75–76, 77
competitive foods and, 76–77, 79, 104, 107, 124
coordination of health-related programs, 87
dietary intake related to, 106–107
financing, 77, 93, 106
grab and go programs, 100–101
nutritional standards for, 25, 78, 106
participation, 76
school environment factors influencing use, 99–101
scope of service, 76
stigmatization of poor children, 107
Nebraska, 222–223
Nevada, 224–225
New Hampshire, 224–225
New Jersey, 224–225
New Mexico, 226–231
New York, 232–233
No Child Left Behind Act, 74, 91
North Carolina, 232–235
North Dakota, 234–235
Nutrient displacement
competitive food availability and, 25, 85–86
definition, 8
fortification and, 41
nonnutritive-sweetened beverages, 8, 9, 48, 131–132, 133
sweetened beverage consumption and, 59–60
Nutrition standards
for competitive foods, rationale for, 16, 23–24, 107–108
current standards, 103, 106, 109, 183–255
food-based, 25, 78, 118
goals for competitive foods and beverages in schools, 14, 108, 119–120, 126, 147
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guiding principles, 2, 21–27, 117, 118–119
National School Lunch and Breakfast Programs, 25, 78, 106
penalties for noncompliance, 111
product information and labeling issues, 14, 127, 128, 138–139
recommendations for after-school availability, 11–12, 136–137
recommendations for implementation, 12–14
recommendations for nonnutritive food components, 8–10, 130–134
recommendations for nutritive food components, 4–8, 126–130
recommendations for school day foods and beverages, 10–11, 134–136
research goals, 1–2, 19
for school-available foods and beverages, rationale for, 22–24, 25–26, 27, 103
scientific base, 26
scope, 26–27
state and local, 2, 109–112
trends, 109–110
two-tier classification of competitive foods, 3–4, 119, 120
wellness program goals, 1, 19
wellness program implementation, 108
See also Implementation of nutrition standards
Nuts/seeds, 122–123
O
Obesity
complications of, 1, 15, 30, 33–35
definition, 31
demographic patterns, 32
energy imbalance in, 43–44
fat intake and, 62
life course, 30
meal-skipping patterns and, 66
socioeconomic status and, 68
sweetened beverage consumption and, 60–61
trends, 1, 31–32
wellness program mandates, 16–19
Ohio, 234–235
Oklahoma, 234–235
Open campuses, 100
Oregon, 236–237
Osteoporosis, 35–36, 56
P
Packaging, for implementation of nutrition standards, 146
Parental restrictions on food consumption, 67
Pennsylvania, 236–237
Physical activity
coordination of school health-related programs, 88
current levels in schools, 88–89
discretionary calorie allowance and, 63
energy requirements, 179–181
recommendations for, 88
state requirements, 88
Portion sizes, 71
Potassium, 42
Preventing Childhood Obesity: Health in the Balance, 26
Private sector
nongovernmental organizations, 114
See also Food industry
Processed foods, 4
Product information and labeling, 14, 127, 128, 138–139
Progress in Preventing Childhood Obesity, 26
Psychosocial factors
effects of parental restrictions on food consumption, 67
food choice behavior, 67
self-reported food intake, 71–72
R
Race/ethnicity
dietary intake differences, 68, 69
hypertension risk, 34
obesity patterns, 32
Rewards, use of foods and beverages as, 11, 85, 135–136
Rhode Island, 238–239
Richard Russell National School Lunch Act, 74
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S
Safety of food supply, 46–47
Saturated fat
current intake, 15, 61
health effects, 62
recommended nutrition standards, 4, 61, 126
School Food Authority, 75–76, 77, 94
School Nutrition Dietary Assessment, 78
School nutrition programs, federally reimbursable, 1, 14
School Physical Activity and Nutrition survey, 148–149
School stores and snack bars, 1, 14, 23, 79, 80, 83, 84
Schools
cafeteria conditions, 101
competitive foods in. See Competitive foods and beverages in schools
coordination of health-related programs, 86–87
current enrollment, 22
dietary intake in, 103, 106–107
environmental factors in food behavior, 73, 99–101
funding system, 75, 91–92
governance structure, 74–75, 113
nutrition education in, 89–91
nutrition standards rationale, 22–24, 25–26, 27
physical education, 88–89
role in children’s health, 1, 15
sources of foods and beverages, 15–16
wellness program mandates, 1
Snacks
calorie limits, 7, 129
consumption patterns, 7, 66, 70–71
definition, 7
discretionary calorie allowance and, 63–64
fat standards, 4
nutrition characteristics, 67
recommended nutrition standards, 7–8, 129–130
sodium content, 8, 130
sugar standards, 6
Socioeconomic status
dental disease and, 37
dietary intake and, 68–69
stigmatization of school lunch programs, 107
Sodium, 44–45
Alliance for a Healthier Generation guidelines, 260
associated health risks, 7, 130
recommended nutrition standards, 7–8, 130
South Carolina, 240–241
South Dakota, 240–241
Sports drinks, 10–11, 135
State and local governments
administration of school meals programs, 77
current school nutrition standards, 183–255
federal wellness program mandates, 1
implementation of recommended nutrition standards, 12–13, 24–25, 138
monitoring outcomes of nutrition standards, 145
physical education requirements, 88
regulation of competitive foods and beverages, 109–112
school funding, 75
school governance structure, 74–75
school nutrition program administration, 75–76
vending machine regulation, 83–84
See also specific states
Sugar
dental health and, 37–38
dietary guidelines, 58
intake patterns, 58
low nutrient density foods, 62
measurement in foods, 59
product labeling, 127, 128
rationale for reduced intake, 6, 127
recommended nutrition standards, 6–7, 127–129
sources, 58–59
sweetened beverages, 59–61, 127–128
See also Sweeteners, nonnutritive
Sweeteners, nonnutritive
concerns, 45, 130
to increase consumption of healthful foods, 9, 133
nutrient displacement, 8, 9, 48, 131–132
purpose, 45
recommendations, 8–9, 130–133
research needs, 133
safety, 8, 9, 45–48, 131, 133
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sources, 45
weight control and, 8, 9, 48–50, 131, 132, 133
Syndrome X, 34–35
T
Taxes, school system funding, 75
Tennessee, 242–243
Texas, 244–249
Tier 1 foods and beverages
definition, 3, 119, 124, 134
recommendations for after-school availability, 11–12, 134, 136–137
recommendations for school day availability, 10, 136
types of, 120–123
Tier 2 foods and beverages
definition, 3–4, 119, 124
recommendations for after-school availability, 11–12
recommendations for nonnutritive components, 8
recommendations for school day availability, 11
Trans fat, 62
recommended nutrition standards, 4, 126
U
Utah, 248–249
V
Vegetables
current consumption patterns, 53
sugar content, 6, 128
Tier 1 foods, 121–122
Vending machines
contents, 83
exterior design, 11, 136
prevalence, 23, 79–80, 83, 97
regulation, 83–84
trends, 97
See also Competitive foods and beverages in schools
Vermont, 250–251
Virginia, 250–251
Vitamin A, 42
Vitamin C, 42
Vitamin D, 36
Vitamin E, 42
W
Washington, 252–253
Water, recommendations for availability and access, 10, 135
Wellness programs
after-school activities and, 84
coordination of health-related programs, 87
current state, 1, 87, 108
federal mandate, 1, 16–19, 87, 108
implementation of nutrition standards in, 146
nutrition education, 89–91
research goals, 1–2
West Virginia, 252–253
Whole-grain foods, 53–55, 121–122
WIC Reauthorization Act, 108
Wisconsin, 252–253
Wyoming, 254–255
Y
Youth Risk Behavior Surveillance System, 148
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