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Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions
Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions
Virginia A. Stallings and Christine L. Taylor, Editors
Committee on Nutrition Standards for National School Lunch and Breakfast Programs
Food and Nutrition Board
INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu
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Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions
THE NATIONAL ACADEMIES PRESS
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This study was supported by Contract No. AG-3198-C-08-0001 between the National Academy of Sciences and the U.S. Department of Agriculture. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
International Standard Book Number-13: 978-0-309-12795-0
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Additional copies of this report are available from the
National Academies Press,
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Copyright 2008 by the National Academy of Sciences. All rights reserved.
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Suggested citation: IOM (Institute of Medicine). 2008. Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Washington, DC: The National Academies Press.
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Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
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Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
www.national-academies.org
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Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions
COMMITTEE ON NUTRITION STANDARDS FOR NATIONAL SCHOOL LUNCH AND BREAKFAST PROGRAMS
VIRGINIA A. STALLINGS (Chair),
The Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia
KAREN WEBER CULLEN,
Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX
ROSEMARY DEDERICHS,
Minneapolis Public Schools, Special School District No. 1, Minneapolis, MN
MARY KAY FOX,
Mathematica Policy Research, Inc., Cambridge, MA
LISA HARNACK,
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
GAIL HARRISON,
School of Public Health, Center for Health Policy Research, University of California, Los Angeles
MARY ARLINDA HILL,
Jackson Public Schools, Jackson, MS
HELEN H. JENSEN,
Department of Economics, Iowa State University, Ames
RONALD E. KLEINMAN,
Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA
GEORGE P. McCABE,
College of Science, Purdue University, West Lafayette, IN
SUZANNE P. MURPHY,
Cancer Research Center of Hawaii, University of Hawaii, Honolulu
ANGELA ODOMS-YOUNG,
Department of Kinesiology and Nutrition, University of Illinois at Chicago
YEONHWA PARK,
Department of Food Science, University of Massachusetts, Amherst
MARY JO TUCKWELL,
inTEAM Associates, Eau Claire, WI
Study Staff
CHRISTINE TAYLOR, Study Director
SHEILA MOATS, Associate Program Officer
JULIA HOGLUND, Research Associate
SANDRA AMAMOO-KAKRA, Program Associate (until August 2008)
HEATHER BREINER, Program Associate (from August 2008)
CAROL WEST SUITOR, Consultant Writer
LINDA D. MEYERS, Food and Nutrition Board Director
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Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions
FOOD AND NUTRITION BOARD*
DENNIS M. BIER (Chair),
Children’s Nutrition Research Center, Houston, TX
MICHAEL P. DOYLE (Vice Chair),
Center for Food Safety, University of Georgia, Griffin
DIANE BIRT,
Department of Food Science and Human Nutrition, Iowa State University, Ames
YVONNE BRONNER,
School of Public Health and Policy, Morgan State University, Baltimore, MD
FERGUS M. CLYDESDALE,
Department of Food Science, University of Massachusetts, Amherst
RICHARD J. DECKELBAUM,
Institute of Human Nutrition, Columbia University, New York, NY
GORDON L. JENSEN,
Department of Nutritional Sciences, Pennsylvania State University, University Park
REYNALDO MARTORELL,
Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
SUSAN T. MAYNE,
Division of Chronic Disease Epidemiology, Yale University School of Medicine, New Haven, CT
SANFORD A. MILLER,
Center for Food, Nutrition, and Agriculture Policy, University of Maryland, College Park
J. GLENN MORRIS, JR.,
Emerging Pathogens Institute, University of Florida, Gainesville
SUZANNE P. MURPHY,
Cancer Research Center of Hawaii, University of Hawaii, Honolulu
JOSE M. ORDOVAS,
Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA
MARTIN A. PHILBERT,
School of Public Health, University of Michigan, Ann Arbor
JIM E. RIVIERE,
Center for Chemical Toxicology Research and Pharmacokinetics, North Carolina State University, Raleigh
PATRICK J. STOVER,
Division of Nutritional Sciences, Cornell University, Ithaca, NY
WALTER C. WILLETT,
Department of Nutrition, Harvard School of Public Health, Harvard University, Boston, MA
Staff
LINDA D. MEYERS, Director
GERALDINE KENNEDO, Administrative Assistant
ANTON L. BANDY, Financial Associate
*
IOM Boards do not review or approve individual reports and are not asked to endorse conclusions and recommendations. The responsibility for the content of the report rests with the authoring committee and the institution.
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Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions
Reviewers
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
George H. Beaton, Department of Nutritional Sciences, University of Toronto
Marilyn Briggs, Center for Integrative Nutrition Environments in School Communities, Department of Nutrition, University of California, Davis
Roger Clemens, University of Southern California School of Pharmacy
Barbara L. Devaney, Human Services Research, Mathematica Policy Research, Inc.
Jean Harris, Government Relations, Pierre Foods
Penny E. McConnell, Food and Nutrition Services, Fairfax County Public Schools, Fairfax, VA
Rodolfo M. Nayga, Jr., Department of Agricultural Economics, Texas A&M University
Barry Sackin, B. Sackin & Associates, L.L.C., Alexandria, VA
Sandra Schlicker, Wellness and Nutrition Services, Office of the State Superintendent of Education, Government of the District of Columbia
Frances H. Seligson, Nutrition Consultant, Hershey, PA
Walter Willett, Department of Nutrition, Harvard School of Public Health
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Elaine L. Larson, School of Nursing, Columbia University, and Johanna T. Dwyer, Tufts University School of Medicine & Friedman School of Nutrition Science & Policy, Frances Stern Nutrition Center, Tufts-New England Medical Center. Appointed by the National Research Council and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
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Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions
Contents
Summary
1
Chapter 1
Introduction
15
Overview: Programs and Participants,
16
Why Is There a Need for Updating and Revisions?,
24
The Committee’s Task,
28
Relevant Findings from Large-Scale Evaluations of School Meal Programs,
30
Implications,
33
Chapter 2
The Nutrition Standards and Meal Requirements: Description and Topics Relevant to Their Revision
35
Current Nutrition Standards and Meal Requirements,
35
Topics Relevant to Revising the Nutrition Standards and Meal Requirements,
47
Summary,
54
Chapter 3
Working Principles and Criteria for the Committee’s Approach to Proposing Revisions
55
Working Principles,
55
Criteria,
57
Overview of the Committee’s Proposed Approach to Developing Recommendations,
59
Chapter 4
Food and Nutrient Needs of Schoolchildren
61
Data Sources,
61
Data Limitations,
63
Assessment of Food Intakes,
65
Assessment of Nutrient Intakes,
72
Summary and Conclusions,
86
Chapter 5
Proposed Planning Model for Establishing Nutrition Standards for School Meals
89
Setting Nutrient Intake Targets for School Meals,
91
Setting Food Intake Targets for School Meals,
101
Summary: Combining the Nutrient Intake and Food Intake Targets,
103
Chapter 6
Proposed Phase II Analyses: Sensitivity Analysis, Cost Implications, and Market Effects
105
Sensitivity Analysis,
105
Addressing Cost Implications,
106
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Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions
Estimation of Market Effects,
112
Summary,
113
Chapter 7
References
115
Appendixes
A
Acronyms, Abbreviations, and Glossary
125
B
A Selection of Laws and Regulations Governing the National School Lunch Program and School Breakfast Program
131
C
Comparison of 1995 and 2005 Dietary Guidelines for Americans
135
D
July 2008 Workshop Agenda
139
E
Critical Issues for Consideration by the Committee
143
F
Selected Evaluations of School Meal Programs
149
G
Current Standards for Food-Based Menu Planning Approach
153
H
Current Standards for Nutrient-Based Menu Planning Approach
159
I
Data Sources and Study Methodology: SNDA-III and 2008 Diet Quality Report
161
J
MyPyramid Calorie Levels and Food Intake Patterns
165
K
Dietary Reference Intakes for Individuals Ages 4 Through 18 Years, Including Those Who Are Pregnant or Lactating
167
L
MyPyramid Food Intake Pattern Compared with Meal Requirements for the NSLP
175
M
Estimation of Cost of Food for One Week’s Menu: Example for Elementary School Level
177
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Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions
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