More than 55 million children and teenagers attend the nation’s 105,000 schools and consume 35% to 40% of their daily energy in those schools. Nutrition in schools represents not only the foods and beverages associated with the formal meal programs, but also products sold in competition to those meal programs as well as the wide variety of foods brought into the school by students, parents, teachers and other staff.

Food and beverages are available to students in schools through 3 venues:

  1. The School Breakfast, National School Lunch, and After-School Programs, sponsored by the US Department of Agriculture (USDA)

    School meal programs have a profound effect on the diet quality of the nation’s children, in particular children at risk for food insecurity. Participating schools serve more than 30 million lunches and 11 million breakfasts per day. The school meal programs are generally operated by public or non-profit private schools of high school grade or lower. Participating school districts and independent schools receive cash subsidies and USDA Foods for each reimbursable meal they serve. School food authorities can also be reimbursed for snacks served to children who participate in approved after school programs.

    Nutritional targets for all school meal programs are based on the Dietary Guidelines for Americans (DGAs). DGAs stress energy balance and nutrient density within a student’s diet.

  1. Competitive items sold outside of the USDA school meals
    Competitive foods sold in vending machines and a la carte lines represent a far less nutritious option that the USDA-sponsored school meals. The new federal nutritional standards for competitive foods sold in schools, titled “Smart Snacks in School,” were proposed in February 2013 and adopted in June 2013. These standards were implemented in 2014. Under the new standards, foods sold in schools must have a fruit, a vegetable, a dairy product, or a protein food as its first ingredient; be a whole grain-rich product; be a “combination food” containing at least one-quarter cup fruit or vegetable; or contain 10% of the Daily Value of a nutrient of concern occurring naturally.

  2. Informal Sources of Food and Beverages (packed meals or snacks, in-class parties, rewards, sporting events, and other such occasions)
    The third source of foods consumed in school, brought in for many different reasons by many different individuals, is unregulated. Packed lunches and snacks, bake sales and booster sales, fundraisers, and class birthdays and holiday parties traditionally feature candy, sweet or fried desserts, chips, and other snack-type foods and sweetened beverages. Informal sources of food and beverages represent an opportunity for pediatricians to join with parents and students, as well as other advocates for child nutrition, to raise awareness of the importance of nutritional choices for children and adolescents.

Registered dieticians, school nurses, and school food service directors are natural collaborators with whom pediatricians can work in advancing a unified perspective on increasing nutrient density while limiting caloric excess. Often, all 4 professional groups can be represented on a school district’s wellness council.

Pediatricians can influence nutritional quality in schools directly through participation as:

  • Parents
  • Members of the school’s wellness council
  • Consultants
  • Sports team physicians
  • Members of the school board
  • Community advocates for child nutrition
  • Through the AAP or their state chapters
  • Encouraging local schools to achieve national or state recognition for their wellness efforts

AAP Policy Statement

Snacks, Sweetened Beverages, Added Sugars, and Schools
This policy statement from the Council on School Health & Committee on Nutrition discusses how pediatricians can offer a perspective promoting nutrient-rich foods within calorie guidelines to improve foods brought into or sold in schools.

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Additional Resources

AAP’s Institute for Healthy Childhood Weight
The Institute for Healthy Childhood Weight serves as a translational engine for pediatric obesity prevention, assessment, management and treatment; and moves policy and research from theory into practice in American healthcare, communities and homes.

CDC Healthy Schools: School Nutrition
The CDC recommends that schools implement policies and practices to create a nutrition environment that supports students in making healthy choices.

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American Academy of Pediatrics