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Promoting Healthier School Lunch Options Reduces Obesity Risk

students eating lunch in school cafeteria
A new study indicates legislation has strengthened nutrition standards.

 JGI/Tom Grill/Getty Images

Key Takeaways

  • A major new study indicates how the Healthy, Hunger-Free Kids Act of 2010 has strengthened nutrition standards for 50 million children.
  • The Act has not lowered childhood obesity trends overall, but has had an impact on obesity risk for children in poverty.
  • Other efforts aimed at reducing obesity in the U.S. in general are likely to also show benefits for kids.

The Healthy, Hunger-Free Kids Act of 2010 (HHFKA) was a major piece of legislation designed to strengthen nutrition standards for meals and beverages provided through the national school lunch and breakfast program, which affects 50 million U.S. children every school day at 99,000 schools. Some of the most significant requirements of the program were based on dietary goals like the following:

  • Increased availability of fruits, vegetables, whole grains, and low-fat milk
  • Reduced levels of sodium
  • Reduced levels of saturated fat and trans fat
  • Meeting nutritional needs within children's calorie requirements

A recent, important study indicates that a decade later, it's having a profound effect on lowering childhood obesity risk in certain populations.

Researchers looked at data from the National Survey of Children's Health for a 15-year time period, on over 173,000 children. Since that time frame includes results from before and after the legislation, they were able to see the potential effects of the program on childhood obesity trends.

They found no significant association between HHFKA and lowered obesity overall, but one finding stood out: For children in poverty, the risk of obesity has declined by 47 percent.

Considering that 18 percent of U.S. children meet the definition of obese, this is a promising conclusion, particularly since obesity in childhood has been linked to chronic disease later in life.

Childhood Obesity Factors

As a public health issue, childhood obesity is especially problematic because of so many confounding variables, according to Erica Kenney, ScD, MPH, in the Department of Nutrition at the Harvard T.H. Chan School of Public Health, lead author on the recent study.

Some of the reasons children gain more weight than they should, and then maintain or increase that weight into their teens and beyond can include:

  • Genetics
  • Home environment and parental/family eating habits
  • Ubiquity of fast food
  • Social cues to "treat" children with sugary options
  • Metabolism changes
  • Sleep issues
  • Childhood trauma
  • Lower income geography issues like food deserts and food swamps
  • Chronic health conditions
  • Stigma and bullying
  • Social and cultural cues
  • Sedentary behavior and/or lack of exercise opportunity
  • Lack of green space and playgrounds
  • Legislation at the federal, state, and local level

Those are just the top issues, Kenney says. Factors like these also drive adult obesity, but children lack the ability to choose their own food, she adds, which means they're expected to eat what's provided. Especially troubling is that once a child is dealing with obesity, it becomes very difficult to change that situation.

“Like any chronic disease, prevention is easier than treatment, and that's very true with childhood obesity,” says Kenney. “There's significant evidence that once obesity takes hold in the body, it’s hard to reverse. Once you’re a certain size, the body doesn’t like to let go of that.”

Steps Forward

In addition to the positive findings of the recent obesity trends study, there are some other indications of progress.

For example, one big step forward is in the drive to tax sugary beverages, says Christina Roberto, PhD, assistant professor of medical ethics and health policy at the Perelman School of Medicine at University of Pennsylvania. She and her colleagues found that after Philadelphia put a tax in place on sweetened beverages, there was a 38 percent drop in sales.

Better food labeling and consumer awareness is likely to pay off as well. A recent analysis of 23 studies on warning labels, presented at a virtual meeting of the American Society for Nutrition, found that warning labels led to notable reductions in sugary drink purchases.

Just like putting a significant tax on sodas and other sugar-laden beverages and including warning labels could shift consumption habits, adding calorie counts to menus may have major health benefits by causing consumers to switch to healthy choices as well, recent research suggests.

A study just published in Circulation suggests that government mandates to include calorie counts on menu items may save thousands of lives, and prevent tens of thousands of new cases of heart disease and type 2 diabetes. Those researchers estimate that because of reduced incidence of excess weight, the law could have these effects by 2023:

  • Prevent 14,698 new cases of heart disease
  • Prevent 21,522 new type 2 diabetes cases
  • Add 8,749 years of life in good health

Efforts like healthier school lunches, sugary drink taxes, and menu labeling could all combine to have a beneficial effect because they're changing not just what kids eat in school, but also family eating habits, says Roberto.

"Childhood obesity is a societal issue, but so is adult obesity," she notes. "If we're going to take on this challenge, it will have to be an approach that works on numerous levels."

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  1. Erica L. Kenney, Jessica L. Barrett, Sara N. Bleich, Zachary J. Ward, Angie L. Cradock, and Steven L. Gortmaker, Impact Of The Healthy, Hunger-Free Kids Act On Obesity Trends Health Affairs 2020 39:7, 1122-1129. doi:10.1377/hlthaff.2020.00133

  2. American Society for Nutrition. Nutrition Live Online 2020. https://meeting.nutrition.org/

  3. Liu, J., et al. Health and Economic Impacts of the National Menu Calorie Labeling Law in the United States. Circulation. Published June 4, 2020. doi: 10.1161/CIRCOUTCOMES.119.006313