Summary
Recent trends in children's health and eating habits are alarming. Over 15 percent of children are overweight--double the rate in 1980. Children's diets are high in fat but low in fruits, vegetables, and other nutritious foods. The National School Lunch Program has had a continuing role in providing students with nutritious meals. However, serving the meals is only the first step. Students must choose to eat the nutritious food and limit the less healthful choices. GAO was asked to report on the extent to which school lunches, nationwide, were meeting nutrition standards, and schools were encouraging healthy eating, what barriers selected schools faced in accomplishing this, and what innovative steps they had taken to overcome the barriers.
Schools are moving toward meeting school lunch nutrition requirements, but more improvements are needed. According to national studies, lunches meet requirements for nutrients such as protein, vitamins, calcium, and iron, but do not meet the required 30 percent limit for calories from fat. Also, efforts to encourage healthy eating could be increased. Students may need more exposure to nutrition education to effect positive changes in their behavior, and most students have access to foods of little nutritional value, such as soft drinks and candy, at school. In schools we visited, barriers to providing nutritious meals and encouraging healthy eating included budget pressures and competing time demands. Regarding providing nutritious food, officials said when they introduce healthier foods, they take the risk that students will buy fewer school lunches resulting in loss of needed revenue. Regarding encouraging healthy eating, officials said the focus on meeting state academic standards limited time to teach nutrition. Also, schools paid for special activities or other items not covered in the school's budget with profits from vending machines and snack bar sales. Schools had taken a variety of innovative steps to overcome barriers. With respect to providing nutritious food, while minimizing the risk students might reject healthier choices, schools modified recipes to lower the fat content of popular foods such as pizza and conducted taste tests before adding healthier choices. To encourage healthy eating, schools found time to teach nutrition by integrating nutrition lessons into reading and math classes, and some established school food policies to restrict unhealthy choices. Some schools enlisted help from parents, community organizations, and businesses. Officials noted that overcoming barriers required strong and persevering leadership.
Recommendations
Our recommendations from this work are listed below with a Contact for more information. Status will change
from "In process" to "Implemented" or "Not implemented" based on our follow up work.
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Recommendations for Executive Action
Recommendation: The Secretaries of Agriculture, Health and Human Services, and Education should use their recently signed memorandum of understanding as a vehicle to identify specific strategies and develop materials to help schools promote nutrition education while still meeting the requirements of state academic standards.
Agency Affected: Department of Agriculture
Status: Implemented
Comments: In September 2005, the U.S. Department of Agriculture's (USDA) Team Nutrition released "My Pyramid for Kids," a child-friendly adaptation of the My Pyramid food guidance system, which includes classroom materials. The purpose of these materials is to introduce children to the My Pyramid for Kids concept and teach them healthy eating and physical activity messages. Lesson plans are available for grades 1-2, 3-4, and 5-6. These materials will be used for the next few years by classroom teachers and community educators. In addition, USDA's Team Nutrition has worked with the Department of Health and Human Services and the Department of Education to develop an activities agenda for the existing Memorandum of Understanding (MOU). This agenda outlines the role for each Department involved in the MOU, and as a part of the agenda, all three departments coordinated and sponsored nationwide physical activity and nutrition events held in the fall of 2006. "Game On! The Ultimate Wellness Challenge," was an all-inclusive, fun event for students, parents, teachers, administrators, and others to celebrate going back-to-school. The three departments recruited schools to be involved in the event, with the goal of at least two schools per state. Some states had signed up ten or more schools. Each site received a toolkit, enabling them to conduct a successful event, and there was also a national event on the Washington Mall on October 5, 2006. All of the events aimed to promote nutrition education while still meeting the requirements of state academic standards.
Agency Affected: Department of Education
Status: Implemented
Comments: The Departments of Education, Agriculture, and Health and Human Services have worked together to develop an activities agenda for the existing Memorandum of Understanding (MOU). This agenda outlines the role for each Department involved in the MOU, and as a part of the agenda, all three departments coordinated and sponsored nation-wide physical activity and nutrition events held in the fall of 2006. "Game On! The Ultimate Wellness Challenge," was an all-inclusive, fun event for students, parents, teachers, administrators and others to celebrate going back-to-school. The three departments recruited schools to be involved in the event, with the goal of at least two schools per state. Some states had signed up ten or more schools. Each site received a toolkit, enabling them to conduct a successful event. There was also a national event held in Washington, D.C. on October 5, 2006. All of the events had the goal of promoting nutrition education while still meeting the requirements of state academic standards.
Agency Affected: Department of Health and Human Services
Status: Implemented
Comments: The Departments of Education, Agriculture, and Health and Human Services have worked together to develop an activities agenda for the existing Memorandum of Understanding (MOU). This agenda outlines the role for each Department involved in the MOU, and as a part of the agenda, all three departments coordinated and sponsored nation-wide physical activity and nutrition events held in the fall of 2006. "Game On! The Ultimate Wellness Challenge," was an all-inclusive, fun event for students, parents, teachers, administrators and others to celebrate going back-to-school. The three departments recruited schools to be involved in the event, with the goal of at least two schools per state. Some states had signed up ten or more schools. Each site received a toolkit, enabling them to conduct a successful event. There was also a national event on the Washington Mall on October 5, 2006. All of the events had the goal of promoting nutrition education while still meeting the requirements of state academic standards.
Recommendation: The Secretaries of Agriculture, Health and Human Services, and Education should use their recently signed memorandum of understanding as a vehicle to encourage states to identify a focal point in each state to promote collaborative efforts that would further develop nutrition education activities for the schools.
Agency Affected: Department of Agriculture
Status: Implemented
Comments: Since 1995, USDA's Team Nutrition has awarded about 20 grants per year to state agencies that administer the National School Lunch Program. The acceptance of a Team Nutrition grant requires the state to identify a focal point to achieve the Team Nutrition goal of improving children's lifelong eating and physical activity habits using the Dietary Guidelines for Americans and the new food guide. In addition to identifying a focal point, states that receive grants are strongly encouraged to collaborate with other state and local groups. However, these grants do not reach all states and are time-limited. On a wider scale, USDA assembled state-specific teams at its first national nutrition education conference in 2003, which included the various state agencies that administer USDA nutrition assistance programs. The teams were tasked with choosing team coordinators and identifying common goals to incorporate into a Nutrition Action Plan. Currently, all 50 states and the District of Columbia have selected a cross-program goal and many states have written specific objectives for achieving their goal. The second USDA national nutrition conference was held in September 2005, and highlighted the progress states have made on their action plans. USDA has encouraged and supported these state activities.
Agency Affected: Department of Education
Status: Implemented
Comments: The Departments of Education, Agriculture, and Health and Human Services have worked together to develop an activities agenda for the existing Memorandum of Understanding (MOU). This agenda outlines the role for each Department involved in the MOU, and as part of the agenda, all three departments coordinated and sponsored nation-wide physical activity and nutrition events in the fall of 2006. "Game On! The Ultimate Wellness Challenge," was an all-inclusive, fun event for students, parents, teachers, administrators and others to celebrate going back-to-school. The three departments collaborated with the nonprofit organization, Action for Healthy Kids, to organize and conduct nutrition and wellness related activities for schools across the country. Action for Healthy Kids assisted the departments by working with state contacts to plan 500 events in all 50 states for fall of the 2006-2007 school year. These state events culminated in a national wellness program event in Washington D.C. on October 5, 2006. Through the MOU and their collaborative partnership with Action for Healthy Kids, all three agencies worked in collaboration with the state teams to involve schools in these events and have laid a foundation for possible future endeavors.
Agency Affected: Department of Health and Human Services
Status: Implemented
Comments: The Departments of Education, Agriculture, and Health and Human Services have worked together to develop an activities agenda for the existing Memorandum of Understanding (MOU). This agenda outlines the role for each Department involved in the MOU, and as part of the agenda, all three departments coordinated and sponsored nation-wide physical activity and nutrition events in the fall of 2006. "Game On! The Ultimate Wellness Challenge," was an all-inclusive, fun event for students, parents, teachers, administrators and others to celebrate going back-to-school. The three departments collaborated with the nonprofit organization, Action for Healthy Kids, to organize and conduct nutrition and wellness related activities for schools across the country. Action for Healthy Kids assisted the departments by working with state contacts to plan 500 events in all 50 states for fall of the 2006-2007 school year. These state events culminated in a national wellness program event in Washington, D.C. on October 5, 2006. Through the MOU and their collaborative partnership with Action for Healthy Kids, all three agencies worked in collaboration with the state teams to involve schools in these events and have laid a foundation for possible future endeavors.
