Journal Issue: Children and Poverty Volume 7 Number 2 Summer/Fall 1997
The School Nutrition Programs
The National School Lunch Program (NSLP) and the School Breakfast Program (SBP) are federally sponsored nutrition programs operating daily in the nation's schools. All public and private nonprofit elementary and secondary schools are eligible to participate. The two programs make a substantial contribution to what children eat and represent a large investment of federal dollars.
The NSLP was largely a response to the discovery during World War II that many young men from poor families were denied admittance to the armed forces because of physical conditions associated with poor nutrition. The NSLP was created in 1946 to provide nutritious foods, either free or at low cost, to children during the critical school-age years. Currently, the NSLP provides financial assistance and commodities to schools whose lunches meet required nutritional standards.
In 1966, Congress established the SBP as a pilot program to provide funding for breakfast in "poor areas and areas where children had to travel a great distance to school." It was largely a response to observations that many children came to school without eating breakfast and to concerns that skipping breakfast impeded school performance. The 1975 amendments to the Child Nutrition Act made the SBP a permanent program.
The federal government subsidizes all school lunches and breakfasts served to children. Children receive free, reduced-price, or "full-price" meals, depending on their family's size and income. Even full-price lunches are federally subsidized. Thus, unlike the other programs discussed in this article, benefits from the NSLP and SBP are available to all school children, regardless of family income, although low-income children have greater financial incentives to participate.
NSLP lunches are planned to provide approximately one-third of the RDA for specific nutrients over some unspecified period of time. Lunch must include five items: meat or meat alternate, two or more vegetables and/or fruits, whole-grain or enriched bread or bread alternate, and fluid milk. SBP breakfasts are supposed to provide approximately one-fourth of the RDA, and each breakfast must include a serving of fluid milk, a serving of either fruit or vegetable or a full-strength fruit or vegetable juice, and two servings of either bread or meat or their alternates. In addition, recent legislation mandated that schools participating in the NSLP and SBP meet the goals in the Dietary Guidelines for Americans for lower fat content in school meals by the 1996–97 school year.23
The most recent evidence concerning the effectiveness of the two school nutrition programs comes from the School Nutrition Dietary Assessment (SNDA) study, conducted between February and May 1992.24 This study determined the dietary effects of program participation by collecting data from a nationally representative sample of schools and a nationally representative sample of students attending these schools. The SNDA study used a comparison group methodology, where selection bias and traditional statistical models provided information about the dietary effects of program participation. Unless otherwise noted, the review below presents findings from the SNDA study.Program Coverage
Almost all public schools participate in the NSLP. The NSLP is available to 92% of all students in the country, and on a typical school day, 56% of those students to whom school lunches are available participate. Participation in the school nutrition programs depends on family income. Almost 80% of students certified for free meals (family income is less than or equal to 135% of poverty) eat a school lunch, 71% of students certified for reduced-price meals (family income between 135% and 185% of poverty) participate, while only 45% of students paying full price participate. In contrast to the NSLP, the SBP is available only to slightly more than half of the nation's students, and just less than 20% of those to whom it is available participate. The SBP is more prevalent in schools that serve a larger proportion of low-income children than the national average. About 47% of NSLP lunches and more than 85% of SBP breakfasts are served to children whose family incomes are below 185% of the poverty level. Reasons for not eating either NSLP lunches or SBP breakfasts include disliking the foods served and stigma associated with free or reduced-price program participation.Achievement of Program Goals
The bulk of the research regarding the effectiveness of the NSLP and SBP focuses on the dietary effects of program participation. In general, the NSLP and SBP are successful at achieving the basic dietary objectives of providing one-third of the RDA for lunch and one-fourth of the RDA for breakfast. The School Nutrition Dietary Assessment study findings indicate that NSLP is associated with increased intakes of some, but not all, dietary components. There is some evidence, however, that NSLP participants are a self-selected group of students who differ from other comparable students in either food preferences, needs, or appetites. After controlling for this bias, the findings show no significant difference in the intakes of calories, cholesterol, iron, and sodium among NSLP participants relative to nonparticipants. Relative to nonparticipants who eat lunch, NSLP participants do have statistically significant higher lunch intakes of vitamin A, calcium, magnesium, and zinc, and have statistically significant lower intakes of vitamin C (although their lunchtime intakes of vitamin C average 60% of the RDA).
Compared with nonparticipants who eat breakfast, SBP participants have higher breakfast intakes of calories, protein, calcium, and magnesium. In contrast to the NSLP, there is no evidence that the self-selection of SBP participants affects the estimated dietary effects of SBP participation.
The dietary intake findings suggest that both the NSLP and SBP are fairly successful at achieving their meal-specific RDA goals. School meals, however, are not successful at conforming to the Dietary Guidelines for Americans,23 which include both broad recommendations for healthy diets and specific quantitative goals regarding total fat and saturated fat intakes. For NSLP lunches, the levels of fat and saturated fat exceed the Dietary Guidelines. SBP breakfasts are actually close to meeting the Dietary Guidelines for total fat but not for saturated fat. It is important to note, however, that until recently (in fact, until the findings from the SNDA study were published), meeting the Dietary Guidelines was not an objective of the school nutrition programs.
The SBP does not apparently achieve one of its primary goals of providing a breakfast to students who otherwise would not eat one. In 1992, on a typical school day, approximately 12% of students did not eat breakfast. This percentage was the same for students in schools that participated in the SBP and for students in schools that did not, even after controlling for other demographic and socioeconomic student characteristics. This finding also persisted when the sample was restricted to students from low-income households. In addition, since the NSLP is almost universally available, it is difficult to determine whether it increases the likelihood of eating lunch. Although the school nutrition programs were created in response to the evidence that inadequate nutrition was impeding poor children's healthy development, there have been few well-controlled studies of whether the school nutrition programs substantially improve health outcomes or reduce hunger among children.
Limited evidence concerning the effects of the SBP on school performance comes from a "natural experiment" study conducted in 1986–87 in Lawrence, Massachusetts.25
Using a pre/post study design, which compared changes in test results for SBP participants with changes in test results for nonparticipants, researchers found that SBP participation was associated with increases in total test scores and reductions in tardiness and absences. The positive effects were small, but the SBP had only been in place three to four months at the time of the study. While these results suggest positive program effects, especially in low-income school districts such as Lawrence, the study was very limited in duration and has not been replicated on a larger scale.