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School Lunch: Is It Nutritious Enough for Our Children?

M. Susan Nason and Darla Stutzman
Ferris State University

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Abstract
Childhood obesity rates are climbing due to an increased consumption of foods with low
nutritional values. State and federal healthy school lunch programs are available and can provide
children with healthy food choices, along with the knowledge of the type of healthy foods that
are accessible. Parents, students, and school officials play a role in providing children with
healthy food choices. The nurses role is to teach children about the nutritional values of popular
products, and educate each child about the necessity for healthy eating habits in order to prevent
nutrition-related diseases.
Key words: School lunch program, nutrition, children, health

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School Lunch: Is It Nutritious Enough for Our Children?
Childhood obesity is one of the fastest rising epidemics in America today. The authors
wondered if the food offered in school lunches was nutritious enough for a generation of
Americans who are susceptible to obesity and nutrition-related health problems. Understanding
more fully the foods served to children in school cafeterias is crucial to determining the role that
schools play in the obesity epidemic and the opportunities for preventing escalating rates of
childhood obesity (Krukowski, Philyaw-Perez, Bursac, Goodell, et al., 2011, p. 431).
Professional nurses need to understand the impact school nutrition has on childhood obesity in
order to perform necessary education for health prevention and health promotion.
The Importance of Nutrition
Nutrition affects every childs life though the process of maintaining a healthy weight,
providing energy, and supporting growth. Learning healthy eating habits early in life can prevent
the development of diseases later in life. Gosliner, Madsen, Woodward-Lopez, and Crawford
(2011) state, In fact, unhealthy eating has been identified as the most prevalent chronic disease
risk behavior among 12 to 17 year-olds in the United States (p.146). Although parents play a
significant role in educating their child about healthy eating, many of their habits are learned at
school. Schools are therefore uniquely positioned to promote healthy eating behaviors and
attitudes toward food among the vast majority of American children (Bevans, Sanchez,
Teneralli, & Forrest, 2011, p. 424).
School lunch programs are regulated by federal and state policies, and many school
districts participate in the National School Lunch Program (NSLP). Bevans et al. (2011) cited,
Participating schools are required to serve lunches that provide at least one third of
childrens recommended daily food and nutrient intake, meet specific macronutrient and
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micronutrient requirements, and include a variety of meat/meat alternatives, whole
grains, fruits, vegetables, and low-fat dairy options. (p. 424)
When schools provide a more nutritious array of foods, it is found that there is an increase in
childrens consumption of healthier foods (Bevans et al., 2011). By providing healthier choices,
it is more likely that children will establish health-promoting eating habits, and therefore
decrease their chances of morbidity later in life.
Points of View
School lunch nutrition is approached from several points of view including the students,
the parents, and the school officials. Each point of view provides unique data about the efforts
and effectiveness of nutritious school lunches, and the meal options available for the children.
The one common theme among these points of view is that each role believes that schools could
do a better job of providing healthy lunches.
While parents and school officials play a large role in offering nutritious meals for
students, the ultimate choice is in the students hand. A previous study by Gosliner, et al. (2011)
states, Students report healthy foods to be important to be able to buy at school, but do not
perceive their school food environment to be healthy and consume more unhealthy foods at
school. Students served healthy items via school lunch are more likely to consume them;
however, they also purchase and consume unhealthy items if available (p. 149).
Parents play an essential role in shaping their childrens eating habits. By providing
healthy choices at home that are high in fiber and low in sugar, the child will learn to make
independent healthy choices (NIH, 2007). Many parents are concerned about the options
available for their children while at school. When researching, parents are often surprised by the
amount of low nutrient foods abundantly available in schools.
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While parents can affect school lunch choices, developing a healthy menu rests mainly
with the school officials. School officials know that providing healthier food choices impacts not
only the students who eat school meals but can encourage students around them to eat less
fattening choices, which can affect the health of all students for the rest of their lives. School
officials state, Students who reported eating school lunch had significantly higher consumption
of healthy items, such as green salad, other vegetables, fruit, milk, and fruit juice at school than
those who did not eat school meals (Gosliner et al., 2011, p. 146).
Purpose for Nursing
When it comes to nurses and their impact on nutritious school lunches, the most
important role the nurse can engage in is education. Although education is essentially the
teachers role, it is difficult for the educators to find time to teach nutrition and how it applies to
health. A CDC study found that most schools, at all grade levels, require some nutrition to be
taught, however, the median amount of time spent on nutrition education as part of schools
health education classes was 5 hours during the elementary years, 5 hours during the high school
years, and 4 hours during the middle school years (GAO, 2003, p. 12). School nurses are in the
optimal position to educate students about how increasing fruit and vegetable intake can affect
their health. Although schools are trying to follow federal regulations for school nutrition, there
is still a rise in childhood obesity rates. It is the school nurses job to perform periodic screening,
which includes height and weight, nutrition screening, and health education (Harkness &
DeMarco, 2011, p. 435). The nurse is able to not only educate the students but work as an
advocate to voice food preferences, which promotes independence in healthy nutrition choices.
Harkness and DeMarco (2011) states, Whether or not the school nurse is in the classroom,
health education is a priority. The school nurse must seek to accomplish health teaching in
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encounters with students and families, in the classroom, in individual counseling sessions, and in
group meetings (p. 439). School nurses have an influential job for children.
Data Interpretation
As researched by Bevans et al. (2011), About 94% of schools in the United States, both
private and public, participate in the NSLP (p. 424). The NSLP meal choices follow the
USDAs program, which include fresh fruits and vegetables, whole grains, and low-fat dairy
products. A study performed by Gosliner et al. (2011) found, Students who reported eating
school lunch had significantly higher consumption of healthy items, such as garden salad, other
vegetables, fruit, milk, and fruit juice at school than those who did not eat school meals (p.
149). Typically, children are more likely to choose junk food over a healthy food when placed
side by side. When schools educate students and provide nutritious food choices, it will help
develop healthy habits, such as choosing the healthy food versus the junk food.
Not surprisingly, the NSLP is a huge benefit for students from a lower socioeconomic
class. Children who are a lower income family are eligible for a free school lunch program,
which, in turn, will contribute to the childs physical health. Bhatia, Jones, and Reicker talk
about how children from low socioeconomic classes are more prone to diet-related diseases. This
is related to the fact that, In lower income households there may be less discretionary income
for healthy food options, less parental supervision of food behaviors, lower-quality neighborhood
food, and fewer physical activity resources (2011, p. 1384). Even though the children have
more choices, it is found that most often foods in the a` la carte lines have poor nutritional
values. Whereas, Bhatia et al. points out, The NSLP line might include 1 or 2 traditional meals
such as baked chicken with rice, salad, bread, fruit, and milk, the a` la carte offerings typically
would include varieties of pizza, hot and cold sandwiches, burritos, chow mein, hamburgers,
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bagels, diverse snacks, confections, and drinks (2011, p. 1381). Although the NSLP provides
healthy food choices, the a` la carte items are interfering with a childs ability to make the right
decisions and thus learn healthy eating habits.
Outcomes
Schools that develop healthy lunches can facilitate a significant change in childhood
obesity rates. As stated by Gosliner et al. (2011) Restructuring school food environments to
facilitate access to fresh, healthy foods and limit access to unhealthy foods by making healthy
choices the easy choices may improve students diets and may also conform to students stated
desires (p. 149). The changes in school lunch programs will provide children with new
knowledge to develop better eating habits, inspire physical activity, and decrease body weight.
The school will indirectly inspire children who eat bag lunches to bring lunches from home
which hold a higher nutritional value. Thus, schools should work to shape the food environment
to help facilitate students consumption of healthier items, and to help students resist consuming
less healthy items by reducing the number of cues and opportunities to eat unhealthy items.
(Gosliner et al, 2011, p.150).
Conclusion
We must continue to examine the federal, state, and local food systems and policies that
currently shape school food environments. Nurses can provide a unique investment in this issue
in that the health of our countrys children currently rests solidly on the shoulders of parents and
schools. Childhood obesity rates are raising alarming fast, and school lunches can help to achieve
a solution by educating children about healthier choices and teaching them healthy eating habits
that will last a lifetime.
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References
Bevans, K., B., Sanchez, B., Teneralli, R., & Forrest, C.B. (2011). Childrens Eating Behavior:
The importance of nutrition standards for foods in schools. Journal of School Health,
81(7), 424-429.
Bhatia, R., Jones, P., & Reicker, Z. (2011). Competitive foods discrimination and participation in
the national school lunch program. American Journal of Public Health, 101(8), 1380
1386. doi:10.2105/AJPH. 2011.300134
Gosliner, W., Madsen, K., Woodward-Lopez, G., & Crawford, P. B. (2011). Would students
prefer to eat healthier foods at school? Journal of School Health, 81(3), 146-151.
Harkness, G.A. & DeMarco, R.F. (2011). Community and Public Health Nursing: Evidence for
Practice. Philadelphia, PA: Wolters Kluwer/ Lippincott, Williams & Wilkins.
Krukowski, R.A., Philyaw-Perez, A.G., Bursac, Z., Goodell, M., Raczynski, J.M., Smith-West,
D., & Phillips, M.M. (2011). Development and evaluation of the School Cafeteria
Nutrition Assessment measures. Journal of School Health, 81(8), 431-436.
National Institutes of Health (2007). Helping Your Child: Tips for Parents. Retrieved October
27, 2011, from http://win.niddk.nih.gov/publications/child.htm#howwill
United States General Accounting Office (2003). School Lunch Program: Efforts Needed to
Improve Nutrition and Encourage Healthy Eating. Retrieved October 29, 2011, from
http://www.gao.gov/new.items/d03506.pdf