Not Applicable

Associations among Food Security, School Meal Participation, and Students’ Diet Quality in the First School Nutrition and Meal Cost Study

Authors:

  • Sarah Forrestal

  • Elizabeth Potamites

  • Joanne Guthrie

  • Nora Paxton

Citation

Forrestal, S.; Potamites, E.; Guthrie, J.; Paxton, N. (2021). Associations among Food Security, School Meal Participation, and Students’ Diet Quality in the First School Nutrition and Meal Cost Study. Nutrients, 13, 307. https://doi.org/10.3390/nu13020307

Academic Editor

Sebastian Schmid

Article History

  • Received: 19 November 2020

  • Accepted: 18 January 2021

  • Published: 22 January 2021

Publisher’s Note

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Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Correspondence: sforrestal@mathematica-mpr.com

Abstract

  • The Healthy, Hunger-Free Kids Act of 2010 updated nutrition standards in National School Lunch and Breakfast Programs (NSLP and SBP) and expanded universal free meals in low-income schools.

  • School meals serve as critical resources for children in food-insecure households.

  • Analysis utilized data from the School Nutrition and Meal Cost Study to classify students as food insecure (FI), marginally secure (MS), or food secure (FS).

  • Diet quality was assessed with Healthy Eating Index (HEI)-2010 scores.

  • Statistical tests (Chi-squared and two-tailed t-tests) compared participation in meals, energy intakes, and diet quality among food security categories.

  • Findings:

    • FI and MS students participated in NSLP significantly more than FS students (79%, 71%, 49% respectively).

    • SBP participation trends similarly but is generally lower (38% FI, 33% MS, 16% FS).

    • School meals contribute more energy to FI and MS diets (22%, 20%, 13% respectively) than to FS students.

    • School food dietary intakes outperformed non-school food intakes in quality across all groups.

  • Keywords: food security, NSLP, SBP, free and reduced-price lunch, energy intakes, HEI, school-age children, School Nutrition and Meal Cost Study.

1. Introduction

  • The USDA’s NSLP and SBP are key elements of the food assistance and nutrition safety net for children in the U.S.

  • Participating schools provide meals that comply with federal nutrition standards and receive USDA reimbursals based on family income.

  • Free meals are provided to children in families earning ≤130% of the federal poverty guidelines, and reduced-price meals are for families earning between 130% and 185%.

  • Schools certified for FRP meals through applications or direct certifications from federal assistance program participation.

  • In 2019:

    • NSLP served 29.4 million children on typical school days.

    • SBP served nearly 15 million.

    • 74% of lunches and 85% of breakfasts were FRP meals for low-income students.

  • Healthy, Hunger-Free Kids Act (HHFKA) of 2010:

    • Updated nutrition standards to align with dietary guidance, including calorie restrictions, whole-grain foods, more vegetables (dark green/red/orange varieties and legumes), increased fruits, and low-fat or nonfat milk.

    • Implementation started in 2012-2013 school year.

    • Established the Community Eligibility Provision (CEP) promoting universal free meals in schools with low-income populations, implemented fully by SY 2014-2015.

    • Allowed for afterschool supper provisions in low-income areas.

Definitions

  • Food Security: Defined as access to sufficient food for an active and healthy life at all times.

  • Households that cannot secure adequate food due to financial constraints are termed Food Insecure.

  • For 2019, 14% of households with children were food insecure.

  • Children in food-insecure households face numerous potential health issues and educational challenges, including chronic health issues, hospitalizations, nutritional deficiencies, behavior problems, and academic challenges.

Study Objective

  • The study examines the relationships between food security status, participation in school meals, and students’ dietary quality using data from the first School Nutrition and Meal Cost Study (SNMCS-I).

  • The hypothesis posits that FI students and, to a lesser degree, MS students utilize USDA school meal programs more than FS students, resulting in greater contributions of quantity (calories) and quality (HEI scores) to their diets.

2. Materials and Methods

2.1. Study Population & Data Collection Methods

  • SNMCS-I involved public, non-charter schools participating in NSLP during SY 2014-2015, assessing student diets.

  • Sampling Process:

    • Random selection of School Food Authorities (SFAs), schools within SFAs, and students within those schools for a nationally representative sample.

  • Data Collection Procedure:

    • Parents/guardians received information regarding the study for consent.

    • Data captured primarily in a scheduled “target week”.

    • Study protocols reviewed and approved by the New England Institutional Review Board.

2.1.1. Data Collection from Students and Parents

  • Child/Youth and Parent Interviews collected demographic data, school meal participation, other assistance program participation, and food security (using USDA’s 18-item Household Food Security Survey Module).

  • Different interview procedures for students based on grade level, including dietary recall sessions detailing food intakes for specified time periods.

  • Compensation offered for participation varied by age group, with high school students receiving more for participation as their recall was done at a later time.

2.1.2. Data Collection from SFAs and Schools

  • Menu surveys required school nutrition managers to document all food items offered in reimbursable meals, facilitating nutritional analysis.

  • School principals and SFA directors provided additional information via web surveys post-target week.

2.2. Key Variables
2.2.1. Characteristics

  • Included age, gender, race/ethnicity, and household poverty levels.

  • Certified status for FRP meals determined via meal sale data or parent self-report.

2.2.2. Participation and Food Analysis

Identifying School Meal Foods

  • Identification of meal foods required matching student-reported items to those recorded in the Menu Survey.

  • Participation classification required student-reported consumption and menu availability such as specific food components for NSLP and SBP.

2.2.3. Healthy Eating Index-2010 Scores

  • HEI-2010 scores comprised 12 components assessing diet quality on a 100-point scale, highlighting both adequacy and moderation components.

  • Adequacy components indicate the nutritional density of diets, while moderation components refer to reductions in less healthful dietary elements (e.g., sodium, empty calories).

3. Results

3.1. Characteristics

  • FS students were predominantly white and less likely to be in lower-income brackets.

  • FI students were more frequently in the lowest income brackets compared to MS students.

  • School characteristics showed similar nutritional quality across groups regardless of food security status.

3.2. Participation Rates

  • Significant differences in participation rates were observed; both FI and MS students participated more actively in NSLP compared to FS students.

  • The nature of school offerings—like universal free meals—had significant positive impact on participation rates.

3.3. Energy Contributions from School Meals

  • Average contributions of school meals to daily energy varied across food security statuses:

    • FI Students: 22.3%

    • MS Students: 19.9%

    • FS Students: 13.4%

    • Participants in both NSLP and SBP saw substantial energy contributions from school meals.

3.4. Diet Quality Comparisons

  • Diet quality was assessed using HEI-2010 scores which showed no significant differences across groups in quality; however, all groups benefitted from higher quality in school foods compared to nonschool foods.

4. Discussion

  • Findings suggest the importance of school meals particularly for FI and MS students, reflecting higher participation and contribution to overall dietary quality.

  • Continued research needed on participation strategies, including universal free meal adoption effects and improving accessibility measures for SBP.

Implications for Practice

  • School meal programs crucially support dietary adequacy for children from food-insecure households.

  • Future strategies should target increasing participation while addressing barriers students may face, thereby enhancing overall dietary outcomes.