Improving School Food with the Institute of Medicine’s New Recommendations: It Still Comes Down To M

October 22, 2009

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By Mark Bishop, Deputy Director

Just the other day the Institute of Medicine published their new recommendations for school food. It’s a comprehensive report and full of excellent practical policy recommendations. And as School Lunch Talk says, “The current nutrition standards for school meals are in sore need of an overhaul.” In short:

…the committee recommends that the USDA adopt standards for menu planning, including:

    • Increasing the amount and variety of fruits, vegetables, and whole grains
    • Setting a minimum and maximum level of calories
    • Focusing more on reducing saturated fat and sodium

Healthy Schools Campaign fully supports these recommendations. From
what we’re hearing, it will take years to get these recommendations
through a rule-making process, but we want to help see it through to
implementation.I found three issues in the recommendations particularly interesting:

  1. Maximum vs. minimum calories
  2. Food-based vs. nutrient-standard-based menu planning
  3. Cost

1. Maximum vs. minimum calories

I
find this to be a really interesting issue. When the National School
Lunch Program was established, the greatest health concern facing the
country was undernourishment rather than obesity. So in the 1940s,
setting a minimum calorie content made sense. Today the opposite is
true. The ideas is simple but from a practical perspective, this
represents a challenging change.

In 2005 HSC
participated in a taskforce to review dietary guidelines for Illinois
schools. One of the hot discussion items was maximum caloric counts for
individual portions of food items. The point that repeatedly came up in
these meetings was the idea that decreasing portion sizes to get
caloric counts down just leads to students taking more items. To me
this illustrates the challenges behind what seems like a logical
change. In the end, our taskforce agreed that we should limit the
portion sizes to reduce calorie counts, but it was not without much
deliberation about the actual implementation challenges. Making this
decision and addressing the implementation challenges are an important
move forward.

2. Food-based vs. nutrient-standard based menu planning

The
committee recommended that schools change their menu planning from an
approach that focuses on nutrient standards to an approach based on
foods. (Again, something that seems simple and intuitive: planning menus based on food rather than nutrients.)

Essentially they are saying that rather
than telling schools to design menus that have X mg of vitamin A, X mg of Calcium and so on, schools should create menus that have at least
two servings of dark green vegetables and one serving of whole grains.

The
intent of this change is to simplify meal creation and focus on the
preparation of healthy meals rather than focus on nutrients. It also
shifts the focus to cooking with whole or minimally processed foods
rather than reheating highly processed foods that have been fortified
with specific nutrients. The benefit here is that it can prevent junk food that’s been fortified with vitamins from being included in a menu.

It’s a great and logical move that can also make things easier for schools. And it’s a move that allows menus to be
created in the same way that we think about food. I mean, I think about
getting foods into my diet (“I should have spinach and some lean
chicken tonight”) rather than getting specific vitamins (“I need to
make a dinner with lots of vitamin A”).

3. Cost

The report mentions many times that it needs to look to a cost effective implementation.  And NPR reported:

Better
nutrition would cost more, the report acknowledges, because fresh fruit
and vegetables can be pricey. A shift to the new standards would
probably add 4 percent to lunch costs and about 20 percent to
breakfasts. If kids really take to the healthier options, the costs
could rise even more.

I don’t know if 4 percent
is accurate or not. I actually called the press office to ask how they
got this number, and was told that they are not trying use any specific
dollar amounts. But they did say that there needs to be
greater investment both in reimbursements as well as in capital
investment. Put another way: we need more money for better food on a
daily basis as well as funding for things like school kitchen equipment
that can be used for scratch cooking rather than just reheating. As La Vida Localvore writes,to adopt the IOM’s recommendations… they WILL need Congress to raise the reimbursement rate.”

I also asked if this additional cost was over and above the 35 cents per meal that most school districts are already losing. There was no clear answer. The reality is too complex – some schools are already doing a great job, large urban schools are loosing closer to 70 cents per meal, and many school food programs are losing money and not serving meals that would measure up to the IOM recommendations. But all in all, implementing improvements in school food will cost more.

In the end, the conclusion is something we’ve
all heard before. To implement the IOM’s recommendations in full, we
need more money. Yes, we also need structural changes to food
distribution, we need changes in the commodity programs at the USDA, we
need to connect schools to locally sourced produce, we need
improvements in school facilities — but without more money for better
food and better kitchens, it will always be an uphill battle.

And since the Child Nutrition Act’s reauthorization has been extended through September 2010, we have until next fall to make sure we can make this type of change a reality.