Background:

In 2004, the Congress directed the Centers for Disease Control to undertake a study with the Institute of Medicine (IOM) to develop scientifically based nutrition standards for foods and beverages offered in schools outside of the federal School Breakfast and Lunch Programs—in vending machines, student stores, cafeterias, a la carte lines, and any other school venues where foods and beverages are offered to students. The call for this study grew out of concerns about the growth of the sale of less-than-healthful foods and beverages in schools, children’s poor dietary habits and resulting nutritional problems, and the rapid growth in the obesity rate among children.

A 15-member multi-disciplinary expert committee of the IOM worked for more than a year to develop a comprehensive set of standards. The committee was guided by a number of principles, including that children’s present and future health is profoundly affected by dietary intake and the maintenance of a healthy weight; schools are uniquely positioned to model healthful eating; and the federally funded child nutrition programs should be the primary source of foods and beverages offered at school.

Implications:

The IOM standards are recommended guidelines for foods and beverages made available to students in schools. They are very likely to influence local, state and national policy. School officials and advocates working with child nutrition programs should develop a basic understanding of these recommendations and recognize the potential power they have to improve the nutrition environments surrounding school children. FRAC’s School Wellness Policy and Practice Guide can be a helpful resource for school officials and advocates to use.

Armed with these new standards, school officials and advocates should work to change local and state policies on foods and beverages offered outside of the school meals, and make them conform to nutrition standards just as the school meals have to.

In thinking about foods sold outside of the school meals, it is important to remember, however, that they really do not have to be sold at all. If federally-funded school breakfasts and lunches are available (including for sale to students not receiving free or reduced-price meals), the sale of other foods and beverages is not necessary. Moreover, the presence of any “competitive foods” can create stigma for low-income children. For example, peers notice who chooses school meals rather than the items from vending machines or the a la carte line.

Nevertheless, in many cases schools are likely to continue to choose to sell other foods and beverages, and if they do so it is important that their choices are healthy ones that build good lifelong dietary habits. The sale of unhealthy foods in schools can be especially harmful for low-income students. If students from families with limited budgets choose to eat less healthy food instead of a free and reduced-price school meal, they may lose more nutritionally than their more affluent peers who make the same kind of choices but are more likely to be able to obtain healthy foods in other ways.

Some worry that schools will lose money if they sell more healthful foods in vending machines and student stores. This need not be true, and in any event schools should not be risking the health of their students for financial reasons.

The IOM Standards:

Overall, the standards are based on promoting the foods most lacking in children’s diets, while reducing the fat, sugar and sodium content of foods and beverages offered to children in school outside of the school nutrition programs. The standards are divided into Tier 1 and Tier 2—Tier 1 foods and beverages can be available to all students throughout the school day and over the entire school campus, and Tier 2 foods and beverages are additional ones that can be offered after school, but in high schools only.

Tier 1 foods are limited to fruits, vegetables, whole grains, and related combination products (i.e. products containing a total of one or more servings of fruit, vegetable, or whole grain products per portion), and non-fat and low-fat dairy products. These foods must have 200 calories or less per portion as packaged, and contain: no more than 35 percent of calories from fat; less than 10 percent of total calories from saturated fats; zero trans fat; 35 percent or less of calories from total sugars (except for yogurt, which can have somewhat higher sugar levels, and fruits, vegetables and their juices if they have no added sugars); and sodium content of 200 mg. or less per portion as packaged. Tier 1 can also include some school lunch entrees, depending on their sugar, fat and sodium content. Tier 1 beverages must be caffeine-free, and can include: water without flavoring, additives, or carbonation; low-fat (1%) or nonfat milk (including lactose-free and soy beverages and flavored milks with limited sugar); and 100 percent fruit juice in 4 ounce servings for elementary/middle schools and up to 8 ounces for high schools. In addition, plain, potable water must be available throughout the school day at no cost to students.

Tier 2 foods are those that do not exceed 200 calories per portion as packaged, and contain no more than 35 percent of total calories from fat; less than 10 percent of total calories from saturated fats; zero trans fats; 35 percent or less of calories from total sugars; and sodium content of 200 mg. or less per portion as packaged. Tier 2 beverages include non-caffeinated, non-fortified beverages with less than 5 calories per portion as packaged (with or without non-nutritive sweeteners, carbonation, or flavoring).

For more information:

• FRAC’s Statement on the guidelines
• Read the full IOM report, Nutrition Standards for Foods in Schools: Leading the Way toward Healthier Youth