September 2012

Slow Progress in Changing the School Food Environment:   

Nationally Representative Results from Public and Private Elementary Schools

Lindsey Turner, PhD; Frank J. Chaloupka, PhD

In response to the rise in childhood obesity, a number of key areas for change to elementary school food environments have been identified in the last decade.  The CDC and the Institute of Medicine (IOM) have suggested a reduction in access to foods and beverages high in sugar and fat at mealtime and through fundraisers, parties, and classroom rewards.  They also recommend an increase in fresh fruit and vegetables and whole grains offered as part of school meals, limiting milk to non-fat (flavored and unflavored) or 1% (unflavored) options, and reducing saturated fat and sodium content of meals.

Federal legislation for change followed these recommendations.  The Child Nutrition and WIC Reauthorization Act of 2004 required schools participation in the National School Lunch Program (NSLP) and other child nutrition programs to adopt and implement a wellness policy by the 2006-7 school year.  The policies were to include goals for nutrition education, physical activity, and other school-based strategies; an assurance that school meal guidelines would meet the federal guidelines for meals and competitive foods; plans for implementation; and involvement of stakeholders in the implementation of the policy.  While these policies aim to address the areas of concern, there are reports that they are weak, fragmented, and do not require schools to take action.

Article Summary

This study examined how school food environment (SFE) practices have changed after the implementation of the wellness policy legislation, specifically the 2009-10 school year, compared to the year the wellness policy requirement went into effect in the year in 2006-7.  Survey data from the Bridging the Gap program sponsored by the CDC was used and was nationally representative and cross-sectional.  A total of 1,830 unique schools participated; 578 schools in 2006-7 and 680 in 2009-10.  One half of the survey was filled out by the school principal, and the other part was completed by the school food service manager.  

Sixteen topics assessed on surveys from both school years were selected and categorized into one of three domains:  competitive foods, school lunches, and other food environment topics.  While none of the same schools completed the survey in both years, demographics were comparable. 

Many significant changes were noted in public SFE practices including an increase in fundraising restrictions, percentage of schools without an exclusive pouring contract, whole grains being offered at lunch along with only lower-fat milks, and school gardens or farm-to-school programs.  A significant decrease in schools that had a food and nutrition practitioner on staff was reported.  In public schools there were significant increases in lower-fat milk, gardens and farm-to-school programs, nutrition education and not offering lunches from commercial sources.  Public schools were more likely than private to have fundraising restrictions, offer fresh fruit at lunch, not sell lunch from commercial sources, have a health advisory council, and have a FN practitioner on staff.

Overall the SFE scores showed a significant increase from 2006-7 to 2009-10.  For public schools the score increased from 50.1 to 53.5 out of a possible 100 points.  Private schools increased from 37.2 to 42.2.  The authors note that while these changes are statistically significant, in real terms the change is minimal.  They conclude that goals for future studies should focus on determining which SFE factors are most easily modified and whether SFE is affected by district and state policies.

A study by Chriqui and Chaloupka in the Journal of School Health sheds some light on the factors that influence the strength of wellness policies that address both nutrition and physical activity.  Using data from the 2007-8 school year they investigated 1) the extent to which districts made their wellness policies easily accessible online (transparency); 2) the degree to which districts included provisions in their wellness policy for health advisory councils to oversee implementation efforts; 3) the factors associated with transparency and advisory council provisions; and 4) whether transparency and wellness policy requirements for health advisory councils were associated with stronger wellness policies.

A total of 641 school districts were included in the sample and data was collected via Internet research with telephone and e-mail follow-up.  They found that less than half of the policies were available online.  Fewer than half required a health advisory council.  Overall policy strength scores for elementary schools averaged 33.8 out of a possible score of 100.  Transparency did not significantly affect overall policy strength, but policies requiring health advisory councils had significantly stronger policies.  The authors suggest that the wellness policy should be updated to require transparency as well as an advisory council to allow for the possibility of increased community awareness, buy-in, and support.

Turner, L., & Chaloupka, F. (2012). Slow progress in changing the school food environment: nationally representative results from public and private elementary schools.Journal Of The Academy Of Nutrition And Dietetics, 112(9), 1380-1389.
http://www.andjrnl.org/article/S2212-2672(12)00590-4/fulltext

Chriqui, J., & Chaloupka, F. (2011). Transparency and oversight in local wellness policies.Journal Of School Health, 81(2), 114-121. doi:10.1111/j.1746-1561.2010.00568.x 
 http://ehis.ebscohost.com.proxy.lib.ilstu.edu/eds/detail?vid=2&hid=116&sid=dc8a919f-6ee1-4a8f-90b4-73c0b6f68c69%40sessionmgr112&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#db=c8h&AN=2010904649