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

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.