The former First Lady Michelle Obama revealed her “Let’s Move!” campaign in February of 2010 with the intent of curbing the childhood obesity epidemic. The initiative included a modification to the nutrition standards of the U.S Department of Agriculture’s (USDA) National School Lunch and School Breakfast Programs which provide 32 million meals to children daily. The principle legislation effecting these standards is the Healthy Hunger-Free Kids Act (HHFKA) of 2010 which has been touted as the first major reform to school lunch and breakfast in nearly 30 years.

In accordance with recommendations from the Institute of Medicine report “Nutrition Standards for Foods in Schools: Leading the Way toward Healthier Youth” and the 2010 Dietary Guidelines for Americans, the HHFKA informs the nutrition guidelines that schools must follow in order to be eligible for reimbursement under the National School Lunch Act and the Child Nutrition Act. Various standards resulting from the HHFKA went into effect in 2012, requiring schools to serve more fruits and vegetables, limit sodium, increase the whole grain composition of foods, and increase low-fat and non-fat options. To be more precise, all grains must be 50% whole grain by weight (or have whole grains as the first ingredient), food items can’t have more than 35% of total calories coming from fat, and only 10% of total calories can come from saturated fat. Many exceptions to these regulations exist and are enumerated in the final rule, which codifies the Act. For example, a high-fat food like peanut butter can be served if it is paired with a vegetable or fruit.

A 2014 study evaluated the initial implementation of the HHFKA in a cohort of students at four elementary schools in Washington State. The new guidelines were adhered to by 2013, and compared to the prior year, there was a decrease in average caloric intake by students across each individual macronutrient. Ingestion of key nutrients such as calcium and vitamin C decreased compared to the meals consumed under the old guidelines. Fiber was the only nutrient that was significantly increased. Despite the general dietary improvements that resulted, only about 1,000 meals in total were examined in this study. Following the implementation of these guidelines, childhood obesity rates have remained rather stable, but extrapolating the impact of this program on obesity rates over such a short time interval would not be sensible.

The new secretary of the USDA, Sonny Perdue, announced this past week that schools will be given “greater flexibility in their nutrition requirements for school meal programs in order to make food choices both healthful and appealing to students”. Schools have been facing increased financial burdens by adhering to the HHFKA regulations alongside a decline in school lunch participation, further exacerbating financial strain. Though students may be foregoing school lunches more often, the levels of food waste have not significantly changed compared to pre-implementation. Secretary Perdue acknowledged that 99% of the schools are partially compliant with the HHFKA standards, but noted that this metric is not indicative of program success. The temporary flexibility granted by Secretary Perdue includes a sodium target that is less rigorous, an exemption of the required 51% whole-grain composition, and the ability to serve 1% flavored milk rather than strictly non-fat flavored milks.

Dr. Margo Wootan of the Center for Science in the Public Interest, a consumer advocacy group, expressed disconcert with Secretary Perdue’s regulatory roll back, stating that “ninety percent of American kids eat too much sodium every day” and that “schools have been moving in the right direction, so it makes no sense to freeze that progress in its tracks.” Conversely, the School Nutrition Association, a nonprofit with 57,000 members, applauded this reform in a press release citing the HHFKA regulations as “overly prescriptive and having resulted in unintended consequences including reduced student participation, high costs, and food waste.” The new flexibility emphasizes the authority granted to localities to bolster the requirements of their own school nutrition and physical activity through the use of local “wellness policies.” The temporary deregulation of the HHFKA lowers the proverbial “floor” set by the federal government, giving the states an opportunity to have a direct impact in fighting the obesity epidemic.

References
https://www.fns.usda.gov/school-meals/healthy-hunger-free-kids-act
https://www.federalregister.gov/documents/2012/01/26/2012-1010/nutrition-standards-in-the-national-school-lunch-and-school-breakfast-programs
https://schoolnutrition.org/uploadedFiles/About_School_Meals/What_We_Do/Nutrition%20Standards%20for%20School%20Meals.pdf
https://www.cdc.gov/obesity/data/childhood.html
https://stateofobesity.org/childhood-obesity-trends
https://www.usda.gov/media/press-releases/2017/05/01/ag-secretary-perdue-moves-make-school-meals-great-again
https://schoolnutrition.org/news-publications/press-releases/sna-commends-usda-supporting-practical-flexibility-benefit-school-meal-programs/
https://www.cdc.gov/healthyschools/npao/wellness.htm
https://cspinet.org/news/trump-administration-undermining-school-meals-menu-labeling-20170501
https://www.ncbi.nlm.nih.gov/pubmed/24650841