School Meal Programs: Competitive Foods Are Available in Many
Schools; Actions Taken to Restrict Them Differ by State and
Locality (23-APR-04, GAO-04-673).
The nation faces a complex challenge in addressing recent trends
in children's health and eating habits. To address these trends,
in 2001, the U.S. Surgeon General issued a call to action to
prevent and decrease overweight and obesity among all Americans,
especially children. In this statement, schools were identified
as one of the key settings for public health strategies to
address these issues. The National School Lunch and School
Breakfast Programs provide millions of children with nutritious
meals each school day. The United States Department of
Agriculture's (USDA) Food and Nutrition Service (FNS) administers
these programs at the federal level, and FNS subsidizes the meals
served through these programs in local schools as long as the
meals meet certain nutritional guidelines. In the last decade,
these nutritional guidelines were amended to require schools to
serve meals that adhere to the Dietary Guidelines for Americans,
which limit total and saturated fat and provide specific minimum
levels of vitamins and nutrients. Despite these efforts to
improve the nutritional quality of meals offered through the
school meal programs, other foods not provided through these
programs are often available to children at school through a la
carte lines in the cafeteria where individual foods and beverages
can be purchased, snack shops, school stores, vending machines,
and other venues. The nutritional value of these foods, often
referred to as competitive foods, is largely unregulated by the
federal government. Because of its concern about the trends in
children's health and eating habits and interest in further
understanding issues related to competitive foods in schools,
Congress asked us to answer the following questions: (1) Which
foods and school food practices fall under the term competitive
foods, and what federal restrictions exist on their sale? (2)
What is currently known about the types of competitive foods and
their availability and prevalence in schools? (3) What is
currently known about additional steps that are being taken on
the state and local levels to curtail the sale of competitive
foods?
-------------------------Indexing Terms-------------------------
REPORTNUM: GAO-04-673
ACCNO: A09841
TITLE: School Meal Programs: Competitive Foods Are Available in
Many Schools; Actions Taken to Restrict Them Differ by State and
Locality
DATE: 04/23/2004
SUBJECT: Children
Food programs for children
Health hazards
Health statistics
Schools
Nutrition
National School Breakfast Program
National School Lunch Program
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GAO-04-673
United States General Accounting Office
GAO
Report to Congressional Requesters
April 2004
SCHOOL MEAL PROGRAMS
Competitive Foods Are Available in Many Schools; Actions Taken to Restrict Them
Differ by State and Locality
GAO-04-673
Contents
Letter 1
Appendix I Briefing Slides
Abbreviations
CDC Centers for Disease Control and Prevention
FMNV foods of minimal nutritional value
FNS Food and Nutrition Service
SHPPS School Health Policies and Programs Study
SMI School Meals Implementation
SNDA-II School Nutrition Dietary Assessment Study-II
USDA United States Department of Agriculture
This is a work of the U.S. government and is not subject to copyright
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United States General Accounting Office Washington, DC 20548
April 23, 2004
The Honorable Tom Harkin
Ranking Member
Committee on Agriculture, Nutrition, and Forestry
United States Senate
The Honorable Patrick J. Leahy
Ranking Member
Subcommittee on Research, Nutrition, and General Legislation
Committee on Agriculture, Nutrition, and Forestry
United States Senate
The Honorable George Miller
Ranking Member
Committee on Education and the Workforce
House of Representatives
The Honorable Lynn Woolsey
Ranking Member
Subcommittee on Education Reform
Committee on Education and the Workforce
House of Representatives
The nation faces a complex challenge in addressing recent trends in
children's health and eating habits. Data from the U.S. Centers for
Disease
Control and Prevention (CDC) have shown that over 15 percent of
children and adolescents ages 6 to 19 are overweight, a proportion that
has
significantly increased since the 1960s. In addition, CDC has also
reported
an increase in the frequency of type 2 diabetes in U.S. children and
adolescents over the last two decades. Trends in obesity and a low level
of
physical activity among children and adolescents may be a major
contributor to this increase.
To address these trends, in 2001, the U.S. Surgeon General issued a call
to
action to prevent and decrease overweight and obesity among all
Americans, especially children. In this statement, schools were identified
as one of the key settings for public health strategies to address these
issues. Since a large portion of a child's day is spent in school,
providing
children with healthy food options throughout the school day can be an
important step toward good child nutrition. The National School Lunch
and School Breakfast Programs provide millions of children with nutritious
meals each school day. The United States Department of Agriculture's
(USDA) Food and Nutrition Service (FNS) administers these programs at the
federal level, and FNS subsidizes the meals served through these programs
in local schools as long as the meals meet certain nutritional guidelines.
In the last decade, these nutritional guidelines were amended to require
schools to serve meals that adhere to the Dietary Guidelines for
Americans, which limit total and saturated fat and provide specific
minimum levels of vitamins and nutrients. Despite these efforts to improve
the nutritional quality of meals offered through the school meal programs,
other foods not provided through these programs are often available to
children at school through a la carte lines in the cafeteria where
individual foods and beverages can be purchased, snack shops, school
stores, vending machines, and other venues. The nutritional value of these
foods, often referred to as competitive foods, is largely unregulated by
the federal government.
Because of your concern about the trends in children's health and eating
habits and your interest in further understanding issues related to
competitive foods in schools, you asked us to answer the following
questions: (1) Which foods and school food practices fall under the term
competitive foods, and what federal restrictions exist on their sale? (2)
What is currently known about the types of competitive foods and their
availability and prevalence in schools? (3) What is currently known about
additional steps that are being taken on the state and local levels to
curtail the sale of competitive foods?
To answer your questions, we reviewed a variety of data sources, including
legislation, policies, and studies that address competitive foods in
schools. From these sources, we gathered information on federal and state
competitive foods laws and regulations. In addition, we analyzed data on
the availability, prevalence, and types of competitive foods in schools
provided in three national studies-the School Nutrition Dietary Assessment
Study-II, the School Health Policies and Programs Study of 2000, and the
Third Year Report of the School Meals Initiative Implementation Study. We
also reviewed several smaller-scale studies that address the association
between competitive foods in schools and child nutrition. We examined each
study to assess the adequacy of the samples and measures employed, the
reasonableness and rigor of the statistical techniques, and the validity
of the results that were drawn from the analyses. To supplement the
information collected from these sources and to gather information on
steps that have been taken at the local level to restrict competitive
foods in schools, we conducted interviews with
several professional organizations, advocacy groups, and other
stakeholders. We conducted our review from January through March 2004 in
accordance with generally accepted government auditing standards.
On April 12, 2004, we briefed interested Senate staff on the results of
our analysis. This report formally conveys the information provided during
that briefing. In summary, we reported that
o Competitive foods include all foods and beverages sold in schools
except for meals provided through the School Lunch and School Breakfast
Programs. Current federal regulations restrict only a subset of
competitive foods, foods of minimal nutritional value, from being sold
during mealtimes in food service areas.
o Competitive foods are sold in a variety of locations on a majority of
school campuses nationwide. The types of competitive foods available often
differ by location where they are sold, with healthy foods more often sold
in a la carte lines in the cafeteria and less healthy foods more often
sold through vending machines, school stores, canteens, and snack bars.
o Several states, school districts, and individual schools have enacted
competitive foods policies that are more restrictive than federal
regulations. These policies differ widely in the types of restrictions
they apply.
We provided a draft of this briefing to officials at FNS for their
technical comments and incorporated their comments where appropriate.
We are sending copies of this report to relevant congressional committees
and other interested parties and will make copies available to others upon
request. In addition, this report will be available on GAO's Web site at
http://www.gao.gov. If you or your staff have any questions about this
report, please contact me at (415) 904-2272 or Kay E. Brown at (202)
5123674. Rachel Weber, Kevin Jackson, and Dan Schwimer also made
significant contributions to this report.
David D. Bellis Director, Education, Workforce, and Income Security Issues
Appendix I: Briefing Slides
School Meal Programs: Competitive Foods Are Available in Many Schools; Actions
Taken to Restrict Them Differ by State and Locality
Requested by
Senator Tom Harkin, Ranking Member
U.S. Senate Committee on Agriculture, Nutrition, and Forestry
Senator Patrick Leahy, Ranking Member
Subcommittee on Research, Nutrition, and General Legislation
Representative George Miller, Ranking Member
U.S. House Committee on Education and the Workforce
Representative Lynn Woolsey, Ranking Member
Subcommittee on Education Reform
April 12, 2004
Related GAO Products
School Lunch Program: Efforts Needed to Improve Nutrition and Encourage
Healthy Eating. GAO-03-506. Washington, D.C.: May 9, 2003.
School Meal Programs: Revenue and Expense Information from Selected
States. GAO-03-569. Washington, D.C.: May 9, 2003.
Public Education: Commercial Activities in Schools. GAO/HEHS-00-156.
Washington, D.C.: September 8, 2000.
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