Lunch Line

As the National School Lunch Program changes gears to address staggering rates of obesity in addition to hunger, how easy will it be to wean today’s kids off of the salty, fatty foods they’ve learned to love?

In August 2010, Newsweek reported that one in every four children in the United States lives in a home that “sometimes runs out of food,” a disturbing consequence of rising unemployment and the country’s economic downturn. Even in this land of plenty, “food insecurity” — a lack of access to quality, nutritious food — plagued more than 50 million Americans in 2009, the highest reported figure since the United States Department of Agriculture (USDA) began tracking such numbers in 1995. As health and medical writer Claudia Kalb points out, Americans rarely starve to death, but hunger — like quality food — always comes at a price.

An experienced teacher like Corinne Varon-Green, C.A.S.’95, Ed.D.’04, from the Amigos School in Cambridge, Mass., knows it when she sees it. Hungry kids can’t focus. They’re grumpy and irritable. Stomachs and heads ache. On a more profound level, underfed children under the age of five face irreparable damage to their cognitive development, and older children don’t fare much better. Brains and bodies simply can’t grow as they should without the essential micronutrients such as iodine, vitamin A, and iron typically found in foods outside your grocer’s freezer section, assuming one has easy access to a grocery store.

“We’ve had a couple of occasions when a child says, ‘I have a horrible stomachache,’ and we find out they haven’t had anything to eat,” says Varon-Green. “Kids who don’t eat breakfast will have a stomachache by 10 a.m. and they can’t function. I also see kids high on sugar, and they can’t concentrate either. They’re jumpy and not attentive.”

Paradoxically, some of these children are also bigger than they’ve ever been before.

“We are seeing obesity in children, diabetes in children; things we used to only see in adults. These are chronic diseases they will have for the rest of their lives,” says Juliana Cohen, a doctoral candidate at the Harvard School of Public Health who focuses on nutrition. “We also see, despite poverty levels and sometimes barely being able to afford food, these obese but malnourished populations. We are bombarded by junk food everywhere we go, and while you can go to a fast food establishment and get all the food you need, your body is not getting what it really needs.”

The United States may indeed lag behind Asian and European nations on math, reading, and science scores, yet Americans remain at the top of the international heap when it comes to weight and body mass index, a measurement of body fat. According to Jean Daniel, public affairs director for the USDA’s Food and Nutrition Service, more than 60 percent of adults are considered overweight or obese, as are one in three American children.

“We are leading the world in a way that we don’t want to lead the world,” says Daniel. “The overweight and obesity rates of children have tripled over the past 20 years. It is an epidemic.”

It is for all these reasons and more that President Barack Obama signed the Healthy, Hunger-Free Kids Act of 2010 on December 13, 2010, a law that will not only change the nutritional guidelines of the 65-year-old National School Lunch Program, but will also provide the program’s first noninflationary budget increase in more than three decades; a total of $4.5 billion over 10 years, which includes an additional 6 cents per meal, per child.

So what’s not to like?

In all, 157 members of Congress voted against the new measure, citing everything from excessive spending to unnecessary government interference in the lives of American families. And, in a time of increasing costs and decreasing revenues, some district leaders and food advocates worry whether 6 cents will allow schools to serve healthier fare, when the current federal reimbursement of $2.72 per free meal already has many school programs running in the red.

Perhaps most important, some experts question whether today’s kids — raised in a world filled with Happy Meals and Ho Hos — will actually embrace more fruit, vegetables, and farro, as promoted by the new legislation. What happens if nutritionally challenged kids don’t eat better food, especially if parents won’t make them?

“We need to recognize that this is a very complex problem and it will need a variety of solutions,” says Andrea Giancoli, a registered dietician and spokesperson for the American Dietetic Association. “Having worked in school nutrition policy for the last 10 years, it is not an easy fix to just put healthy food out there. Often, when schools put the healthy choices out there, the kids aren’t taking it. They need to put out a product that the children will eat.”

A History of Hunger As teachers and educational leaders will tell you, the National School Lunch Program and the newer School Breakfast Program, introduced in 1966, may provide the only nutrition some school children receive each day. Families living at or below 130 percent of poverty level — or $28,665 for a family of four — are eligible for meals at no charge, while those who live between 130 and 185 percent of the poverty level receive reduced price meals, paying no more than 40 cents per lunch. In all, more than 31 million children across the country were fed through the National School Lunch Program at a cost of $9.8 billion in fiscal year 2009.

For David Kauffman, Ed.M.’98, Ed.D.’05, principal of the Perez Elementary School in Austin, Texas, the program is vital.

“Sleep and food are our two biggest challenges,” he says, “and a hungry kindergartener is a force to be reckoned with.”

It is no surprise then that concerns surrounding poverty and hunger in America paved the way to the creation of the earliest school lunch programs, some of which date back to the 1850s. The Children’s Aid Society of New York began to provide meals to vocational students in 1853 and was soon followed by other civic organizations that did the same in Boston, Philadelphia, Cincinnati, Milwaukee, and Chicago, among others.

As cited by the USDA, what likely brought this issue to the fore was the 1904 publication of Poverty, a book by Robert Hunter that detailed the catastrophic implications of malnutrition on children. As Hunter wrote, “Learning is difficult because hungry stomachs and languid bodies and thin blood are not able to feed the brain. The lack of learning among so many poor children is certainly due, to an important extent, to this cause. … It is utter folly, from the point of view of learning, to have a compulsory school law which compels children, in that weak physical and mental state which results from poverty, to drag themselves to school and to sit at their desks, day in and day out, for several years, learning little or nothing.”

By the early 1920s, Chicago and Los Angeles had widespread school lunch programs, sponsored and paid for, in part, by their boards of education. (In Los Angeles, poorer high school students sometimes had to work at the school to help cover their lunch cost.) During the depression of the 1930s, with rampant unemployment, states and municipalities around the nation formalized lunch programs via local legislation. These programs were aided, on a year-to-year basis, by the federal government as a way to dispense unused and undervalued surplus from the nation’s farms, which were also suffering.

By the 1940s, there was another major concern: Many young men graduating or leaving high school were being rejected from the World War II draft because they were malnourished.

“Food insecurity and the hunger crisis was much more widespread and posed a serious threat to national security and the economy,” says Matt Sharp, senior advocate for the California Food Policy Advocates, a public policy organization focused on antipoverty initiatives.

By the time the 79th Congress passed the National School Lunch Act in 1946 to formalize, subsidize, and make permanent a National School Lunch Program, 48 states — the entire country, at that point — were already on board, serving 6 million children in 42,000 schools. As President Harry Truman said at the bill’s signing, “In the long view, no nation is any healthier than its children or more prosperous than its farmers; and in the National School Lunch Act, the Congress has contributed immeasurably both to the welfare to our farmers and the health of our children.”

But the legislation was not without controversy. Some members of Congress considered the proposed appropriation of $75 million to be an unseemly expenditure for the federal government and “destructive to the national morale,” according to a New York Times article from February 20, 1946.

“If you pass this bill,” said Representative Hattan Sumners, a Democrat from Texas, “you will be inculcating in little children at the most impressionable period of their lives the idea that they can get something for nothing from Uncle Sam.”

Healthy and Hunger Free Now 65 years later, Truman’s act provides daily lunch in 101,000 schools nationwide in urban, rural, and suburban areas, and the program still faces opposition. Even with mounting medical evidence that current high-fat, high-sodium food choices must change, the upgrade of nutritional standards and the related $4.5 billion increase — which was deducted from the federal food stamp program — still faced a host of critics last year after Obama signed the bill. Some argued that government had no business telling students what to eat. Others worried that schools would have to raise the price of lunch for those who do pay. Groups, like the National Governors Association, objected to it as a barely funded mandate. Advocates for the poor argued that money shouldn’t be siphoned from one antipoverty program to another.

“While it may be a noble goal, at the end of the day, jobs are far more important for us to focus on,” said Republican Representative Bill Posey from Florida, after voting against the Healthy, Hunger-Free Kids Act. “And I think it would be a better idea to let America’s families choose what food they want their children to eat.”

At Perez Elementary School, Kauffman knows that some of the 890 students arrive hungry. On a daily basis, the school serves 800 lunches to its K–5 children, 93 percent of whom qualify for free or reduced-price lunch.

“We’ve gone up a couple points in this recent economic downturn, from 90 to 93 percent,” says Kauffman, who has been principal at the school for five years, “and the vast majority of the meals are free. Roughly, one in 10 is reduced.”

Kauffman’s numbers reflect the national trend as well. While National School Lunch Program participants have remained fairly steady, USDA Spokesperson Daniel says they have seen a 5 percent gain in families whose eligibility has transitioned from reduced price to free.

When it comes to school breakfasts, Perez Elementary serves as a microcosm again, serving 250 students — 550 fewer than at lunch. Nationwide, about 11 million students partake in what is considered to be the most important meal of the day, a dramatically lower figure than the 31 million receiving free or reduced lunch. (See sidebar, "What About Breakfast?")

The government hopes to change this. For starters, according to the USDA website, the new Healthy, Hunger-Free legislation will improve “the nutritional quality of all food in schools by providing USDA with the authority to set nutritional standards for all foods sold in schools, including in vending machines, the ‘a la carte’ lunch lines, and school stores.” In addition, available federal data, such as from Medicaid, will be used to better identify eligible children before they fill out an application, which is expected to increase participation by approximately 115,000 students. In high-poverty communities, census data will be used to assess which schools should have universal access to free and reduced-price lunch.

Translated to a school tray, children will be served food they may not be used to — fresh fruits; green, leafy vegetables; and whole grains — but, as food and nutrition experts say, it is time to move past the days of chicken pucks and taco tubs to close the widening nutritional gap.

“The problem we are having is our population is consuming too many macronutrients with too many calories and not enough nutrients in these calories,” says Giancoli, referring to the abundance of fat and carbohydrates in the American diet. “We’re overfed with macronutrients and underfed with micronutrients." In school, a child’s ability to think and learn is being compromised with the poor nutritional choices that are being made. Still, I would say that most of the research that has been done on kids who consume the school meal shows that they have a better nutritional profile than those not receiving the school meal. The school meal is often the scapegoat to the problem, but that is not what is causing the obesity crisis.

“It’s tough,” Giancoli continues. “I don’t want to blame parents or schools because we live in a much different society today and it’s tough to make ends meet. When we talk about poverty and you are trying to feed your children well and all you have to spend is $5, it is very much a socioeconomic issue and it’s very much an environmental issue.”

Says Daniel, “Hunger and obesity are two sides of a similar coin.”

Dollars and Sense So how far will 6 cents go? It depends on whom you ask.

At the current free lunch reimbursement rate of $2.72 per meal, many school providers say it is tough, if not impossible, to deliver healthy nutritious food while covering all other food services costs, including staffing and equipment, while staying within budget.

“There are very few good options in school nutrition, and most schools serve their kids lousy food that is unappealing,” says Bob Nardo, managing director of operations for KIPP TEAM Charter Schools in Newark, N.J. “This is a problem everywhere, but particularly in low-income areas that are considered food deserts, where you can’t get adequate, nutritious food nearby. For our kids at KIPP, they are getting nearly half or two-thirds of their nutrition at school, so our schools face a particularly heavy burden. They need this food in order to learn. This is the context in which we are operating.”

Other districts struggle as well to hold to their bottom line. Chicago and New York City, for example, have multi-million dollar deficits in food services, attributable to escalating costs and money owed from families who have not kept up with either their full or reduced-priced payments.

“The other piece is efficiency. It is hard to realize how much money schools lose on this business,” says Nardo. “I’ve seen countless schools where tens of thousands of dollars can be lost without putting two plus two together.”

Nardo says that was the case with KIPP in Newark, until they outsourced the management to Revolution Foods (see sidebar, "Other Options"), a health-based school foods company launched in California in 2006.

In fact, approximately 1,000 schools around the country started piloting healthier nutritional guidelines even before the Healthy, Hunger-Free Kids Act was signed, using their existing budgets, says Daniel. Under the new legislation, school districts will be encouraged to work together, and order together on certain items, to “achieve economies of scale.” “It will require being creative,” Daniel says.

That is exactly what Rebecca Mozaffarian, project manager for the Harvard Prevention Research Center, set out to do in her work with YMCA afterschool programs around the country where they were charged with finding healthier snack and drink alternatives to fit within the 76-cent per child federal reimbursement for afterschool programs.

“We have found in these programs that they can get pretty far with it, serving an apple and a cheese slice and water, or carrots and hummus and water,” says Mozaffarian. “Our goal isn’t so much about weight loss or about obesity; it is about a healthy lifestyle. What children are exposed to when they are young affects what they eat when they are older and into adulthood. Having them exposed to as many healthy options as possible during the day is essential to getting them on track for healthy eating. There are a number of kids for whom every meal they have … is outside the home, and it’s critical that those foods that are being provided through school systems are healthy.”

Back at the Amigos School in Cambridge, changes are also under way thanks to a program with the city’s Department of Public Health that sends nutritionists to the school on a regular basis. Friday’s pizza now has whole wheat crust. Bake sales are a thing of the past. And physical activity happens for every student, every day.

But there is always progress to be made. Cheeseburgers are still popular, and cafeteria workers report that the fresh fruit they serve with meals is often found rolling under lunch tables. And what happens at home is another matter. As one 9-year-old student diner reported, her breakfast of Frosted Flakes was preceded the night before by a dinner of chicken nuggets.

“Last year, every classroom had a basket of fresh fruit brought in each day,” says Varon-Green, noting that this practice changed once the school’s low-income population dipped below 40 percent. “Now, some parents will bring in snacks, so there is a basis for a healthy snack every day, but I always have extra bags of healthy chips just in case. As teachers, if there is no provision, we buy. We can’t see children go hungry.”

— Mary Tamer is a frequent writer for Ed. Her last piece looked at public service incentives for teachers.

Related:

• What About Breakfast?
• Other Options
• Ed Extra: Healthy Appetite