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March 28, 2020

Comments from Kathy Higgins on USDA’s “Simplifying Meal Service and Monitoring Requirements” Rule

The following comments were submitted by Healthier Generation CEO, Kathy Higgins, in response to the U.S. Department of Agriculture’s “Simplifying Meal Service and Monitoring Requirements in the National School Lunch and School Breakfast Programs” proposed rule

School Programs Branch 
Policy and Program Development Division 
Food and Nutrition Service 
1320 Braddock Place, 4th Floor 
Alexandria, Virginia 22314 

Re: Docket No. FNS-2019-0007; Simplifying Meal Service and Monitoring Requirements in the National School Lunch and School Breakfast Programs 

The Alliance for a Healthier Generation (Healthier Generation)1 submits these comments in strong opposition to the U.S. Department of Agriculture’s (USDA) “Simplifying Meal Service and Monitoring Requirements in the National School Lunch and School Breakfast Programs” proposed rule (85 FR 4094). These changes would further weaken the strong school meal standards put into place by the Healthy, Hunger-Free Kids Act of 2010, decrease the healthfulness of school meals, and result in a lack of alignment between the school meal standards and the Dietary Guidelines for Americans. Furthermore, these rollbacks will have the most deleterious effects on families who experience food insecurity and struggle to provide nutritious food to their children.  

The Harvard University T.H. Chan School of Public Health concluded that the 2012 update to school meal standards and the 2013 update to competitive foods was, “one of the most important national obesity prevention policy achievements in recent decades.”2 Researchers estimate that these improvements could prevent more than two million cases of childhood obesity and save up to $792 million in health care related costs over ten years. Improved school nutrition is critical given that one out of three children and adolescents aged 2 to 19 years is overweight or obese3,4 and children consume one-third to one-half of daily calories during the school day.5 The proposed changes would decrease the healthfulness of school meals by requiring less fruit, and allowing schools to serve more starchy vegetables such as potatoes. 

Virtually all schools (99 percent) participating in the National School Lunch Program (NSLP) and School Breakfast Program (SBP) have made great progress toward serving healthier meals with less sodium; more whole grains, fruits, and vegetables; and fewer sugary drinks and unhealthy snacks.6 USDA’s 2019 School Nutrition and Meal Cost Study, found that the nutritional quality of school lunches and breakfasts, measured by the HEI-2010 [Healthy Eating Index] scores, increased by 41 percent and 44 percent, respectively, between school years 2009-10 and 2014-15.7,8 Additional studies have documented the efficacy of the updated nutrition standards. A Healthy Eating Research study examining 1.7 million meals served in six schools in an urban Washington school district found that the overall nutritional quality of meals increased by 29 percent under the healthier 2012 standards.9 A study by the Rudd Center for Food Policy & Obesity examined 12 middle schools in an urban, low-income school district and found that more students chose fruit after the healthier standards went into effect and students ate more of their vegetables and lunch entrées.10 

This rule is not USDA’s first weakening of school nutrition. In 2018, USDA implemented a final rule (Child Nutrition Programs: Flexibilities for Milk, Whole Grains, and Sodium Requirements, 83 Fed. Reg. 63775 [Dec. 12, 2018]) that delayed the next levels of sodium reduction by seven years and eliminated sodium-reduction Target 3, cut the whole grain-rich standard in half from 100 to 50 percent, and allowed flavored low-fat (1 percent) milk to be sold without a calorie (and/or added sugar) limit. Despite overwhelming public opposition to these rollbacks, USDA finalized a rule that went further in harming child nutrition and health than what was proposed in the interim final rule.  

USDA purports that the proposed changes are “customer-focused;” however, the data show that parents and students are in favor of the healthier standards. More than 70 percent of parents with school-aged children support the updated school meal nutrition standards, according to a nationally representative poll.11 Proponents of the rollbacks also cite decreasing participation as justification for weakening child nutrition; however, USDA’s School Nutrition and Meal Cost Study found that participation is highest in schools with the healthiest meals.12 Participation among students receiving free meals has dramatically increased (from 15.4 million children in 2008 to 20 million children in 2019) and remains the largest category (about two-thirds of participating students in 2019).13 Overall participation remains high with about 30 million students participating in 2019. USDA also claims that some program operators have experienced an increase in food waste, yet USDA’s own research shows that plate waste has not increased with implementation of the healthier school meal standards.14 Weakening the standards will not decrease food waste. 

The proposed changes in this rule, combined with the 2018 rollbacks, will further undermine the school meal programs.  

In short, we urge the Department to: 

  • Remove the a la carte entrée exemption entirely. Do not allow an a la carte side exemption and maintain the whole grain-rich entrée requirement. These proposed a la carte changes would widen the existing junk food loophole to allow students with the economic means to purchase unhealthy foods like pizza, French fries, and cookies for lunch every day of the week, further widening the equity gap and decreasing participation in the school meal programs. 
  • Maintain the existing variety of vegetable subgroups. Weakening this requirement would allow an additional three cups of French fries or other starchy vegetables in lunch per week, reducing a healthful variety of vegetables.  
  • Maintain the fruit requirement in breakfast outside of the cafeteria. Halving this requirement will reduce whole fruit for students and could lead to only juice being served. 
  • Do not make permanent the potato appropriations rider allowing schools to substitute starchy vegetables for fruit in breakfast. This would decrease fruit and the healthful variety of vegetables.  
  • Ensure that removing the grain requirement in breakfast does not increase the amount of processed meat served. The nutritional quality of school breakfast has already been weakened by halving the whole grain-rich requirement and there is no existing added sugar limit. Rather than further diminishing the grain requirement and potentially exposing children to more processed meat, which poses a risk to health, the Department should add a limit for added sugars in school meals, restore the whole grain-rich requirement, and limit processed meat in school meals. 
  • Do not allow grain-based desserts in the Child and Adult Care Food Program. 
  • Ensure schools are providing age-appropriate meals and portion sizes by not allowing K-12 or similarly configured schools use one or two meal patterns for all students. 
  • Expand water options in the safest way possible.  
  • Develop an administrative review process that is less burdensome but maintain the 3-year frequency. 

Although Executive Orders 12866 and 13563 require agencies to assess costs and benefits of regulatory actions and select approaches that maximize net benefits, including the effect on public health and equity, USDA did not do these assessments, nor did they consult the public health or medical communities. A vast majority of NSLP and SBP participants experience food insecurity: 85 percent of SBP participants and 71 percent of NSLP participants receive free or reduced-priced meals, determined by their household income.15 According to research by Bridging the Gap, prior to the updated 2012 school nutrition standards, students in more affluent and larger schools were more likely to have access to healthier foods than those in lower-income and smaller schools.16 Another study found that improved school nutrition standards are associated with a decrease in obesity among students suffering from food-insecurity.17 A public health and equity analysis must be conducted to assess the potential repercussions of these proposed rollbacks. In addition to decreasing the nutritional quality of school meals, the proposed changes are likely to decrease school meal participation by encouraging a la carte purchases, which is both a fiscal risk to school meal programs and an equity concern.  

Absent a review by USDA, a recent Health Impact Assessment (HIA) conducted by the Robert Wood Johnson Foundation’s Healthy Eating Research program found that the proposed changes would adversely affect students’ health and academic performance, and that students from low-income families attending schools that are majority black or Hispanic and in rural neighborhoods are most likely to be impacted by the proposed changes.18 The HIA recommends USDA reverse course and maintain strong nutrition standards. 

Rather than weakening standards, the USDA should be focusing on solutions that effectively address the problem. Any challenges schools face in implementing the school meal standards should be addressed through enhanced training, technical assistance, and investments in school kitchen equipment and infrastructure. Weakening the standards does not benefit children, is unlikely to decrease food waste or increase meal participation, and damages the progress that has been made through school efforts and industry reformulation. The health of our children should be our top priority, and thus we should not tear down one of the greatest public health achievements of all time. Instead we should be seeking ways to ensure that all children -- but most importantly, children plagued by food insecurity -- have access to the healthiest food possible in school and throughout their communities. 

Sincerely,

Kathy Higgins, CEO
Alliance for a Healthier Generation

________________________________

1. The Alliance for a Healthier Generation believes every child deserves a healthy future. For over a decade, Healthier Generation has empowered kids to develop lifelong healthy habits by ensuring the environments that surround them provide and promote good health. Driven by our passion that all young people deserve a chance to live healthier lives, our work, in total, has reached more than 29 million kids across the country.

2. Gortmaker SL, Wang YC, Long MW, et al. Three Interventions that Reduce Childhood Obesity Are Projected to Save More Than They Cost to Implement. Health Aff. 2015;34:1932-9.

3. Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of Obesity Among Adults and Youth: United States, 2011-2014. NCHS Data Brief. 2015;219:1-8. 

4. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of Childhood and Adult Obesity in the United States, 2011-2012. JAMA. 2014;311:806-14.

5. U.S. Department of Agriculture. School Nutrition Dietary Assessment Study-III. Washington, DC: USDA; 2007.

6. U.S. Department of Agriculture. School Meal Certification Data (as of September 2016). Washington, DC: USDA; 2017.

7. U.S. Department of Agriculture. School Nutrition and Meal Cost Study. Washington, DC. USDA; 2019.

8. Total HEI-2010 scores provide an overall measure of nutritional quality. A higher score reflects better conformance with Dietary Guidelines for Americans recommendations and higher nutritional quality.

9. Johnson DB, Podrabsky M, Rocha A, et al. Effect of the Healthy Hunger-Free Kids Act on the Nutritional Quality of Meals Selected by Students and School Lunch Participation Rates. JAMA Pediatr. 2016;170:e153918.

10. Schwartz MB, Henderson KE, Read M, et al. New School Meal Regulations Increase Fruit Consumption and Do Not Increase Total Plate Waste. Child Obes. 2015;11:242-7.

11. Hart Research Associates and Ferguson Research. Nationwide Polling Regarding Parents’ Views of School Meal and Smart Snacks Standards telephone poll among 1,112 parents. 2014. 

12. U.S. Department of Agriculture, 2019.

13. U.S. Department of Agriculture. Child Nutrition Tables: National Level Annual Summary Tables: FY 1969-2019. Washington, DC: USDA; 2019. 

14. U.S. Department of Agriculture, 2019.

15. U.S. Department of Agriculture, 2019.

16. Terry-McElrath YM, O'Malley PM, Johnston LD. Foods and Beverages Offered in US Public Secondary Schools through the National School Lunch Program from 2011–2013: Early Evidence of Improved Nutrition and Reduced Disparities. Preventive Medicine. 2015; 78:52-58.

17. Taber DR, Chriqui JF, Powell L, Chaloupka FJ. Association Between State Laws Governing School Meal Nutrition Content and Student Weight Status: Implications for New USDA School Meal Standards. JAMA Pediatr. 2013:167:513-9.

18. Lott M, Miller L, Arm K, Story M. Rapid Health Impact Assessment on USDA Proposed Changes to School Nutrition Standards. Durham, NC: Healthy Eating Research; 2020. Available at https://healthyeatingresearch.org/

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