School Lunches Get a Garnish

From the WebMD Archives

Sept. 3, 2001 -- Gone are the days when school lunch meant Sloppy Joes or mystery meat served up lukewarm on an orange tray.

Today, school lunches may include organic pork tacos, sushi, vegetarian stir-fry -- or all of the above.

School lunches in some districts are getting a much-needed makeover -- including a wider variety of lean entrees and an increased number of fruits and vegetables, thanks to the School Meals Initiative for Healthy Children, a program designed to improve the nutritional quality of school meals. The USDA reports that schools have trimmed fat, cholesterol, and sodium from lunches. Consider that 10 years ago, barely one-third of schools offered low-fat lunches; now four of every five schools do.

What's more, many schools are creating their own healthful and innovative variations on the school lunch of yore:

  • At Berkeley High School in Berkeley, Calif., students are offered gourmet fare -- such as hormone-free chicken and chow mein made with fresh vegetables form the local farmer's market -- all of which is delivered from a growing number of local restaurants.
  • In another school near Santa Cruz, Calif., elementary students cook breakfast and lunch in the food lab using ingredients grown in the school's organic garden.

And such menu variety is also making its way onto college campuses, where it can help collegians avoid packing on the dreaded "freshman 15."

And the changes are desperately needed.

The latest statistics show that 13% of American children ages 6 to 11 are overweight -- up from 11% in 1994. Also, obesity-related disorders -- including type 2 diabetes -- are increasing in children at a rapid rate. More than half of obese children between 5 and 10 years old have at least one risk factor for heart disease, including high blood pressure, high blood cholesterol levels, and high blood sugar levels; more than one-quarter have two or more of these complications.

"Childhood and adolescent obesity is a ... [true] epidemic, and childhood and adolescent diabetes is now, regrettably, not uncommon and directly associated with obesity," says Robert Berkowitz, MD, medical director of the weight and eating disorders program at University of Pennsylvania in Philadelphia.

Still, it's not just about healthier meal choices, say experts -- nutrition education and increased physical activity are also needed to reverse this alarming trend.

Today's Specials: More Choices, Less Fat

"The latest studies show that we have continued to decrease the amount of fat in school meals. Deep fat fryers are gone, and we are seeing more oven-baked foods," says Marcia Smith, president of the Alexandria, Va.-based American School Food Service Association.

And students have more lunch choices today. "Things normally found at breakfast, like bagels, are available at lunch with different things to go with then -- and there are more salad options for students and 'grab and go' [items] for students who are in a hurry," she says.

"If you contact the majority of districts, you would basically see that one of the choices every day is a vegetarian entrée such as a meatless chef salad made with cheese, or a bagel with peanut butter," says Smith.

It Takes a Village

"We need a community effort involving parents, faculty, staff, and other organizations because we don't have students 24 hours a day, so part of the process is to educate the parents," Smith says.

"It's critical for parents to be aware of what children eat in school and what they are learning about nutrition," agrees Plainview, Texas' Shirley Igo, president of the National Parent Teacher Association.

"We always encourage parents to visit schools during lunch and find out what is being served," Igo says. "We know that in many cases, our schools contract out food services, so it's especially critical to be aware of who has that contract."

Parents will probably be surprised by what they see, she says. "In many cafeterias, there are a wide variety of choices -- not just a single tray," Igo says.

Sandy Procter, RD, a nutritionist at Kansas State University in Manhattan, Kan., agrees with Igo.

"It's worth a parent's time to check out what kinds of meals are being served because in many cases they will be pleasantly surprised," she tells WebMD.

"There are a lot more choices -- including heart-healthy ones -- and they are very cleverly packaged," she says. "All sorts of products are being served ... from pocket sandwiches in pita bread to wraps that are screened for a healthy level of fat and sodium."

And, Procter says, substitutions are widely available because of food allergies and diet constraints.

Reputation Persists

But school lunch still gets a bad rap, says Sheah Rarback, an American Dietetic Association spokeswoman and the director of nutrition at the Mailman Center for Child Development at the University of Miami in Florida.

"It's an easy target because kids are picky eaters, but school lunch does meet guidelines for having certain nutritional standards," she says.

"Now the schools are competing with fast-food establishments, so they are working to make foods competitive and appealing," Rarback says. The American School Food Service Association estimates that 13% of U.S. public schools sell fast foods, including food from such chains as Pizza Hut, Taco Bell, Arby's, and Subway.

New, improved school lunches must be coupled with education, says Rarback, also the chairwoman of the Dade County School's food and nutrition advisory board.

"We try to use more whole grains and ... have meatless entrees, and it's a great idea, but it needs to be coupled with nutritional education," she says.

"The big picture," she says, "is making better choices in the cafeteria and having some program to support and encourage children to do this."

But everyone agrees that another piece of this pie is physical activity.

"Nutrition can't function alone. We have known that it is a combination of knowledge of nutrition and eating right, but also good amount of physical activity," says Procter.

"Physical activity in schools has gone down in priority and frequency," Berkowitz tells WebMD. "There's less physical education, less funding for physical education. We need to rethink how we get kids to be more physically active and try to reduce sedentary behavior."

Fizzy Milk?

Another problem plaguing school children is calcium deficiency and the risk of the bone-thinning disease osteoporosis.

But who is going to drink milk when there is soda?

Enter E-moo, a fizzy, calcium-rich, and low-fat drink that comes in such flavors as orange creamsicle and bubble gum. Developed by scientists at Cornell University in Ithaca, N.Y., E-moo is available in most top food markets in the Northeast and is about to go nationwide.

A few hurdles exist before it's offered in the schools, says Mary Ann Clark, RN, vice president of technical services at Mac Farms, Inc., of Burlington, Mass, but the product was extremely well-received at a recent school foods fair.

"We are not competing with milk," Clark says. "We want kids who drink milk and like it the way it is to drink milk, but we want to give the other kids the opportunity to have a beverage that is lightly carbonated, flavored, and available in colors that are kind of neat, with all the nutrition of milk."

Currently, most schools comply with an agreement not to sell soda during the pre-lunch or lunchtime period. And the Coca-Cola company recently reported that it will end its exclusive contracts with a limited number of schools; include juice, milk, and water in its school vending machines; and replace advertising on those machines with pictures of students engaged in sports and other physical activity.

"Schools have a responsibility to offer good nutrition to children whether during the meal or afterward," the PTA's Igo says. "Many children are overweight and don't get enough exercise, so when snack foods are available it just compounds the problem and just closing them off at noontime is not the answer," she says.

"We appreciate that schools are strapped for cash, but children should not be a marketing commodity," Igo says. "The revenues from soft drink machines do not add the kind of dollars that schools need to do the things they want to do," she says.

If you would like to learn more about school lunches, participate in WebMD's live event on Thursday, Sept. 6 at 1 p.m. titled "Ask the Expert: School Lunches -- Healthy or Harmful?" Expert Ellen Haas, former undersecretary for food, nutrition, and consumer services at the USDA, will be on hand to answer your questions.