Kids' Bag Lunches Not Meeting Nutrition Guidelines: Study

Second study found that providing classroom breakfast didn't improve grades, though longer-term studies are needed

Monday, November 24, 2014

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MONDAY, Nov. 24, 2014 (HealthDay News) -- The lunches children bring from home may be less healthy than the school cafeteria offerings, a new study suggests.

Researchers found that for kids in one Texas school district, bag lunches typically had more salt and fewer fruits, vegetables and whole grains, compared with standards set for school cafeterias.

What's more, nearly all of those home lunches contained desserts, sugary drinks or snack chips -- foods not allowed in school lunches, according to the researchers.

The findings are not necessarily surprising, said the study's senior researcher, Karen Cullen, a professor at Baylor College of Medicine in Houston.

"Parents often pack lunches based on their children's preferences," she noted. Plus, she added, some other recent studies have found a similar pattern.

Taken together, the findings suggest that many kids' bag lunches need a revamp, according to Cullen, who reports her team's findings in the Nov. 24 JAMA Pediatrics.

Since 2012, meals at U.S. schools have been required to meet certain nutrition standards in order to win federal reimbursements.

"The school lunch guidelines are based on the national dietary recommendations for all Americans," Cullen said.

That means lunches must include fruit, vegetables, whole grains, a meat or meat alternative, and low-fat milk -- with limits on sodium and saturated fat.

But recent research has found that lunches brought from home often fall short on the nutrition front. In one study, researchers found that preschool and kindergartners' bag lunches typically had more fat and sugar, but less protein, fiber and calcium, than the school lunch.

The new study involved 12 elementary and middle schools in one Houston-area school district. Over two months, the researchers observed more than 300 students who brought their lunch from home -- noting what they ate and what they threw away.

On average, Cullen said, bag lunches were low on fruits and whole grains, and especially vegetables and milk. School guidelines say kids should have three-quarters of a cup of vegetables with every lunch. The average elementary school bag lunch had about one-tenth of that amount, according to the study.

On the other hand, bag lunches went overboard on sodium -- averaging 1,000 to 1,110 mg, versus a limit of 640 mg in elementary school lunches, the study noted.

Finally, the researchers found that 90 percent of home lunches contained a dessert, sugary drink or snack chips. And kids nearly always polished off those foods, whereas between 20 and 30 percent of vegetables ended up in the garbage, according to the study.

"There was a lot of waste," Cullen said. "Even when parents packed vegetables, a lot of it was thrown away."

Packing milk and palatable vegetables is tricky, noted Dr. Virginia Stallings, a pediatrician at Children's Hospital of Philadelphia who specializes in nutrition.

The milk dilemma can be solved by giving your kids money to buy it at school, said Stallings, who wrote an editorial published with the study. With vegetables, though, it can be challenging to go beyond carrot sticks, she added.

"I think that's one of the advantages of the school lunch," Stallings said. "Kids can have a hot meal, with cooked vegetables." She added that schools are working on making meals that are tasty without relying on salt, and expanding to include culturally diverse choices.

"For families who don't have the time or resources to do detailed meal planning, the school lunch could be the better option," Stallings said.

Cullen agreed that parents face obstacles -- one being their child's taste buds. But she said they can make lunches healthier without being authoritarian.

"Make kids part of the process," Cullen said. "Ask them what kind of fruit they want. It shouldn't be a surprise when they open their lunch box."

In general, she said, it's important to involve kids in meal planning, and give them a taste for healthy foods from an early age.

A separate study in the same journal looked at a different school meal: breakfast.

The U.S. school breakfast program began in the 1960s, and offers lower-income students free or reduced-cost meals; but kids' participation has always been lower than it could be, according to the researchers, from Tufts University in Boston.

That's thought to be related to "stigma," along with the logistics of getting kids to school earlier. So many U.S. schools are now trying a program called Breakfast in Classroom, where breakfast is served in class, at the start of every day -- and offered to all kids.

The Tufts researchers found that in more than 250 schools that launched the program, nearly three-quarters of students ate breakfast at school. That compared with about 190 schools that did not start a Breakfast in Classroom program.

There was, however, no evidence that breakfast boosted kids' math or reading skills. But, the researchers pointed out, the program had only been in place for a short time when students' skills were tested. They said larger, longer-term studies are needed.

SOURCES: Karen Cullen, Dr.P.H., R.D., professor, pediatrics-nutrition, Baylor College of Medicine, Houston, Texas; Virginia A. Stallings, M.D., professor of pediatrics, division of gastroenterology, hepatology and nutrition, Children's Hospital of Philadelphia, Philadelphia, Pa.; Nov. 24, 2014 JAMA Pediatrics online

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