Changes to nutrition and health outcomes following implementation of the 2012 USDA school nutrition standards: analysis using NHANES, 2005–2016
Embargo Date
2021-01-27
OA Version
Citation
Abstract
BACKGROUND: In 2012, the Department of Agriculture overhauled school nutrition standards to combat the childhood obesity epidemic. No prior studies have evaluated these nutrition standards at the national level. This study evaluates the impact of the revised 2012 school nutrition standards on dietary and health outcomes of grade school children in a nationally-representative dataset.
METHODS: We used a difference-in-differences model to analyze the effect of the 2012 school nutrition standards in grade school students who participated in the National Health and Nutrition Examination Survey, 2006–2014. The primary outcome was change in 24-hour fruit and vegetable intake, which was derived from 24-hour dietary recall data, and the secondary outcomes were 24-hour solid fats and added sugars (SoFAS) intake and overweight and obesity prevalence. Difference-in-differences estimates of outcomes incorporated the interaction between implementation of the 2012 school nutrition standards and school lunch participation status. Analyses were adjusted for age, gender, race/ethnicity, country of birth, and family socioeconomic factors.
RESULTS: Our sample included 10,224 grade school students who ate school lunch five days per week or ate no school lunches each week. Implementation of the 2012 school nutrition standards did not have a significant impact on fruit and vegetable intake (β= -0.03 cups, 95% CI: -0.22, 0.15) for students with daily school lunch participation relative to those with no school lunch participation. However, the policy was associated with an absolute decline in SoFAS of 1.2% of total daily calories (95% CI: -2.4, 0.0). No changes were identified in overweight and obesity prevalence (β= -5.1%, 95% CI: -11.1, 1.0).
CONCLUSIONS: Changes to school nutrition standards were associated with reductions in consumption of empty calories in children who eat school lunch. However, these policy changes have not demonstrated improvements in intake of healthy fruits and vegetables or in prevalence of overweight and obesity.