2003 School Lunch Report Card: Review Process

The Physicians Committee

2003 School Lunch Report Card: Review Process

A Report by the Physicians Committee for Responsible Medicine
August 2003

Background | Review Process and Grading System | Report Card

Review Process and Grading System

PCRM dietitians looked at 15 days of recent elementary school lunch menus for 18 school districts in the following cities and counties: Detroit, Miami, Gwinnett County (Georgia), Charlotte, Fairfax County (Virginia), Pinellas County (Florida), Broward County (Florida), Hillsborough County (Florida), New York City, Philadelphia, Montgomery County (Maryland), Prince George’s County (Maryland), Dallas, Palm Beach County (Florida), Los Angeles, San Diego, Clark County (Nevada), and the District of Columbia.

One point was awarded each time the menu included a low-fat vegetable side dish, a whole or dried fruit, a vegetarian entrée (meatless, hot or cold), a featured vegan entrée (meatless, dairy-free, and egg-free), and a vegan option by request over the 15-day period, for a total of 75 possible points.

Twenty points were then awarded to each school district meeting the NSLP nutrition requirements, which include a menu featuring less than 30 percent of calories from fat, less than 10 percent of calories from saturated fat, and one-third of the Recommended Daily Allowances (RDAs) for protein, vitamin A, vitamin C, iron, calcium, and calories.

An additional five points were given to school districts offering non-dairy, calcium-rich beverages, such as calcium-fortified orange juice or enriched soymilk or rice milk, on a daily basis to help meet the calcium needs of students who either cannot or do not drink cow’s milk.

A district could score a total of 100 possible points.

PCRM dietitians mailed elementary menu questionnaires to the nation’s 25 largest school districts, plus the organization’s home district of Washington, D.C. These questionnaires asked food service directors about the meatless and vegan entrées and options available in the schools, the frequency of low-fat vegetable and fruit side dishes offered, the availability of non-dairy, calcium-rich beverages, and whether or not their menus met the NSLP nutrition standards. The questionnaires also asked respondents to describe healthy nutrition programs, changes, or initiatives taking place in their districts.

When a school district did not respond to the questionnaire, PCRM attempted to consult directly with the school district’s nutrition staff. Eight of the 25 districts did not provide enough information to permit PCRM to evaluate their programs. Each district that did respond received a percentage score, which was then converted into a letter grade.

Note: All of the school districts included in this survey are using the “Offer vs. Serve” (OVS) menu system. OVS is a federal regulation designed to reduce food waste in the lunch program by allowing students to choose only foods they intend to eat. The school lunch pattern includes five food items: 1. meat or meat alternative, 2. bread or bread alternative, 3. milk, 4. fruits, 5. vegetables. Students are permitted to select from three to five of the five offered components of the meal. Students are not allowed to choose two of the same component, but they can request a second portion of fruit or vegetable at no extra charge.

Below are the possible points awarded for each category. One point is given each time the menu includes each of the following items in 15 days of sample lunch menus, plus an additional 20 points for meeting NSLP nutrition guidelines and 5 points for offering non-dairy, calcium-rich beverages.


Low-Fat Vegetable Side Dish:



Whole or Dried Fruit:



Meatless Entrée (Hot or Cold):



Featured Meatless, Dairy-Free, Egg-Free (Vegan) Entrée:



Vegan Entrée Option:








for meeting NSLP nutrition guidelines



for offering non-dairy, calcium-rich beverages




The Criteria:

Low-Fat Vegetable Side Dishes: 0 – 15 points

Research indicates that adults who regularly eat vegetables tend to have consumed them from childhood. Vegetables are packed with vitamin C, beta-carotene, riboflavin, iron, calcium, fiber, and many other nutrients. Dark green, leafy vegetables, such as broccoli, collards, kale, mustard and turnip greens, chicory, and bok choy, are especially good sources of important nutrients for children. Dark yellow and orange vegetables, such as carrots, winter squash, sweet potatoes, and pumpkin, provide the powerful antioxidant beta-carotene. When schools offer tasty, low-fat vegetable side dishes, such as green salads, mixed vegetables, steamed broccoli, corn on the cob, and raw baby carrots with low-fat Italian salad dressing, children adopt healthy eating habits that will stay with them for the rest of their lives. In this survey, one point was awarded for each day the school district offered a low-fat vegetable side dish. Points were not given for such high-fat side dishes as French fries, mashed potatoes, or tater tots.

Whole or Dried Fruit Offered as a Side Dish or Dessert: 0 – 15 points

As with vegetables, research shows that adults who eat fruits in adulthood also consumed them as children. Fruits are rich in fiber, vitamin C, beta-carotene, and many other nutrients. Fruit juices contain less fiber than whole fruits. In this survey, one point was awarded for each day the school district offered a whole or dried fruit on the menu. Points were given for applesauce, but not for fruit juice or frozen fruit bars, which are not rich in fiber and often feature added sugar.

Vegetarian and Vegan Entrées and Vegan Options: 0 – 45 points

Nutrition research now emphasizes the importance of fiber, the health risks of cholesterol and fats, and the disease-preventive power of many nutrients found exclusively in plant-based foods. Researchers have also discovered that the plant kingdom provides excellent sources of nutrients once associated only with meat and dairy products.

A diet drawn from varied plant sources easily satisfies calorie, calcium, and protein requirements, providing all essential amino acids—even without intentional combining or “protein complementing.” There is ample protein in whole grains, vegetables, and legumes and plenty of calcium in dark green, leafy vegetables, fortified juices, and other plant foods.

The major killers of Americans—heart disease, cancer, and stroke—have a dramatically lower incidence among people consuming primarily plant-based diets. The condition of overweight, which contributes to a host of other health problems, can also be brought under control by following plant-based diets, even in children.

With the approval of Alternate Protein Products (APPs) in the NSLP, schools are now allowed to provide children with meatless, cholesterol-free entrées. However, many of the healthier meat substitutes are not available in the commodity food program and cost schools more to include in their menus.

In this survey, a maximum of 45 points was awarded for the frequency of both vegetarian (meatless) and vegan (meatless, dairy-free, and egg-free) entrées. However, due to the dangers of dairy product consumption (which are explained below), completely plant-based meals are preferred. When featured vegan entrées appeared on the menu, the school district received one point in the vegetarian entrée category and one point in the vegan entrée category, unless the item featured was a peanut butter and jelly sandwich, in which case, the district only received credit in one of the categories. It is important for districts to expand beyond peanut butter as a vegan menu item and explore other healthy vegan dishes.

Because many schools have not yet begun to feature vegetarian main entrées (but still include some plant-based selections in their menus), the category of “vegan option” was included in this review. Having a daily vegan choice, such as a peanut butter and jelly sandwich or a salad bar, guarantees that children at least have the option to eat something that is meatless and dairy-free for lunch. The vegan option category accounted for 15 of the 45 vegetarian and vegan entrée points.

Ideally, schools will begin offering vegan entrées, such as veggie burgers, bean and rice burritos, hummus sandwiches, and veggie chili, on a regular basis so that children will be presented with nutritious selections, develop tastes for health-promoting foods, and acquire healthy eating habits that will stay with them for the rest of their lives.

Non-Dairy, Calcium-Rich Beverages: 0 or 5 points

Numerous scientific studies link the consumption of cow’s milk to obesity, anemia, ear infections, constipation, respiratory problems, heart disease, and some cancers. Due to the dangers of dairy product consumption, cow’s milk with added lactase, such as Lactaid® milk, is not a suitable alternative.

Moreover, since many children, particularly those of African, Asian, Hispanic, or Native American heritage, are unable to digest lactose (a dairy sugar), relying on dairy products as the sole source of calcium in child nutrition programs can cause kids to have digestive problems. According to the American Academy of Family Physicians’ 2002 report on lactose intolerance, 60 to 80 percent of blacks, 50 to 80 percent of Hispanics, 80 to 100 percent of American Indians, 95 to 100 percent of Asians, and 6 to 22 percent of American whites are lactose intolerant. Lactose intolerance, which develops gradually over the childhood and early adult years, causes flatulence, cramping, diarrhea, and bloating in some individuals. Therefore, the USDA should mandate the offering of non-dairy, calcium-fortified beverages as a reimbursable alternative in child nutrition programs so that milk and other dairy products are not the only source of calcium available in school lunches.

Despite the extra expense, many school districts are already offering calcium-fortified juices in their school lunch programs. In this review, PCRM awarded five extra points to school districts that provide calcium-rich juices to students on a daily basis.

Grading Scale