School Lunch Report Card
A Report by the Physicians Committee for Responsible Medicine
Fall 2002

It’s time for the Nnation’s children to be heading back to school, —and back to school lunch.  Because parents and health professionals are interested in the nutrition quality of the meals being offered in school cafeterias, the Physicians Committee for Responsible Medicine (PCRM) graded the nutrition quality of the menus offered in 10 ten of the largest U.S. school U.S. districts participating in the U.S. Department of Agriculture’s (USDA’s) National School Lunch Program (NSLP). 

The NSLP is a federally assisted meal program operating in nearly 100,000 public and nonprofit private schools and residential childcare institutions. Schools that choose to participate in the program receive cash subsidies, donated commodities, and free bonus shipments for each meal served. In return, they must serve lunches that meet federal nutrition requirements, as well as offer free or reduced-price lunches to eligible children.

Dietitians at PCRM looked at 15 days of recent elementary school lunch menus for New York City, Los Angeles, Miami, Fort Lauderdale, Fairfax County (Virginia), Dallas, Houston, Philadelphia, Las Vegas, and Detroit.  One point was awarded for each time the menu included a low-fat vegetable side dish, a whole or dried fruit, a hot vegetarian entrée (meatless), a hot vegan entrée (meatless, dairy-free, and egg-free), and or a vegan option by request over the 15- day period—, totaling 75 possible points. Twenty points were then awarded to each school district for meeting the National School Lunch ProgramNSLP nutrition requirements, including 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 (RDA’s) for protein, vitamin A, vitamin C, iron, calcium, and calories. All of the school districts surveyed are currently meeting these nutrition guidelines. And, aAn additional 5five points were given to school districts that offering non-dairy, calcium-rich beverages, such as calcium-fortified orange juice, on a daily basis to help meet the calcium needs of students who either cannot or do not drink milk. PCRM dietitians consulted the school districts’ nutrition staffs as needed for with information onquestions about food items that could not be answered by reviewing the menus and or the school districts’ websites. Each school district was given a score out of 100 possible points, which was then converted into a letter grade.

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, and 5. vegetables. Under the National School Lunch Act, students are permitted the opportunity of selecting to select anywhere from three to five of the five 3 of the 5 offered components of the meal. OVS is a federal regulation designed to reduce food waste in the lunch program by allowing students to choose only those foods, which they will intend to eat. The school lunch pattern includes five food items: (1) meat/meat alternate, (2) bread/bread alternate, (3) milk, (4) fruits, and (5) vegetables. They may choose to accept all five items, or as few as three items. Students are not allowed to choose two of the same component, but they can request a second portion of fruit or vegetable at for no extra charge.

Background

On average, children in the United States consume too much total fat and too much saturated fat and far too few fruits and vegetables.  This is problematic because it is tThese dietary patterns that contribute to the rising problem with of childhood obesity in children.  And, a A Centerss for Disease Control and Prevention report on obesity in America found that sixty 60 percent of overweight five- to ten-year-olds already have at least one risk factor for heart disease, such as raised blood pressure or insulin levels.

 To reverse these trends, children should be served low-fat, plant-based meals, encouraging them to follow healthy, vegetarian eating habits right from the start.  Choosing a vegetarian diet is a simple way to achieve or maintain a healthy weight, because no calorie counting is necessary, and it contains the nutrients a fit body needs. A diet drawn from varied plant sources easily achieves or maintains a healthy body weight without calorie counting and satisfies calcium and protein requirements, providing all essential amino acids,— even without intentional combining or “protein complementing.”  There is plenty ofample protein in whole grains, vegetables, and legumes, and plenty of calcium in green leafy vegetables, fortified juices, and other plant foods other foods with health advantages the that meat and dairy products lack. In short, diets built from grains, vegetables, fruits, and beans are easy- to- prepare, are low-cost, and satisfying to hungry children, and  while offering the most disease-fighting protection of any dietary pattern..

The Review process and grading systemGrading S

PCRM dietitians looked at 15 days of recent elementary school lunch menus for New York City, Los Angeles, Fort Lauderdale, Fairfax County (Virginia), Miami, Dallas, Houston, Philadelphia, Las Vegas, and Detroit.

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

Twenty points were then awarded to each school district meeting the NSLP nutrition requirements, including 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. All of the school districts surveyed are currently meeting these nutrition guidelines.

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

PCRM dietitians consulted the school districts’ nutrition staffs as needed with questions about food items that could not be answered by reviewing the menus or the school districts’ Web sites.

Each district was given a score out of 100 possible points, 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, and 5. vegetables. Students are permitted to select anywhere 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.

Here Below are the possible points awarded for each category. One point is given for 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-fFat Vegetable Side-d Dish:       15

Whole or Dried Fruit:        15

Hot Meatless Entrée:        15

Hot Meatless, DairylessDairy-Free, Egg-Free Entrée:   15

Vegan Option:         15 

                                 -----

         TOTAL:   75
 

         + 20 for meeting NSLP nutrition      guidelines

         +  5  for offering non-dairy, calcium-      fortified rich      beverages juices

                        -----

         TOTAL:   100 points

The Criteria

Low-Ffat Vegetable Side Dishes:/ 0 – 15 points

Research indicates that adults who consume regularly eat vegetables are those who consumed these foods during from childhood. Vegetables are packed with nutrients; they provide vitamin C, beta-carotene, riboflavin, iron, calcium, fiber, and other nutrients. Dark green, leafy vegetables, such as broccoli, collards, kale, mustard and turnip greens, chicory, or and bbok choy, are especially good sources of these important nutrients for children. Dark yellow and orange vegetables, such as carrots, winter squash, sweet potatoes, and pumpkin, provide a 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 will adopt healthy eating habits that will stay with them for the rest of their lives. In this survey, 1one point was given awarded for each day that the school district offered a low-fat vegetable side dish. Points were not given for French fries, mashed potatoes, or tater tots.

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

As with vegetables, rAs with vegetables, research shows that adults who eat fruits in adulthood also  are those who consumed them as children. Fruits are rich in fiber, vitamin C, and beta-carotene. Fruit juices do not contain very muchless fiber when compared to thethan whole fruits. Thus, iIn this survey, 1 one point was awarded for each day the school district offered a whole or dried fruit on the menu. Points were given for applesauce as well, but not for fruit juice or frozen fruit bars.

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

Nutrition research is now emphasizesing 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. It’ has also been discovered that the plant kingdom provides excellent sources of the nutrients once only associated only with meat and dairy products—, namely, protein and calcium. The major killers of Americans—heart disease, cancer, and stroke—have a dramatically lower incidence among people consuming primarily plant-based diets. Weight problems—The condition of overweight, a which contributesor to a host of other health problems—, can also be brought under control by following plant-based diets, even for in children. Research shows that vegetarian children grow up to be slimmer and, healthier, and live longerlive longer than their meat-eating friends. It is much easier to build a nutritious diet from vegetarian foods than to attempt to build one from animal products, which contain animal fat, cholesterol, and other substances that growing children certainly do not need. Vegan diets are best of all, since as they are free of cholesterol, animal fat, and animal protein, while rich in fiber and numerous health-promoting nutrients.

With the approval of Alternate Protein Products (APPs) in the NSLP, schools are now given the freedomable to provide children with meatless, cholesterol-free entreées. However, since these foods are not in the commodity or bonus foods program, few schools districts surveyed actually include them in their menu plans. many of the healthier meat substitutes are not available in the commodity food program and cost the schools more to include in their menus.

In this survey, a maximum of 30 points were was awarded for the frequency of both vegetarian (meatless), and vegan (meatless, dairy-free, and egg-free) entreeentrées. (30 points total). However, due to the dangers of dairy product consumption as (explained below), completely plant-based meals are preferred, and. wWhen hot vegan entreeentrées appeared on the menu, a point was also awarded in the vegetarian categorythe school district received one point in the vegetarian entrée category and one point in the vegan entrée category. 

Because many schools have not yet begun offering to featured vegetarian main dishesentrées, (but still include some plant-based selections in their menus), another the category of “vegan option” was included in this review. Having a daily vegan choiceselection offered daily, such as a peanut butter and jelly sandwich, or a salad bar, at least guarantees that children at least can have the option to eat something that is meatless and dairy-free for lunch. Ideally, schools will begin offering healthy, vegan main dishesentrées, such as veggie burgers, bean and rice burritos, and veggie chili, on a regular basis, so that children will have no choice but to select abe presented with healthynutritious entréeselections, develop tastes for health-promotingy foods, and acquire healthy healthy eating habits that will stay with them for the rest of their lives.

Non-dDairy, Calcium-Rich Foods and Beverages:/ 0 or–or 5 points

There are Nnumerous scientific studies showing thatlink the consumption of cow’s milk contributes 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. What’s more, in contrast to CaucasiansAnd, as people of other ethnicities other than Caucasian are typically unable to digest dairy protein,oducts. Due to the dangers of dairy product consumption, cow’s milk with added lactase such as Lactaid® milk is not a suitable alternative. relying onIncluding dairy productsets as the sole source of calcium in child nutrition programs favors those children of Northern European descent. According to the American Academy of Family Physicians’ 2002 report on lactose intolerance, 60  to – 80 percent0% of Blacksblacks, 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 whites are lactose intolerant.  Intolerance to lLactose intolerance, which is generally apparent by age three3, causes flatulence, cramping, diarrhea, and bloating after eating dairy products in some individuals.  Unfortunately, however, calcium-fortified juices are more expensive for school districts than the unfortified versions. Thereforeus, the USDA needs toshould mandate such non-dairy, calcium-fortified beverages in child nutrition programs so that milk and other dairy products are not the only source of calcium available in these programsin school lunches. 

Despite the extra costsexpense, many school districts are already offering calcium-fortified juices in their school lunch programs. Thus, iIn this review, PCRM awarded 5 extra points to school districts already providing calciumthat provide calcium-rich juices to students despite the extra costs on a daily basis..

Nutrition Grades

Here are the school districts’ nutrition grades: