COVID-19 has increased awareness of the fact that a large number of low-income families depend on school meals to feed their children. As schools shut down this spring, many districts quickly pivoted to pick-up and delivery so their students wouldn’t go hungry, especially given rising rates of unemployment and increased demand at food banks.

And as officials around the country consider whether or not to reopen schools, one of the many factors under discussion is access to meals. At the end of July, House Democrats even introduced a bill to introduce universal school meals for the 2020-2021 school year, in response to renewed advocacy around the issue.

Less discussed in recent months is the quality of the meals themselves. In the midst of the pandemic, the Trump administration has been trying to roll back the nutrition standards that determine what exactly kids are eating in school. In response, a number of advocacy groups are fighting to keep the existing standards in place.

Now, a Harvard study published in July has introduced new evidence into the debate. The study found that Obama-era changes to school meals have led to a significant decrease in obesity among low-income children, resulting in an estimated half a million fewer children living with obesity five years later.

“Schools have been part of this huge public health success story,” said Erica L. Kenney, an assistant professor at the Harvard T. H. Chan School of Public Health and the lead author of the study. She adds that, “the kind of rollbacks [the administration] is proposing would undo a lot of these standards, when all evidence points to the fact that they have had a beneficial public health impact.”

The results come at a time when the nutrition standards are also being altered to allow schools flexibility during COVID-19 supply chain disruptions, raising questions about how these health gains for children in poverty could be affected in both the near and distant future.

Healthy, Hunger-Free Kids

The Healthy, Hunger Free Kids Act (HHFK), championed by former first lady Michelle Obama, became law in 2010. It required the U.S. Department of Agriculture (USDA), which oversees the National School Lunch and Breakfast programs, to establish science-based nutrition standards for all meals.

The act led the USDA to issue a 2012 rule that mandated big changes, including replacing refined flour with whole grains, increasing the amount and variety of vegetables served, reducing sodium, and implementing age-specific serving sizes. It also limited the kinds of sugary snacks and beverages schools could sell. Schools began implementing the standards in the 2012-2013 school year.

To analyze the effects of the changes, the Harvard researchers analyzed data on childhood obesity in the years leading up to the change in nutrition standards and compared it to data in the years after. When looking at a nationally representative sample of all children aged 10 to 17, they found no significant association between the changes and a shift in obesity trends.

But for children living in poverty, the risk of obesity decreased significantly, leading to a 47 percent decrease by 2018. Depending on the year, those children made up about 15 to 20 percent of the sample, but children from low-income families make up a much greater proportion of children eating school meals.

Kenney said that since they are more likely to eat breakfast and lunch at school than kids from higher-income families, the difference in results didn’t surprise her. “If you think of it almost like a dose, the kids in poverty are receiving a larger dose of these meals,” she explained.

The research cannot definitively prove the changes to the standards caused the shift in obesity risk, but Kenney said the team looked at other changes happening in the same time frame to rule out as many other factors as possible. Based on the specific timing and the results of earlier research, she’s confident that the reduced risk can be attributed to the higher nutrition standards.

In 2019, for example, a study commissioned by the USDA showed the nutritional quality of school meals increased significantly in the years right after the standards changed and that students who participated in school lunch ate more nutritious meals with fewer calories compared to students who didn’t.

Rolling Back the Standards

The same USDA study found that the standards were not associated with an increase in the amount of food served that ends up in the trash. But Agriculture Secretary Sonny Perdue has cited children wasting their food instead of eating it, as well as regulatory challenges faced by school nutrition directors, to justify rollbacks, which he initiated soon after taking over at the USDA.

Perdue’s first big rule change, initiated in 2018, gave schools more time to reduce sodium in meals, allowed for the reintroduction of flavored milks, and cut the whole grain requirement in half, from 100 to 50 percent. Advocacy groups and states filed multiple lawsuits. Then, in April, a judge ruled that the agency’s changes violated the law and that the rule “must be vacated,” which essentially means the earlier standards are back in place.

In the meantime, however, the USDA proposed changing the nutrition standards in a variety of additional, different ways. Those include loosening the mandate around vegetable variety in lunches in a way that could lead to more starches over more nutritious vegetables, reducing the amount of fruit required at breakfast, and allowing schools more flexibility to sell certain meal components a la carte. More than 37,600 individuals and organizations commented on this proposed rule, many in opposition to the changes, and the agency plans to issue a final rule in August.

According to the USDA, “Implementation of the wide range of proposed changes and flexibilities is expected to simplify operational requirements, increase efficiency, and make it easier for State and local Program operators to feed children.” Some groups, like the School Nutrition Association—a nonprofit that represents cafeteria workers nationally—support the rollbacks.

Colin Schwartz, of the Center for Science in the Public Interest (CSPI), one of the organizations involved in the lawsuit over the first rollback, sees it differently. “It’s sort of ‘death by a thousand cuts,’ by weakening various standards all at once,” he said. “The biggest concern that we have is that [the a la carte rule] creates a junk food loophole, so that you can actually serve unhealthier food items more often and have that count as the meal.”

Schwartz said that the rollbacks were part of the administration’s “deregulatory agenda” and that previous changes were driven by food industry groups, such as the dairy industry pushing for the approval of flavored milks.

COVID-19 Waivers, Too

While debate over the proposed rollbacks has been ongoing, the pandemic has also caused more immediate, direct changes to school meals.

In the spring, in order for districts to operate meal programs while students were at home, the USDA waived multiple regulations. One waiver, called the “meal pattern waiver,” allows schools to serve meals that don’t meet the nutrition standards in instances where the food supply has been disrupted due to COVID-19. In order to use the waiver, districts are required to demonstrate difficulty with food sourcing.

On June 15, the USDA extended that waiver through the 2020-2021 school year, and CSPI is concerned that the extension could lead to vulnerable students being served unhealthy meals at a time when nutrition in low-income populations is especially crucial. Communities of color, which are also more likely to be low-income, have been disproportionately affected by COVID-19, and diet-related diseases like Type 2 diabetes and obesity increase the risk of serious illness for those who contract the virus.

COVID-19 is also likely to increase the number of students relying on school meals. One recent report from Northwestern University found that during the pandemic, food insecurity in households with children has tripled.

“More kids are going to be qualifying for the program because of the economic downturn,” Schwartz said. “School meals are actually more important now than ever, so we can’t go back on nutrition.”

However, it’s unclear how widespread the use of meal pattern waivers is. The USDA gave states the job of processing waiver requests, and the agency referred Civil Eats to state agencies for data.

Civil Eats reached out to several states, and there was a wide range in terms of how many districts were using waivers. Florida has only approved five; Connecticut has approved 19; and Wisconsin has approved 117. The most common waivers granted were related to the quantity and variety of vegetables served. These numbers provide examples but are not enough to draw conclusions about what’s happening across the country.

One national survey conducted in May by the School Nutrition Association found that a small percentage of school nutrition directors felt they needed the waivers to operate. It found that 21 percent of the schools that were unsure of whether they’d continue providing meals through the summer, identified “product availability/expiration of meal pattern waiver” as a barrier.

Since there is little data on exactly how the waivers are being used, it’s not yet clear whether their use is actually leading to less nutritious meals. But given the evidence that sticking to the Healthy, Hunger Free Kids Act nutrition standards has resulted in significantly better health for children in poverty, advocates say that the focus should first be on helping districts that are struggling meet the standards.

For instance, Schwarz said, state agencies could help connect districts to new suppliers of foods they’re having difficulty sourcing or offer recommendations on ingredient replacements that are available and would meet the standards.

“We totally get that schools need flexibility and help, but we want to first try to resolve the challenges. We don’t want the default to be just waive the requirement,” Schwartz said. More importantly, he added, “We don’t want this to be the precedent for the next school year—that we actually can’t rely on school meals being healthy and more nutritious.”

Top photo CC-licensed by Phil Roeder.