More than a decade ago, the Obama administration passed the Healthy, Hunger-Free Kids Act of 2010 as a way to counter the toll the obesity epidemic was taking on children's health.
The goal was to markedly improve the nutritional value of federal food programs that regularly put free and/or low-cost breakfasts, lunches and snacks on the plates of nearly 30 million American students.
Did it work? A new study delivers a resounding yes.
“We showed that the annual change in body mass index [BMI] decreased by 10 percent in children and adolescents in America following the implementation” of the law, said study lead author Dr. Aruna Chandran. She is a social epidemiologist and senior scientist with the Johns Hopkins Bloomberg School of Public Health, in Baltimore.
What fueled the drop? School-based federal food programs provide “an estimated 50% of students' caloric intake each school day,” Chandran noted.
So, the upshot is that “accessibility to school meals and snacks represents a key opportunity for intervention to combat the childhood obesity epidemic,” she added.
In the study, Chandran and her colleagues pored over BMI trends among 14,000 kids between the ages of 5 and 18.
As a point of comparison, the investigators focused on two periods of time. The first fell between 2005 and the summer of 2016, before the new law was implemented; the second stretched from the fall of 2016 through pre-pandemic 2020, after most schools were in compliance but before COVID-19 safety measures triggered widespread school closures.
By the latter period, the law had triggered significant reductions in the amount of salt and fat found in school meals, alongside a notable increase in the amount of whole grains, fruit, vegetables and low-fat dairy products.
In the end, the team observed a drop in BMI levels among children and teens after the healthier federal food programs were in place.
Looking ahead, Chandran said that she and her colleagues “believe that policymakers could use evidence from studies like this to support policies related to improving the nutritional quality of meals provided in schools.”
The findings were published online Feb. 13 in JAMA Pediatrics.
Dr. Lauren Fiechtner, director of nutrition at MassGeneral Hospital for Children in Boston, penned an accompanying editorial.
“What the authors found is meaningful,” Fiechtner said.
For example, she noted that Chandran's analysis found that an at-risk 10-year-old student who had a high BMI before the law came into effect ended up losing roughly one pound of excess weight once the law was fully implemented.
That same outcome in the larger population stands to take a notable bite out of the obesity struggle that “now affects 14.7 million children in the United States,” Fiechtner said.
With that in mind, she agreed with the study team's conclusion that “decreasing the trends of BMI for all children with the implementation of these nutrition changes in the school lunch program has the potential to curb the obesity epidemic and improve children's lifelong health.”
There's more on childhood obesity at the U.S. Centers for Disease Control and Prevention.
SOURCES: Aruna Chandran, MD, MPH, social epidemiologist and senior scientist, department of epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore; Lauren Fiechtner, MD, MPH, director of nutrition, division of pediatric gastroenterology and general academic pediatrics, MassGeneral Hospital for Children, assistant professor, pediatrics, Harvard Medical School, and senior health and research advisor, Greater Boston Food Bank, Boston; JAMA Pediatrics, Feb. 13, 2023, online