School Meal Nutrition Standards Reduce Disparities Across Income and Race/Ethnicity.

INTRODUCTION: Children's diets in the U.S. typically fail to meet dietary recommendations, contributing to associated adverse health outcomes. The Healthy, Hunger-Free Kids Act (HHFKA) of 2010 required the U.S. government to update nutrition standards for school meals to align with the Dietary Guidelines for Americans (DGAs). This study estimates the evolving impact of substituting school-prepared food for home-prepared food on overall daily diet quality and by subcomponents of diet quality. Subgroup analyses are performed by race/ethnicity and income. METHODS: Two, nonconsecutive days of dietary recall data from the National Health and Nutrition Examination Survey (2005-March 2020) are used to calculate schoolchildren's Healthy Eating Index (HEI)-2020 scores. The study includes children with complete two-day dietary intakes who attend kindergarten through twelfth grade in a school offering lunch. An individual-level fixed effects regression is employed to examine the relationship of school food consumption on HEI-2020 scores before and after HHFKA-mandated changes in nutrition standards. Analyses were conducted on September 23, 2023. RESULTS: Prior to changes in standards (2005-2008), school food did not impact diet quality within the overall group of children. In 2009-2012, positive associations between school food and diet quality emerged for low-income students and for non-Hispanic Black students. By 2013-2020, improvements were seen across all groups. The association between school food and diet quality was most attributable to more favorable consumption of dairy, fruit, whole grains, refined grains, added sugars and saturated fats. CONCLUSIONS: HHFKA-based nutrition standards were associated with beneficial dietary changes and reduced dietary disparities for children across diverse backgrounds.

Plate Waste Evaluation of Plant-Based Protein Entrees in National School Lunch Program.

OBJECTIVE: To assess plate waste of plant-based protein entrees compared with regularly served meat-based entrees in the National School Lunch Program (NSLP). DESIGN: Plate waste data were collected before and after introducing the plant-based entrees, using digital photography and the quarter-waste method. PARTICIPANTS: National School Lunch Program participants in grades 6-8. INTERVENTION: Two newly developed plant-based protein entrees were introduced into the menu cycle by replacing 2 regularly served meat-based entrees. MAIN OUTCOME MEASURE: Student plate waste of plant-based entrees compared with entrees regularly served in the NSLP meal pattern. ANALYSIS: A total of 4,138 meal observations were analyzed. Ordinary least-squares regressions and 2-sample unpaired t tests were used to determine significant differences in waste. RESULTS: National School Lunch Program participants wasted plant-based entrees more than all other entrees served during lunch. Students wasted all or none of the plant-based entrees more than partial servings. There were no significant differences in waste between demographic groups for the plant-based entrees. CONCLUSIONS AND IMPLICATIONS: Plant-based entrees served as a part of the NSLP may lead to increased plate waste than meat-based entrees. Novel food pairings and visibility of legumes may have led to increased plate waste.

Air pollution and noncognitive traits among Chinese adolescents.

Most residents in developing countries live under poor air quality. The adverse effects of air pollution on cardiovascular and respiratory health are well documented. More recently, it has been shown that air pollution adversely affects areas of the central nervous system regulating noncognitive traits. Because the developing brain is particularly vulnerable, this study focuses on adolescents. We match air pollution data from monitoring stations in China to repeated measures of noncognitive traits using panel data. In general, poorer contemporaneous air quality, rather than poorer past air quality, negatively affects adolescent noncognitive traits. Specifically, an increase in the Air Pollution Index by 15 points-the average daily fluctuation-leads to a 5.5% increase in psychological distress, 0.9% decrease in self-esteem, 3.2% reduction in self-satisfaction, and 0.9% decrease in confidence in the future. No such effects are found among adults.

Temperature and self-reported mental health in the United States.

This study estimates the association between temperature and self-reported mental health. We match individual-level mental health data for over three million Americans between 1993 and 2010 to historical daily weather information. We exploit the random fluctuations in temperature over time within counties to identify its effect on a 30-day measure of self-reported mental health. Compared to the temperature range of 60-70°F, cooler days in the past month reduce the probability of reporting days of bad mental health while hotter days increase this probability. We also find a salience effect: cooler days have an immediate effect, whereas hotter days tend to matter most after about 10 days. Using our estimates, we calculate the willingness to pay to avoid an additional hot day in terms of its impact on self-reported mental health.

Dietary Guidance and New School Meal Standards: Schoolchildren's Whole Grain Consumption Over 1994-2014.

INTRODUCTION: Since 2005, the federal government's Dietary Guidelines for Americans have recommended at least half of total grain intake be whole grains. Beginning with the 2012-2013 school year, the U.S. Department of Agriculture updated school meal regulations to align with this recommendation. METHODS: Nationally representative food consumption survey data spanning 1994-2014 were analyzed in 2018 to construct a sample of 17,016 schoolchildren aged 5-19 years. Regression models were used to examine changes in whole grain/total grain intake by food source. For school-obtained foods, changes in whole grain intake are decomposed into changes in propensity (proportion of students consuming whole grains) and intensity (amount consumed by whole grain consumers). RESULTS: The whole grain/total grain ratio from all sources fell from 9.67% (1994-1998) to 7.6% (2005-2006) before climbing to 13.48% (2013-2014). Home-prepared foods topped the whole grain/total grain ratio among all sources until surpassed by school foods in 2013-2014 (17.16% vs 21.48%). The whole grain/total grain ratio from school rose from 4.02% to 21.48% during 1994-2014. Among those consuming school foods, increased intensity contributed more than propensity to increases in whole grain intake from school between 2005-2010 and 2011-2012; the opposite occurred between 2011-2012 and 2013-2014 because of increasing propensity, from one in four to one in two students consuming whole grains. CONCLUSIONS: During 1994-2006, the whole grain/total grain ratio of schoolchildren's diets declined, contrary to expert advice. Following the 2012 U.S. Department of Agriculture school meal regulations, both the propensity and the intensity of whole grain consumption from school rose considerably, demonstrating the important role school meals may play in improving children's diets.

Salience, Food Security, and SNAP Receipt.

Household food insecurity status in the United States is ascertained by a battery of close-ended questions. We posit that the monthly nature of benefit receipt from the Supplemental Nutrition Assistance Program (SNAP) creates experiences of food hardship, which become salient in the context of SNAP receipt, and in turn exert influence on the response to food security questions. We test this hypothesis by examining answers to a 30-day food security module in relation to when SNAP benefits are received. We find that for SNAP households near the end of or at the beginning of the benefit month, the probability of being classified as food insecure increases by 11 percentage points, over a baseline of 42 percent. We also find that the probability of responding affirmatively to any of the first five items in the module increases during this time. We discuss the importance of these findings for the estimation of food security and its implication on program evaluation.

Measuring weight outcomes for obesity intervention strategies: the case of a sugar-sweetened beverage tax.

Taxing unhealthy foods has been proposed as a means to improve diet and health by reducing calorie intake and raising funds to combat obesity, particularly sugar-sweetened beverages (SSBs). A growing number of studies have examined the effects of such food taxes, but few have estimated the weight-loss effects. Typically, a static model of 3500 calories for one pound of body weight is used, and the main objective of the study is to demonstrate its bias. To accomplish the objective, we estimate income-segmented beverage demand systems to examine the potential effects of a SSB tax. Elasticity estimates and a hypothetical 20 percent effective tax rate (or about 0.5 cent per ounce) are applied to beverage intake data from a nationally representative survey, and we find an average daily reduction of 34-47 calories among adults and 40-51 calories among children. The tax-induced energy reductions are translated into weight loss using both static and dynamic calorie-to-weight models. Results demonstrate that the static model significantly overestimates the weight loss from reduced energy intake by 63 percent in year one, 346 percent in year five, and 764 percent in year 10, which leads to unrealistic expectations for obesity intervention strategies. The tax is estimated to generate $5.8 billion a year in revenue and is found to be regressive, although it represents about 1 percent of household food and beverage spending.