E266: What's next for school meal quality?
The food and nutrition landscape in our schools is really important. School meals affect the health, wellbeing, energy, vitality, and ability to learn for millions and millions of children. And for those whose family struggled to buy food, the importance of school meals cannot be overstated. This makes decisions about what foods are served in schools and where they come from. Highly consequential and raises issues about national and state nutrition policies, the influence of big food companies in shaping this picture and lots more. It's a good time to unravel all this, which we can do today. Thanks to two experts with us. Dr. Marlene Schwartz is Professor of Human Development and Family Sciences and Director of the Rudd Center for Food Policy health at the University of Connecticut. Mara Fleishman is CEO of the Chef Ann Foundation, where she has been a leader advancing school food change, advocating for scratch cook meals that promote children's health and for more sustainable food systems. Interview Summary In discussions about school food, it seems there first came a nutrition part, which in more recent years has been joined with a concern about where foods come from. Better connections, say between schools and low whole food systems. Let's talk about both, Marlene, let's start with nutrition. You have been a pioneer in working with schools, an interest that goes back a number of years. What was this food environment like in schools before change began to occur? It was my impression it was sort of a free for all. So, yes, I would agree that it was a free for all. The actual school lunch, what we call the reimbursable school lunch, which is the meal that the federal government gives states and then states give the local food service directors funds to support, that has actually always had nutrition standards. But historically the problem was under nutrition. The standards were very focused on making sure students had enough to eat. There were no maximums. It was really all about making sure that there was at least the minimum number of calories and foods available. But the other foods that were sold in schools, which we call competitive foods, so these are foods that were vending machines and school stores and fundraisers and things like that, were hardly regulated at all. And that is really where we saw a complete free for all. We saw ice cream and chips and soda and sports drinks and things like that. And I remember going to one school here in Connecticut and counting 13 vending machines in the high school. It really was remarkable the amount of unhealthy food that was being sold in schools. You know, I was thinking of that same thing when I was living in Connecticut, I went to my son's high school, a different school than what you're talking about. And I forget the number of soft drink machines they had around the school, but it was in the teens. And when I was a boy, I don't remember any soft drink machines in my schools. Maybe they hadn't been invented yet. I'm so old. But it was really pretty remarkable how much access children had to these things. And as I understand, the importance of those machines in the schools to the companies was more than just what food was being sold. There was a real branding opportunity. Is that right? I think that's exactly right. And I remember over 20 years ago when we were talking to some of the soft drink companies about the vending machines, they were quick to point out that they didn't make all that much money selling soft drinks in schools. Which I felt was them basically admitting that they weren't there because of the income from the sales in schools. But rather it was a hundred percent branding. And that was also really evident by the fact that you had to have a contract. So, the school districts had to have contracts with Coke or Pepsi or Cadbury Schwepps to only sell that company's products. It was blatantly obvious that this was all about marketing and marketing to an audience that they had to go to school, and they were going to be exposed to those logos every time they walked past one of those machines. Yeah. I remember in those days it felt like a victory when the companies agreed to change what was in the machines, but it was what was on the machines that was more important. So, you know, once again, that was a sign of the industry having upper hand. Let me ask you a different question. So there have been some important systemic changes discussed in context to school meals, ones that really could affect the nutrition landscape nationwide. And I'm thinking in particular universal free school meals. Can you tell us what this means and why it's important and what do you think ought to be done? Sure. So universal free school meals, or as the advocates call it Healthy School Meals for All, is a policy that is providing meals at no cost to all students. So typically the way it works in most school districts is there's three categories of payment. There are students who pay quote, full price. There are students who pay a reduced price and there are students who receive the meal at no cost, and it has to do with the income of their household. But what has been shown, interestingly most significantly during the pandemic, there was a policy from the USDA that all students would receive meals at no cost because we were clearly in a national crisis. And in some ways, it was this silver lining of that time because what it showed, those of us who study school meals, is how wonderful it is to be able to provide meals at no cost for everyone there. There are a lot of benefits. Some of it is just the administrative burden of having to figure out each and every household and which category they're in is lifted. You don't have to track which student is which as they're picking up their lunch. But it also really removed the stigma. One of the most surprising things that we've seen in our data is that even students who would have gotten their meal at no cost already were more likely to take a meal when it was provided at no cost for everyone. Because it just became part of what you did. Everybody was eating the school meal. And I think that it always leads to higher rates of participation among all of those sorts of categories of kids. And I think it also really allows the people running the food service to focus on preparing the food and making it the best it can be and not having that burden of the paperwork. And will there come a day, in your belief where this will happen? I hope so. What we've seen is that a number of states, I think it's eight right now, actually passed state policy to keep universal free school meals after the federal guidance that had been out there was lifted after the pandemic was over. And so \ my hope is that they'll really demonstrate the benefits and that other states will join in. There's certainly a lot of advocacy in a lot of other states to try to do this. And some of the benefits that have also been shown are outcomes like attendance and academic achievement and just really showing that just like we use our public funds to fund the teachers and the building and the water and the library books. It's sort of seen as a basic tool that the school needs to make available to students so that they can succeed academically. And I think that shift in attitude as opposed to seeing the lunchroom as this sort of separate thing from the rest of the school building. I think that shift in attitude will be really helpful overall. That makes good sense. Mara, let's turn to you. I'm really eager to hear about the work of the Chef Ann Foundation. I've followed its work for a number of years, but I'm eager to hear what the most recent iteration of this. So, I'm hoping you can tell us, and also give us some sense of why you got interested in these issues. Well, the Chef Ann Foundation is actually celebrating its 15th birthday this year. And we help school food programs move from serving more processed heat and serve food to serving more freshly prepared scratch made meals in schools. And we do that through looking at what are the barriers to school food programs actually serving this freshly prepared meal. And there are a number of barriers: training, skill sets, equipment, access to healthier food, local farmers. The reimbursement rate, you know, how much money they get actually for serving these meals. What about the power of the companies that are providing the prepared foods to schools? Yes, that's a big piece. So those are very loud voices that have a [00:09:00] lot of power behind them. Through the passing of the Healthy Hunger-Free Kids Act in 2010, there was an increase in nutrition standards change and what Marlene was saying is that while there was some basic before that, after Healthy Hunger Free Kids Act, we had saturated fat standard, sodium, whole grain. But what happened was these big food companies just kind of R&D'd their food to meet these standards. So, we are in a better place today, right? Because we are serving more whole grains. We are serving less saturated fat, less sodium. But one of the big things that the passage of that Child Nutrition Reauthorization did not do was really reduce ultra processed food in school. And that I think is the next horizon for school food, is how to actually help them reduce that ultra processed food. Because there is, you know, a lot of research out there, I'm sure Marlene is familiar with this, that is linking more ultra processed food to diet related disease. So, we go in and really help these school food programs with more culinary training, we do assessments to tell them what kind of equipment they need to serve fresh food. A lot of it is financial training. So, when you're serving a chicken nugget. One chicken nugget that meets the standards. You bring it in frozen. All you have to do is reheat it and put it on the line. If you're making a chicken strip from scratch, you know you have to buy the chicken, you have to buy the breadcrumbs. You have to buy all the ingredients. You have to start looking at your program through a different lens. Your financial modeling is different. Your labor resources are different. Meeting meals per labor hour is different. We provide training on all these fronts to help them run that program. Well, it sounds enormously beneficial. How much do, in the modern day, how much do schools care about these things and how much do parents care about them? Well, I think something that's really exciting, and I think we have the best vantage point for it, is that schools, parents, communities, even government cares way more about it today than they did when the Chef Ann Foundation was launched. We were definitely considered more of a niche nonprofit organization that only worked with kind of districts that were very progressive. But today, we have, waiting lists for our grants. we work in every state in the country. And we now have a cooperative agreement with the USDA, which would never have really been possible 15 years ago. They just weren't looking for partnerships with organizations that were pushing the envelope to this level. So, I think now's our time. It's so nice to hear that because I remember back when the Chef Ann Foundation got started. And that niche role that it played was clear, but there was so much hope that it would expand and it's really nice that it has. And the fact that you're in every state and the USDA is working with you, those are all really good signs. Well, let me ask you another question. This one about equity. How does this work fit into an equity point of view? I mean, that's pretty much the heart of the matter, I think in many ways. I started this work because I worked for Whole Foods Market for 13 years and I was very interested in food systems work. I have three children and my oldest, who's now 23, when she started in kindergarten, I went to lunch with her. They were serving, this was before the Healthy Hunger Free Kids Act, they were serving a very highly processed, high sugar, low protein meal. And I was looking around at the cafeteria really looking at who is eating this meal and thinking to myself, what are we doing here? We are not providing the same springboard for every kindergartner to thrive and meet their true potential, right? There were kids coming to school with their very healthy packed lunches and little baby organic carrots and whole wheat bread and no-nitrate turkey sandwiches. And then there was a whole host of kids eating this very ultra processed high sugar, low fiber, no protein meal. And the equity issue that you're speaking of was right there and very blatant. And if we're not going to provide children that same springboard to thrive from, which, you know, is what K 12 is about, right? That's what we're trying to do for everyone then we have some big issues. And to Marlene's point, we disregard food in that equity issue. So, we don't make higher income kids pay for their bus rides or anything else. And we don't kind of create that divide. We don't devalue anything as significantly as we do food. And it's what makes you thrive. I heard once a very interesting statement from a physician who worked on brain development. And he said that if children are not fed correctly during critical stages of their development amounts to a life sentence. That there are just certain things that will never recover no matter what happens. Having a better school food environment helps erase some of that for sure. Not all of it, but at least some of it. And then each of the children are more on a level playing field in terms of their academic achievement because some aren't so much more burdened by a terrible food environment. I can see why this would, would really be so important. Marlene, let's talk about what changes have been made. Both you and Mara have alluded to this, but specifically what's happened over the years in terms of school meals and have there been studies on the impacts on children? Sure. Well, I completely agree with Mara that the Healthy Hunger Free Kids Act was a really bright spot, certainly in, in my career, in terms of seeing changes to school meals. So, as I mentioned before, we used to have only minimum calories and things like that. And now we finally have maximum calories based on the age of the child as well as sodium, saturated fat, increasing whole grains, low fat dairy, things like that. The other thing with the smart snacks, so the competitive foods that started to have nutrition regulations. That was a perfect example though of where the companies use their research and development dollars to essentially make a Dorito that fit the standards and a cookie that fit the standards. And I think in some ways that has highlighted the fact that our society is starting to look much more skeptically at highly processed foods. Because I remember standing in my kids' high school a number of years ago after smart snacks went into a fat, and I was in front of the vending machine, and a parent came up to me who knew this was what I studied and said: 'What are you talking about? That school food is healthier. Look at that!' And sort of pointing to all the packaged chips and cookies and other snacks. And I tried, I was like, well, but those are reduced fat Doritos and those cookies are lower in sugar and probably have some whole grains and nobody cared. Parents basically can recognize junk food when they see it. I one hundred percent agree that processed food is the next dimension that we need to really be able to assess, measure it so that we can start to regulate it. And to have that be a new way in which we try to manage the quality of school meals. Before we get to the issue of what sort of research has been done to show the impact on kids, let me follow up on the Doritos example. Well, it sounds like what we were talking about earlier with a Coke machine being so important because of the logo and branding and stuff like that. Sounds like exactly the same things that work here. That the company wants to have Doritos in the school, not because they sell so much or make so much money. But that they brand, it's a chance to brand that particular product or that particular company. And then of course, kids want those when they get out of school and they talk to their parents about getting them. So, it seems like the fact that they get reformulated to be a tad healthier isn't much of a victory is it. No, and I feel like it's almost like the worst of all situations. So, we've done some research on this at the Rudd Center and have a graphic where we show like the school version and then the grocery store version. And it's completely clear that it's the same branding. Nobody would mistake or not think it was the same product. But the grocery store version is not as healthy as the school version. So you're simultaneously - if someone were to know, for example, that about smart snacks and the nutrition standards they could say, well, they sell it in schools maybe it's better. They might be more likely to buy it in the grocery store, but of course what they're buying in the grocery store is worse. And then if you ask folks from the food industry, which I've done, well, why don't you just reformulate all of it? Why don't you only sell the school version in the grocery store? They say, 'oh, well, we are just worried that people won't like it because it's not, you know, as palatable.' It's like a lose-lose proposition. I would like, personally, to see all of those foods removed from schools. And to answer your question about the research though, it's really promising. I mean, there have been a couple of studies that I always go to, to sort of document the positive impact of the regulations that came from the Healthy Hunger Free Kids Act. One was a study showing that basically the meals that students eat in school for most American children are the healthiest meals that they eat all day. So that it's sort of the best source of nutrition. And then another study that was looking at BMI trajectories over time and found that particularly among lower income children there was a measurable impact on BMI in terms of reducing the risk of childhood obesity after the Healthy Hunger-Free Kids Act regulations were put into place. So, I feel like when you have those sort of large national data sets and you can look at impact across the country, it's pretty clear that even though we of course, want to see more change and keep going forward, even the changes we've made so far have had an important impact. Do you think the changes are sufficient to produce impacts on learning and academic achievement and things like that? We have a hard time having enough data to really get at that very specific outcome because so many things have impact on academic achievement. But there definitely have been some studies that have been able to show some impact. But it's a tricky thing to measure. Mara, let's talk a little bit about how the school can be part of a vital and healthy food system overall. Tell us about your work in that space. We look at health in its kind of larger capacity, right? So direct related nutrition results with kids eating certain foods. But in addition, the school lunch program is funded to the tune of $17 billion a year, right? So, if we think about spending those dollars in the food system and how we're going to change the food system we have to really think about how we empower these school food professionals to make the best choices they can to affect change. With approximately about a $4.30 reimbursable rate price of a lunch, it's not easy right now. Labor prices are going up and you have to pay for labor out of that. You have to pay for food cost out of that. But you can prioritize your choices. Some of the things that we work with districts on are what are their top 20 highest volume purchases in the school food program. And how can we look at that top 20 and make some adjustments to purchase things that can impact the environment in a more significant way. Often it is animal protein that's in their top 20. That is really an opportunity for districts to make better choices. Local choices. Higher quality choices. You know, choices that impact not only the health of the environment, but the health of their local economy. But it is challenging because your district has to be able to manage raw animal protein. A lot of the processed animal protein products coming to the districts are pre-cooked, and so they don't have to always know how to manage in a kitchen raw animal protein. And that's usually this barrier that we help districts get over. But once we do, there is this huge opportunity for them to purchase higher quality animal protein. Also fruits and vegetables, right? I always get asked this from parent groups who are looking to change school food. Why can't we just purchase everything organic in schools, right? So that's hard on $4.30, right? You can't. But you can make choices and you can look at the highest volume products or the products that are more affected by pesticides, right? So, if you have a salad bar you know you're serving lettuce every day. You can move to serving an organic lettuce, and that is a huge opportunity to move forward. I think things like that are how we look at the food system in terms of school food. But it's really important not just for us food systems people to be looking at it like this, but for us to be training and teaching the school food professionals about their job and the impact they can make, both on student nutrition and environmental impact. And that's a lot of what we do in our workforce development initiatives. How does seasonal things figure in? Because schools are in session during the months when it's colder in most parts of the country, and the agricultural system isn't going full bore like it might in the summer months. How do you deal with that? It's really a great point. I know whenever I bring up any kind of exemplary food program in California, people say to me, 'Ugh, California. You can do a lot in California, but what can you do elsewhere?' Well, here where I live in Boulder, the Boulder Valley School district serves close to 15,000 lunches a day. They have 55 schools. It's kind of that perfect midsize district example. And they purchase 40% of their products locally. This is a Northern Climate District. This is Colorado. It takes time. It takes a real steadfast plan. But you, you know, you can purchase potatoes through December. There's a lot of indoor growing right now locally too. So that's also this great opportunity to purchase things like if you have a salad bar purchase, things like lettuce locally, all year long. There's, there's a lot of local wheat production that is happening these days in northern climates and then it's getting milled and processed into different products that you can buy locally. It's very much possible. Can you get to a hundred percent local procurement? Not right now, not at the current reimbursable rate, but there's a lot of room for improvement even in northern climates. When the schools are buying such foods that come from local sources, are they buying directly from the farmers or is there some agent in the middle? It depends. Mostly for local farmers, small local farmers, they're buying direct. And that's a challenge for small and even some midsize districts because of their capacity, their procurement capacity, their administrative capacity. But it is possible. Obviously, it's in some ways easier for big districts like, you know, LAUSD (Los Angeles Unified School District). We work with LAUSD. It's an amazing district that buys a lot locally. But they have the volume, they have the capacity, they have the administrative support. That's why a lot of our work focuses on small and midsize districts to actually provide them with that kind of structure and support to do it. And to really prioritize the buying processes through their local purveyors. There are some local distributors that have more local products than others. You know, gold Star is a distributor on the West coast that has more local products. But in reality, the prime vendors for these districts are mostly Sysco or US Foods. And they don't carry a ton of local farm product for these districts. So, they're really going to have to create those partnerships. I'm thinking of the farmers and what impact it might have on them. And I could imagine for some farmers at least, it would provide a reliable income source and a reliable customer for their products, which would be helpful financially. And I imagine, although I don't know that there are probably cases where the schools are inviting the farmers to come in and meet the kids, and that's probably good for everybody. Does that kind of thing happen? Yeah, I mean that is huge and as I kind of talked about ultra processed food being the next horizon to look at reducing in school food, I also think how we work with school food programs to connect them and actually have them be stronger customers of local farmers is also this next horizon. One of the new projects that we're working on is called Values Align Purchasing Collectives. So, we're currently doing assessments to determine how we can group small and mid-size districts together to form buying cohorts, basically, to purchase from local farmers. So how can we get them to look at serving some of the same menu items, purchasing together, working together to relieve some of the administrative stress on the districts, but also on the farmer side. So how do we create hubs to do and look at creating a process that can better support? And I think that's the future. Oh boy. That sounds like a very exciting development. Marlene, just you have something you wanted add? Yeah, I'm just so exciting to hear all of that. I was going to mention that we have a new project in Connecticut looking at farm-to-school practices across the state, and really trying to work with districts on both the procurement part of it as well as incorporating more into the classroom. So having that connection with local farmers, having that being part of the sort of educational curriculum. And then really what I've always thought was the goal was to have the cafeteria more of a learning lab. Not having it as this, I guess I said before, separate part of the school, but rather incorporating nutrition education, incorporating this is where that apple came from and teaching students where the food is from and particularly if it's from a local producer. I think there's a lot of excitement around there. I think the USDA is funding a lot of states to do more work in this area, and so it's a pretty exciting time. You know, connecting up what the two of you have just said, Marlene, I remember in the time I was living in Connecticut. Connecticut has a lot of small to midsize towns that are feeding kids and the collaborative that Mara was talking about sounds like it might be a really interesting solution in that kind of a context. I completely agree. I know some of the New England states, and maybe this happens in other parts of the country too, but it does feel like each school food authority is tiny. I mean, we have towns with one high school and to try to have any kind of buying power when you're so small, I think, is a real challenge. So, I know there are some collaboratives in Connecticut, but absolutely supporting, bringing people together to try to negotiate the best prices and things like that, and make those relationships with the local farmers. It feels like a really great strategy to pursue. I'd like to ask you both, what is it going to take or what does it take to make these things happen? You're talking about some very good things when they do happen, but what does it take to make them happen? And Mara, let's start with you. What are the factors you think are really important? We approach our work from a systems perspective. What is the system and what is the biggest barriers in the system that we can kind of selectively tackle, and kind of dig into from a programmatic engineering perspective. For us, and Marlene, I love that you brought up the lunchroom as a classroom, because I think that is really important. I think that's the kind of the ultimate goal and we're so grateful for programs across the country that are working on that kind of thing. What we want to stay focused on at the Chef Ann Foundation is school food professionals. We want to actually educate them. We want to figure out how to provide more professional development, learning, education so that they can start looking at their jobs differently. And the country can start looking at what they're doing differently; and start really looking at the value that they're providing during a school day. So, what it takes, back to your question, is it really takes breaking down the problem to understand how to put some pieces together to test out programs that can look at breaking down that barrier. And for us right now, we're doing a lot with workforce because what we believe is that in 10 years from now, if we have a workforce in school food that has a different perspective of their job, has different skill sets, is a kind of a different workforce than is right now, than a lot of these things we want to tackle as food systems people will be a lot easier. That makes good sense. And Marlene, you've been involved for many years in local and state and national policies. In your mind, what sort of things lead to change? So, that's a good question. I would love to be able to say, oh, it's the research, clearly. That people do studies and they document, this is what we need to do. I think that's necessary, but not sufficient. I think the real answer is parents and people. I had a similar experience going to my daughter's when she was in first grade going and having lunch at her school and looking around and thinking, oh my goodness, what are we doing? I think that it's the fact that even though this is my profession, this is something I study, It's deeply personal. And I think there's a lot of passion behind the importance of making sure our children are healthy. And if I think about the policy makers along the way who have really been the ones that have made the biggest difference, it was off often because they cared about this deeply, personally. And so, I think continuing to tap into that and reminding people how important this is, is how you get the political will to pass the policies that make the real changes. Well, you know, you both made that really important point about how important parents can be. But really impressive that this started as a personal thing, and you were caring for the welfare of your children and that helped inspire your professional work and look where it's gone. It's really very impressive. I'd like to end with a following question. Are you hopeful for the future? Mara, let's start with you. I am very hopeful for the future. I think when you look at what's important to our society, school food is often the answer. I feel like when you look at achievement, school food is often the answer. When you look at diet related illness, school food is often the answer. When you look at building local economies, school food is often the answer. And I am really hopeful because I think there's a lot of incredible work being done right now, and we are moving past piloting and we're moving into research. And we're moving into institutionalizing the work. And I think you can see that through policies, through USDA cooperative agreements with organizations and work that they're doing and through the guidelines. And through the excitement and integration you're seeing in communities with superintendents, school food directors, parents, and advocates. And Marlene, are you hopeful? I am hopeful. I mean, if I think back to, you know, kind of the early days of working on this issue, I feel like we were met with a lot of skepticism. People felt like, oh, the industry's so powerful, you'll never be able to do anything. I feel like there have been a lot of changes. And I think another shift that I've sort of seen over the course of my career is early on, because of the rates of childhood obesity increasing, a lot of these initiatives that was the hook, that was sort of the anchor. And there were positive things about that because it was such a dramatic change that had occurred that you could point to. But sort of the downside is it wasn't just about that. It's about all children. It doesn't matter what your body weight is, it's about diet quality and having food security and getting adequate nutrition. I feel like we've broadened a lot in the field in terms of how we think about the reason why we're doing that. And that has made it much more inclusive, and we've been able to talk about, as Mara said, how it's affecting lots and lots of things outside of individual children. Bios Marlene Schwartz Marlene Schwartz, Ph.D. is Director of the Rudd Center for Food Policy & Health and Professor of Human Development and Family Sciences at UConn. Dr. Schwartz studies how nutrition and wellness policies implemented in schools, food banks, and local communities can improve food security, diet quality, and health outcomes. Dr. Schwartz earned her Ph.D. in Psychology from Yale University in 1996. Prior to joining the Rudd Center, she served as Co-Director of the Yale Center for Eating and Weight Disorders from 1996 to 2006. She has received research grants from a variety of funders including the Robert Wood Johnson Foundation, the United States Department of Agriculture, and the National Institutes of Health to study federal food programs, school wellness policies, the effect of food marketing on children, and strategies to address food insecurity and diet quality. She is also the recipient of the 2014 Sarah Samuels Award from the Food and Nutrition Section of the American Public Health Association; the 2020 Faculty Service Award from the Department of Human Development and Family Sciences; and the 2021 Community-Engaged Health Research Excellence Award from the Institute for Collaboration on Health, Intervention and Policy at UConn. Mara Fleishman Mara Fleishman’s career in food systems advocacy started in her early 20’s when she looked to the power of food after being diagnosed with an autoimmune disease. Mara has over 20 years of experience in leading systems change initiatives in the for-profit and non-profit sectors including over a decade at Whole Foods Market where she served as Global Director of Partnerships. In Mara’s current role, CEO of the Chef Ann Foundation, she has spent the last 10 years fighting for healthier food for our nation’s kids. Mara’s niche is system-based change and although she takes on many roles as a leader, her favorite is programmatic engineering; breaking down problems to their foundation and building programmatic solutions through dynamic and integrated approaches. This type of programmatic engineering can be seen through the work of the Chef Ann Foundation, an organization recognized as the national leader in driving fresh, healthy scratch cook food in schools. Mara also serves on regional and national boards, has spoken at conferences and academic institutions across the country, and has been recognized in publications as a champion and national advocate for change.
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