Citing improvements made in school nutrition over the past two decades, the American Academy of Pediatrics (AAP) calls for universal school meals as a strategy to ensure that all children have access to nutritious food.
"For many families, a school meal is the most reliable source of a balanced, nutritious meal they eat every day," said Elizabeth Zmuda, DO, FACOP, FAAP, a lead author of the policy statement, written by the AAP Council on School Health and Committee on Nutrition.
"Breakfasts, lunches and snacks provided at school not only satisfy hunger; they support learning, growth and health. We know that children whose diets are healthy and well-balanced are more likely to participate in class and improve in overall academic performance," Dr. Zmuda said.
The policy statement updates a prior AAP statement published in 2015. Policy recommendations align with the 2020–2025 Dietary Guidelines for Americans and the 2025–2030 dietary guidelines, incorporating their emphasis on fruits, vegetables, whole grains and dairy, with limits on added sugars, saturated fat and sodium.
Federal, state and local regulations have improved the nutritional quality of school meal programs, including updated school meal guidelines from the U.S. Department of Agriculture. Limits on added sugars and sodium and requirements for whole-grain foods are intended to bring school meals into closer alignment with the Dietary Guidelines for Americans.
The AAP encourages pediatricians to advocate and partner with school nutrition proponents through wellness councils, policy advocacy, and support for universal access to healthy meals. Universal access to school meals helps remove stigma, prevent unpaid meal debt, and ensure children and adolescents don’t miss meals for reasons that have nothing to do with nutrition or health.
Children who eat school meals often show healthier eating patterns, with a neutral or reduced risk of obesity, the AAP points out in the statement.
What the AAP recommends for school meals & snacks:
Competitive foods and beverages sold in schools should meet Smart Snacks standards and align with school meal nutrition rules. Beverage standards prioritize water, milk, milk alternatives and limited portions of 100% juice, while restricting sugar-sweetened beverages.
Foods provided outside reimbursable meals, such as classroom celebrations and rewards, often have lower nutritional quality and should better align with nutrition standards.
Comprehensive, hands-on nutrition education from pre-K through high school is emphasized as an effective way to improve dietary behaviors and health outcomes.
Schools should provide sufficient, protected time and a pleasant environment for students to eat, which supports higher intake of nutritious foods and less waste.
Schools must provide appropriate meal accommodations for students with medical, disability-related or religious dietary needs.
"Pediatricians can partner with families and schools to make sure all students have access to nutritious meals," Dr. Zmuda said. "A child who is well-nourished is also a happier, more productive and engaged student."
Policy statements created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics.
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