Variable improvement in whole grain consumption among youth by school lunch participation level in the United States: Findings from the 2007–2018 National Health and Nutrition Examination Survey

Abstract

Introduction

The Healthy, Hunger Free Kids Act (HHFKA) 2010 renewed food and nutrient requirements in school meals. Changes in whole grain consumption and fiber among youth may vary by school meal participation level.

Methods

We analyzed cross-sectional data of five to seventeen year olds from the National Health and Nutrition Examination Survey across three policy periods (pre-policy (2007–2010), during the transition (2011–2014), and after HHFKA 2010 (2015–2018)). Weighted, multivariable regression models were fitted to estimate the association between policy periods and each of the dietary outcomes with interactions between policy periods and school meal participation levels, adjusting for sociodemographic characteristics.

Results

Over 70 % of the children and adolescents participated in the school lunch program regularly in 2007–2018. Overall, there was an increasing trend in the whole grain consumption. At baseline, the group who did not participate in school lunch generally had a better nutritional profile including higher whole grain intake. However, the increase in whole grain intake after HHFKA 2010 among youth with regular participation, along with recent plateauing trends among infrequent participation groups, led to similar levels of whole grain intake across school meal participation groups. The amount of whole grain consumption among youth remained lower than the recommendation for all groups.

Conclusion

After HHFKA 2010, the improvement in whole grain consumption among youth was variable by the levels of school meal participation. There is a need for additional measures of school-based interventions to promote whole grain and fiber consumption among youth.