1. Improve Food Available at School

Increasing the quantities of fresh fruits and vegetables available to students during the day at school is extremely important, and a natural way to reduce the empty calories that students consume. There are many ways to approach this goal – for instance, placing salad bars in the school cafeteria or offering apples as a mid-afternoon snack. There are also obstacles, as fresh food is harder to obtain, store, handle and serve. See our Bonus Tip Sheet on Healthy Snack Ideas and Action Areas for specific suggestions.

School health advocates often focus on the quality of food offered in the cafeteria line. Of course that's an important area to address.  It is equally important, however, to address “competitive” foods – those available at the school store, in vending machines, in classroom parties or available through school fundraisers – which account for a large percentage of school food purchases. See Action Areas for specific suggestions.

Of course, if students won’t eat the healthier food you provide, much of this effort is wasted. That's why it's important to invest in ongoing marketing activities designed to increase awareness of healthier alternatives and encourage students to make healthy food choices.  See Action Areas for specific suggestions.

The CDC-based NANA nutritional guidelines represent an ideal that individual schools and districts should strive for, but which may not be possible for some to achieve, at least not immediately. Different schools may be starting at different places and face different challenges because of the socioeconomic status of the student body, school size, rural or urban location, or presence of immigrant, dual-language, or limited-English students. See Action Areas for specific suggestions.

In making changes in school food, as in other wellness areas, you can expect objections from some in the school community. At the administrative level, changes that have financial implications (increased cost and/or loss of revenue) are generally the most controversial. Teachers, parents and students themselves may object to particular changes, such as elimination of a favorite soda or food-based fundraising program.  See FAQ for specific suggestions.

To make lasting changes, it is important to gain support from school stakeholders as well as commitment from the school and/or district by bringing them in from the very beginning. This is true for all school wellness efforts, but particularly so in a complicated area such as school food.  Assembling a wellness team (see Who's Who in School Wellness), conducting an assessment of your current program, developing a wellness plan, measuring progress and celebrating success are important steps in this process. For detailed guidance and tools in this area, see Long-Term Success.

The school food environment teaches children important lessons about the habits and behaviors they associate with eating, and one of the most important health-promoting habits we can instill in children is simple hand hygiene.

According to the Centers for Disease Control and Prevention (CDC) and leading public health officials, hand hygiene is the single most important method of preventing the spread of infection. Experts recommend washing with plain soap and running water and using alcohol based sanitizers only when soap and water are not available.

Children should wash hands for about 15-20 seconds, about the time it takes to sing two choruses of "Happy Birthday to You."

The Harvard Health Letter suggests these steps to make sure you clean your hands thoroughly, whether you're using soap and water or a hand sanitizer:

1. Spread soap or sanitizer over hands.
2. Clean backs.
3. Clean fingertips.
4. Clean fingernails.
5. Clean thumbs.
6. Clean between fingers.
7. And be sure to dry hands thoroughly. Wet hands are more likely to spread germs than dry hands.

Alcohol-based sanitizers are effective at reducing the number of bacteria present on hands and are an acceptable alternative to hand-washing when soap and water hand washing facilities are not available. However, alcohol based sanitizers are not preferred over traditional soap-and-water hand washing and should not be used to replace it.

• Triclosan, a common antibacterial ingredient found in many hand soaps, is not recommend for routine hand hygiene. Studies have shown that antibacterial soaps (containing triclosan) are no more effective than plain soap at preventing infections in the community setting. It may be appropriate to use antimicrobial soaps in for wound care and special situations in the health care office, though not for routine hand hygiene.

To learn more about hand hygiene, visit the Documents & Resources section of this guide and check out HSC's Quick & Easy Guide to Green Cleaning in Schools.

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Breakfast: We have all heard that “breakfast is the most important meal of the day” for children because it gets them going and sustains their energy and concentration until lunch. Every day, 6.3 million American children eat breakfast at school under the National School Breakfast Program, a Federal program that provides states with funding to provide non-profit breakfasts. Unfortunately, they often are being served foods that contain a lot of sugar and have been stripped of their natural nutrients. Schools should try to avoid serving frosted and chocolate cereals, donuts, white bread and high-sugar breakfast bars in their breakfast programs. Instead of sugary juices, provide children with 100% fruit juices or fat-free or low-fat milk. The USDA's Team Nutrition Launch Your Day With School Breakfast is a guide to increasing school breaksfast participation, improving breakfast offerings and celebrating National School Breakfast Week. A copy can be downloaded from Documents and Resources.

Lunch: In concept, school meals should be healthy meals. To qualify for reimbursement, school lunches must meet federal guidelines based on the Dietary Guidelines for Americans. It is important to analyze your current menu to ensure that the school lunch meets the current guidelines of no more than 30% of an individual's calories coming from fat, and less than 10% from saturated fat. Regulations also establish a standard for school lunches to provide one-third of the Recommended Dietary Allowances of protein, Vitamin A, Vitamin C, iron, calcium, and calories. For a helpful tool for analyzing your school meal menus, see Resources and Tools. 

CREATIVE IDEAS FOR IMPROVING SCHOOL LUNCHES

1. Salad Bars:  A number of grade schools and many high schools have added “kid-sized” salad bars to the lunchroom and seen an increase in consumption of fresh fruits and vegetables, particularly when the effort is combined with nutrition education.  Check with your food service company to see if this is available in your area. 2.  Apple a Day: Locally grown fruits and vegetable not only taste better -- research shows that knowing that foods come from a local farm or farmer can increase their appeal.  At certain times of year, schools can feature apples from a local orchard or promote snacking on vegetables from a community garden or farmers’ market. 3.  Taste Testing: Research shows that getting children to try healthier foods is half the battle – once they do, they are more receptive to including them in their diet. So provide students with an opportunity to do taste tests: for example, offer small cups of cut up vegetables with low fat dip. Helping Students Make Better Food Choices in School: A Report by Action for Healthy Kids contains case studies and recommendations for improving school food. A copy can be downloaded from Documents and Resources.

After-School Snacks: Serving healthy snacks to children is important to providing good nutrition, supporting lifelong healthy eating habits, and helping to prevent costly and potentially-disabling diseases. Snacks play a major and growing role in children's diets. Between 1977 and 1996, the number of calories that children consumed from snacks increased by 120 calories per day. Replacing potentially empty calories with nutritious foods that satisfy and provide energy is an important goal.

The National School Lunch Program (NSLP) offers cash reimbursement to help schools serve snacks to children in after school activities aimed at promoting the health and well being of children and youth in our communities. A school must provide children with regularly scheduled activities in an organized, structured and supervised environment; include educational or enrichment activities (e.g., mentoring or tutoring programs). Competitive interscholastic sports teams are not an eligible after school program. The programs must meet State or local licensing requirements, if available, or State or local health and safety standards. All programs that meet the eligibility requirements can participate in the National School Lunch program and receive USDA reimbursement for after school snacks. Visit the National School Lunch Program on the web.

Food Allergies: In the past five years, peanut allergies in children have doubled.  For unknown reasons, the estimated number of Americans with food allergies has increased from six million to approximately 12 million. Thus, food allergy safety is another important consideration for school food advocates. Making accommodations for students affected by this problem is of concern to teachers and other school personnel in planning school meals, lessons, class activities, field trips, lunchroom procedures, and every aspect of the school day. For recommendations and tips for dealing with food allergies in schools, visit the Food Allergy and Anaphylaxis Network or see Documents and Resources.

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Creating and disseminating regular communications to parents and students is an important part of promoting healthy food choices and healthy lifestyles. Cafeteria promotions can serve as a great way to generate excitement and boost participation in your school meals programs. Schools should promote new programs with printed educational materials (e.g., posters, pamphlets) for parents and students, as well as out-of-classroom nutrition education and promotional tools. Such tools include videos and/or audio announcements at school, cafeteria taste-tests, games, contests, giveaways, and “grand openings.” Widespread, sustained promotion is more likely to encourage students to try new food offerings. If students try and like healthier offerings, they are likely to continue their healthy eating habits. Positive messages that are age-appropriate and connect with school activities and traditions are most likely to succeed. For assistance, consult with the communications director for the school district, principal or food service director, who may have access to nutrition education resources/posters. For examples and ideas for cafeteria marketing, see Documents and Resources.  

CAFETERIA MARKETING CASE STUDY

Duffy Elementary Tucson, AZ: An Arizona school developed two popular events: The first was "Start Your Engines" to encourage students to eat breakfast. Every student who participated in school breakfast received a car to color and post on the cafeteria wall. Students then received a sticker to adorn their car each day they returned for breakfast. Breakfast participation increased by 50% that week! The second was a "Nutrition Express" theme in the cafeteria. Classes received a large "railroad car" with the students' names on it when they signed up for a nutrition class. Cars roll down the wall of the cafeteria for all to see. Every classroom in the school wanted to have their own car, and shortly after the promotion was announced the cafeteria had at least 10 cars on the walls! For more examples, visit USDA's Team Nutrition website.

Nutrition standards for vending machines would address two of the biggest venues through which many schools raise funds by selling food to students. Many school vending machines are still stocked with unhealthy products, although experience indicates that schools have found that they can make as much money through vending machines selling healthy snacks and beverages as unhealthy ones. Any vending machine can become a healthy vending machine if it is stocked with healthy items. For tips on how to “makeover” your vending machine visit Stony Field Farms' Vending Machine Makeover or see Documents and Resources.

VENDING CASE STUDY

The Corpus Christi (TX) Independent School District (CCISD) piloted a reimbursable meal vending program in 2006. Branded "DeliZone by VendSMARTT," the program used a vending machine to deliver nutritious breakfasts, lunches and snacks, as well as accessing meaningful financial reports. Director of Food Services Jodi Houston, and the district's nutrition consultant, Jean Fields, R.D., organized student focus groups and taste panels to determine what foods and beverages would be most popular. Menus were written and analyzed using USDA-approved Nutrient Standard Menu Planning software and evaluated for compliance with the Texas Public Schools Nutrition Policy. The pilot has since been expanded to Mesa (AZ) Public Schools, Denver Public Schools, Shawnee (KS) Mission School District and Conroe (TX) Independent School District. (From Food Service Magazine, December 2006)

According to the Center for Science in the Public interest, food is commonly used to reward students for good behavior and academic performance. It's an easy, inexpensive and powerful tool to bring about immediate short-term behavior change. Yet, using food as a reward has many negative consequences that go far beyond the short-term benefits of good behavior or performance. Studies show that it encourages over-consumption of unhealthy foods, contributes to poor eating habits and increases preferences for sweets. It is important to educate teachers about the consequences of this practice and provide them with alternative ideas that can work as well if not better than food. For a handy Tip Sheet on Healthy Classroom Rewards and links to teacher resources, see our Bonus Tip Sheets on Constructive Classroom Rewards.

“Rewarding children with unhealthy foods in school undermines our efforts to teach them about good nutrition. It's like teaching children a lesson on the importance of not smoking, and then handing out ashtrays and lighters to the kids who did the best job listening.” -- Marlene Schwartz, PhD, Co-Director, Rudd Center for Food Policy and Obesity, Yale University

Sending cupcakes to school for birthdays or candy for Valentines Day is a cherished ritual for many parents, who grew up in a time when these were indeed rare treats. While school wellness programs don’t have to eliminate the practice, they should curtail it by encouraging parents to provide healthier items for class consumption. See Resources and Tools for parent education tools and other resources for encouraging healthy treats.

BETTER THAN A CUPCAKE: Gavin's Banana Muffins

Yield: 24 muffins six bananas, soft ½ c canola oil Two eggs ½ c buttermilk ¾ c sugar Two c all purpose flour 1 c whole wheat flour 1 tsp baking soda 1 tsp baking powder ½ tsp salt optional additions: ¾ c raisins or ¾ c blueberries Preheat oven to 375o. Prepare muffin tins (line with muffin cups or spray with pan spray). Mash bananas. Mix with canola oil, eggs buttermilk and sugar, set aside. In a separate bowl, combine flours, baking soda, baking powder and salt. Combine with a whisk. Add dry ingredients to banana mixture. Mix gently to combine. Scoop batter into prepared muffin tins. Bake for 16 to 18 minutes.  Cool for five minutes in muffin tins and then remove from tins and cool on a wire rack. Recipe courtesy of Gavin Adams

Many healthy fundraising alternatives are available for schools. A majority of these are not only practical, but also can be profitable since schools usually keep 45% of sales revenues from product fundraisers. Healthy fundraisers set a positive example and support healthy eating by children, nutrition education, and parents’ efforts to feed their children healthfully. Schools should make sure foods sold in fundraisers meet the same nutrition standards as other foods offered in school.  For recommended healthy fundraisers, visit Documents and Resources.

QUICK TIP ON HEALTHY FUNDRAISER

Scrip or schoolpop is a gift card for use at local grocery stores, clothing stores, coffee shops, or other retail stores. Schools purchase scrip at a discount from those retailers. There is no added cost to parents, who purchase the scrip for the full face value and spend it, like a gift card, at participating stores. Schools make money because they get to keep the difference between the discounted price they pay the retailer and the full face value that parents pay them. This example and others are included in Sweet Deals: School Fund Raising can be Healthy and Profitable [pdf], written by Center for Science in the Public Interest.