Sarah Moreland-Russell, an associate professor at the Brown School at Washington University in St. Louis, has received a four-year $2.65 million federal grant to understand how schools respond to changes in policy guiding school lunch and breakfast programs and how those responses affect health.
The grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) aims to understand how schools followed changes to the National School Lunch and Breakfast Program nutrition guidelines, which offered schools some flexibility. Ultimately, researchers hope to learn the changes’ impact on student health and education outcomes.
Federal policy guiding the National School Lunch and Breakfast Program has changed multiple times in the past six years, and the U.S. Department of Agriculture just issued another policy change to take effect in the 2025-26 school year, said Moreland-Russell, principal investigator for the grant, titled “Examining system-wide implementation of new flexibilities to the National School Lunch and Breakfast Programs.”
“That is a lot of change to a major system providing over 40 million lunches and breakfasts to young people every day across the United States,” she said.
The federal policy allows schools flexibility on implementing the evidence-based dietary guidelines outlined in the 2010 Healthy Hunger Free Kids Act, she noted. The first change in federal policy, which started in the 2019 school year, allowed schools to decide if they want to implement specific flexibilities for milk, whole wheat and sodium standards.
“Prior to the change, milk was required to be unflavored fat-free or low-fat (1 percent fat). Schools now may also offer flavored milk with more sugar,” she said.
“We actually don’t know which schools have opted to follow which guidelines. Some serve 100% whole grain, others provide 50%, some serve food with less sodium and sugar, while others do not.
“It is important to understand how these major changes and differences in implementation from school to school affect the food supply and distribution system, school food service, and ultimately the food that students consume to inform future federal policy,” she added.
Co-investigators on the grant are the Brown School’s Ross Hammond, the Betty Bofinger Brown Distinguished Professor of Public Health, and Peg Allen, a research assistant professor. Other Brown School members on the team are Jess Gannon, project manager at the Prevention Research Center; Jason Jabbari, an assistant professor; and Dan Ferris, an assistant professor of practice.
School food staff members want to provide healthy meals but also have to weigh many factors, Moreland-Russell said. This is a big question the grant is trying to answer. “The pilot study that we completed prior to developing the grant showed that food service personnel cared about child nutrition and health and wanted to provide healthy meals,” she said. “However, they were concerned that participation was dropping because of evidence-based standards affecting the taste. Some personnel also stated that they had a hard time accessing whole-grain foods.”
Moreland-Russell and her team will conduct a nationwide survey of implementation practices for the lunch and breakfast programs and examine factors that influence school decision-making. They will interview people in the food industry to understand how the policy changes result in food supply and distribution changes. They also will develop a computer simulation allowing them to test policy scenarios to inform the design of school lunch and breakfast policy that has the most positive impact on health.
The project ultimately aims to explore whether federal changes to nutrition standards in schools — as well as how those changes are implemented — might influence youth obesity, hypertension and diabetes, all precursors to adult cardiovascular disease.
“Any flexibility to the nutritional standards of school meals has the potential to affect the health trajectory of youth in both directions,” Moreland-Russell said. “It is imperative to understand how schools decide to change the food served to students to inform more health-forward policy change.”
