School Nutrition Environment and Services: Policies and Practices That Promote Healthy Eating Among K-12 Students

Abstract

Background: Changes to policies at the federal, state, and local levels over the last decade have influenced the school nutrition environment and services.

Methods: This systematic review includes an analysis of individual research articles and government reports published from 2010 to 2021 that examine interventions to improve the school nutrition environment and services and increase the availability, selection, and consumption of healthier foods and beverages in K-12 schools in the United States.

Results: Nutrition standards for school meals and food outside of meals improved access to healthier options in school. Providing school nutrition professionals with professional development, improving the palatability of school meals, offering taste tests, pre-slicing fruit, providing recess before lunch, offering incentives for trying healthier options, and providing access to drinking water resulted in increased selection and consumption of healthier items. There were inconclusive or mixed findings for some intervention strategies including adequate seat time for meals.

Conclusions: Despite demonstrated improvements to school meal programs and competitive foods, more work is needed to change the selection and consumption of healthier options among K-12 students. Schools can use multiple interventions to improve the school nutrition environment and services and help students adopt food and beverage choices that support health.

Keywords: healthy eating; policies; professional development; school meals; school nutrition; students.

Figure 1.. Centers for Disease Control’s Comprehensive Framework for Addressing the School Nutrition Environment and Services

Figure 2.. Identifying articles describing school-based interventions to the nutrition environment.

Abbreviations: SME, subject matter expert; USDA, United States Department of Agriculture. *See introduction and methods article for full project flow chart. ** Topics prioritized for inclusion in Phase 2: Smart Snacks nutrition standards for foods sold in schools, nutrition standards for classroom celebrations, use of food as a reward, drinking water in schools, and food marketing. ***Out of scope: Wrong outcomes, process data only, single point in time cross-sectional, wrong date, or wrong topic.