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Nutrient Quality of School Lunches in
Indiana: Compared by School Enrollment and
Menu Planners' Education Levels
Sunhee Seo, MS; Stephen J. Hiemstra, PhD; Carol J. Boushey, MPH, PhD, RD
ABSTRACT
This study compares the nutrient quality of planned menus among
schools grouped by school enrollment size and menu planners education levels.
This study was conducted in three phases: (1) questionnaire development and administration,
(2) nutrient analysis of school lunch menus, and (3) comparison of nutrient quality
among groups categorized by the school enrollment sizes and menu planners
education levels. In Phase I, menu planners in all 425 Indiana school corporations
were surveyed. Following two mailings, the response rate was 61% (n= 251). About
half of the respondents (n=124) indicated that they would provide the researchers
with one weeks menus and recipes. Eighteen school corporations were selected
from this group, using stratified random sampling based on the school enrollment
size and the menu planners education levels. Two of these school corporations
failed to send their menus and recipes.
The researchers used NutriKids® to analyze the nutrient content of
one week of planned menus for each of the 16 participating school corporations.
The menus exceeded the Recommended Dietary Allowance (RDA) for protein, calcium,
iron, vitamin A, and vitamin C. The school lunches did not comply with the Dietary
Guidelines for Americans (DGAs) goals for total fat and saturated fat when
examined on average. The amount of sodium in the planned menus exceeded the
National Research Council (NRC) recommendation, while cholesterol was within
the NRC guidelines. The percentage of schools meeting the DGA goals for total
fat was associated with school enrollment size (p<0.05), but not with menu
planners education levels. Lunch menus of medium school enrollment size
(1,236-2,500) met the DGA goals for total fat.
Results did not support the hypothesis that the menu planners education
levels influence meeting nutrient standards of planned menus. Nevertheless,
results illustrated the importance of providing workshops and training materials
on menu planning and the U.S. Department of Agriculture (USDA) meal patterns.
Without this training, foodservice professionals would not have the knowledge
and skills needed to plan menus to meet USDA regulations and other nutritional
guidelines. Results support the need for menu planners to learn about methods
to limit total fat and saturated fat. For future studies, a larger sample size
would be helpful in measuring the importance of menu planners education
levels.
INTRODUCTION
In 1997, more than 26.3 million children participated in the
National School Lunch Program (NSLP) (U.S. Department of Agriculture [USDA], 2001c).
While lunches offered in the NSLP normally provided one-third of the Recommended
Dietary Allowances (RDA) (Food and Nutrition Board, 1989) for most nutrients,
they often included excessive amounts of total fat, saturated fat, and sodium
(Burghardt, Gordon, & Fraker, 1995). The School Nutrition Dietary Assessment
Study (SNDA-I) reported the nutrient content of school meals offered in School
Year (SY) 1991-92. In SY 1991-92, school lunches on average met the National Research
Council (NRC) recommendations for dietary cholesterol and, in general, met or
exceeded the RDAs for vitamins and minerals (Burghardt et al., 1995). However,
school lunches contained an estimated mean of 1,479 mg of sodium, an amount that
is nearly twice the NRC recommendation (800 mg).
The School Nutrition Dietary Assessment Study (SNDA-II) revealed that elementary
school meals in SY 1998-99 provided 33% of energy from total fat, with 12% from
saturated fat (USDA, 2001b). The same study showed that the average lunch served
in secondary schools provided about 35% of energy from total fat and 12% of
energy from saturated fat. These data clearly indicated that school lunches
have not kept pace with the current scientific knowledge about diet and that
school lunches need to significantly reduce intake of total fat, saturated fat,
and sodium. Improving the nutrient quality of school lunches has been consistent
with the history and spirit of the NSLP (Frank, Vaden, & Martin, 1987; Gregoire,
Sneed, & Martin, 1993).
In the past, strategies to improve the nutrient quality of school meals focused
on a single issue such as the fat or sodium content of menu items and meals.
However, an increasing number of studies have investigated the feasibility of
implementing the Dietary Guidelines for Americans (DGAs) (USDA, 2001d)
and the impact that this would have on menu planning, procurement, production,
and service of school meals (Glover, Stitt, Kendrick, & Hayes, 1991; Hurd,
Friedman, & Cise, 1996; Johnson, Johnson, Harvey-Berino, & Wang, 1994;
Miller, Gould, Pearson, & Jensen, 1994). Hurd et al. (1996) reported a direct
correlation between district size and compliance with DGA goals. They found
that large school districts complied with the DGA goals more often than small
districts enrolling fewer than 1,000 students. They presumed that school foodservice
directors in large districts had better access to food products and greater
economic and educational resources.
The nutrient content of the menus is an important factor in planning menus for
school foodservice (Sneed & Gregoire, 1995). Sneed and White (1993) indicated
that evaluating the nutrient quality of food items and menu planning were important
competencies for program management. However, Williams et al. (1997) reported
that most foodservice directors responsible for menu planning had only a high
school education and were not registered dietitians. Hoover et al. (1998), on
the other hand, reported that managers education made no difference in
the compliance of Texas school foodservice menus with USDA meal patterns, DGA
goals, and the NRC recommendations.
Our review of literature revealed that previous research has not evaluated the
influence of both school enrollment sizes and menu planners education
levels on the nutrient quality of planned menus. The specific objective of this
study was to compare the nutrient quality of planned menus among schools grouped
by school enrollment sizes and menu planners education levels.
METHODOLOGY
Research Design
The research proceeded in three phases: (1) questionnaire development
and administration, (2) nutrient analysis of school lunch menus, and (3) comparison
of nutrient quality among groups categorized by school enrollment sizes and
menu planners education levels. Stratified random sampling was used in
terms of school enrollment sizes (large, medium, and small) and menu planners
education levels (high school diploma or less and bachelors degree or
higher). Nutrient quality was defined in this study as the degree of compliance
of lunch menus with nutrient standards for energy, protein, calcium, iron, vitamin
A, vitamin C, sodium, cholesterol, percentage energy from total fat, and percentage
energy from saturated fat. Nutrient standards were based on one-third of the
RDA for energy, protein, calcium, iron, vitamin A, and vitamin C; DGA goals
for percentage energy from total fat and percentage energy from saturated fat;
and NRC recommendations for sodium and cholesterol.
Phase I. Questionnaire Development and Administration
Sample and Data Collection. The
purpose of Phase I was to determine the sampling population for the stratified
random sampling in Phase II. Researchers developed a questionnaire that was
comprised of two sections. The first section requested information about the
characteristics of the menu planners, including:
- Job title;
- Menu planners education levels;
- Years worked in school foodservice;
- Years in present position;
- Certification status (no certification, ASFSA certification,
registered dietitian, State Department of Education certification);
- Number of nutrition courses taken;
- Use of consultants in menu planning; and
- Attitude toward menu planning.
The second section requested information about the school corporations,
including:
- Number of schools in the corporation;
- School corporation enrollment size;
- Average number of NSLP lunches served per day;
- Type of menu planning used; and
- Type of food production system.
Researchers asked menu planners about their willingness to send one weeks
menus and recipes. The researchers pilot-tested the questionnaire using 22 menu
planners who were not included in the study sample. The revised questionnaire,
cover letter, and postage-paid return envelope were mailed in October 1999 to
425 Indiana school corporation directors, including public and private schools.
The directors were asked to distribute the questionnaire to their menu planners
or to complete it themselves if they assumed the role of menu planner. Non-respondents
received follow-up postcards two weeks after the initial mailing to increase
the response rate.
Phase II. Nutrient Analysis of School Lunch Menus
Sample and Data Collection.
A total of 251 school corporations responded in Phase I (61%). These school
corporations were used for the Response Group. Only 124 school corporations
in the Response Group indicated that they would send one weeks
menus and recipes for nutrient analysis, and they were used for the Volunteer
Group. Eighteen school corporations were selected from the Volunteer
Group, using stratified random sampling in terms of school enrollment
size and menu planners education level. School enrollment size was defined
as large (>2,500; n=5), medium (1,236 - 2,500; n=5), and small (≤1,235;
n=6). Menu planners education levels were categorized as high school diploma
or less (n=8) or bachelors degree or higher (n=8).
Menu planners were asked to provide information on all foods planned as part
of the NSLP meals during one week. Menu planners supplied menus, recipes for
food items prepared in the school corporations, manufacturers labels,
nutrient analysis or product specifications of food items purchased from vendors,
and details on food preparation procedures and portion sizes for all items.
The researchers collected any missing information through telephone calls. Two
school corporations in the volunteer group failed to send their menus and recipes.
Data Analysis. The nutrient content of the
weekly menus and their corresponding recipes for 16 school corporations were
analyzed using NutriKids for Windows (1.6.3) (LunchByte System, Inc., Rochester,
NY). All nutrient analyses were made by one researcher to ensure consistency
in the data analysis process. Ingredients not included in the NutriKids database
but used by individual school corporations were entered manually. Researchers
relied on corporation recipes or standard formulations in the NutriKids database
and coded the nutrients in each food item on the basis of the information provided.
The researchers averaged the 2 or 3 selective choices for entrees, fruit, and
milk.
Once all the ingredients and the amounts of ingredients specified by the recipes
included on the planned menus were entered, the NutriKids software program calculated
the nutrient content for each menu item and produced a spreadsheet based on
an average portion size of each menu item. The menu spreadsheet included a daily
and a weekly average of specific nutrients and the percentage of those meeting
the recommended standard. The standards used in the NutriKids software program
are based on one-third of the RDA. The researchers entered the sodium and cholesterol
guidelines from NRC recommendations. The fat content of planned menus was compared
with the goals suggested by the DGA.
Phase III. Comparison of Nutrient Quality
Data Analysis. Based on results
of the two phases, the researchers obtained the average amount of each nutrient
among groups categorized by school enrollment sizes and menu planners
education levels. The average of the percentage meeting the standard for each
school lunch menu also was calculated. Using the Statistical Analysis System
(6.12, Cary, NC), researchers conducted two-way Analysis of Variance (ANOVA)
to test differences in average percentage meeting the standard for each nutrient
in each grouping in relation to school enrollment sizes and menu planners
education levels. A probability level of 0.05 was used for all tests of significance.
RESULTS AND DISCUSSION
Characteristics of the Menu Planners and School Corporations in
the Response Group
Characteristics of the menu planners and their school corporations
from the Response Group are presented in Table 1.
The menu planners education levels varied; 71 (57.3%) menu planners had
a high school diploma or less, and 26 (20.9%) had a bachelors degree or
higher. More than half of the menu planners had some type of certification.
These findings are consistent with results of previous research. Williams et
al. (1997) reported that 63% of the menu planners in their study had a high
school education. Gregoire and Sneed (1994) found that more managers had high
school or less education (70.8%) than directors/supervisors (41.4%). They also
found that 38.8% of directors/supervisors had college degrees, but only 7.4%
of managers did.
In this study, many menu planners (45.2%) held state or American School Food
Service Association (ASFSA) certification; 12% were registered dietitians (RDs).
Approximately 44% of the menu planners had completed more than three nutrition
courses; however, 28.2 % had never taken a nutrition course. Few school corporations
in this study used a consultant to assist with menu planning (4%). Most menu
planners had responsibility for the entire school foodservice operation (65.3%).
Nearly 27% of the menu planners had worked for more than 20 years in school
foodservice.
Most (82.3%) of the school foodservice operations planned menus using the Traditional
Meal Pattern or Enhanced Food-Based Menu Planning system. The Nutrient Standard
Menu Planning or Assisted Nutrient Standard Menu Planning systems were used
in only 15.3% of the school corporations. School enrollment ranged from 70 to
41,800 students. Approximately 35% of the school corporations had fewer than
1,235 students.
Nutrient Content of School Lunch Menus
The nutrient content of school lunch menus as planned was analyzed
using the information provided by 16 school foodservice menu planners. The menus
as planned provided an average of 653 kilocalories of food energy and 28 grams
of protein. The school lunches provided more than one-half of the RDA for protein,
calcium, vitamin A, and vitamin C for each grade level. However, the average
energy provided was less than the one-third of energy guidelines for the 6th-grade
level.
The average amounts of total fat and saturated fat in the 16 planned menus exceeded
the DGA goals. The average percentage of energy from total fat in 16 planned
menus was 33%, compared with the DGA goals for ≤30%. The average percentage
of energy from total fat was similar to that of the SNDA II Study (USDA, 2001b)
findings. However, Rainville (2001) found that reimbursable school lunches were
more likely to meet recommendations for ≤30% kcal from fat, protein, vitamin
A, calcium, iron, and zinc in a study of the nutritional quality and food items
in reimbursable school lunches compared to lunches brought from home in elementary
schools. The average percentage of energy from saturated fat in Rainville's
2001 study was higher than that of the SNDA II Study (USDA, 2001b). The average
percentage of energy from saturated fat in the planned menus was 15%, compared
with the DGA goals for ≤10%. As shown in Table
2, lunch menus in 5 of 16 school corporations provided an average of
≤30% of food energy from fat. Only one school foodservice operation conformed
to the DGA goals for saturated fat.
Sodium in the planned menus exceeded the NRC recommendations, although the average
amount of cholesterol was within the recommended range. The average amount of
sodium in planned menus was 1,105 mg, nearly 1.4 times the lunch target of 800
mg. The average amount of cholesterol in the planned menus was 69 mg, which
was less than one-third of the maximum recommended intake of 300 mg per day.
Comparison of Nutrient Quality
Table 3 shows the average nutrients
per each enrollment and education level. For each enrollment size and each menu
planners education level, protein, iron, calcium, vitamin A, and vitamin
C exceeded the RDA, and sodium exceeded the NRC recommendations, while cholesterol
met the NRC recommendations. Only one school lunch menu met the DGA goals for
saturated fat and five school lunch menus met the DGA goals for total fat.
The two-way ANOVA was conducted to test menu planners education levels,
school enrollment sizes, and to determine the interaction between these variables
as they might influence menu planning and nutrient quality of school lunch menus.
Menu planners education levels and school enrollment sizes were used as
predictors of the dependent variable-percentage of each nutrient standard met
in school lunch menus. No differences were found among school enrollments in
meeting nutrient standards for saturated fat, energy, cholesterol, sodium, iron,
vitamin A, and vitamin C. None of the enrollment size groups or education levels
met the DGA goals for saturated fat when examined on a group average. However,
total fat and saturated fat were lower in school corporations where menu planners
had a bachelors degree or higher. No differences were found between menu
planners education levels in meeting nutrient standards for energy, cholesterol,
sodium, iron, Vitamin A, and Vitamin C. Menu planners with bachelors degree
or higher provided less saturated fat (13.6%) than menu planners with a high
school diploma or less.
However, we found a significant interaction between education/enrollment and
the percentage of energy from total fat. As shown in Table
4, the percentage of energy from total fat was 26.5% in school lunch
menus whose menu planners had a bachelors degree or higher in the medium
enrollment school. Medium school enrollment size had a positive correlation
with the percentage of energy from total fat for menu planners with a bachelors
degree or higher, but not for those with a high school diploma or less. Menu
planners who had a bachelors degree or higher in the medium enrollment
school met the percentage of energy from total fat better than those who had
a high school diploma or less in the medium enrollment school.
CONCLUSIONS AND APPLICATIONS
The ANOVA results showed that menu planners education
levels did not affect the level of most nutrients, including saturated fat, energy,
protein, cholesterol, sodium, iron, calcium, vitamin A, and vitamin C. Despite
average levels of total fat and saturated fat being lower in menus planned by
an individual with a bachelors degree compared to a high school diploma,
the results of this study did not demonstrate that the menus are superior for
any other nutrient. Indeed, results support that menu planners need to learn about
methods to limit total fat and saturated fat.
One possible conclusion could be that most menu planners, regardless of their
educational background, follow the state and federal regulations that require
them to meet the USDA meal patterns for meal reimbursement. When following the
USDA meal patterns, menu planners are likely to meet nutrient requirements.
Additionally, extensive school foodservice experience and continuous job training
in workshops may help to improve the nutrient quality of school lunch menus.
Without this training, foodservice professionals may not have the knowledge
and skills needed to plan menus to meet USDA regulations and other nutritional
guidelines.
There were several limitations to this study. This research focused on the average
nutrients in planned menus. This assumes that each food on the menu would have
been available to each student. The foods and nutrients that students actually
consumed would differ from the foods planned because students in many schools
were able to choose their meals from among a number of alternative foods or
may not consume all of the food they were served.
The major limitation of this study was the small sample size in conducting two-way
ANOVA to examine the relationship between the nutrient quality and the menu
planners education levels and school enrollment sizes. The small number
of sample school menus limits the ability to generalize the findings. Additional
research with a larger sample could be conducted to help confirm results of
this study.
The scope of this study also was limited by an inconsistency of information
provided by each school. While many school corporations provided well-prepared
information for coding their menus, a few did not provide their recipes or the
nutrition labels of vendor products. Thus, the nutrient analyses of these menus
were based on written documents without direct observations. Use of a computerized
nutrient analysis program is another limitation due to use of average nutrient
data for some foods. This may have resulted in an underestimation of sample
nutrient values. (The combination of direct observations and written documents
can provide data for an in-depth comparison, although this is a time-consuming
and labor-intensive project.)
Moreover, the primary unit of analysis was menus planned for only a one-week
period of time. This time frame reflected the USDA requirements for nutrient
evaluation, but most schools follow a multi-week menu planning cycle. When researchers
requested the menus, a particular week was not specified, and several schools
had a special National School Lunch Week menu designated during the month menus
were reported. The menu planners sent one-month menus, and the researchers selected
one week for nutrient analysis. Therefore, the one-week period selected for
this study may not be truly representative of the food planned on average.
Schools incorporated the guidelines into menu planning by following the established
USDA meal patterns, regardless of the menu planners education levels.
Thus, results of this study suggest that using guidelines provided by the USDA
(USDA, 2001a) can have a major impact on the nutrient quality of the school
lunch menus.
ACKNOWLEDGEMENTS
The Child Nutrition Foundation provided financial support for
this research through the Hubert Humphrey Research Grant. The authors wish to
thank Dr. Barbara Almanza, the Indiana State Department of Education, and the
school foodservice directors in the 16 school districts who participated in this
study.
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BIOGRAPHY
Seo is
a doctoral candidate, Department of Hotel, Restaurant, Institution Management
and Dietetics, Kansas State University, Manhattan, KS. Hiemstra is emeritus
professor, Department of Hospitality and Tourism Management, Purdue University,
West Lafayette, IN. Boushey is assistant professor and director of the
Coordinated Program in Dietetics, Department of Foods and Nutrition, Purdue
University, West Lafayette, IN.
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