It's Time for Whole Grain Products in School Meals
A growing concern about childhood obesity and the increased incidence
of type 2 diabetes has placed pressure on school foodservice to serve
foods that address these health issues. Recent studies indicate that
whole grain intake lowers the risk for heart disease and type 2 diabetes,
and it may contribute to lower caloric intake. However, children are
only consuming one-third of the recommended three daily servings of whole
grains. The inclusion of whole grain foods in school meals could substantially
improve intake for school-aged children. To successfully achieve this
goal, several issues should be addressed: 1) the acceptable level of
whole grain flour in various types of foods; 2) the feasibility of gradually
increasing whole grain flour content in school meals; and 3) the cost
of introducing these whole grain foods. One approach is to experiment
with the introduction of foods that consist of a 25/75 blend of whole
grain to all-purpose flour and assess taste, acceptability, and cost.
The prevalence of childhood obesity has increased steadily over the
past 20 years (Centers for Disease Control and Prevention, 2002; Ogden,
Flega, Carroll, & Johnson, 2002;) and appears to be linked to the
increased incidence of type 2 diabetes in children (Kaufman, 2002; Steinberger & Daniels,
2003). Evidence shows that a higher intake of whole grain foods, approximately
one to three servings per day, reduces the risk for type 2 diabetes (Liu
et al., 2000; Meyer et al., 2000), heart disease (Anderson, Hanna, Peng, & Kryscio,
2000; Jacobs, Meyer, Kushi, & Folsom, 1998), some cancers (Chatenoud
et al., 1998; Jacobs, Marquart, Slavin, & Kushi, 1998), and all-cause
mortality (Jacobs et al., 1999; Jacobs et al., 2000). Furthermore, adolescents
and adults who eat more whole grain foods have a lower body mass index
(BMI) as compared to those individuals who consumed fewer servings (Kaufman,
2002; Liu et al., 2003; Steffen et al., 2003;). Additionally, the higher
dietary fiber intake that results from the consumption of whole grain
foods may help people feel fuller longer, which could contribute to a
lower daily calorie intake.
The U.S. Department of Agriculture's (USDA) School Breakfast Program
(SBP) and National School Lunch Program (NSLP) feed about 8 and 26 million
children a day, respectively (U.S. Department of Agriculture, Food and
Nutrition Service, 2003a; 2003b). Due to their size, these programs are
in a critical position to aid children in meeting their daily dietary
requirements and help shape their eating behaviors. In recognition of
this influence, USDA introduced its School Meals Initiative for Healthy
Children in 1995 to help school foodservice programs offer meals that
meet the recommendations of the Dietary Guidelines for Americans (USDA & Center
for Nutrition Policy and Promotion, 1995). While this initiative has
been helpful in improving the dietary quality of school meals, more attention
needs to be paid to the guideline that advocates eating a variety of
grains on a daily basis, with a greater emphasis on whole grain intake.
Dietary Intake of Whole Grain Foods
Recommendations concerning whole grain intake have been established by
government and health organizations, including the Healthy People 2010
Objectives program, which suggests three servings of whole grains daily
(U.S. Department of Health and Human Services, 2000); the American
Diabetes Association (2002); and the American Heart Association (Krauss
et al., 2001). However, few Americans meet these daily recommendations.
Data from USDA's 1994-96 Continuing Survey of Food Intakes by
Individuals (CSFII) indicate that 10% of individuals between the ages
of 20 and 59 consume the recommended three or more servings of whole
grains daily (Kantor et al., 2001). Likewise, the intake of whole grains
among U.S. children and adolescents was found to be similarly low,
with only 9% of children aged 2 to 19 consuming three or more servings
of whole grains daily. In 2002, the Institute of Medicine of the National
Academies of Science (IOM) recommended, for the greatest protection
against coronary heart disease, 31 and 26 grams of dietary fiber for
children between the ages of 9 and 13, respectively (Institute of Medicine
of the National Academies of Science, 2002).
The obstacles for the purchase and consumption of whole grain items
that are most frequently cited are limited availability, low consumer
awareness, confusion about the identification of whole grain versus whole-wheat
or dark bread, and aversions to the taste, color, and texture of whole
grain foods (Adams, 2000). These issues present challenges to school
foodservice programs to provide whole grain foods that children will
eat and to educate students about the health benefits of whole grain
inclusion in their diets.
Whole Grain Products in School Meals
Including more whole grain foods in the SBP and NSLP provides children
with several dietary advantages. First, an increased intake of whole
grain foods may contribute to improved long-term health and the development
of healthier eating habits that are carried into adulthood. Second,
offering whole grain foods provides the opportunity for children to
experience and accept a healthy new repertoire of whole grain alternatives
in their diet at young ages. Due to the fact that children may initially
reject the taste and texture of 100% whole grain products, school foodservice
programs must explore innovative methods of incorporating such products
into their school meals. These methods include new recipe development,
sensory testing, and a determination of the acceptable level of whole
grain flours in products such as bread, rolls, buns, pizza, and muffins.
Previous interventions have been made, through social marketing techniques
and recipe modification, to successfully modify the intake of fruits
and vegetables (Perry et al., 1998; Reynolds et al., 2000), fat, sodium
(Ellison et al., 1989), and low-fat milk (Wechsler, Basch, Zybert, & Shea,
1998) of children in school cafeteria settings. For example, Ellison
et al. (1989) devised an environmental program directed at foodservice
departments in two boarding schools. The program demonstrated that changes
in food purchasing and preparation practices markedly decreased sodium
and modified fat content of foods, and the use of these practices resulted
in significant changes in the nutrient intake of students. Even without
an educational component directed at students who maintained their usual
dietary practices, changes by foodservice workers led to a 15% to 20%
decrease in sodium intake and a 20% decrease in saturated fat intake.
Such modifications by school foodservice workers were well received by
students, as the program provided them with palatable food options.
School foodservice workers are key to introducing whole grain products
into school cafeterias. A preliminary survey was conducted by the authors
in the greater Minneapolis/St. Paul area to determine what perceptions
school foodservice employees had concerning whole grain foods. Respondents
included 114 school foodservice employees who participated in the Minnesota
School Food Service Association (MSFSA) Nutrition Conference and Workshop
during Winter and Spring 2003. The group included staff from elementary
schools (46%), middle school and junior high schools (19%), and high
schools (26%). The remaining 10% of the respondents worked in miscellaneous
locations, including childcare and district offices.
The results of the survey suggest that foodservice personnel would be
receptive to including whole grain foods in their cafeterias. The majority
of respondents to the preliminary survey (72%) reported they were somewhat
or very motivated to serve whole grain foods and many (59%) were somewhat
or very motivated to look for whole grain alternatives to add to school
meals. The majority (77%) agreed that the inclusion of whole grain foods
in school meals would provide health benefits for their students.
Although these results show that the perception of whole grain products
is favorable, only half of the respondents indicated that whole grain
products had been served in their facilities and only one-third indicated
that whole grain products currently were being served. The responses
also revealed that whole grain breads and buns were the most common whole
grain foods served by foodservice staff.
About 51% of the respondents believed administrators were somewhat or
very likely to support serving whole grain foods in their cafeteria.
Serving whole grain foods was perceived by 75% of the respondents as
an approach that would result in more satisfied customers. In terms of
school meal programs, two-thirds of respondents believed that the addition
of whole grain foods would not increase or would only slightly increase
the workload, but a majority (65%) believed that serving whole grain
products would increase the cost of school meals. Despite potential cost
issues, foodservice personnel had an overall positive impression regarding
the benefits of whole grain foods and their potential for improving school
Recommendations to Increase the Consumption of Whole Grain Products
Improving the nutritional quality of school meals likely will raise their
costs, although the relationship between the cost and success of school
meal programs has not been examined in detail (Guthrie, 2003). It has
been reported that most whole grain products cost more than their refined
grain counterparts, with the exception of ready-to-eat cereals (Kantor
et al., 2001). Representatives from the baking industry attribute the
higher cost to more wear and tear of whole grain products on equipment
due to the tougher bran constituents in whole-wheat flour, and to smaller-scale
production associated with lower consumer demand (Rogers, 2002). Currently
only 10% of retail grain products are made with whole grain (Kantor et
al., 2001). Higher costs also are attributed to lower loaf volume and
longer production time (Rogers, 2002).
The cost implications of increasing whole grain products in public schools
will depend upon whether vendors charge higher prices for whole grain
products, as compared to all-purpose flour products. The most recent
prices reported by the U.S. Bureau of Labor Statistics (BLS) (April 2003)
show white bread at $1.047/lb. and whole wheat bread at $1.448/lb., a
difference of 38%. Anecdotal observations of prices for other products,
such as hamburger buns and pizza in Minneapolis-St. Paul grocery stores,
show greater price premiums for the whole grain versions.
The researchers analyzed costs involved in shifting to whole grain products
in one Minnesota elementary school menu in February 2004. Results showed
that the cost of whole grain items at the estimated daily rate over an
instructional year would increase the foodservice budget by approximately
4%. This figure was based on calculations of the number of grain-based
products served, the average cost of pre-packaged whole grain versus
non-whole grain products, and the number of students served.
This cost potentially could be managed through additional USDA allocations,
either in the form of dollars or commodities that could be incorporated
into whole grain foods by retailers or through recipe modifications by
school foodservice personnel. Individual operations or, preferably, a
regional consortium of school districts may address cost issues through
efforts with local bakers and suppliers to encourage the development
of highly palatable partial or 100% whole grain foods. Since federally
funded school meal programs are responsible for feeding more than 26
million students a day, a favorable policy for increasing whole grain
consumption could create a significant rise in demand. Increased demand
would favor competition among bakers through new technologies, recipe
development, and higher quality products. This would result in lower
production, retail, and consumer costs associated with whole grain products.
As a promising sign for policy support, the Healthy Children Through
Better Nutrition Act of 2003 includes a report to Congress that outlines
the most efficient ways to increase the servings of whole grain foods
in school nutrition programs. However, it likely will take several years
for school foodservice directors to implement these recommendations.
In order to effectively introduce whole grain foods into school meals,
there are several important questions to consider:
- What is the acceptable level of whole grain flour that children
initially will accept in various types of grain products, such as bread,
and pizza? There has been success in introducing pre-packaged buns
and rolls with a blend of 25% whole-wheat flour and 75% all-purpose
flour. Using plate-waste studies, 70% to 80% of dinner rolls consisting
25/75 whole-wheat to all-purpose flour blend that were placed on
tables in an elementary school cafeteria were consumed. The cost of
whole grain foods in the school foodservice setting was not calculated.
- Is it feasible to gradually increase the level of whole grain flour
content in grain-based foods over the course of the school year,
ranging from 25% to 100% whole grain flour content? The answer depends
length of time it takes students to adapt to a higher level of whole
grain content, such as a 50/50 blend of whole-wheat to all-purpose
flour. It is also important to ascertain which grain foods most easily
the whole grain flavor and what types of whole grain flour (white
whole wheat, oats, or barley) provide the most acceptable products.
- What is the potential cost of food and labor in introducing these
new products in different school settings? This is a crucial issue
in weighing the short-term cost to benefit ratio of serving whole
grain foods along with the potential long-term impact on the risk for
- What types of education programs are necessary to encourage greater
whole grain consumption? Should whole grain education involve parents,
teachers, and community support from local bakeries, distributors,
grocery stores, and commodity programs, in addition to school foodservice
One way to address these issues is to experiment initially with various
grain foods containing a blend of 25% whole grain flour. There are a
variety of breads, rolls, and buns available on the market with a full
range of whole grain flour content. The use of white whole-wheat is becoming
more popular as it is lighter in color, milder in flavor, and lighter
in texture, as compared to traditional products made with red whole-wheat
flour. These characteristics are child-friendly and are likely to increase
the acceptability of whole grain foods. Through the gradual exploration
of several partial or full whole grain foods, these items can be assessed
for acceptability via plate waste studies and cost analysis. If these
foods are acceptable in terms of taste and cost guidelines, the gradual
introduction of higher levels of whole grain content might be explored.
The success of these initiatives may serve as models to encourage other
school foodservice personnel to adopt innovative methods to increase
the presence of whole grain foods in their school meals.
Recent scientific evidence and policy recommendations place an emphasis
on greater consumption of whole grain foods. School foodservice personnel
are in a position to gradually increase the amount of whole grain foods
consumed by children. However, collaboration among the government, the
baking industry, and school foodservice is essential if the cost implications
and health benefits of whole grain foods are to be incorporated successfully
into school meals. The gradual integration of whole grain foods into
school foodservice menus would be a major step in achieving the Healthy
People 2010 goal of 50% of the U.S. population consuming three whole
grain products on a daily basis.
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Ujszaszy and Lazarus are, respectively, a graduate research assistant
and a professor and extension economist in the Department of Applied
Economics at the University of Minnesota. Burgess-Champoux, Reicks, and
Marquart are, respectively, a research assistant, professor and extension
nutritionist, and assistant professor for the Department of Food Science
and Nutrition at the University of Minnesota in St. Paul, MN.