Commentary on who participates in the National School Lunch Program and the School Breakfast Program

The School Nutrition Dietary Assessment Study provides much new and valuable information on the National School Lunch Program (NSLP) and the School Breakfast Program (SBP). Some of the more interesting sets of findings are those made possible by the collection of information on students, both those who participate in the programs and those who do not. Data on dietary intake of participating and nonparticipating students, both at breakfast and at lunch, as well as data on their sociodemographic characteristics and family background, provide an intriguing portrait of who participates in the meal programs and who does not. The analysis shows clearly not only that all eligible students do not participate, but also that those who participate are systematically different from those who do not. More important, the analysis suggests that students’ decisions on whether or not to participate are partly a function of the types of meals being offered. This finding has important implications for school meal policy, for it raises the question of how much nutritional improvement these programs can achieve-even the best lunch in the country will have no effect if no students choose to buy it. The analysis discussed by Gleason (1) provides direct cvidence on the difference between participating and nonparticipating students. For instance, girls are less likely to eat the school lunches and breakfasts than are boys, and older girls are less likely to eat school meals than are young girls. Thus, adolescent girls have the lowest participation rates. In addition, although many of the nonparticipating girls bring their lunches from home, many instead eat a la carte items, which are often less nutritious than the NSLP meals. In addition, the fact that a large number of nonparticipating students say they do not participate because they “don’t like the food” is a cause for concern for the same reasons. The most worrisome evidence in the Gleason analysis is that which indicates that there would be a large reduction in the number of students who eat NSLP lunches if the fat content of the meals were reduced to <32% of food energy. The magnitude of the estimated coefficients implies that a reduction below this amount would cause almost 2 million students to stop eating the lunches (8% of 24.6 million students, the current caseload). This is a serious problem because the Dietary Guidelines ‘ goal is to consume 30% of food energy from fat (2). Although it might be possible to reduce the fat content of the school meals in a way which does not so severely discourage participation, as Gleason suggests, his analysis already mdicates that this deleterious effect on participation could be ameliorated by other changes in the program which the results show would increase participation rates. Certifying more students for reduced-price or free meals, reducing the full price, restricting the ability of students to go off campus, and restricting the offering of a la carte items all would increase the participation rate in the program. The analysis by Gordon et al (3) on the dietary effects of the school nutrition programs sheds further light on these issues by providing indirect evidence on how participating and nonparticipating students differ in their actual dietary intakes. To estimate the effects of the NSLP and SBP on dietary intake, the analysis used the technique of selection-bias-adjustment, a well-known and widely accepted method of correcting for any noncomparability of treatment and comparison groups in a nonexperimental, no-clinical-trial evaluation. Their results show that, at least for the NSLP, participating students differ markedly from nonparticipating students in their predispositions toward dietary intake. For example, Table 1 in their paper shows that students who choose to eat NSLP lunches are students who ordinarily consume more food energy than students who do not choose the lunches. Specifically, students who decide to eat school lunches would have consumed six percentage points more of food energy than would nonparticipating students even if they had not decided to eat NSLP lunches (the average student who eats a school lunch would consume about two percentage points of food energy less per day, so participating students actually consume only four percentage points of food energy more per day than do nonparticipating students). Thus, it appears that students who are “big eaters” are more likely to choose an NSLP lunch. Gordon et al also show that students who choose the NSLP lunch tend to be those with predispositions toward higher intakes of protein, vitamins, minerals, and other components, all of which is consistent with the suggestion that the students who have hearty appetites are more likely to want an NSLP lunch than other students. Unfortunately, the analysis is unable to identify the reason for these hearty appetites, such as higher food energy needs, predisposition to eating a lot, or food preferences. The analysis by age and sex by Gordon et al suggests further that it is older students, especially adolescent girls, who choose NSLP lunches. For both adolescent boys and adolescent girls,