Competitive foods in schools are those foods sold to students during the school day that are not part of the federal meal programs. These federal programs, the National School Lunch Program (NSLP) and the School Breakfast Program, subsidize public school meals and regulate their nutritional content. Competitive foods, however, are only minimally regulated at the federal level. They are typically sold a la carte in the cafeteria, and through vending machines and school stores. The two largest federal school meal programs, the NSLP and the School Breakfast Program, aim to address problems of hunger, food insecurity, and poor nutrition by providing nutritious meals to children in schools. The NSLP, established in 1946, provides nutritionally balanced low-cost or free lunches in participating schools to more than 28 million children each school day, as well as reimbursement for snacks served to those through age 18 in after-school educational and enrichment programs. Similarly, the School Breakfast Program, permanently established in 1975, provides free or reduced price breakfasts to more than 8 million schoolchildren daily. At the federal level, these programs are administered by USDA’s Food and Nutrition Service (FNS). As part of its strategic goal to improve the nation’s nutrition and health, the department has laid out plans to increase access to, and utilization of, these school meal programs. In fiscal year 2004, the federal government spent over $8 billion on the NSLP and the School Breakfast Program. FNS provides reimbursement in the form of cash subsidies and donated commodities based on the number of lunches and breakfasts served that meet certain federal requirements. The meals must adhere to the Dietary Guidelines for Americans, which include limits on total fat and saturated fat and call for diets moderate in sodium. The meals must also meet standards for the recommended daily allowances of calories, as well as nutrients such as protein, calcium, iron, and vitamins A and C. Compliance with the standards is determined by averaging the nutritional content of the meals offered over a school week. USDA reimburses states, usually through the state departments of education, which in turn reimburse local SFAs that operate the programs in one or more schools. SFAs function as the governing entities responsible for the local administration of the federal meals programs. They are often, but not always, responsible for school meals in an entire school district. SFAs have some flexibility in operating their school meal programs. For example, they may operate the programs themselves or contract with food service management companies to perform functions such as planning and preparing menus and selecting and buying food. All or some food preparation may occur at on-site school kitchens or at central kitchens, which then distribute food to satellite schools. In addition, SFAs may select among different menu-planning approaches to comply with the federal nutritional requirements. SFAs receive a significant portion of their funding from federal reimbursements that are based on the number of meals served to students in their schools. In addition, SFAs also receive some funding from states for program operations, and they may generate revenues by selling competitive foods or by offering fee-based catering services. Further, SFAs are permitted to combine costs and revenues for reimbursable meals and nonreimbursable offerings, such as competitive foods, as long as they maintain their nonprofit status. Therefore, if revenues from reimbursable meals are less than the costs of producing these meals, SFAs may use competitive food revenues to support the cost of reimbursable meals. Likewise, if revenues from reimbursable meals are more than the costs of producing these meals, SFAs may use these funds to support competitive food sales. Competitive foods are those foods sold in schools, during the school day, that are not part of the federal school meal programs—that is, they compete with the nutritionally regulated school meal programs. These foods can range from candy and soda to pizza and popcorn to apples and milk and are typically available in cafeteria a la carte lines, vending machines, and school stores. Unlike federally subsidized school meals, the sale and nutritional content of competitive foods are largely unregulated by the federal government. Federal regulations prohibit the sale of certain competitive foods, known as foods of minimal nutritional value (FMNV), during meal periods in school cafeterias and other food service areas. FMNV, as defined by USDA, include soda, chewing gum, and hard candy, for example (see fig. 1). Other than this restriction, federal regulations do not prohibit or limit the sale of any other competitive foods anywhere on school grounds at any time. In contrast, from 1980 to 1983, federal regulations prohibited the sale of FMNV anywhere in the school from the beginning of the school day until the last meal period. In National Soft Drink Ass’n v. Block, 721 F. 2d 1348 (D.C. Cir. 1983), the Court of Appeals for the District of Columbia overturned this regulation and construed a 1977 amendment to the Child Nutrition Act as allowing USDA to regulate the sale of competitive foods only in food service areas during meal periods. Following this decision, USDA amended its regulation to limit the prohibition of these foods to food service areas during meal periods. According to federal regulations, states and SFAs may impose further restrictions on all foods sold at any time throughout their schools. As of April 2005, 28 states have made efforts to restrict the sale of competitive foods beyond USDA regulations (see fig. 2). Five state policies do not restrict particular food items, but instead typically address the competitive food environment more broadly. For example, some of these states have created committees to develop policies concerning competitive foods in schools or have encouraged schools to find ways to improve their competitive food environments. The remaining 23 of these state policies place some form of specific restrictions on competitive foods, though they differ in the type and extent of restrictions. The majority of these policies restrict some, but not all, competitive foods and restrict foods only at times associated with school meal periods, rather than during the entire school day. The federal government has an interest in improving child nutrition in order to promote the health and wellness of the nation’s children. Moreover, the current child obesity trend poses public health risks because of the relationship of obesity to serious illnesses, such as type 2 diabetes and hypertension. These illnesses can result in substantial long- term costs to society. In response, USDA has recently developed initiatives to support school efforts to provide a healthy nutrition environment, including competitive food sales. Beginning in 1995, USDA introduced the School Meals Initiative for Healthy Children in an effort to improve the nutritional quality of meals served through the NSLP and the School Breakfast Program. That same year, in order to assist with implementation of the School Meals Initiative, USDA launched Team Nutrition to focus on schools and promote the nutritional health of the nation’s children. Team Nutrition provides schools with nutrition education materials for children and families, technical assistance materials for school food services, and materials to build school and community support for healthy eating and physical activity. Since 1995, USDA has also created additional resources to help schools improve student nutrition, address competitive foods, and foster long-term health, sometimes in collaboration with other federal agencies (see table 1). The Department of Health and Human Services (HHS) has also focused on the school nutrition environment through various initiatives by CDC. These include an eight-component coordinated health model for schools that includes school nutrition services as one component, and a School Health Index designed to help schools assess their environments and improve the effectiveness of their health and safety policies and programs. In addition to these efforts to support a healthy school nutrition environment, the National Academy of Sciences’ Institute of Medicine recently released a broad-based report on preventing childhood obesity. Among other things, the institute recommended that the current federal funding structure of school meals and the policies and practices of selling competitive foods in schools be examined for improvements that would encourage students to consume nutritious foods and beverages, and that nutritional standards be developed and implemented for all competitive foods sold or served in schools. The Child Nutrition and WIC Reauthorization Act of 2004 requires school districts that participate in the federal meal programs to establish local wellness policies by the first day of the 2006-2007 school year. Congress added this requirement, in part, in order to promote nutrition and address child obesity by encouraging localities to provide healthy school environments. These policies must include nutrition guidelines for all foods available on each school campus during the school day and goals for nutrition education and physical activity, as well as establish a plan for measuring implementation of the local wellness policy. Further, the local wellness policies must be developed in collaboration with the community—including a combination of school officials, parents, students, and the public. The act also requires that USDA, HHS—through CDC—and the Department of Education provide technical assistance to districts regarding wellness policies. In addition, in order to assist schools in setting appropriate nutrition standards for foods available in schools, Congress—through the Conference Report of the Consolidated Appropriations Act of 2005—provided $1 million to the Institute of Medicine. With these funds, the institute will conduct a study and provide recommendations regarding appropriate nutritional standards for the availability, sale, content, and consumption of all foods at school, with a particular emphasis on competitive foods. Nearly 9 out of 10 schools sold competitive foods to students in 2003-2004, and over the last 5 years, the availability of competitive foods has increased both in middle schools and in a la carte lines in many schools. While competitive foods were commonly available in all school levels, students in high schools and middle schools had greater access to these foods than students in elementary schools. The competitive foods available ranged from nutritious items such as fruit and milk to less nutritious items such as soda and candy. Between 1998-1999 and 2003- 2004, the availability of competitive foods increased in middle schools, and the volume and variety of a la carte foods sold increased in many schools.