Childhood obesity is an ongoing public health program. As such, a major public health research objective is to identify potential targets for intervention; one such area is school lunches (SL). The National School Lunch Program (NSLP) serves over 31 million children each day; the National Health and Nutrition Examination Survey (NHANES) is uniquely positioned to allow researchers to assess diet quality in federal nutrition assistance programs. The objective of the study was to investigate whether lunches provided by schools provide different nutritional value than lunches obtained elsewhere. In a nationally representative sample of 2190 children, consumption of a school-provided lunch (SL) was associated with greater nutritional quality compared to lunches obtained elsewhere across both age and income categories. Children who were eligible for no-cost school lunch, but did not participate in the NSLP consumed approximately 60% more energy, 58% more total fat, 60% more saturated fat, 50% more solid fat, 61% more sodium, double the amount of added sugars and less than half the amount of fruit than NSLP participants (all p < 0.001). The results of this study suggest that though widely criticized, school lunches provide superior nutrient quality than lunches obtained from other sources, particularly for low-income children.
Keywords: NHANES; diet quality; energy density; obesity; school lunch.