The U.S. Department of Agriculture (USDA) Food and Nutrition Service is proposing nutrition standard updates to public school meals to begin in Fall 2025. For Mona A. Eissa, MD, MPH, PhD, adolescent medicine pediatrician with UT Physicians, the proposal is welcome news.
“They are making the changes so children receive healthier meals to reduce their risk of diet-related diseases, such as diabetes, high blood pressure, heart disease, and obesity,” said Eissa, professor of pediatrics and division director of adolescent medicine with McGovern Medical School at UTHealth Houston.
According to Eissa, who is also board-certified in obesity medicine, an increasing number of children are already starting to develop obesity, high blood pressure, and prediabetes. It is key for schools to offer balanced and nutritious meals.
“We know that millions of children did get half of their daily food from the school breakfast and lunch program,” Eissa said. “School meals may be the healthiest meals they receive throughout the day. This is an opportunity to improve the dietary standard so it benefits all students who eat at school.”
Eissa breaks down the proposed updates that target four key areas: added sugar, milk, sodium, and whole grains.
Added sugars
The USDA is proposing to reduce added sugars in a phased approach.
Phase 1: Beginning in Fall 2025, rules will be placed on four products: grain-based desserts (e.g., doughnuts, cereal bars), dry/cold cereal, yogurt, and flavored milk.
● Grain-based desserts will have a limit of 2 ounces per week.
● Cereal will have a limit of 6 grams of added sugar per ounce.
● Yogurt will have a limit of 12 grams of added sugar per 6 ounces.
● Flavored milk will have a limit of 10 grams of added sugar per 8 fluid ounces.
Phase 2: Beginning in Fall 2027, the rule will limit the overall added sugars across the weekly menu to less than 10% of calories per meal to better align meals with the dietary guidelines.
The pediatrician supports fully supports both phases to reduce added sugars.
“Right now, 17% of calories from some breakfast meals come from added sugars, which is much higher than the recommended dietary guidelines,” Eissa said. “It is better to not introduce children to sugary foods. Those who are already eating sugary foods will get used to eating foods with less sugar. Their palates will adapt.”
Milk
The USDA is proposing to allow flavored milk with reasonable limits on added sugar and two serving options.
Option 1: Beginning in Fall 2025, fat-free and low-fat flavored milk with reasonable limits on added sugar will be available to only high school students.
Option 2: Fat-free and low-fat flavored milk with reasonable limits on added sugar will be available to all students.
Eissa supports the option to limit flavored milk to high school students.
“We should not expose young children to sugary drinks, even if it is milk,” she said. “Young children who already prefer flavored milk will get used to the taste of unflavored milk.”
Sodium
The USDA is proposing to reduce sodium in three phases for school lunches and two phases for school breakfasts.
Lunch
● Phase 1: Beginning Fall 2025, the rule will reduce the weekly sodium limit by 10% from the prior school year.
● Phase 2: Beginning Fall 2027, the rule will reduce the weekly sodium limit by 10% from the prior school year.
● Phase 3: Beginning Fall 2029, the rule will reduce the weekly sodium limit by 10% from the prior school year.
Breakfast
● Phase 1: Beginning Fall 2025, the rule will reduce the weekly sodium limit by 10% from the prior school year.
● Phase 2: Beginning Fall 2027, the rule will reduce the weekly sodium limit by 10% from the prior school year.
Eissa fully supports all the phases to reduce sodium in all meals.
“High salt intake is related to high blood pressure. According to research, children are beginning to develop high school pressure at a young age,” Eissa said. “It is best to get them used to eating meals with low amounts of sodium so they have less risk of developing heart disease.”
Whole grains
The USDA is proposing to prioritize whole grains in meals with two options.
Option 1: At least 80% of all grains served during the school week will continue to be whole-grain rich (i.e., contain at least 50% whole grains).
Option 2: 100% whole grains will be served four days out of the school week and enriched grains (e.g., tortillas, pasta) may be served one day.
Though she finds both options acceptable, Eissa leans toward the option that provides whole grain-rich foods each day.
“I think children should eat whole grains or whole grain-rich foods each day because of the fiber they provide and their lower glycemic index,” Eissa said. “Whole grains can help them help fight diabetes and obesity.”
After-school snacks
The USDA is proposing a rule to extend the dietary components of after-school snacks.
Current: After-school snacks must include two of the following four components: fluid milk, meat or meat alternative, a vegetable or fruit, or whole-grain or enriched bread (or equivalent product).
Proposed update: After-school snacks must include two of the following five components: fluid milk, meat or meat alternative, vegetable, fruit, or grains.
Eissa supports the proposal and hopes nuts and seeds will be pushed as a meat alternative.
“Nuts and seeds are nutrition-rich foods because they contain vitamins and minerals the body needs and they also contain healthy fat, protein, and fiber,” Eissa said.
Comments
The USDA is accepting public comments on the proposed nutrition updates until April 10, 2023. For more details on the proposed updates to the school nutrition standards, visit the USDA website.
The doctor encourages anyone with a school-age child to comment, particularly if the child has a special diet due to allergies, culture, or lifestyle.
“The updates do not mention rules for children with allergies or intolerance to milk,” Eissa said. “The USDA will probably need to address this and other dietary issues, but this is why everyone is allowed to comment. They will take the feedback to try to provide healthy alternatives.”
Eissa believes the USDA’s nutrition changes are reasonable and give children an opportunity to adjust to the changes.
“These changes will help children avoid future health problems. The goal is not just to feed them but to offer them the best nutrition value,” Eissa said.
