Introduction: Millions of children consume school lunches daily. Children from low-income families are eligible for free or reduced-price school meals. While studies show improvement in the nutritional quality of school lunches, the effect of school lunch or lunch brought from home on cardiovascular risk factors among children is unknown.
Hypothesis: We hypothesized that frequently consuming school lunch is associated with increased cardiovascular risk factors when compared with lunch brought from home.
Methods: All 15,742 sixth graders enrolled in Project Healthy Schools, a school-based wellness intervention, were included in this cross-sectional study (2004-2015). We examined 10,169 behavioral surveys and 1,845 physiological screenings. We compared self-reported diet, physical activity (PA), sedentary behaviors and physiologic parameters (height, weight, blood pressure (BP) and heart rate) in 2 groups, children who reported eating school lunch daily and those who eat home-prepared lunch daily. The groups were further stratified by socioeconomic status (SES); low SES (<$35,000) or high SES (>$50,000) based on the median household income of the school region. Students in the middle SES range ($35,000-$50,000) were excluded from analysis (n=4230).
Results: School lunch students were associated with less healthy behaviors (PA, diet [fruit/vegetable servings, meat and sugary beverage intake], and sedentary activities) and physiologic measures (percent of overweight/obesity, systolic BP and recovery heart rate) compared with students bringing lunch from home in low and high SES groups (Table 1).
Conclusions: In this large cohort of children, we observed frequent school lunch consumption, even after adjustment for SES, was associated with less healthy behaviors and physiologic parameters. Further research is warranted to determine whether healthier school lunches would improve cardiovascular health characteristics and health behaviors in middle-school students.