HHFKA

NIH Study Finds the Healthy, Hunger-Free Kids Act Reduced Children’s Body Mass Index

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

 

There has been an overall decrease in the body mass index (BMI) of children and adolescents in America following the implementation of the Healthy, Hunger-Free Kids Act (HHFKA), according to a new study funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

“The National School Lunch Program and School Breakfast Program (NSLP) provides free or low-cost meals to over 30 million children annually, providing an estimated 50% of students’ caloric intake each school day,” said Aruna Chandran, MD, MPH, an ECHO Program investigator at the Johns Hopkins Bloomberg School of Public Health.

The HHFKA was fully implemented in 2016 and is the first legislation passed in nearly 3 decades to improve the nutritional quality of school meals. To evaluate the effect of the HHFKA on children’s BMI, ECHO researchers analyzed data from over 14,000 children collected between January 2005 and March 2020 from 50 cohorts across the U.S.

“School meals and snacks represent a key opportunity for intervention to combat the childhood obesity epidemic,” said Emily Knapp, PhD, an ECHO Program investigator at the Johns Hopkins Bloomberg School of Public Health. “This is particularly important for children in lower-income families who are more likely to participate in the NSLP and are at higher risk of obesity.”

Dr. Chandran and Dr. Knapp led this collaborative research published in JAMA Pediatrics.

Chandran, A. et al. Changes in Body Mass Index Among School-Aged Children Following Implementation of the Healthy, Hunger-Free Kids Act. JAMA Pediatrics. DOI:10.1001/jamapediatrics.2022.5828

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About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

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Child Body Mass Index Dropped After Healthy, Hunger-Free Kids Act in Schools

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Child Body Mass Index Dropped After Healthy, Hunger-Free Kids Act in Schools

Author(s): Aruna Chandran, Emily Knapp, et al.

 

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health.

 

What were the study results?

The study showed an overall decrease in BMI in the first few years following the implementation of the HHFKA compared to BMI in the decade prior to the program. Among children ages 12-18 years, who may have more autonomy in purchasing their own lunches or snacks during the school day, BMI decreased from year to year following the start of the HHFKA. This was a reversal of the trends seen during the decade before the program, during which adolescent BMI was increasing each year. This study also supported findings from previous studies that found the HHFKA had a positive effect on the health of children from lower-income families by contributing to an annual decrease in their BMI.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What was the study's impact?

The National School Lunch Program and School Breakfast Program (NSLP) provides free or low cost meals to over 30 million children annually, providing an estimated 50% of students’ caloric intake each school day. This study found that the HHFKA was associated with decreases in child and adolescent BMI. Increasing BMI trends before the HHFKA was implemented were stopped or even reversed in several populations after the law was implemented, which could critically influence their long-term health. The study also found that the implementation of the HHFKA decreased BMI of children from lower-income families, who are more likely to participate in the NSLP and are at higher risk of obesity. Accessibility to school meals and snacks represents a key opportunity for intervention to combat the childhood obesity epidemic.

 

Why was this study needed?

Childhood obesity is a serious health concern with long-term consequences for health and quality of life. Nearly 1 in 5 children in America is obese. The 2010 Healthy, Hunger-Free Kids Act (HHFKA) was the first legislation passed in nearly 3 decades aimed at improving the nutritional quality of breakfast, lunch, and snacks sold at schools. Studies have shown that the HHFKA has improved the quality of school meals without affecting cost or program participation, but only a few small studies have explored whether the HHFKA reduced body mass index (BMI) in children over time.

 

Who was involved?

This study included 14,121 children from the ECHO Program between the ages of 5 and 18 who had at least one height and weight measurement recorded between January 2005 to March 2020.

 

What happened during the study?

Researchers used height and weight measurements from children across 50 ECHO cohorts to calculate each child’s BMI and adjusted each measurement based on age and sex. They used these data to evaluate yearly BMI trends from before and after the implementation of the Healthy, Hunger Free Kids Act in September 2016.

 

What happens next?

Future studies are needed to further explore and verify the effect of improving the nutritional quality of school meals on childhood obesity. In addition, policymakers could use data from studies like this to evaluate policies related to improving the nutritional quality of meals provided in schools.

 

Where can I learn more?

Access the full journal article, titled “Changes in Body Mass Index Among School-Aged Children Following Implementation of the Healthy, Hunger-Free Kids Act,” in JAMA Pediatrics.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

 

Published: February 13, 2023

 

Access the associated article.

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Child Body Mass Index Dropped After Healthy, Hunger-Free Kids Act in Schools

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ECHO Researchers Investigate the Effect of the Healthy, Hunger-Free Kids Act on the Body Mass Index of School-aged Children

Posted on by Jodi Snare

Collaborative ECHO research led by Aruna Chandran, MD, MPH and Emily Knapp, PhD of the Johns Hopkins Bloomberg School of Public Health, examines how the body mass index (BMI) trends of school-aged children have changed following the implementation of the 2010 Healthy, Hunger-Free Kids Act (HHFKA). Researchers analyzed height and weight data from over 14,000 children in the ECHO Program and found an overall decrease in BMI following the implementation of the HHFKA. These results suggest a reversal of the pre-implementation trends, which indicated that BMI was increasing from year to year, particularly among adolescents and children from lower-income families. This research, titled “Changes in Body Mass Index Among School-Aged Children Following Implementation of the Healthy, Hunger-Free Kids Act,” is published in JAMA Pediatrics.

“The National School Lunch Program and School Breakfast Program (NSLP) provides free or low-cost meals to over 30 million children annually, providing an estimated 50% of students’ caloric intake each school day,” said Dr. Chandran. “The Healthy, Hunger-Free Kids Act was the first legislation in nearly 3 decades aimed at improving the nutritional quality of breakfast, lunch, and snacks sold at schools.”

Childhood obesity is a serious health concern, affecting nearly 1 in 5 children in America, that has long-term consequences for health and quality of life. While many studies have already shown the success of the HHFKA in improving the quality of school meals, there are still gaps in understanding the effect of this policy on childhood BMI.

For this study, researchers analyzed height and weight measurements collected between January 2005 and March 2020 from children ages 5 to 18 years across 50 ECHO cohorts in the United States. They used these measurements to calculate each child’s BMI, then adjusted those measurements based on the child’s age and sex. Using this data, the researchers compared yearly BMI trends from before and after the implementation of the HHFKA.

The researchers found that increasing BMI trends from the decade before the HHFKA was implemented were reversed after the law was implemented. This effect was also observed in adolescents, who tend to have more autonomy in purchasing their own meals and snacks during the school day but still benefited from HHFKA implementation.

“School meals and snacks represent a key opportunity for intervention to combat the childhood obesity epidemic, given the high rates of participation in school meal programs and the significant proportion of caloric intake that children receive at school,” said Dr. Knapp. “This is particularly important for children in lower-income families, who are more likely to participate in the NSLP and are at higher risk of obesity.”

In the future, researchers should continue to the examine the effects of improving the nutritional quality of school meals on childhood obesity. Results from this study can also help policymakers evaluate future policies related to improving school meals and snacks.

Read the research summary.­­