2003 School Lunch Report Card A Report by the Physicians Committee for Responsible Medicine, August 2003

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The Criteria:

Below are the possible points awarded for each category. One point is given each time the menu includes each of the following items in 15 days of sample lunch menus, plus an additional 20 points for meeting NSLP nutrition guidelines and 5 points for offering non-dairy, calcium-rich beverages.

Low-Fat Vegetable Side Dish:	15
Whole or Dried Fruit:	15
Meatless Entrée (Hot or Cold):	15
Featured Meatless, Dairy-Free, Egg-Free (Vegan) Entrée:	15
Vegan Entrée Option:	15
TOTAL	75
	+20	for meeting NSLP nutrition guidelines
	+5	for offering non-dairy, calcium-rich beverages
TOTAL	100	Points

Low-Fat Vegetable Side Dishes: 0 – 15 points

Research indicates that adults who regularly eat vegetables tend to have consumed them from childhood. Vegetables are packed with vitamin C, beta-carotene, riboflavin, iron, calcium, fiber, and many other nutrients. Dark green, leafy vegetables, such as broccoli, collards, kale, mustard and turnip greens, chicory, and bok choy, are especially good sources of important nutrients for children. Dark yellow and orange vegetables, such as carrots, winter squash, sweet potatoes, and pumpkin, provide the powerful antioxidant beta-carotene. When schools offer tasty, low-fat vegetable side dishes, such as green salads, mixed vegetables, steamed broccoli, corn on the cob, and raw baby carrots with low-fat Italian salad dressing, children adopt healthy eating habits that will stay with them for the rest of their lives. In this survey, one point was awarded for each day the school district offered a low-fat vegetable side dish. Points were not given for such high-fat side dishes as French fries, mashed potatoes, or tater tots.

Whole or Dried Fruit Offered as a Side Dish or Dessert: 0 – 15 points

As with vegetables, research shows that adults who eat fruits in adulthood also consumed them as children. Fruits are rich in fiber, vitamin C, beta-carotene, and many other nutrients. Fruit juices contain less fiber than whole fruits. In this survey, one point was awarded for each day the school district offered a whole or dried fruit on the menu. Points were given for applesauce, but not for fruit juice or frozen fruit bars, which are not rich in fiber and often feature added sugar.

Vegetarian and Vegan Entrées and Vegan Options: 0 – 45 points

Nutrition research now emphasizes the importance of fiber, the health risks of cholesterol and fats, and the disease-preventive power of many nutrients found exclusively in plant-based foods. Researchers have also discovered that the plant kingdom provides excellent sources of nutrients once associated only with meat and dairy products.

A diet drawn from varied plant sources easily satisfies calorie, calcium, and protein requirements, providing all essential amino acids—even without intentional combining or “protein complementing.” There is ample protein in whole grains, vegetables, and legumes and plenty of calcium in dark green, leafy vegetables, fortified juices, and other plant foods.

The major killers of Americans—heart disease, cancer, and stroke—have a dramatically lower incidence among people consuming primarily plant-based diets. The condition of overweight, which contributes to a host of other health problems, can also be brought under control by following plant-based diets, even in children.

With the approval of Alternate Protein Products (APPs) in the NSLP, schools are now allowed to provide children with meatless, cholesterol-free entrées. However, many of the healthier meat substitutes are not available in the commodity food program and cost schools more to include in their menus.

In this survey, a maximum of 45 points was awarded for the frequency of both vegetarian (meatless) and vegan (meatless, dairy-free, and egg-free) entrées. However, due to the dangers of dairy product consumption (which are explained below), completely plant-based meals are preferred. When featured vegan entrées appeared on the menu, the school district received one point in the vegetarian entrée category and one point in the vegan entrée category, unless the item featured was a peanut butter and jelly sandwich, in which case, the district only received credit in one of the categories. It is important for districts to expand beyond peanut butter as a vegan menu item and explore other healthy vegan dishes.

Because many schools have not yet begun to feature vegetarian main entrées (but still include some plant-based selections in their menus), the category of “vegan option” was included in this review. Having a daily vegan choice, such as a peanut butter and jelly sandwich or a salad bar, guarantees that children at least have the option to eat something that is meatless and dairy-free for lunch. The vegan option category accounted for 15 of the 45 vegetarian and vegan entrée points.

Ideally, schools will begin offering vegan entrées, such as veggie burgers, bean and rice burritos, hummus sandwiches, and veggie chili, on a regular basis so that children will be presented with nutritious selections, develop tastes for health-promoting foods, and acquire healthy eating habits that will stay with them for the rest of their lives.

Non-Dairy, Calcium-Rich Beverages: 0 or 5 points

Numerous scientific studies link the consumption of cow’s milk to obesity, anemia, ear infections, constipation, respiratory problems, heart disease, and some cancers. Due to the dangers of dairy product consumption, cow’s milk with added lactase, such as Lactaid® milk, is not a suitable alternative.

Moreover, since many children, particularly those of African, Asian, Hispanic, or Native American heritage, are unable to digest lactose (a dairy sugar), relying on dairy products as the sole source of calcium in child nutrition programs can cause kids to have digestive problems. According to the American Academy of Family Physicians’ 2002 report on lactose intolerance, 60 to 80 percent of blacks, 50 to 80 percent of Hispanics, 80 to 100 percent of American Indians, 95 to 100 percent of Asians, and 6 to 22 percent of American whites are lactose intolerant. Lactose intolerance, which develops gradually over the childhood and early adult years, causes flatulence, cramping, diarrhea, and bloating in some individuals. Therefore, the USDA should mandate the offering of non-dairy, calcium-fortified beverages as a reimbursable alternative in child nutrition programs so that milk and other dairy products are not the only source of calcium available in school lunches.

Despite the extra expense, many school districts are already offering calcium-fortified juices in their school lunch programs. In this review, PCRM awarded five extra points to school districts that provide calcium-rich juices to students on a daily basis.

Grading Scale

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