Among all food venues, school cafeterias provide the healthiest choices for children and teens. In a study published in JAMA Network Open, researchers analyzed questionnaires collected from 20,905 children and 39,757 adults between 2003-2018. They asked about types of food, and where Americans purchased foods and beverages, such as grocery stores, cafeterias, and restaurants. The researchers used the American Heart Association diet score and the 2015 Healthy Eating Index to assess the heart-healthfulness of foods and drinks purchased from these establishments.
School meals also accounted for the most significant dietary changes among children surveyed, regardless of sociodemographic factors. In 2003-2004, one-half of students consumed foods of poor dietary quality from school. By 2017-2018, one-quarter of students consumed less-healthful options. Policy changes in 2010 supported a shift toward healthier school meals, which were reflected by students consuming more whole grains and less saturated fat, sugar-sweetened beverages, and sodium from school lunchrooms.
Modest changes were found for foods purchased from grocery stores, but with disparities related to age, sex, race, and income. Minimal or no changes were noted for restaurant food choices, with stagnant or worsening trends related to “other” food sources – like food trucks. Similar to grocery stores, disparities overlapped with food choices. The researchers note improvements can be made to improve food environments at all venues, while focusing on health equity. They found changes at grocery stores, where most food is purchased, could have the greatest impact. The study was supported by the NHLBI.