Lunches brought from home by elementary and middle school students are not measuring up to the National School Lunch Program (NSLP) guidelines used for meals served in schools, according to a study published online by JAMA Pediatrics.

In 2010, Congress passed the first update to the U.S Department of Agriculture's core children's nutrition program in more than 30 years. That included new requirements for school meals. Major changes included minimum and maximum calorie allowances, increased servings of fruits, vegetables and whole grains, a gradual reduction in sodium and the elimination of high-fat milk. While the new regulations changed school meals, they did not address food brought from home for lunch.

Michelle L. Caruso, M.P.H., R.D., of the Houston Department of Health and Human Services, and Karen W. Cullen, Dr.P.H., R.D., of the Baylor College of Medicine, Houston, examined lunches over two months brought from home by students at eight elementary (kindergarten to grade 5) schools (n=242) and four middle (grades 6-8) schools (n=95) in a Houston area school district on the basis of quality and cost. Nutrient and food group content were compared with the current NSLP guidelines. Per-serving prices for each item also were averaged.

Lunches brought from home did not fare well when compared with the NSLP guidelines, according to the study findings. Lunches brought from home contained more sodium (1,110 vs less than or equal to 640 mg for elementary and 1,003 vs. less than or equal to 710 mg for middle school students) and fewer servings of fruit (0.33 cup for elementary and 0.29 cup for middle school students vs. 0.50 cup per the NSLP guidelines). There also were fewer servings of vegetables in home lunches (0.07 cup for elementary and 0.11 cup for middle school students vs. 0.75 cup per the guidelines) and whole grains (0.22-ounce equivalent for elementary and 0.31-ounce equivalent for middle school students vs. 0.50-ounce minimum in the guidelines) and milk (0.08 cup for elementary and 0.02 cup for middle school students vs. 1 cup in the guidelines).About 90% of lunches from home contained desserts, snack chips, and sweetened beverages, which are not permitted in reimbursable school meals.

Study results show the cost of home lunches averaged $1.93 for elementary students and $1.76 for middle school students.

"Because of the problem of childhood obesity, much attention has been given to the school food environment and the NSLP. However, it is apparent that a large component of the school food environment - foods brought from home - has not been thoroughly investigated and could be a contributing factor to child overweight status," the study concludes.

Editorial: A Look at the New School Lunch Criteria

In a related editorial, Virginia A. Stallings, M.D., of the Children's Hospital of Philadelphia and University of Pennsylvania, writes: "Future studies and educational activities are needed to encourage families who choose to provide lunch from home to prepare meals that are similar to the NSLP diet patterns and the health promotion goals. Little contemporary information is available about families and students who choose not to participate in the school lunch and may result in less healthful lunch alternatives or skipping lunch."