This is the accessible text file for GAO report number GAO-04-673 
entitled 'School Meal Programs: Competitive Foods Are Available in Many 
Schools; Actions Taken to Restrict Them by State and Locality' which 
was released on April 26, 2004.

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Report to Congressional Requesters:

United States General Accounting Office:


April 2004:

School Meal Programs:

Competitive Foods Are Available in Many Schools; Actions Taken to 
Restrict Them Differ by State and Locality:




Appendix I: Briefing Slides:


CDC: Centers for Disease Control and Prevention:
FMNV: foods of minimal nutritional value: 
FNS: Food and Nutrition Service:
SHPPS: School Health Policies and Programs Study:
SMI: School Meals Implementation:
SNDA-II: School Nutrition Dietary Assessment Study-II: 
USDA: United States Department of Agriculture:

United States General Accounting Office:

Washington, DC 20548:

April 23, 2004:

The Honorable Tom Harkin: 
Ranking Member: 
Committee on Agriculture, Nutrition, and Forestry: 
United States Senate:

The Honorable Patrick J. Leahy: 
Ranking Member: 
Subcommittee on Research, Nutrition, and General Legislation: 
Committee on Agriculture, Nutrition, and Forestry: 
United States Senate:

The Honorable George Miller: 
Ranking Member: 
Committee on Education and the Workforce: 
House of Representatives:

The Honorable Lynn Woolsey: 
Ranking Member: 
Subcommittee on Education Reform: 
Committee on Education and the Workforce: 
House of Representatives:

The nation faces a complex challenge in addressing recent trends in 
children's health and eating habits. Data from the U.S. Centers for 
Disease Control and Prevention (CDC) have shown that over 15 percent of 
children and adolescents ages 6 to 19 are overweight, a proportion that 
has significantly increased since the 1960s. In addition, CDC has also 
reported an increase in the frequency of type 2 diabetes in U.S. 
children and adolescents over the last two decades. Trends in obesity 
and a low level of physical activity among children and adolescents may 
be a major contributor to this increase.

To address these trends, in 2001, the U.S. Surgeon General issued a 
call to action to prevent and decrease overweight and obesity among all 
Americans, especially children. In this statement, schools were 
identified as one of the key settings for public health strategies to 
address these issues. Since a large portion of a child's day is spent 
in school, providing children with healthy food options throughout the 
school day can be an important step toward good child nutrition. The 
National School Lunch and School Breakfast Programs provide millions of 
children with nutritious meals each school day. The United States 
Department of Agriculture's (USDA) Food and Nutrition Service (FNS) 
administers these programs at the federal level, and FNS subsidizes the 
meals served through these programs in local schools as long as the 
meals meet certain nutritional guidelines. In the last decade, these 
nutritional guidelines were amended to require schools to serve meals 
that adhere to the Dietary Guidelines for Americans, which limit total 
and saturated fat and provide specific minimum levels of vitamins and 
nutrients. Despite these efforts to improve the nutritional quality of 
meals offered through the school meal programs, other foods not 
provided through these programs are often available to children at 
school through a la carte lines in the cafeteria where individual foods 
and beverages can be purchased, snack shops, school stores, vending 
machines, and other venues. The nutritional value of these foods, often 
referred to as competitive foods, is largely unregulated by the federal 

Because of your concern about the trends in children's health and 
eating habits and your interest in further understanding issues related 
to competitive foods in schools, you asked us to answer the following 
questions: (1) Which foods and school food practices fall under the 
term competitive foods, and what federal restrictions exist on their 
sale? (2) What is currently known about the types of competitive foods 
and their availability and prevalence in schools? (3) What is currently 
known about additional steps that are being taken on the state and 
local levels to curtail the sale of competitive foods?

To answer your questions, we reviewed a variety of data sources, 
including legislation, policies, and studies that address competitive 
foods in schools. From these sources, we gathered information on 
federal and state competitive foods laws and regulations. In addition, 
we analyzed data on the availability, prevalence, and types of 
competitive foods in schools provided in three national studies--the 
School Nutrition Dietary Assessment Study-II, the School Health 
Policies and Programs Study of 2000, and the Third Year Report of the 
School Meals Initiative Implementation Study. We also reviewed several 
smaller-scale studies that address the association between competitive 
foods in schools and child nutrition. We examined each study to assess 
the adequacy of the samples and measures employed, the reasonableness 
and rigor of the statistical techniques, and the validity of the 
results that were drawn from the analyses. To supplement the 
information collected from these sources and to gather information on 
steps that have been taken at the local level to restrict competitive 
foods in schools, we conducted interviews with several professional 
organizations, advocacy groups, and other stakeholders. We conducted 
our review from January through March 2004 in accordance with generally 
accepted government auditing standards.

On April 12, 2004, we briefed interested Senate staff on the results of 
our analysis. This report formally conveys the information provided 
during that briefing. In summary, we reported that:

* Competitive foods include all foods and beverages sold in schools 
except for meals provided through the School Lunch and School Breakfast 
Programs. Current federal regulations restrict only a subset of 
competitive foods, foods of minimal nutritional value, from being sold 
during mealtimes in food service areas.

* Competitive foods are sold in a variety of locations on a majority of 
school campuses nationwide. The types of competitive foods available 
often differ by location where they are sold, with healthy foods more 
often sold in a la carte lines in the cafeteria and less healthy foods 
more often sold through vending machines, school stores, canteens, and 
snack bars.

* Several states, school districts, and individual schools have enacted 
competitive foods policies that are more restrictive than federal 
regulations. These policies differ widely in the types of restrictions 
they apply.

We provided a draft of this briefing to officials at FNS for their 
technical comments and incorporated their comments where appropriate.

We are sending copies of this report to relevant congressional 
committees and other interested parties and will make copies available 
to others upon request. In addition, this report will be available on 
GAO's Web site at If you or your staff have any 
questions about this report, please contact me at (415) 904-2272 or Kay 
E. Brown at (202) 512-3674. Rachel Weber, Kevin Jackson, and Dan 
Schwimer also made significant contributions to this report.

Signed by: 

David D. Bellis: 

Director, Education, Workforce, and Income Security Issues:

[End of section]

Appendix I: Briefing Slides:

[See PDF for slides]

[End of slideshow]

[End of section]

Related GAO Products:

School Lunch Program: Efforts Needed to Improve Nutrition and Encourage 
Healthy Eating. GAO-03-506. Washington, D.C.: May 9, 2003.

School Meal Programs: Revenue and Expense Information from Selected 
States. GAO-03-569. Washington, D.C.: May 9, 2003.

Public Education: Commercial Activities in Schools. GAO/HEHS-00-156. 
Washington, D.C.: September 8, 2000.

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