Autumn. School

Do Free School Meals Reduce Obesity Prevalence?

Eight states have moved to provide nutritious meals at school for free to all students. A few simple reasons make it clear enough that this is a good idea. It reduces the stigma attached to receiving free school meals while improving food security for children from low-income families. Furthermore, nutrition quality goes up for all students.

But a provocative new study in Pediatrics is prompting headlines saying free school meals “cut obesity prevalence.” We confess. The clickbait worked because this is a remarkable claim and Pediatrics is quite a credible journal.

So we dug into the facts.

An Association Rather Than an Effect

Going straight to the bottom line, the truth is that this very good study found:

“In a balanced sample of California schools, CEP participation was associated with a modest net decrease in obesity prevalence compared with eligible, nonparticipating schools.” (CEP is the Community Eligibility Provision for universal free school meals.)

Knowing that our readers are discerning, we likely don’t need to remind you that observing an association is not the same thing as finding an effect. So no, we should not be confident that free school lunches will cause obesity prevalence to drop.

There are plenty of other reasons the provision of free school meals is a good policy.

A Solid Study

The authors of this study creep right up to the line and say their findings are “suggesting that universal free school meals policies may be effective for addressing childhood obesity.” But their words make it clear they are speculating. Not making firm conclusions.

Andrew Brown, a biostatistics professor at the University of Arkansas, pays close attention to such research as this because of his work in obesity prevention at the Arkansas Children’s Research Institute. He’s also a stickler for scientific rigor. He explains why this is a good study and why it has limitations:

“They did use a strong quasi-experimental design. Having the staggered adoption dates adds to the robustness. This makes the evidence stronger than typical cross-sectional or ordinary association tests. However, quasi- or natural-experiments assume assignment to condition is ‘as good as randomization.’ We know that adoption of free school meals, or anything in school policy, is unlikely to be as good as randomization.

“In contrast, a cluster randomized trial in which breakfast was served in the classroom (which, granted, is different than ‘universal free school meals’) concluded ‘the initiative had an unintended consequence of increasing incident and prevalent obesity.’ I think there is a lot more to learn.”

Yes, indeed. We have a lot more to learn about effective ways to reduce the prevalence of obesity.

Click here for the study, here, here, and here for further reporting on it. For other research on free school nutrition, click here and here.

Autumn. School. Painting by Marianne von Werefkin / WikiArt

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March 26, 2024