Document

Child Nutrition Programs: Meal Patterns Consistent With the 2020-2025 Dietary Guidelines for Americans

This rulemaking finalizes long-term school nutrition requirements based on the goals of the Dietary Guidelines for Americans, 2020-2025, robust stakeholder input, and lessons le...

Department of Agriculture
Food and Nutrition Service
  1. 7 CFR Parts 210, 215, 220, 225, and 226
  2. [FNS-2022-0043]
  3. RIN 0584-AE88

AGENCY:

Food and Nutrition Service (FNS), Department of Agriculture (USDA).

ACTION:

Final rule.

SUMMARY:

This rulemaking finalizes long-term school nutrition requirements based on the goals of the Dietary Guidelines for Americans, 2020-2025, robust stakeholder input, and lessons learned from prior rulemakings. Notably, this rulemaking gradually phases in added sugars limits for the school lunch and breakfast programs and in the Child and Adult Care Food Program, updates total sugars limits for breakfast cereals and yogurt to added sugars limits. As a reflection of feedback from stakeholders, this final rule implements a single sodium reduction in the school lunch and breakfast programs and commits to studying the potential associations between sodium reduction and student participation in the school lunch and breakfast programs. This rulemaking addresses a variety of other school meal requirements, including establishing long-term milk and whole grain requirements. Finally, this rule includes provisions that strengthen Buy American requirements. While this rulemaking takes effect school year 2024-2025, the Department is gradually phasing in required changes over time. Program operators are not required to make any changes to their menus as a result of this rulemaking until school year 2025-2026 at the earliest.

DATES:

This final rule is effective July 1, 2024. Phased-in implementation dates for required changes are addressed in the SUPPLEMENTARY INFORMATION section of this rule.

ADDRESSES:

Docket: Go to the Federal eRulemaking Portal at https://www.regulations.gov for access to the rulemaking docket, including any background documents.

FOR FURTHER INFORMATION CONTACT:

Andrea Farmer, Director, School Meals Policy Division—4th floor, Food and Nutrition Service, 1320 Braddock Place, Alexandria, VA 22314; telephone: 703-305-2054.

SUPPLEMENTARY INFORMATION:

Table of Contents

1. Background

Phased-In Implementation

USDA Support for Child Nutrition Programs

Federal Strategies To Reduce Sodium and Added Sugars in the Food Supply

Overview of Public Comments

2. Added Sugars

3. Milk

3A: Flavored Milk

3B: Fluid Milk Substitutes: Responses to Request for Input

3C: Fluid Milk Substitutes: Nutrient Requirements

4. Whole Grains

5. Sodium

6. Meats/Meat Alternates at Breakfast

7. Substituting Vegetables for Grains in Tribal Communities

8. Traditional Indigenous Foods

9. Afterschool Snacks

10. Substituting Vegetables for Fruits at Breakfast

11. Nuts and Seeds

12. Beans, Peas, and Lentils at Lunch

13. Competitive Foods: Bean Dip Exemption

14. Meal Modifications

15. Clarification on Potable Water Requirements

16. Synthetic Trans Fats

17. Professional Standards: Hiring Exception for Medium and Large Local Educational Agencies

18. Buy American

18A: Limited Exceptions to the Buy American Requirement

18B: Exception Documentation and Reporting Requirements

18C: Procurement Procedures

18D: Definition of “Substantially”

18E: Clarification of Requirements for Harvested Farmed and Wild Caught Fish

19. Geographic Preference

20. Miscellaneous Changes

21. Summary of Changes

21A: Descriptive Summary of Changes

21B: Table of Changes by Program

22. Procedural Matters

Regulatory Impact Analysis

Table of Abbreviations

AFHK—Action for Healthy Kids

ADA—Americans with Disabilities Act

CACFP—Child and Adult Care Food Program

CNA—Child Nutrition Act

CN-OPS—Child Nutrition Operations Study

FAR—Federal Acquisitions Regulations

FDA—U.S. Food and Drug Administration

FNS—Food and Nutrition Service

HEI—Healthy Eating Index

HMI—Healthy Meals Incentives

ICN—Institute of Child Nutrition

NASEM—National Academies of Science, Engineering, and Medicine

NSLA—National School Lunch Act

NSLP—National School Lunch Program

SBP—School Breakfast Program

SFSP—Summer Food Service Program

SNAP—Supplemental Nutrition Assistance Program

SMP—Special Milk Program

SY—School Year

USDA—U.S. Department of Agriculture

Section 1: Background

On February 7, 2023, the U.S. Department of Agriculture (USDA) published Child Nutrition Programs: Revisions to Meal Patterns Consistent With the 2020 Dietary Guidelines for Americans[1] (“2023 proposed rule”) to update the school meal pattern requirements based on a comprehensive review of the Dietary Guidelines for Americans, 2020-2025 (Dietary Guidelines), robust stakeholder input on the school meal patterns, and lessons learned from prior rulemakings.[2] USDA is finalizing that proposed rule, with some modifications based on public input. This final rule is the next step in an ongoing effort toward healthier school meals that USDA and the broader school meals community have been partnering on for well over a decade.

Separately, on January 23, 2020, USDA published a proposed rule, Simplifying Meal Service and Monitoring Requirements in the National School Lunch and School Breakfast Programs (“the 2020 proposed rule”).[3] As noted in the 2023 proposed meal pattern rule, based on public comment, USDA is finalizing certain meal pattern provisions from the 2020 proposed rule in this final rule.[4] The following sections address rule provisions that were included in the 2020 proposed rule:

Footnotes

1.   Child Nutrition Programs: Revisions to Meal Patterns Consistent With the 2020 Dietary Guidelines for Americans (88 FR 8050, February 7, 2023). Available at: https://www.federalregister.gov/​documents/​2023/​02/​07/​2023-02102/​child-nutrition-programs-revisions-to-meal-patterns-consistent-with-the-2020-dietary-guidelines-for.

Back to Citation

2.  U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

3.   Simplifying Meal Service and Monitoring Requirements in the National School Lunch and School Breakfast Programs (85 FR 4094, January 23, 2020). Available at: https://www.federalregister.gov/​documents/​2020/​01/​23/​2020-00926/​simplifying-meal-service-and-monitoring-requirements-in-the-national-school-lunch-and-school.

Back to Citation

4.  Other provisions of the 2020 proposed rule related to program monitoring were finalized in Child Nutrition Program Integrity (88 FR 57792, August 23, 2023). Available at: https://www.federalregister.gov/​documents/​2023/​08/​23/​2023-17992/​child-nutrition-program-integrity.

Back to Citation

5.  The Dietary Guidelines, 2020-2025 provide four overarching recommendations: (1) Follow a healthy dietary pattern at every life stage. (2) Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations. (3) Focus on meeting food group needs with nutrient-dense foods and beverages and stay within calorie limits. (4) Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages.

Back to Citation

6.   Child Nutrition Programs: Revisions to Meal Patterns Consistent With the 2020 Dietary Guidelines for Americans (88 FR 8050, February 7, 2023). Available at: https://www.federalregister.gov/​documents/​2023/​02/​07/​2023-02102/​child-nutrition-programs-revisions-to-meal-patterns-consistent-with-the-2020-dietary-guidelines-for.

Back to Citation

7.  Liu J, Micha R, Li Y, Mozaffarian D. Trends in Food Sources and Diet Quality Among US Children and Adults, 2003-2018. JAMA. April 12, 2021. Available at: https://jamanetwork.com/​journals/​jamanetworkopen/​fullarticle/​2778453?​utm_​source=​For_​The_​Media&​utm_​medium=​referral&​utm_​campaign=​ftm_​links&​utm_​term=​040921.

Back to Citation

8.  “While USDA school meals were bigger contributors to the caloric intakes of students from less food-secure households, they contributed positively to the diet quality of all participating students . . . For both food-insecure and food-secure students, the average HEI scores for non-school foods were between 55 and 57, whereas school foods scored between 79 and 81. School foods were particularly noteworthy as sources of fruit, dairy, and whole grains.” U.S. Department of Agriculture. USDA School Meals Support Food Security and Good Nutrition. May 3, 2021. Available at: https://www.ers.usda.gov/​amber-waves/​2021/​may/​usda-school-meals-support-food-security-and-good-nutrition/​.

Back to Citation

9.  See “Percent Exceeding Limits of Added Sugars, Saturated Fat, and Sodium” on pages 79, 82, and 85. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

10.  Michael SL, Jones SE, Merlo CL, et al. Dietary and Physical Activity Behaviors in 2021 and Changes from 2019 to 2021 Among High School Students—Youth Risk Behavior Survey, United States, 2021. MMWR Suppl 2023;72(Suppl-1):75-83. DOI: http://dx.doi.org/​10.15585/​mmwr.su7201a9.

Back to Citation

11.  Karen Weber Cullen, Tzu-An Chen, The contribution of the USDA school breakfast and lunch program meals to student daily dietary intake, Preventive Medicine Reports. March 2017. Available at: https://www.sciencedirect.com/​science/​article/​pii/​S2211335516301516.

Back to Citation

12.  U.S. Department of Agriculture. USDA Launches $100 Million Healthy School Meals Initiative, Announces Grant Program for Rural Schools. September 23, 2022. Available at: https://www.fns.usda.gov/​news-item/​fns-0010.22.

Back to Citation

13.  U.S. Department of Agriculture Food and Nutrition Service. Available at: https://www.fns.usda.gov/​.

Back to Citation

14.  The Food and Drug Administration. Memo: Salt Taste Preference and Sodium Alternatives. 2016. Available at: https://www.regulations.gov/​document/​FDA-2014-D-0055-0152.

Back to Citation

15.  The Food and Drug Administration. Sodium Reduction. Available at: www.fda.gov/​SodiumReduction.

Back to Citation

17.   Biden-Harris Administration National Strategy on Hunger, Nutrition, and Health, September 2022. Available at: https://www.whitehouse.gov/​wp-content/​uploads/​2022/​09/​White-House-National-Strategy-on-Hunger-Nutrition-and-Health-FINAL.pdf.

Back to Citation

18.  U.S. Department of Health and Human Service's Office of Disease Prevention and Health Promotion. Health People 2030. Available at: https://health.gov/​healthypeople.

Back to Citation

19.  U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

20.  The White House. FACT SHEET: The Biden-Harris Administration Announces More Than $8 Billion in New Commitments as Part of Call to Action for White House Conference on Hunger, Nutrition, and Health. September 28, 2022. Available at: https://www.whitehouse.gov/​briefing-room/​statements-releases/​2022/​09/​28/​fact-sheet-the-biden-harris-administration-announces-more-than-8-billion-in-new-commitments-as-part-of-call-to-action-for-white-house-conference-on-hunger-nutrition-and-health/​.

Back to Citation

21.  USDA received requests to extend the proposed rule comment period from the American Commodity Distribution Association and the Urban School Food Alliance and from Senator Boozman and Representative Foxx. The letters are available at: https://www.regulations.gov/​comment/​FNS-2022-0043-2915 and https://www.regulations.gov/​comment/​FNS-2022-0043-12391.

Back to Citation

22.  See: Docket FNS-2022-0043. Child Nutrition Programs: Revisions to Meal Patterns Consistent with the 2020 Dietary Guidelines for Americans. Available at: https://www.regulations.gov/​docket/​FNS-2022-0043.

Back to Citation

23.  To meet USDA's whole grain-rich criteria, a product must contain at least 50 percent whole grains, and the remaining grain content of the product must be enriched.

Back to Citation

24.  According to USDA research conducted following implementation of the 2012 final rule, “There was a positive and statistically significant association between student participation in the NSLP and the nutritional quality of NSLP lunches, as measured by the HEI-2010. Rates of student participation were significantly higher in schools with HEI-2010 scores in the third and highest quartiles (that is, the top half) of the distribution compared to the lowest quartile.” See page 38. U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, School Nutrition and Meal Cost Study Summary of Findings. Available at: https://www.fns.usda.gov/​school-nutrition-and-meal-cost-study.

Back to Citation

25.  U.S. Department of Agriculture Food and Nutrition Service, Office of Policy Support data collection of nutrition label information from major cereal and yogurt manufacturer K-12 and food service catalogs. Data were collected on 191 total cereal products and 110 total yogurt products. See Regulatory Impact Analysis.

Back to Citation

26.  U.S. Department of Agriculture. FNS Actions to Address COVID-19 Related Supply Chain Disruptions. Available at: https://www.fns.usda.gov/​supply-chain.

Back to Citation

27.  See: Section 3(k) of the Food and Nutrition Act of 2008 (7 U.S.C. 2012(k)).

Back to Citation

28.  U.S. Department of Agriculture. Foods Typically Purchased by Supplemental Nutrition Assistance Program (SNAP) Households. November 18, 2016. Available at: https://www.fns.usda.gov/​snap/​foods-typically-purchased-supplemental-nutrition-assistance-program-snap-households.

Back to Citation

29.   GusNIP NTAE. Gus Schumacher Nutrition Incentive Program (GusNIP): Impact Findings Y3: September 1, 2021 to August 31, 2022. Prepared for U.S. Department of Agriculture, National Institute of Food and Agriculture; 2023. Available at: https://nutritionincentivehub.org/​gusnip-ntae-y3-impact-findings.

Back to Citation

30.  U.S. Department of Agriculture. Evaluation of the Healthy Incentives Pilot (HIP) Final Report. September 2014. Available at: https://www.fns.usda.gov/​snap/​hip/​final-evaluation-report.

Back to Citation

31.  Fox MK, Gearan EC, Schwartz C. Added Sugars in School Meals and the Diets of School-Age Children. Nutrients. 2021; 13(2):471. Available at: https://doi.org/​10.3390/​nu13020471.

Back to Citation

32.  U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

33.  U.S. Department of Agriculture, Food Buying Guide for Child Nutrition Programs. Available at: https://foodbuyingguide.fns.usda.gov/​Appendix/​DownLoadFBG. See: Section 4—Grains, Exhibit A: Grain Requirements for Child Nutrition Programs, for a list of grain-based desserts.

Back to Citation

34.  Competitive food is a term to define all food and beverages that are available for sale to students on the school campus during the school day. (7 CFR 210.11(a)(2))

Back to Citation

35.  For clarification, USDA proposed a higher added sugars limit for flavored milk sold as a competitive food in middle and high schools due to the larger serving size. The serving size for milk offered as part of a reimbursable meal is 8 fluid ounces. Milks sold to middle and high school students as a competitive food may be up to 12 fluid ounces.

Back to Citation

36.  U.S. Department of Agriculture, Food Buying Guide for Child Nutrition Programs. Available at: https://foodbuyingguide.fns.usda.gov/​Appendix/​DownLoadFBG. See: Section 4—Grains, Exhibit A: Grain Requirements for Child Nutrition Programs, for a list of grain-based desserts.

Back to Citation

37.  In April 2023, the International Dairy Foods Association announced its “Healthy School Milk Commitment.” According to a press release from the International Dairy Foods Association, “[b]eginning with the 2025-2026 school year, 37 school milk processors representing more than 90% of the school milk volume in the United States commit to provide healthy, nutritious school milk options with no more than 10 grams of added sugar per 8 fluid ounce serving.” See: International Dairy Foods Association. IDFA Announces `Healthy School Milk Commitment' to Provide Nutritious Milk with Less Added Sugar for Students in Public Schools, Surpassing USDA Standards. April 5, 2023. Available at: https://www.idfa.org/​news/​idfa-announces-healthy-school-milk-commitment-to-provide-nutritious-milk-with-less-added-sugar-for-students-in-public-schools-surpassing-usda-standards.

Back to Citation

38.  Regulations for competitive food service and standards are found at 7 CFR 210.11.

Back to Citation

39.  For clarification, the added sugars limit for flavored milk sold as a competitive food in middle and high schools due to the larger serving size. The serving size for milk offered as part of a reimbursable meal is 8 fluid ounces. Milks sold to middle and high school students as a competitive food may be up to 12 fluid ounces. Milks sold to elementary school students as a competitive food may be up to 8 fluid ounces, and so will follow the 10 grams of added sugars per 8 fluid ounce limit.

Back to Citation

41.   Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Revisions in the WIC Food Packages (April 2024). Available at: https://www.fns.usda.gov/​wic/​fr-041824.

Back to Citation

42.  USDA Food and Nutrition Service, Office of Policy Support data collection of nutrition label information from major cereal and yogurt manufacturer K-12 and food service catalogs. Data were collected on 191 total cereal products and 110 total yogurt products.

Back to Citation

43.  In April 2023, the International Dairy Foods Association announced its “Healthy School Milk Commitment.” According to a press release from the International Dairy Foods Association, “[b]eginning with the 2025-2026 school year, 37 school milk processors representing more than 90% of the school milk volume in the United States commit to provide healthy, nutritious school milk options with no more than 10 grams of added sugar per 8 fluid ounce serving.” See: International Dairy Foods Association. IDFA Announces ‘Healthy School Milk Commitment’ to Provide Nutritious Milk with Less Added Sugar for Students in Public Schools, Surpassing USDA Standards. April 5, 2023. Available at: https://www.idfa.org/​news/​idfa-announces-healthy-school-milk-commitment-to-provide-nutritious-milk-with-less-added-sugar-for-students-in-public-schools-surpassing-usda-standards.

Back to Citation

44.  For NSLP, according to 7 CFR 210.10(c)(2)(iii)(C) (previously 7 CFR 210.10(c)(2)(iv)(C), schools may count up to two ounce equivalents of grain-based desserts per week toward meeting the grains requirement at school lunch. For CACFP, according to 7 CFR 226.20(a)(4)(iii), grain-based desserts do not count toward meeting the grains requirement. The grain-based dessert requirements for NSLP and CACFP remain in effect under this final rule.

Back to Citation

45.  Amelie A. Hecht, Deborah A. Olarte, Gabriella M. McLoughlin, Juliana F.W. Cohen, Strategies to Increase Student Participation in School Meals in the United States: A Systematic Review, Journal of the Academy of Nutrition and Dietetics, Volume 123, Issue 7, 2023, Pages 1075-1096.e1, ISSN 2212-2672, https://doi.org/​10.1016/​j.jand.2023.02.016. Available at: https://www.sciencedirect.com/​science/​article/​pii/​S221226722300103X.

Back to Citation

46.  Although respondents used a variety of terms in public comments, USDA will refer to “sweeteners” in this final rule, consistent with FDA terminology. U.S. Food and Drug Administration, How Sweet It Is: All About Sweeteners, June 9, 2023. Available at: https://www.fda.gov/​consumers/​consumer-updates/​how-sweet-it-all-about-sweeteners.

Back to Citation

47.  U.S. Food and Drug Administration, Aspartame and Other Sweeteners in Food, July 14, 2023. Available at: https://www.fda.gov/​food/​food-additives-petitions/​aspartame-and-other-sweeteners-food.

Back to Citation

48.  Amelie A. Hecht, Deborah A. Olarte, Gabriella M. McLoughlin, Juliana F.W. Cohen, Strategies to Increase Student Participation in School Meals in the United States: A Systematic Review, Journal of the Academy of Nutrition and Dietetics, Volume 123, Issue 7, 2023, Pages 1075-1096.e1, ISSN 2212-2672, https://doi.org/​10.1016/​j.jand.2023.02.016. Available at: https://www.sciencedirect.com/​science/​article/​pii/​S221226722300103X.

Back to Citation

49.  U.S. Department of Agriculture, Best Practices for Reducing Added Sugars at School Breakfast, August 4, 2022. Available at: https://www.fns.usda.gov/​tn/​best-practices-reducing-added-sugars-school-breakfast.

Back to Citation

50.  According to the International Dairy Foods Association, “When the Commitment was announced in April 2023, flavored milk products offered in schools contained an average of 8.2 grams of added sugar per serving. By July 2023, the average had fallen to 7.6 grams of added sugar per serving.” See: International Dairy Foods Association, School Milk Is Critical to Child Nutrition—School Year 2023-2024. Available at: https://www.idfa.org/​wordpress/​wp-content/​uploads/​2023/​09/​Back-to-School-Milk-Fact-Sheet-2023_​2024.pdf.

Back to Citation

51.  The annual payments and rates adjustments for the National School Lunch and School Breakfast Programs reflect changes in the Food Away From Home series of the Consumer Price Index for All Urban Consumers. See: U.S. Department of Agriculture. Rates of Reimbursement. Available at: https://www.fns.usda.gov/​cn/​rates-reimbursement.

Back to Citation

52.  This final rule redesignates the paragraph outlining requirements for competitive beverages, which was previously 7 CFR 210.11(m) to instead be 7 CFR 210.11(l). Under this final rule, the requirements for milk sold as a competitive beverage are outlined at 7 CFR 210.11(l).

Back to Citation

53.  U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Page 36. Available at: DietaryGuidelines.gov.

Back to Citation

54.  See page 58. Institute of Medicine, Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth (“IOM Report”). Available at: https://nap.nationalacademies.org/​catalog/​11899/​nutrition-standards-for-foods-in-schools-leading-the-way-toward. See also: Mary M. Murphy et al., Drinking Flavored or Plain Milk is Positively Associated with Nutrient Intake and Is Not Associated with Adverse Effects on Weight Status in U.S. Children and Adolescents.

Back to Citation

55.  See Table 5.1: Mean Percentage of Observed Trays including Specific Foods and Mean Percentage of Observed Foods Wasted in NSLP Lunches. U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, School Nutrition and Meal Cost Study, Final Report Volume 4: Student Participation, Satisfaction, Plate Waste, and Dietary Intakes, by Mary Kay Fox, Elizabeth Gearan, Charlotte Cabili, Dallas Dotter, Katherine Niland, Liana Washburn, Nora Paxton, Lauren Olsho, Lindsay LeClair, and Vinh Tran. Project Officer: John Endahl. Alexandria, VA: April 2019. Available at: https://www.fns.usda.gov/​school-nutrition-and-meal-cost-study.

Back to Citation

56.  U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, School Nutrition and Meal Cost Study Volume 4: Student Participation, Satisfaction, Plate Waste, and Dietary Intakes Appendix I-P. Available at: https://www.fns.usda.gov/​school-nutrition-and-meal-cost-study.

Back to Citation

57.  This final rule redesignates the paragraph outlining requirements for competitive beverages, which was previously 7 CFR 210.11(m) to instead be 7 CFR 210.11(l). Under this final rule, the requirements for milk sold as a competitive beverage are outlined at 7 CFR 210.11(l).

Back to Citation

58.  However, Program operators should not deny or delay a requested modification because the medical statement does not provide recommended alternatives. When necessary, Program operators should work with the participant's parent or guardian to obtain a supplemental medical statement. See Question 17. U.S. Department of Agriculture, Accommodating Disabilities in the School Meal Programs: Guidance and Questions and Answers (Q&As). April 25, 2017. Available at: https://www.fns.usda.gov/​cn/​accommodating-disabilities-school-meal-programs-guidance-qas.

Back to Citation

59.  The public comment cited the following study: Wegienka et al., Racial Differences in Allergic Sensitization: Recent Findings and Future Directions, Current Allergy and Asthma Reports, June 2013, https://www.ncbi.nlm.nih.gov/​pmc/​articles/​PMC4888051.

Back to Citation

61.  As detailed in the Current Requirements section, the following requirements related to fluid milk substitutes are statutory, meaning that USDA does not have discretion to change them: that the fluid milk substitute is nutritionally equivalent to fluid milk and meets nutritional standards established by the Secretary, which must include fortification of calcium, protein, vitamin A, and vitamin D to levels found in cow's milk (42 U.S.C. 1758(a)(2)(B)(i)); that the substitution is requested in writing by a medical authority or the child's parent or legal guardian (42 U.S.C. 1758(a)(2)(B)(ii)); that the school notify the State agency if it is providing fluid milk substitutes for non-disability reasons (42 U.S.C. 1758(a)(2)(B)(ii)); and that the school cover any expenses related to providing fluid milk substitutes in excess of program reimbursements (42 U.S.C. 1758(a)(2)(B)(iii)). This requirement also applies to institutions or facilities in the CACFP (42 U.S.C. 1766(g)(4)(D)).

Back to Citation

62.  Food and Drug Administration. Food Labeling: Revision of the Nutrition and Supplement Facts Labels (81 FR 33742, May 27, 2016). Available at: https://www.federalregister.gov/​documents/​2016/​05/​27/​2016-11867/​food-labeling-revision-of-the-nutrition-and-supplement-facts-labels.

Back to Citation

63.  For more information on Smart Snacks in Schools, see: U.S. Department of Agriculture, Tools for Schools—Focusing on Smart Snacks. Available at: https://www.fns.usda.gov/​cn/​tools-schools-focusing-smart-snacks.

Back to Citation

64.  See page 18. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

65.  Lin, Biing-Hwan, Travis A. Smith, and Joanne F. Guthrie. April 2023. Trends in U.S. WholeGrain Intakes 1994-2018: The Roles of Age, Food Source, and School Food, ERR-311, U.S. Department of Agriculture, Economic Research Service. Available at: https://www.ers.usda.gov/​publications/​pub-details/​?pubid=​106291.

Back to Citation

66.  See Figure ES.14. And Figure ES.17. School Nutrition and Meal Cost Study, Final Report Volume 2: Nutritional Characteristics of School Meals by Elizabeth Gearan, Mary Kay Fox, Katherine Niland, Dallas Dotter, Liana Washburn, Patricia Connor, Lauren Olsho, and Tara Wommak. Project Officer: John Endahl. Alexandria, VA: April 2019. Available at: https://www.fns.usda.gov/​school-nutrition-and-meal-cost-study. (OMB Control Number 0584-0596, expiration date 07/31/2017.)

Back to Citation

67.  U.S. Department of Agriculture, USDA Foods Available List January 9, 2023. Available at: https://www.fns.usda.gov/​usda-fis/​usda-foods-available.

Back to Citation

68.  U.S. Department of Agriculture, Whole Grain Resource for the National School Lunch and Breakfast Programs December 13, 2022. Available at: https://www.fns.usda.gov/​tn/​whole-grain-resource-national-school-lunch-and-breakfast-programs.

Back to Citation

69.  U.S. Department of Agriculture, Crediting in the Child Nutrition Programs May 23, 2023. Available at: https://www.fns.usda.gov/​tn/​crediting-grains.

Back to Citation

70.  U.S. Department of Agriculture, Crediting Handbook for the Child and Adult Care Food Program May 8, 2023. Available at https://www.fns.usda.gov/​tn/​crediting-handbook-child-and-adult-care-food-program.

Back to Citation

71.  U.S. Department of Agriculture, Team Nutrition Recipes March 10, 2023. Available at: https://www.fns.usda.gov/​tn/​team-nutrition-recipes.

Back to Citation

72.  See: 7 Recommendations for Nutrient Targets and Meal Requirements for School Meals.” Institute of Medicine. 2010. School Meals: Building Blocks for Healthy Children. Washington, DC: The National Academies Press. https://doi.org/​10.17226/​12751. National Academies of Sciences, Engineering, and Medicine. 2010. School Meals: Building Blocks for Healthy Children. Washington, DC: The National Academies Press. https://doi.org/​10.17226/​12751.

Back to Citation

73.  U.S. Department of Agriculture, Identifying Whole Grain-Rich Foods For CACFP June 7, 2023. Available at: https://www.fns.usda.gov/​tn/​identifying-whole-grain-rich-foods-cacfp.

Back to Citation

74.  Sodium Target 2 was established by the 2012 rule. Under the 2012 rule, Sodium Target 2 would have been implemented in SY 2017-2018; however, legislative and administrative action prevented implementation of sodium targets beyond Sodium Target 1. To view the Sodium Target 2 limits as established by the 2012 rule, see: U.S. Department of Agriculture. Nutrition Standards in the National School Lunch and School Breakfast Programs. (77 FR 4088, January 26, 2012). Available at: https://www.federalregister.gov/​d/​2012-1010/​p-138.

Back to Citation

75.  U.S. Department of Agriculture. Nutrition Standards in the National School Lunch and School Breakfast Programs. (77 FR 4088, January 26, 2012). Available at: https://www.federalregister.gov/​documents/​2012/​01/​26/​2012-1010/​nutrition-standards-in-the-national-school-lunch-and-school-breakfast-programs.

Back to Citation

76.  See page 46. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

77.  See page 46 and page 102. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

78.  Gordon, E.L., Morrissey, N., Adams, E., Wieczorek, A. Glenn, M.E., Burke, S & Connor, P. (2019). Successful Approaches to Reduce Sodium in School Meals Final Report. Prepared by 2M Research under Contract No. AG-3198-P-15-0040. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service. Available at: https://fns-prod.azureedge.us/​sites/​default/​files/​resource-files/​Approaches-ReduceSodium-Volume1.pdf.

Back to Citation

79.  See page 76. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

80.  See page 77. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

81.  See page 46 and page 102. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

82.  McGuire S. Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. Adv Nutr. 2010 Nov;1(1):49-50. doi.org/10.3945/an.110.1002. Epub 2010 Nov 16. PMID: 22043452; PMCID: PMC3042781.

Back to Citation

83.  U.S. Food and Drug Administration. Sodium Reduction. Available at: https://www.fda.gov/​food/​food-additives-petitions/​sodium-reduction.

Back to Citation

84.  Gordon, E.L., Morrissey, N., Adams, E., Wieczorek, A. Glenn, M.E., Burke, S & Connor, P. (2019). Successful Approaches to Reduce Sodium in School Meals Final Report. Prepared by 2M Research under Contract No. AG-3198-P-15-0040. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service. Available at: https://www.fns.usda.gov/​nslp/​successful-approaches-reduce-sodium-school-meals-study.

Back to Citation

85.  Gordon, E.L., Morrissey, N., Adams, E., Wieczorek, A. Glenn, M.E., Burke, S & Connor, P. (2019). Successful Approaches to Reduce Sodium in School Meals, Volume II: Detailed Study Findings. Prepared by 2M Research under Contract No. AG-3198-P-15-0040. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service. Available at: https://www.fns.usda.gov/​nslp/​successful-approaches-reduce-sodium-school-meals-study.

Back to Citation

86.  National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board; Committee to Review the Dietary Reference Intakes for Sodium and Potassium; Oria M, Harrison M, Stallings VA, editors. Dietary Reference Intakes for Sodium and Potassium. Washington (DC): National Academies Press (US); 2019 Mar 5. 11, Sodium Dietary Reference Intakes: Risk Characterization and Special Considerations for Public Health. Available at: https://www.ncbi.nlm.nih.gov/​books/​NBK545448/​#sec_​ch11_​2.

Back to Citation

87.  Under current regulations, the minimum daily grains requirement for each age/grade group at breakfast is 1.0 ounce equivalent.

Back to Citation

88.  “Meat alternates” include cheese, eggs, yogurt, nuts and seeds, tofu and soy products, and beans and peas.

Back to Citation

89.  The Dietary Guidelines include recommendations for “food groups—vegetables, fruits, grains, dairy, and protein foods—eaten at an appropriate calorie level and in forms with limited amounts of added sugars, saturated fat, and sodium”. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

90.  See Table 5.2. Mean Percentage of Observed Trays including Specific Foods and Mean Percentage of Food Wasted in SBP Breakfasts. U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, School Nutrition and Meal Cost Study, Final Report Volume 4: Student Participation, Satisfaction, Plate Waste, and Dietary Intakes by Mary Kay Fox, Elizabeth Gearan, Charlotte Cabili, Dallas Dotter, Katherine Niland, Liana Washburn, Nora Paxton, Lauren Olsho, Lindsay LeClair, and Vinh Tran. Project Officer: John Endahl. Alexandria, VA: April 2019. Available at: https://www.fns.usda.gov/​school-nutrition-and-meal-cost-study.

Back to Citation

91.  The most common categories of meat/meat alternates offered at breakfast in SY 2014-2015 were cheese (offered on 5.4 percent of observed trays) and yogurt (offered on 5.0 percent of observed trays). U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, School Nutrition and Meal Cost Study, Final Report Volume 2: Nutritional Characteristics of School Meals by Elizabeth Gearan, Mary Kay Fox, Katherine Niland, Dallas Dotter, Liana Washburn, Patricia Connor, Lauren Olsho, and Tara Wommak. Project Officer: John Endahl. Alexandria, VA: April 2019. Available at: https://www.fns.usda.gov/​school-nutrition-and-meal-cost-study.

Back to Citation

92.  Please see Section 2: Added Sugars, for information on the new added sugars limit for yogurt, which will take effect in SY 2025-2026.

Back to Citation

93.  U.S. Department of Agriculture. Flexibility for Co-Mingled Preschool Meals: Questions and Answers, June 30, 2017. Available at: https://www.fns.usda.gov/​school-meals/​flexibility-co-mingled-preschool-meals-questions-and-answers.

Back to Citation

94.  Current SFSP regulations at 7 CFR 225.15(f)(3) also allow sponsors in Trust Territory of the Pacific Islands, and the Northern Mariana Islands to substitute vegetables for breads. However, these references are outdated.

Back to Citation

95.  According to the Dietary Guidelines, “Almost 90 percent of the U.S. population does not meet the recommendation for vegetables. In addition, with few exceptions, the U.S. population does not meet intake recommendations for any of the vegetable subgroups.” Further, according to the Dietary Guidelines, “For most individuals, following a healthy eating pattern will require an increase in total vegetable intake and from all vegetable subgroups, shifting to nutrient-dense forms, and an increase in the variety of different vegetables consumed over time.” See page 31. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

96.  U.S. Department of Agriculture, USDA Equity Action Plan in Support of Executive Order (E.O.) 13985 Advancing Racial Equity and Support for Underserved Communities through the Federal Government, February 10, 2022. Available at: https://www.usda.gov/​equity/​action-plan.

Back to Citation

97.  As noted above, USDA currently allows schools in American Samoa, Puerto Rico, and the U.S. Virgin Islands to serve vegetables such as yams, plantains, or sweet potatoes to meet the grains component. See 7 CFR 210.10(c)(3) and 220.8(c)(3).

Back to Citation

98.  U.S. Department of Agriculture, Child Nutrition Programs and Traditional Foods, July 15, 2015. Available at: https://www.fns.usda.gov/​cn/​child-nutrition-programs-and-traditional-foods.

Back to Citation

99.  Information on calculating in-house yield data may be found on page I-5 of the Food Buying Guide.

Back to Citation

100.  U.S. Department of Agriculture, Bringing Tribal Foods and Traditions Into Cafeterias, Classrooms, and Gardens, August 2017. Available at: https://www.fns.usda.gov/​f2s/​tribal-foods.

Back to Citation

101.  U.S. Department of Agriculture, Child Nutrition Programs and Traditional Foods, July 15, 2015. Available at: https://www.fns.usda.gov/​cn/​child-nutrition-programs-and-traditional-foods.

Back to Citation

102.  U.S. Department of Agriculture. USDA Foods Available Foods List for SY 2024. January 9, 2023. Available at: https://www.fns.usda.gov/​usda-fis/​usda-foods-available.

Back to Citation

103.  U.S. Department of Agriculture, Serving Traditional Indigenous Foods in Child Nutrition Programs. Available at: https://www.fns.usda.gov/​cn/​serving-traditional-indigenous-foods.

Back to Citation

104.  The nutrition requirements for snacks served through the CACFP are found at 7 CFR 226.20(c)(3).

Back to Citation

105.   Simplifying Meal Service and Monitoring Requirements in the National School Lunch and School Breakfast Programs (85 FR 4094, January 23, 2020). Available at: https://www.federalregister.gov/​documents/​2020/​01/​23/​2020-00926/​simplifying-meal-service-and-monitoring-requirements-in-the-national-school-lunch-and-school.

Back to Citation

106.  While existing CACFP regulations limit breakfast cereals to no more than 6 grams of total sugars per dry ounce, in this final rule, USDA has opted to delay implementation of the breakfast cereals limit in NSLP snacks to SY 2025-2026, when USDA will implement the added sugars limit for NSLP, SBP, CACFP, and NSLP snacks.

Back to Citation

107.  While existing CACFP regulations limit yogurt to no more than 23 grams of total sugars per 6 ounces, in this final rule, USDA has opted to delay implementation of the yogurt limit in NSLP snacks to SY 2025-2026, when USDA will implement the added sugars limit for NSLP, SBP, CACFP, and NSLP snacks.

Back to Citation

108.  U.S. Department of Agriculture, Child and Adult Care Food Program: Meal Pattern Revisions Related to the Healthy, Hunger-Free Kids Act of 2010, April 25, 2016. Available at: https://www.federalregister.gov/​documents/​2016/​04/​25/​2016-09412/​child-and-adult-care-food-program-meal-pattern-revisions-related-to-the-healthy-hunger-free-kids-act.

Back to Citation

109.  “Although 100% fruit juice without added sugars can be part of a healthy dietary pattern, it is lower in dietary fiber than whole fruit. Dietary fiber is a dietary component of public health concern. With the recognition that fruit should mostly be consumed in whole forms, the amount of fruit juice in the USDA Food Patterns ranges from 4 fluid ounces at the lower calorie levels and no more than 10 fluid ounces at the highest calorie levels.” See page 87: U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

110.  While existing CACFP regulations include total sugars limits for breakfast cereals and yogurt, in this final rule, USDA has opted to delay implementation of these limits for NSLP snacks to SY 2025-2026, when USDA will implement the added sugars limit for NSLP, SBP, CACFP, and NSLP snacks.

111.  Consistent with existing policy guidance, schools may choose to follow the K-5 NSLP snack meal pattern when preschoolers and K-5 students are co-mingled at meal service. See Flexibility for Co-Mingled Preschool Meals: Questions and Answers, June 30, 2017. Available at: https://www.fns.usda.gov/​cn/​flexibility-co-mingled-preschool-meals-questions-and-answers.

Back to Citation

112.  See: “Vegetables” page 31. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

113.  See: U.S. Department of Agriculture, School Breakfast Program: Substitution of Vegetables for Fruit, March 18, 2019. Available at: https://www.fns.usda.gov/​sbp/​substitution-vegetables-fruit See also: U.S. Department of Agriculture, School Breakfast Program: Continuation of the Substitution of Vegetables for Fruit Flexibility, January 22, 2020. Available at: https://www.fns.usda.gov/​sbp/​school-breakfast-program-continuation-substitution-vegetables-fruit-flexibility.

Back to Citation

114.  See: U.S. Department of Agriculture, Consolidated Appropriations Act, 2023: Effect on Child Nutrition Programs, March 3, 2023. Available at: https://www.fns.usda.gov/​cn/​consolidated-appropriations-act-2023-effect-programs.

Back to Citation

115.  See: U.S. Department of Agriculture, Consolidated Appropriations Act, 2023: Effect on Child Nutrition Programs, March 3, 2023. Available at: https://www.fns.usda.gov/​cn/​consolidated-appropriations-act-2023-effect-programs.

Back to Citation

116.  See “Protein Foods,” page 34. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at https://www.dietaryguidelines.gov/​.

Back to Citation

117.  See “Protein Foods,” page 33. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

118.  U.S. Department of Agriculture, Reducing the Risk of Choking in Young Children at Mealtimes. September 2020. Available at: https://www.fns.usda.gov/​tn/​reducing-risk-choking-young-children-mealtimes.

Back to Citation

119.  See Question 35. U.S. Department of Agriculture. Meal Requirements Under the National School Lunch Program and School Breakfast Program: Questions and Answers for Program Operators Updated to Support the Transitional Standards for Milk, Whole Grains, and Sodium Effective July 1, 2022, March 2, 2022. Available at: https://www.fns.usda.gov/​cn/​sp052022-questions-answers-program-operators.

Back to Citation

120.  The Dietary Guidelines, 2020-2025, changed the terminology for the “legumes (beans and peas)” vegetable subgroup to “beans, peas, and lentils.” The foods within this vegetable subgroup did not change. See “About Beans, Peas, and Lentils,” page 31. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

121.  U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

122.  As noted in the proposed rule, based on statutory requirements, USDA regulations include several other requirements for fluid milk substitutions for non-disability reasons, such as specific nutrition standards. See page 8061: Child Nutrition Programs: Revisions to Meal Patterns Consistent With the 2020 Dietary Guidelines for Americans (88 FR 8050, February 7, 2023). Available at: https://www.federalregister.gov/​d/​2023-02102/​p-208.

Back to Citation

123.  U.S. Department of Agriculture, Modifications to Accommodate Disabilities in the School Meal Programs, September 27, 2016. Available at: https://www.fns.usda.gov/​cn/​modifications-accommodate-disabilities-school-meal-programs.

Back to Citation

124.  U.S. Department of Agriculture, Policy Memorandum on Modifications to Accommodate Disabilities in the Child and Adult Care Food Program and Summer Food Service Program, June 22, 2017. Available at: https://www.fns.usda.gov/​cn/​modifications-accommodate-disabilities-cacfp-and-sfsp.

Back to Citation

125.  See Question 16. U.S. Department of Agriculture, Accommodating Disabilities in the School Meal Programs: Guidance and Questions and Answers (Q&As). April 25, 2017. Available at: https://www.fns.usda.gov/​cn/​accommodating-disabilities-school-meal-programs-guidance-qas.

Back to Citation

126.  For comparison, current regulations at 7 CFR 210.10(m)(3) state that, “Schools should consider ethnic and religious preferences when planning and preparing meals . . . Any variations must be consistent with the food and nutrition requirements specified under this section and needed to meet ethnic, religious, or economic needs.”

Back to Citation

127.  This language reflects regulatory language formerly included in NSLP regulations at 7 CFR 210.10(m)(2). Similar language was also previously included in CACFP regulations at 7 CFR 226.20(g)(2).

Back to Citation

128.  The Commission on Dietetic Registration is the credentialing agency for the Academy of Nutrition and Dietetics. See: Commission on Dietetic Registration. Registered Dietitian (RD) or Registered Dietitian Nutritionist (RDN) Certification. Available at: https://www.cdrnet.org/​RDN.

Back to Citation

129.  According to page ix of the Dietary Guidelines, “A healthy dietary pattern can benefit all individuals regardless of age, race, or ethnicity, or current health status. The Dietary Guidelines provides a framework intended to be customized to individual needs and preferences, as well as the foodways of the diverse cultures in the United States.” U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at: DietaryGuidelines.gov.

Back to Citation

130.  U.S. Department of Agriculture, Policy Memorandum on Modifications to Accommodate Disabilities in the Child and Adult Care Food Program and Summer Food Service Program, June 22, 2017. Available at: https://www.fns.usda.gov/​cn/​modifications-accommodate-disabilities-cacfp-and-sfsp.

Back to Citation

131.  U.S. Department of Agriculture. Water Availability During NSLP Meal Service. July 12, 2011. Available at: https://www.fns.usda.gov/​cn/​water-availability-during-nslp-meal-service.

Back to Citation

132.  U.S. Department of Agriculture. Nutrition Standards in the National School Lunch and School Breakfast Programs. (77 FR 4088, January 26, 2012). Available at: https://www.federalregister.gov/​documents/​2012/​01/​26/​2012-1010/​nutrition-standards-in-the-national-school-lunch-and-school-breakfast-programs.

Back to Citation

133.  U.S. Department of Agriculture. National School Lunch Program and School Breakfast Program: Nutrition Standards for All Foods Sold in School as Required by the Healthy, Hunger-Free Kids Act of 2010. (81 FR 50132, July 29, 2016). Available at: https://www.federalregister.gov/​documents/​2016/​07/​29/​2016-17227/​national-school-lunch-program-and-school-breakfast-program-nutrition-standards-for-all-foods-sold-in.

Back to Citation

134.  U.S. Food and Drug Administration. Final Determination Regarding Partially Hydrogenated Oils (Removing Trans Fat). Available at: https://www.fda.gov/​food/​food-additives-petitions/​final-determination-regarding-partially-hydrogenated-oils-removing-trans-fat.

Back to Citation

135.  See: “Implementation.” U.S. Food and Drug Administration. Final Determination Regarding Partially Hydrogenated Oils (Removing Trans Fat). Available at: https://www.fda.gov/​food/​food-additives-petitions/​final-determination-regarding-partially-hydrogenated-oils-removing-trans-fat.

Back to Citation

136.  Of the 26 percent of school food authorities that reported using exceptions to the Buy American provision in SY 2017-2018, 93 percent reported using them to purchase fruit, while 53 percent reported using them to purchase vegetables. By comparison, 18 percent reported using them to purchase “other” foods, such as yeast, oils, and spices, and less than 10 percent each reported using them to purchase grains or meat/meat alternates. See Exhibit 4: Among SFAs that Reported Using an Exception to the Buy American Provision, Reasons for Using an Exception and Products Purchased. U.S Department of Agriculture, Food and Nutrition Service, Office of Policy Support, Child Nutrition Program Operations Study (CN-OPS-II): SY 2017-18. Beyler, Nick, Jim Murdoch, and Charlotte Cabili. Project Officer: Holly Figueroa. Alexandria, VA: November 2022.

Back to Citation

137.  U.S. Food and Drug Administration. Final Determination Regarding Partially Hydrogenated Oils (Removing Trans Fat). Available at: https://www.fda.gov/​food/​food-additives-petitions/​final-determination-regarding-partially-hydrogenated-oils-removing-trans-fat.

Back to Citation

138.  U.S. Department of Agriculture. Nutrition Standards in the National School Lunch and School Breakfast Programs. (77 FR 4088, January 26, 2012). Available at: https://www.federalregister.gov/​d/​2012-1010/​p-161.

Back to Citation

139.  Nutrition and dietetics technicians, registered (NDTRs) are educated and trained at the technical level of nutrition and dietetics practice for the delivery of safe, culturally competent, quality food and nutrition services. See: Academy of Nutrition and Dietetics, What is a Nutrition and Dietetics Technician Registered? Available at: https://www.eatrightpro.org/​about-us/​what-is-an-rdn-and-dtr/​what-is-a-nutrition-and-dietetics-technician-registered.

Back to Citation

140.  U.S. Department of Agriculture. Professional Standards. Available at: https://www.fns.usda.gov/​cn/​professional-standards.

Back to Citation

141.  U.S. Department of Agriculture. SP 38-2017 Compliance with and Enforcement of the Buy American Provision in the NSLP. June 2017. Available at: https://www.fns.usda.gov/​nslp/​compliance-enforcement-buy-american.

Back to Citation

142.  AMS used the following list as product types: Beef, Cotton, Dairy Products, Eggs, Fish & Seafood, Flowers & Plants, Fruits, Goat, Grain, Lamb, Nuts, Pork, Organic, Poultry, Rabbits, Rice & Pulses, Vegetables, Specialty Products, Tobacco, Wool & Mohair. Also available at: https://www.ams.usda.gov/​grades-standards.

Back to Citation

143.  41 U.S.C chapter 83 is the Buy American statute that requires public agencies to procure articles, materials, and supplies that were mined, produced, or manufactured in the United States, substantially all from domestic components. Available at: https://www.acquisition.gov/​far/​part-25.

Back to Citation

144.   Child Nutrition Program Integrity (88 FR 162, August 23, 2023). Available at https://www.govinfo.gov/​content/​pkg/​FR-2023-02-07/​pdf/​2023-02102.pdf.

Back to Citation

145.  U.S Government Accountability Office. USDA Could Enhance Implementation of the Buy American Provision. April 2023. Available at: https://www.gao.gov/​assets/​gao-23-105884.pdf.

Back to Citation

146.  U.S. Department of Agriculture, Compliance with and Enforcement of the Buy American Provision in the National School Lunch Program, June 30, 2017. Available at: https://www.fns.usda.gov/​nslp/​compliance-enforcement-buy-american.

Back to Citation

147.  U.S Government Accountability Office. USDA Could Enhance Implementation of the Buy American Provision. April 2023. Available at: https://www.gao.gov/​assets/​gao-23-105884.pdf.

Back to Citation

148.  School food authorities are required to have documented procurement procedures, as per 2 CFR 200.318(a).

Back to Citation

149.  U.S. Department of Agriculture, Compliance with and Enforcement of the Buy American Provision in the National School Lunch Program, June 30, 2017. Available at: https://www.fns.usda.gov/​nslp/​compliance-enforcement-buy-american.

Back to Citation

150.  “Monitoring is also accomplished by reviewing products and delivery invoices or receipts to ensure the domestic food that was solicited and awarded is the food that is received. SFAs also need to conduct a periodic review of storage facilities, freezers, refrigerators, dry storage, and warehouses to ensure the products received are the ones solicited, and awarded, and comply with the Buy American provision.” U.S. Department of Agriculture, Compliance with and Enforcement of the Buy American Provision in the National School Lunch Program, June 30, 2017. Available at: https://www.fns.usda.gov/​nslp/​compliance-enforcement-buy-american.

Back to Citation

151.  See also section 4207(b) of the Agriculture Improvement Act of 2018, Public Law 115-334 (42 U.S.C. 1760).

Back to Citation

152.  U.S. House of Representatives. Child Nutrition and WIC Reauthorization Amendments of 1998—House Report 105-633. July 20, 1998. Available at: https://www.govinfo.gov/​content/​pkg/​CRPT-105hrpt633/​html/​CRPT-105hrpt633.htm.

Back to Citation

153.  U.S. Department of Agriculture, Compliance with and Enforcement of the Buy American Provision in the National School Lunch Program, June 30, 2017. Available at: https://www.fns.usda.gov/​nslp/​compliance-enforcement-buy-american.

Back to Citation

154.  U.S. Department of Agriculture. Buy American and the Agriculture Improvement Act of 2018. August 15, 2019. Available at: https://www.fns.usda.gov/​cn/​buy-american-and-agriculture-improvement-act.

Back to Citation

155.   The Food, Conservation, and Energy Act of 2008 (Pub. L. 110-246). June 18, 2008. Available at: https://www.congress.gov/​110/​plaws/​publ246/​PLAW-110publ246.pdf.

Back to Citation

156.   Geographic Preference Option for the Procurement of Unprocessed Agricultural Products in Child Nutrition Programs (75 FR 20316, April 4, 2011). Available at: https://www.federalregister.gov/​documents/​2011/​04/​22/​2011-9843/​geographic-preference-option-for-the-procurement-of-unprocessed-agricultural-products-in-child.

Back to Citation

157.  U.S. Department of Agriculture. Procurement Geographic Preference Q&As. February 1, 2011. Available at: https://www.fns.usda.gov/​cn/​procurement-geographic-preference-qas.

Back to Citation

158.  U.S. Department of Agriculture. Procuring Local Foods for the Child Nutrition Programs. Available at: https://fns-prod.azureedge.us/​sites/​default/​files/​resource-files/​June22F2SProcurementGuide508.pdf.

Back to Citation

159.  U.S. Department of Agriculture. Geographic Preference Fact Sheet. Available at: https://www.fns.usda.gov/​f2s/​geographic-preference.

Back to Citation

160.  U.S. Department of Agriculture. Procurement Geographic Preference Q&As. February 1, 2011. Available at: https://www.fns.usda.gov/​cn/​procurement-geographic-preference-qas.

Back to Citation

161.  U.S. Department of Agriculture. Procurement Geographic Preference Q&As: Part II. October 9, 2012. Available at: https://www.fns.usda.gov/​cn/​procurement-geographic-preference-qas-%E2%80%93-part-ii.

Back to Citation

162.  U.S. Department of Agriculture. USDA Support for School Meals. Available at: https://www.fns.usda.gov/​cn/​support-schools.

Back to Citation

163.  For information on crediting the meat/meat alternate component, see the Food Buying Guide for Child Nutrition Programs, available at: https://www.fns.usda.gov/​tn/​food-buying-guide-for-child-nutrition-programs.

164.  Exceptions include certain smoothie ingredients and pasta products made from vegetable flours. See Question 104: U.S. Department of Agriculture, Meal Requirements Under the NSLP & SBP: Q&A for Program Operators Updated to Support the Transitional Standards Effective July 1, 2022, March 2, 2022. Available at: https://www.fns.usda.gov/​cn/​sp052022-questions-answers-program-operators.

Back to Citation

165.  See “About Beans, Peas, and Lentils,” page 31. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

166.  According to the Dietary Guidelines, “Green peas and green (string) beans are not counted in the beans, peas, and lentils subgroup because the nutrient content of these vegetables is more similar to vegetables in other subgroups.” The Dietary Guidelines consider green peas to be a starchy vegetable, and green beans to be part of the “other” vegetable subgroup. NSLP regulations for the vegetable subgroups reflect the Dietary Guidelines. See “About Beans, Peas, and Lentils,” page 31. U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020-2025 Dietary Guidelines for Americans. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov/​.

Back to Citation

167.  Office of the Federal Register. Amendatory instruction: Revise and Republish. Available at: https://www.archives.gov/​federal-register/​write/​ddh/​revise-republish.

Back to Citation

168.  Using 2023 dollars and not adjusting for annual inflation results in $1.256 billion dollars over eight school years (over nine fiscal years) or $52 to $227 million annually ($0.03 per meal), see appendix.

Back to Citation

169.  See Appendix A. U.S. Department of Agriculture. Results of USDA's Food and Nutrition Service-Administered School Food Authority Survey II on Supply Chain Disruption and Student Participation. July 2023. Available at: https://fns-prod.azureedge.us/​sites/​default/​files/​resource-files/​SFASurvey-II-Supply-Chain-072523.pdf.

Back to Citation

170.  See appendix A. U.S. Department of Agriculture. Results of USDA's Food and Nutrition Service-Administered School Food Authority Survey II on Supply Chain Disruption and Student Participation. July 2023. Available at: https://fns-prod.azureedge.us/​sites/​default/​files/​resource-files/​SFASurvey-II-Supply-Chain-072523.pdf.

Back to Citation

171.  As detailed in the proposed rule, USDA held listening sessions with Academy of Nutrition and Dietetics, American Beverage Association, American Commodity Distribution Association, American Heart Association, Center for Science in the Public Interest, Education Trust, FoodCorps, Friends of the Earth, International Dairy Foods Association, National Congress of American Indians, National Indian Education Association, School Nutrition Association, State agencies, Urban School Food Alliance, Whole Grains Council members, and local school districts, including tribally-run schools, and others.

Back to Citation

172.  USDA's mission is: “To serve all Americans by providing effective, innovative, science-based public policy leadership in agriculture, food and nutrition, natural resource protection and management, rural development, and related issues with a commitment to deliverable equitable and climate-smart opportunities that inspire and help America thrive.” See: U.S. Department of Agriculture. Strategic Plan Fiscal Years 2022-2026. Available at: https://www.usda.gov/​sites/​default/​files/​documents/​usda-fy-2022-2026-strategic-plan.pdf.

Back to Citation

173.  41 U.S.C chapter 83 is the Buy American statute that requires public agencies to procure articles, materials, and supplies that were mined, produced, or manufactured in the United States, substantially all from domestic components. Available at: https://www.acquisition.gov/​far/​part-25.

Back to Citation

1.  U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.

Back to Citation

2.  Simplifying Meal Service and Monitoring Requirements in the National School Lunch and School Breakfast Programs (85 FR 4094, January 23, 2020). Available at: https://www.federalregister.gov/​documents/​2020/​01/​23/​2020-00926/​simplifying-meal-service-and-monitoring-requirements-in-the-national-school-lunch-and-school.

Back to Citation

3.  Statutory language can be found in the Richard B. Russell National School Lunch Act (NSLA) section 12(n) on page 56: https://www.fns.usda.gov/​nsla.

Back to Citation

4.  Liu J, Micha R, Li Y, Mozaffarian D. Trends in Food Sources and Diet Quality Among US Children and Adults, 2003-2018. JAMA Netw Open. 2021;4(4):e215262. doi:10.1001/jamanetworkopen.2021.5262. This study found that foods consumed at schools provided the best mean diet quality of major US food sources.

Back to Citation

5.  Except where noted in the participation impacts, the terms “costs” and “savings” are used in this analysis to describe the school level shifts in food purchases and labor associated with school meal production.

Back to Citation

6.  This is about 0.5% of the average cost to SFAs per breakfast and lunch, in 2024 dollars. Factoring 4% annual inflation, breakfast costs $4.03 and lunch costs $5.64 for SFAs to produce. Based on School Nutrition Meal Cost Study (SNMCS) Report—Volume 3, the average SFA had a reported cost of $3.81 per NSLP lunch and $2.72 per SBP breakfast in SY 2014-2015 ( https://fns-prod.azureedge.us/​sites/​default/​files/​resource-files/​SNMCS-Volume3.pdf).

Back to Citation

7.  This annual average is based on this rulemaking finalizing Milk Alternative B in the proposed rule.

Back to Citation

8.  Using 2023 dollars and not adjusting for annual inflation results in $1.256 billion dollars over eight school years (over nine fiscal years) or $52 to $227 million annually ($0.03 per meal), see appendix.

Back to Citation

9.  No adjustment for inflation was done for this table aside for inflation from the time-period of data collection up to 2023.

10.  For data in 2023 dollars presented by school years (July-June) instead of fiscal years (October-September), see table A in the `Appendix' section. Totals are the same as table 1 and the breakdown of costs is shown across the eight school years.

11.  First year of provision implementation presents half a year of costs from SY 2024-2025 (first half of the school year).

12.  Including costs from the second half of SY 2024-2025 and the first half of SY 2025-2026; this style is also true of FY 2026 through 2031.

13.  Presenting half a year of costs from SY 2030-2031 (second half of the school year).

14.  This is eight full fiscal years, including 7 full fiscal years and two half years.

15.  The nominal cost stream values are based upon 2023 participation levels and assumes participation holds steady through FY 2032.

16.  The percentage of baseline is calculated as total costs of the proposed changes divided by the total expected costs of the NSLP, SBP, and CACFP programs in each fiscal year. Expected costs for NSLP, SBP and CACFP are inflated from FY 2019 based on actual and forecasted food price inflation.

Back to Citation

20.  The Healthy Eating Index is a measure of diet quality used to assess how well a set of foods aligns with key recommendations of the Dietary Guidelines for Americans that is periodically updated with each edition of the Guidelines. HEI-2010 and HEI-2015 scores are cited/calculated in this impact analysis. At this time, no HEI-2020 score version has been released.

Back to Citation

22.  This was not an exhaustive data collection of milk products across the marketplace, simply a fact-finding search. See `Added Sugars' subsection of the `Impacts' section below.

Back to Citation

23.  International Dairy Foods Association. IDFA Announces `Healthy School Milk Commitment' to Provide Nutritious Milk with Less Added Sugar for Students in Public Schools, Surpassing USDA Standards. April 5, 2023. Available at: https://www.idfa.org/​news/​idfa-announces-healthy-school-milk-commitment-to-provide-nutritious-milk-with-less-added-sugar-for-students-in-public-schools-surpassing-usda-standards.

Back to Citation

24.  These costs are school food authority costs as a percentage of reimbursement baselines at this time (not Federal costs).

Back to Citation

26.  Refer to Preamble section 21B: Table of Changes by Program.

Back to Citation

27.  SNMCS Study Report Volume 3: Table 2.6.

Back to Citation

28.  Three school years when provisions of the rule take effect: SY 2024-2025, SY 2025-2026, and SY 2027-2028.

Back to Citation

29.  USDA Food and Nutrition Service, Office of Policy Support data collection of nutrition label information from major cereal and yogurt manufacturer K-12 and food service catalogs.

Back to Citation

30.  USDA Food and Nutrition Service, Office of Policy Support internal analysis using collected nutrition label data during the development of the rule. Data were collected on 110 total yogurt products and 191 total cereal products.

Back to Citation

31.  USDA Food and Nutrition Service, Office of Policy Support data collection of nutrition label information from major cereal and yogurt manufacturer K-12 and food service catalogs. Data were collected on 191 total cereal products.

Back to Citation

32.  USDA Food and Nutrition Service, Office of Policy Support data collection of nutrition label information from major cereal and yogurt manufacturer K-12 and food service catalogs. Data were collected on 110 total yogurt products.

Back to Citation

34.  SNMCS Report—Volume 2.

Back to Citation

36.  This was not an exhaustive data collection of milk products across the marketplace, simply a fact-finding search.

Back to Citation

37.  International Dairy Foods Association. IDFA Announces ‘Healthy School Milk Commitment’ to Provide Nutritious Milk with Less Added Sugar for Students in Public Schools, Surpassing USDA Standards. April 5, 2023. Available at: https://www.idfa.org/​news/​idfa-announces-healthy-school-milk-commitment-to-provide-nutritious-milk-with-less-added-sugar-for-students-in-public-schools-surpassing-usda-standards.

Back to Citation

38.  Added Sugars in School Meals and Competitive Foods.

Back to Citation

39.  Fox MK, Gearan EC, Schwartz C. Added Sugars in School Meals and the Diets of School-Age Children. Nutrients. 2021;13(2):471. Published 2021 Jan 30. doi:10.3390/nu13020471.

Back to Citation

40.  Based on an internal USDA analysis using SNMCS-II data.

Back to Citation

41.  World Health Organization Taxes on Sugary Drinks: Why Do It? World Health Organization. 2017 Available online: https://apps.who.int/​iris/​handle/​10665/​260253.

Back to Citation

42.  See 7 CFR 210.11(m)(3) https://www.ecfr.gov/​current/​title-7/​part-210#p-210.11(m)(3) and https://www.fns.usda.gov/​cn/​nutrition-standards-all-foods-sold-school-summary-chart.

43.  Fox MK, Gearan EC, Schwartz C. Added Sugars in School Meals and the Diets of School-Age Children. Nutrients. 2021;13(2):471. Published 2021 Jan 30. doi:10.3390/nu13020471.

Back to Citation

44.  Warshaw H, Edelman SV. Practical Strategies to Help Reduce Added Sugars Consumption to Support Glycemic and Weight Management Goals. Clin Diabetes. 2021;39(1):45-56. doi:10.2337/cd20-0034.

Back to Citation

45.  Malik VS, Hu FB. Sugar-Sweetened Beverages and Cardiometabolic Health: An Update of the Evidence. Nutrients. 2019;11(8):1840. Published 2019 Aug 8. doi:10.3390/nu11081840.

46.  O'Connor L, Imamura F, Brage S, Griffin SJ, Wareham NJ, Forouhi NG. Intakes and sources of dietary sugars and their association with metabolic and inflammatory markers. Clin Nutr. 2018;37(4):1313-1322. doi:10.1016/j.clnu.2017.05.030.

Back to Citation

47.  Bomback AS, Derebail VK, Shoham DA, et al. Sugar-sweetened soda consumption, hyperuricemia, and kidney disease. Kidney Int. 2010;77(7):609-616. doi:10.1038/ki.2009.500.

Back to Citation

48.  Valenzuela MJ, Waterhouse B, Aggarwal VR, Bloor K, Doran T. Effect of sugar-sweetened beverages on oral health: a systematic review and meta-analysis. Eur J Public Health. 2021;31(1):122-129. doi:10.1093/eurpub/ckaa147.

Back to Citation

49.  Wang L, Cohen J, Maroney M, et al. Evaluation of health and economic effects of United States school meal standards consistent with the 2020-2025 dietary guidelines for Americans. The American Journal of Clinical Nutrition. 2023. DOI: https://doi.org/​10.1016/​j.ajcnut.2023.05.031.

Back to Citation

50.  Lioret S, Campbell KJ, McNaughton SA, et al. Lifestyle Patterns Begin in Early Childhood, Persist and Are Socioeconomically Patterned, Confirming the Importance of Early Life Interventions. Nutrients. 2020;12(3):724. Published 2020 Mar 9. doi:10.3390/nu12030724.

Back to Citation

51.  USDA is finalizing a higher added sugars limit for flavored milk sold as a competitive food in middle and high schools due to the larger serving size. The serving size for milk offered as part of a reimbursable meal is 8 fluid ounces. Milks sold to middle and high school students as a competitive food may be up to 12 fluid ounces.

Back to Citation

53.  U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.

Back to Citation

54.  Bouchey C, Ard J, Bazzano L, Heymsfield S, Mayer-Davis E, Sabaté J, Snetselaar L, Van Horn L, Schneeman B, English LK, Bates M, Callahan E, Butera G, Terry N, Obbagy J. Dietary Patterns and Risk of Cardiovascular Disease: A Systematic Review. July 2020. U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Nutrition Evidence Systematic Review. Available at: https://doi.org/​10.52570/​NESR.DGAC2020.SR0102.

Back to Citation

55.  Based on an internal USDA analysis using data from: U.S. Department of Agriculture, Food and Nutrition Service, School Nutrition and Meal Cost Study Final Report Volume 2: Nutritional Characteristics of School Meals, by Elizabeth Gearan et al. Project Officer, John Endahl, Alexandria, VA: April 2019. Available online at: www.fns.usda.gov/​research-and-analysis.

Back to Citation

56.  SNMCS Volume 2—Figures 5.2 and 5.5.

Back to Citation

57.  SNMCS Volume 4—Figures 9.2 and 12.2.

Back to Citation

58.  Chanson-Rollé A., Meynier A., Aubin F., Lappi J., Poutanen K., Vinoy S., Braesco V. Systematic Review and Meta-Analysis of Human Studies to Support a Quantitative Recommendation for Whole Grain Intake in Relation to Type 2 Diabetes. PLoS ONE. 2015;10:e0131377. doi: 10.1371/journal.pone.0131377.

Back to Citation

59.  Wang L., Cohen J., Maroney M., et al. Evaluation of health and economic effects of United States school meal standards consistent with the 2020-2025 dietary guidelines for Americans. The American Journal of Clinical Nutrition. 2023. DOI: https://doi.org/​10.1016/​j.ajcnut.2023.05.031.

Back to Citation

60.  Bouchey C., Ard J., Bazzano L., Heymsfield S., Mayer-Davis E., Sabaté J., Snetselaar L., Van Horn L., Schneeman B., English L.K., Bates M., Callahan E., Butera G., Terry N., Obbagy J., Dietary Patterns and Risk of Cardiovascular Disease: A Systematic Review. July 2020. U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Nutrition Evidence Systematic Review. Available at: https://doi.org/​10.52570/​NESR.DGAC2020.SR0102.

Back to Citation

61.  Meynier A., Chanson-Rollé A., Riou E., Main Factors Influencing Whole Grain Consumption in Children and Adults—A Narrative Review. Nutrients. 2020;12(8):2217. Published 2020 Jul 25. doi:10.3390/nu12082217.

Back to Citation

62.  SNMCS Report Volume 2.

Back to Citation

64.  Gordon, E.L., Morrissey, N., Adams, E., Wieczorek, A. Glenn, M.E., Burke, S & Connor, P. (2019). Successful Approaches to Reduce Sodium in School Meals Final Report. Prepared by 2M Research under Contract No. AG-3198-P-15-0040. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service.

Back to Citation

65.  Standing, Kim, Joe Gasper, Jamee Riley, Laurie May, Frank Bennici, Adam Chu, and Sujata Dixit-Joshi. Special Nutrition Program Operations Study: State and School Food Authority Policies and Practices for School Meals Programs School Year 2012-13. Project Officer: John R. Endahl. Prepared by Westat for the U.S. Department of Agriculture, Food and Nutrition Service, October 2016.

Back to Citation

66.  Gordon, E.L., Morrissey, N., Adams, E., Wieczorek, A. Glenn, M.E., Burke, S & Connor, P. (2019). Successful Approaches to Reduce Sodium in School Meals Final Report. Prepared by 2M Research under Contract No. AG-3198-P-15-0040. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service.

Back to Citation

68.  Internal USDA analysis using FDA targets and SNMCS data.

Back to Citation

70.  HEI-2020 was published in September 2023, after this analysis was complete. For application to school age children in this RIA, using HEI-2010, HEI-2015 or HEI-2020 produces the same scores.

Back to Citation

74.  National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board; Committee to Review the Dietary Reference Intakes for Sodium and Potassium; Oria M., Harrison M., Stallings V.A., editors. Dietary Reference Intakes for Sodium and Potassium. Washington (DC): National Academies Press (US); 2019 Mar 5. Available from: https://www.ncbi.nlm.nih.gov/​books/​NBK538102/​ doi: 10.17226/25353.

Back to Citation

77.  SNMCS Report Volume 4 Appendices I to P—Tables J.1 to J.4 and Tables M.1 to M.4.

Back to Citation

78.  SNMCS Report Volume 4.

Back to Citation

79.  The HEI-2010 score corresponds to the Dietary Guidelines for Americans, 2010-2015.

Back to Citation

80.  Cobb L.K., Appel L.J., Anderson C.A., Strategies to reduce dietary sodium intake. Curr Treat Options Cardiovasc Med. 2012;14(4):425-434. doi:10.1007/s11936-012-0182-9.

Back to Citation

81.  Liem D.G., Miremadi F., Keast R.S., Reducing sodium in foods: the effect on flavor. Nutrients. 2011;3(6):694-711. doi:10.3390/nu3060694.

82.  Levings J.L., Cogswell M.E., Gunn J.P., Are reductions in population sodium intake achievable? Nutrients. 2014;6(10):4354-4361. Published 2014 Oct 16. doi:10.3390/nu6104354.

83.  Dehmer S.P., Cogswell M.E., Ritchey M.D., et al. Health and Budgetary Impact of Achieving 10-Year U.S. Sodium Reduction Targets. Am J Prev Med. 2020;59(2):211-218. doi:10.1016/j.amepre.2020.03.010.

Back to Citation

84.  Drake S.L., Lopetcharat K., Drake M.A., Salty taste in dairy foods: can we reduce the salt? [published correction appears in J Dairy Sci. 2012 Dec;95(12):7429]. J Dairy Sci. 2011;94(2):636-645. doi:10.3168/jds.2010-3509.

Back to Citation

89.  Quader ZS, Gillespie C, Sliwa SA, et al. Sodium Intake among US School-Aged Children: National Health and Nutrition Examination Survey, 2011-2012. J Acad Nutr Diet. 2017;117(1):39-47.e5. doi:10.1016/j.jand.2016.09.010.

Back to Citation

90.  2019 Sodium Chronic Disease Reduction Risk (Dietary Reference Intake) values.

Back to Citation

91.  2015 Dietary Guidelines Advisory Committee and Nutrition Evidence Library. Systematic Reviews of the Cross-Cutting Topics of Public Health Importance Subcommittee. 2015 Dietary Guidelines Advisory Committee Project. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, March 2017. Available at: https://nesr.usda.gov/​2015-dietary-guidelines-advisory-committee-systematic-reviews.

Back to Citation

92.  Cheng S, Xanthakis V, Sullivan LM, Vasan RS. Blood pressure tracking over the adult life course: patterns and correlates in the Framingham heart study. Hypertension. 2012;60(6):1393-1399. doi:10.1161/HYPERTENSIONAHA.112.201780.

Back to Citation

93.  Wang L, Cohen J, Maroney M, et al. Evaluation of health and economic effects of United States school meal standards consistent with the 2020-2025 dietary guidelines for Americans. The American Journal of Clinical Nutrition. 2023. DOI: https://doi.org/​10.1016/​j.ajcnut.2023.05.031.

Back to Citation

94.  U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, School Nutrition and Meal Cost Study, Final Report Volume 2: Nutritional Characteristics of School Meals Project Officer: John Endahl. Alexandria, VA: April 2019. Available at: https://www.fns.usda.gov/​school-nutrition-and-meal-cost-study.

Back to Citation

95.  Agriculture Improvement Act of 2014, as amended (25 U.S.C. 1685(b)(5)).

Back to Citation

96.  USDA—Food and Nutrition Service National Database Publicly Available Data.

Back to Citation

97.  SNMCS Report Volume 2.

Back to Citation

98.  Of these peanut butter and jelly sandwiches, over 85 percent were made with whole grain-rich bread.

Back to Citation

99.  SNMCS Study Data, USDA internal analysis.

Back to Citation

100.  SNMCS Study Data, USDA internal analysis.

Back to Citation

101.  U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, School Nutrition and Meal Cost Study, Final Report Volume 2: Nutritional Characteristics of School Meals. Project Officer: John Endahl. Alexandria, VA: April 2019. Available at: https://www.fns.usda.gov/​school-nutrition-and-meal-cost-study.

Back to Citation

103.  This restriction does not apply to naturally occurring trans fats, which are present in meat and dairy products.

Back to Citation

107.  Urban location and low poverty level of the SFA were also correlated with higher educational attainment among SFA directors. USDA, FNS, Office of Policy Support, School Nutrition and Meal Cost Study, Final Report Volume 1: School Meal Program Operations and School Nutrition Environments, prepared by Mathematica Policy Research and Abt Associates, April 2019, pp. 34-35, https://fns-prod.azureedge.net/​sites/​default/​files/​resource-files/​SNMCSVolume1.pdf.

Back to Citation

108.  Child Nutrition Program Operations Study (CN-OPS-II) Report: School Year 2017-2018. https://fns-prod.azureedge.us/​sites/​default/​files/​resource-files/​CNOPS-II-SY2017-18.pdf.

Back to Citation

109.  As explained in the PRA (Paperwork Reduction Act program).

Back to Citation

110.  Using the U.S. Bureau of Labor Statistics series ID of CMU3019200000000D of total compensation cost per hour worked for state and local government workers in public administration industries ( https://data.bls.gov/​cgi-bin/​dsrv).

Back to Citation

111.  See final rule Paperwork Reduction Act (PRA) burden charts.

Back to Citation

112.  Record keeping costs are total annual estimates for the final Buy American provision, not estimates per phase of implemented cap. No inflation adjustment was completed for record keeping costs since they are not food costs or based on a factor of food costs.

Back to Citation

113.  Bobronnikov, E. et al. (2021). Farm to School Grantee Report. Prepared by Abt Associates, Contract No. AG-3198-B-16-0015. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, Project Officer: Ashley Chaifetz.

Back to Citation

114.  Values reflect annual costs from sections above with added three percent annual inflation. Costs are also shown by school year in this table. This varies from table 1 which shows fiscal years and does not include expected annual inflation through the duration of the final rule.

115.  Due to rounding, numbers may not add up to rounded sum in `total' column exactly.

116.  Annual average over 8 school years of rule implementation.

117.  Only local costs (not State costs) are adjusted for inflation because they are based on a factor of food-costs.

118.  Only food costs (not record keeping) are adjusted for inflation.

Back to Citation

119.  Product-specific added sugars limits and weekly added sugars and sodium limits included in this final rule will not take effect until SY 2025-2026 and SY 2027-2028, respectively.

Back to Citation

120.  Results of USDA's FNS-Administered SFA Survey II on Supply Chain Disruption and Student Participation | Food and Nutrition Service.

Back to Citation

122.  Either a direct WTP estimate could be developed or a multistep estimation could quantify health and longevity effects with lost eating-experience utility subsequently being subtracted. For example, in the context of sugar-sweetened beverages (SSB), Kalamov and Runkel (2021), citing Allcott et al.'s (2019) estimates, suggest that internalities (representing the harm consumers of relatively unhealthy foods suboptimally impose on their future selves) could be 30- to 50-percent of gross health impacts; it is the 30- to 50-percent that would appropriately be retained in an analysis of the intrapersonal benefits of a policy that reduces consumption of SSB or foods with similar characteristics. Kalamov, Z. Y. and M. Runkel, Taxation of unhealthy food consumption and the intensive versus extensive margin of obesity. International Tax and Public Finance, 2021: p. 1-27. Allcott, H., B. B. Lockwood, and D. Taubinsky, Regressive sin taxes, with an application to the optimal soda tax. The Quarterly Journal of Economics, 2019. 134(3): p. 1557-1626.

Back to Citation

123.  Wang L, Cohen J, Maroney M, et al. Evaluation of health and economic effects of United States school meal standards consistent with the 2020-2025 dietary guidelines for Americans. The American Journal of Clinical Nutrition. 2023. DOI: https://doi.org/​10.1016/​j.ajcnut.2023.05.031.

Back to Citation

124.  Lioret S, Campbell KJ, McNaughton SA, et al. Lifestyle Patterns Begin in Early Childhood, Persist and Are Socioeconomically Patterned, Confirming the Importance of Early Life Interventions. Nutrients. 2020;12(3):724. Published 2020 Mar 9. doi:10.3390/nu12030724.

125.  Movassagh EZ, Baxter-Jones ADG, Kontulainen S, Whiting SJ, Vatanparast H. Tracking Dietary Patterns over 20 Years from Childhood through Adolescence into Young Adulthood: The Saskatchewan Pediatric Bone Mineral Accrual Study. Nutrients. 2017;9(9):990. Published 2017 Sep 8. doi:10.3390/nu9090990.

Back to Citation

126.  More detailed explanations of health effects of the most impactful provisions are in the `Impacts' section above.

Back to Citation

127.  Wang G, Zhou X, Zhuo X, Zhang P. Annual total medical expenditures associated with hypertension by diabetes status in US adults. Am J Prev Med. 2017;53(6 suppl 2):S182-S189.

128.  Kirkland EB, Heincelman M, Bishu KG, et al. Trends in healthcare expenditures among US adults with hypertension: national estimates, 2003-2014. J Am Heart Assoc. 2018;7(11).pii: e008731.

Back to Citation

129.  Dieleman JL, Cao J, Chapin A, et al. US Health Care Spending by Payer and Health Condition, 1996-2016. 2020;323(9):863-884. doi:10.1001/jama.2020.0734.

Back to Citation

130.  Birger M, Kaldjian AS, Roth GA, Moran AE, Dieleman JL, Bellows BK. Spending on Cardiovascular Disease and Cardiovascular Risk Factors in the United States: 1996 to 2016. Circulation. 2021;144(4):271-282. doi:10.1161/CIRCULATIONAHA.120.053216.

Back to Citation

131.  Vreman RA, Goodell AJ, Rodriguez LA, et al. Health and economic benefits of reducing sugar intake in the USA, including effects via non-alcoholic fatty liver disease: a microsimulation model. BMJ Open. 2017 Aug 3;7(8):e013543. doi: 10.1136/bmjopen-2016-013543. PMID: 28775179; PMCID: PMC5577881.

Back to Citation

132.  Vos MB, Kaar JL, Welsh JA, American Heart Association, et al. Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement From the American Heart Association. Circulation. 2017 May 9;135(19):e1017-e1034. doi: 10.1161/CIR.0000000000000439. Epub 2016 Aug 22. PMID: 27550974; PMCID: PMC5365373.

Back to Citation

133.  American Diabetes Association. Economic costs of diabetes in the US in 2017. Diabetes Care. 2018;41:917-928.

Back to Citation

134.  The search was conducted in 2022, however some product catalogs were older. It was found that at least four manufacturers had at least one flavored milk product with under 10 grams of added sugars per serving and in fact, three of them had products with six grams of added sugars per serving. A total of 10 flavored milk products from four companies were below the 10-gram added sugars limit. The catalogs used for data collection generally showed that there were lower sugar and higher sugar versions of flavored milk available.

Back to Citation

135.  The Healthy School Milk Commitment—IDFA.

Back to Citation

137.  School Food Purchase Study III.

Back to Citation

138.  Bobronnikov, E. et al. (2021). Farm to School Grantee Report. Prepared by Abt Associates, Contract No. AG-3198-B-16-0015. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, Project Officer: Ashley Chaifetz.

Back to Citation

139.   Federal Register : Final Rule: Nutrition Standards in the National School Lunch and School Breakfast Programs.

Back to Citation

140.  U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, Child Nutrition Program Operations Study (CN-OPS-II): SY 2015-16 by Jim Murdoch and Charlotte Cabili. Project Officer: Holly Figueroa. Alexandria, VA: December 2019.

Back to Citation

141.  Changes to sodium limits as a result of this final rule will not take effect until SY 2027-2028.

142.  Includes the $30 million offset of annually available equipment grants.

Back to Citation

143.  U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, Child Nutrition Program Operations Study (CN-OPS-II): SY 2017-18. Beyler, Nick, Jim Murdoch, and Charlotte Cabili. Project Officer: Holly Figueroa. Alexandria, VA: November 2022. https://fns-prod.azureedge.us/​sites/​default/​files/​resource-files/​CNOPS-II-SY2017-18.pdf.

Back to Citation

146.  USDA—Food and Nutrition Service, National Data Bank—Publicly available data.

Back to Citation

147.  Turner, Lindsey, and Frank Chaloupka (2014). “Perceived Reactions of Elementary School Students to Changes in School Lunches after Implementation of the United States Department of Agriculture's New Meals Standards: Minimal Backlash, but Rural and Socioeconomic Disparities Exist,” Childhood Obesity 10(4):1-8.

Back to Citation

149.  ox MK, Gearan E, Cabili C, et al. School Nutrition and Meal Cost Study, Final Report Volume 4: Student Participation, Satisfaction, Plate Waste, and Dietary Intakes. U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support; 2019. https://www.fns.usda.gov/​school-nutrition-and-meal-cost-study.

Back to Citation

151.   https://www.transportation.gov/​briefing-room/​usdot-supply-chain-tracker-shows-progress-supply-chains-remain-stressed.

152.  Results of USDA's Food and Nutrition Service-Administered School Food Authority Survey II on Supply Chain Disruption and Student Participation ( azureedge.us).

Back to Citation

154.  Cobb LK, Appel LJ, Anderson CA. Strategies to reduce dietary sodium intake. Curr Treat Options Cardiovasc Med. 2012;14(4):425-434. doi:10.1007/s11936-012-0182-9.

Back to Citation

155.  If the decrease in participation is caused by provisions of this final rulemaking, then there would be other effects—for example, incremental health consequences of revised eating patterns, or the transition cost to parents and guardians as they make other eating arrangements for their children—that would also be attributable to the rule. By contrast, if participation decreases due to unrelated trends, then the quantified cost estimates would be as reported here but the (unquantified) accompanying effects would not be attributable to this final rule.

Back to Citation

156.  If the increase in participation is caused by provisions of the final rule, then there would be other effects—for example, incremental health consequences of revised eating patterns—that would also be attributable to the provision. By contrast, if participation increases due to unrelated trends, then the quantified cost estimates would be as reported here but the unquantified accompanying effects would not be attributable to the final rule.

Back to Citation

157.  U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.

Back to Citation

158.  Grummer-Strawn LM, Li R, Perrine CG, Scanlon KS, Fein SB. Infant feeding and long-term outcomes: results from the year 6 follow-up of children in the Infant Feeding Practices Study II. Pediatrics. 2014;134 Suppl 1(Suppl 1):S1-S3. doi:10.1542/peds.2014-0646B.

159.  Lioret S, Campbell KJ, McNaughton SA, et al. Lifestyle Patterns Begin in Early Childhood, Persist and Are Socioeconomically Patterned, Confirming the Importance of Early Life Interventions. Nutrients. 2020;12(3):724. Published 2020 Mar 9. doi:10.3390/nu12030724.

Back to Citation

160.  Albertson AM, Reicks M, Joshi N, Gugger CK. Whole grain consumption trends and associations with body weight measures in the United States: results from the cross sectional National Health and Nutrition Examination Survey 2001-2012. Nutr J. 2016;15:8. Published 2016 Jan 22. doi:10.1186/s12937-016-0126-4.

Back to Citation

161.  Based on an internal USDA analysis using data from: U.S. Department of Agriculture, Food and Nutrition Service, School Nutrition and Meal Cost Study Final Report Volume 2: Nutritional Characteristics of School Meals, by Elizabeth Gearan et.al. Project Officer, John Endahl, Alexandria, VA: April 2019. Available online at: www.fns.usda.gov/​research-and-analysis.

Back to Citation

162.  Wang L, Cohen J, Maroney M, et al. Evaluation of health and economic effects of United States school meal standards consistent with the 2020-2025 dietary guidelines for Americans. The American Journal of Clinical Nutrition. 2023. DOI: https://doi.org/​10.1016/​j.ajcnut.2023.05.031.

Back to Citation

163.  2020 Dietary Guidelines Advisory Committee and Nutrition Evidence Systematic Review Team. Dietary Patterns and Risk of Cardiovascular Disease: A Systematic Review. 2020 Dietary Guidelines Advisory Committee Project. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, July 2020. Available at: https://nesr.usda.gov/​2020-dietary-guidelines-advisory-committee-systematic-reviews.

164.  2020 Dietary Guidelines Advisory Committee and Nutrition Evidence Systematic Review Team. Dietary Patterns and Growth, Size, Body Composition, and/or Risk of Overweight or Obesity: A Systematic Review. 2020 Dietary Guidelines Advisory Committee Project. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, July 2020. Available at: https://nesr.usda.gov/​2020-dietary-guidelines-advisory-committee-systematic-reviews.

Back to Citation

165.  DeBruyn L, Fullerton L, Satterfield D, Frank M. Integrating Culture and History to Promote Health and Help Prevent Type 2 Diabetes in American Indian/Alaska Native Communities: Traditional Foods Have Become a Way to Talk About Health. Prev Chronic Dis 2020;17:190213. DOI: http://dx.doi.org/​10.5888/​pcd17.190213external icon.

166.  Satterfield D, DeBruyn L, Santos M, Alonso L, Frank M. Health promotion and diabetes prevention in American Indian and Alaska Native communities—Traditional Foods Project, 2008-2014. CDC Morbidity Mortality Weekly Report. 2016;65(S1):4-10. https://www.cdc.gov/​mmwr/​volumes/​65/​su/​su6501a3.htm.

Back to Citation

169.  USDA—Food and Nutrition Service, National Data Bank—Publicly available data.

Back to Citation

170.  Matthew P. Rabbitt, Laura J. Hales, Michael P. Burke, and Alisha Coleman-Jensen, October 2023. Household Food Security in the United States in 2022, ERR-325, U.S. Department of Agriculture, Economic Research Service.

Back to Citation

171.  Ralston, K.; Treen, K.; Coleman-Jensen, A.; Guthrie, J. Children's Food Security and USDA Child Nutrition Programs; U.S. Department of Agriculture, Economic Research Service: Washington, DC, USA, 2017.

Back to Citation

172.  Gearan EC, Monzella K, Jennings L, Fox MK. Differences in Diet Quality between School Lunch Participants and Nonparticipants in the United States by Income and Race. Nutrients. 2021;12(12):3891. https://www.mdpi.com/​2072-6643/​12/​12/​3891.

Back to Citation

173.  Gordon, E.L., Morrissey, N., Adams, E., Wieczorek, A. Glenn, M.E., Burke, S & Connor, P. (2019). Successful Approaches to Reduce Sodium in School Meals Final Report. Prepared by 2M Research under Contract No. AG-3198-P-15-0040. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service.

Back to Citation

175.  USDA Food and Nutrition Service, Office of Policy Support data collection of nutrition label information from major cereal and yogurt manufacturer K-12 and food service catalogs.

Back to Citation

176.  Hoppu U, Hopia A, Pohjanheimo T, et al. Effect of Salt Reduction on Consumer Acceptance and Sensory Quality of Food. Foods. 2017;6(12):103. Published 2017 Nov 27. doi:10.3390/foods6120103.

177.  Institute of Medicine (US) Committee on Strategies to Reduce Sodium Intake; Henney JE, Taylor CL, Boon CS, editors. Strategies to Reduce Sodium Intake in the United States. Washington (DC): National Academies Press (US); 2010. Available from: https://www.ncbi.nlm.nih.gov/​books/​NBK50956/​ doi: 10.17226/12818.

Back to Citation

178.  U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.

Back to Citation

179.  Due to rounding, numbers may not add up to rounded sum in `total' column exactly.

180.  This data is the same as in table 1, but broken down by school years instead of fiscal years.

181.  Annual average over 8 school years of rule implementation.

Back to Citation

BILLING CODE 3410-30-P

BILLING CODE 3410-30-C

[FR Doc. 2024-08098 Filed 4-24-24; 8:45 am]

Legal Citation

Federal Register Citation

Use this for formal legal and research references to the published document.

89 FR 31962

Web Citation

Suggested Web Citation

Use this when citing the archival web version of the document.

“Child Nutrition Programs: Meal Patterns Consistent With the 2020-2025 Dietary Guidelines for Americans,” thefederalregister.org (April 25, 2024), https://thefederalregister.org/documents/2024-08098/child-nutrition-programs-meal-patterns-consistent-with-the-2020-2025-dietary-guidelines-for-americans.