Evaluation of Variability in Dietary Quality of School Lunches Meeting National School Lunch Program Guidelines by Socioeconomic Status and Rurality

Research suggests that the dietary quality (DQ) of school lunches meeting the National School Lunch Program (NSLP) requirements may vary significantly. Possible drivers of variation include factors, such as socioeconomic status (SES) and rurality. The purpose of this cross-sectional study was to determine whether there was variation in nutrient content and DQ by SES and rurality, when analyzing middle school lunch menus meeting NSLP requirements. A random sample of 45 Kansas middle school lunch menus each were obtained from websites of randomly selected districts from low- and high-SES strata. Thirty-day menus were analyzed for nutrient content. Healthy Eating Index (HEI) 2015 scores were calculated for DQ. Rurality was determined for schools by National Center for Education Statistics (NCES) locale. There were significant differences in added sugar (p < 0.001) and calcium (p = 0.001) favoring high-SES menus, and in sodium (p = 0.001) favoring low-SES menus. There were no nutrient differences by rurality. The HEI scores were not different by SES or rurality, with a mean score (SD) 61.9 (2.6) across all schools. Middle school lunch DQ in Kansas does not vary by SES or rurality. Efforts to improve DQ should focus on all foodservice operations, not specifically low-SES or rural schools.