title: Evaluating changes to sodium content in school meals at a large, urban school district in Los Angeles County, California.
abstract: BACKGROUND
  Children consume more than one-third of their daily food intake in schools, suggesting that these environments are ideal places for intervening on poor dietary behaviors.
  
  
  OBJECTIVE
  To assess the impact of strategy-focused menu planning on the sodium content of student meals served in the Los Angeles Unified School District (LAUSD).
  
  
  METHODS
  Pre- and post-LAUSD menu change analyses for school years (SY) 2010-2011 and 2011-2012 were performed using nutritional analysis data and food production records. The analyses assessed changes in sodium content by meal categories.
  
  
  METHODS
  900+ schools, grades K-12, operated by the LAUSD.
  
  
  METHODS
  The LAUSD Food Services Branch, which serves about 650 000 meals per day.
  
  
  METHODS
  A multistage menu planning approach that focused on implementing evidence-based strategies to improve the nutritional content of school breakfast and lunch menus. Engagement and formation of multisectoral partnerships, including public health and parent/student groups, were vital elements of the intervention process.
  
  
  METHODS
  Sodium content changes in the LAUSD menu, SY 2010-2011 versus SY 2011-2012; other measures include documentation of program reach.
  
  
  RESULTS
  From SY 2010-2011 to SY 2011-2012, the mean unweighted sodium levels for elementary (K-5) breakfast and for secondary (6-12) breakfast and lunch decreased. These changes met or exceeded the 2014-2015 US Department of Agriculture sodium targets for school meals and for secondary breakfast, the 2022-2023 target(s). These results, however, were not as notable once student food selection patterns (weighted data) and condiments were considered in the analysis.
  
  
  CONCLUSIONS
  Use of strategy-focused menu planning as a mechanism to reduce sodium in school meals appeared to be promising, demonstrating favorable declines in mean sodium levels for at least 3 of 4 meal categories in the LAUSD. Student food selection patterns and condiments use, however, can affect the strength of the intervention.
authors: Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, California (Mss Cummings, Burbage, Wood, and Butler and Dr Kuo); and Department of Epidemiology, Jonathan & Karin Fielding School of Public Health (Ms Cummings), and Department of Family Medicine, David Geffen School of Medicine (Dr Kuo), University of California, Los Angeles.
authors: Patricia L
authors: PL
authors: Cummings
authors: Lindsey
authors: L
authors: Burbage
authors: Michelle
authors: M
authors: Wood
authors: Rebecca K
authors: RK
authors: Butler
authors: Tony
authors: T
authors: Kuo
mesh_terms: D062408:Breakfast; D005522:Food Services / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D015141:Los Angeles; D062409:Lunch; D008612:Menu Planning / Q000592:standards*; D015397:Program Evaluation; D044469:Racial Groups; D012574:Schools; D012982:Sodium, Dietary / Q000008:administration & dosage*
chemical_list: D012982:Sodium, Dietary