Evaluating changes to sodium content in school meals at a large, urban school district in Los Angeles County, California.

CONTEXT: 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). DESIGN: 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. SETTING: 900+ schools, grades K-12, operated by the LAUSD. PARTICIPANTS: The LAUSD Food Services Branch, which serves about 650 000 meals per day. INTERVENTION: 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. MAIN OUTCOME MEASURE(S): 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.