LAUSR

Objectives Recent research suggests the possibility for significant variability in nutrient content and dietary quality (DQ) of school lunches, even when meeting National School Lunch Program (NSLP) nutrition standards. The purpose of this study was to determine whether there were differences in nutrient content and DQ by socioeconomic status (SES) and rurality, among middle school lunch menus meeting NSLP standards. Methods All 283 Kansas school districts were stratified into high and low SES groups (< 50% or > 50% of students received free/reduced-price lunch). Forty-five menus from low and from high SES strata (N = 90) were obtained from websites of randomly selected school districts for the same time period (first six weeks of school). Included menus were also stratified for analyses by rurality, determined by National Center for Education Statistics locales. Thirty days of each menu were portioned per NSLP standards for the middle school age group and per standardized assumptions across all menus. Portioned menus were analyzed for macro- and micro-nutrient content using ESHA Food Processor. Daily DQ scores were calculated using the Healthy Eating Index (HEI) 2015. Two-way ANOVA was used to determine differences in nutrient content and DQ by SES and rurality, with Bonferroni correction for multiple comparisons. Effect size was calculated using Cohen's d. Results Eighty-five menus were included in final analyses. There were significant differences between high SES vs. low SES menus for added sugar (‒0.4 g or ‒80%, Cohen's d = 0.78, P < 0.001) and calcium (5.3 mg or 1%, d = ‒0.22, P = 0.001) favoring high SES menus, and sodium (54.1 mg or 48%, d = ‒0.66, P = 0.001) favoring low SES menus. There were no significant differences in nutrient content between city, suburban, town, or rural locales (ps > 0.05). HEI scores did not differ by SES or rurality (ps > 0.05), with mean score and standard deviation of 62.0 ± 4.0 across all schools. Conclusions There were few differences in nutrient content and DQ with minimal clinical significance when comparing middle school lunch menus in Kansas by SES and rurality. Efforts to improve school lunch DQ should focus on all school foodservice operations, not specifically low SES or rural, although these schools may have other foodservice needs outside the scope of this study. Funding Sources None.