Almost everything about a school cafeteria meal has a regulation. The federal government caps the amount of fat and salt in breakfasts and lunches. It sets minimum standards for servings of fruit, vegetables, grains, milk and meat.
But one widely used and often-overused product has no official limits: sugar.
As Congress faces increased scrutiny over subsidies to the sugar industry, nutritionists and anti-obesity crusaders are focusing on the amount of sugar in school meals – and asking whether regulations governing school lunches deliberately exclude limits on sugar to favor a powerful industry.
"Certainly, the food industry has pushed back against having a sugar standard," said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, which has been pushing for a limit on added sugars for years. "If the USDA (U.S. Department of Agriculture) is going to address other key parts of the dietary guidelines – fats, salts and calories – why choose to leave one dietary guideline out?"
Recent research shows that sugar levels in school meals are more than double what is recommended for the general public. Elementary school lunch menus contain 115 percent of the recommended daily calories from added sugars and fats, according to a November study by the USDA's Food and Nutrition Service. Middle school and high school lunch menus also are sugar- and fat-heavy, averaging between 59 and 74 percent of the recommended amounts.
About 1 in 5 school lunch menus includes dessert, the federal study said. The most common are cookies, cakes and brownies, some of which are counted as grain requirements. Other popular options are fruit with gelatin, ice cream and pudding.
The data from the School Nutrition Dietary Assessment is based on a 2010 survey of about 900 schools across the country and is considered the most comprehensive federal research on school meals.
For years, schools added sweets, such as graham crackers or cookies, to bump up calorie counts and meet minimum thresholds. Researchers say that practice is less common now that the USDA has implemented calorie limits. But some say sugary treats still are appealing to school administrators.
"Sugar-related products are the least expensive source of calories in the school meal program," said Matthew Sharp, senior advocate for California Food Policy Advocates. He said many school officials oppose reducing sugar in meals because it would force them to buy more expensive products.
The report did not break out sugars specifically. It also didn't count sugars that occur naturally in fruit and milk, but rather sweeteners added to processed or prepared foods.
The USDA, which administers the national school lunch and breakfast programs, says newly created total calorie limits are designed to discourage extra-sugary and fatty foods. A USDA spokesman noted that as of June 30, about 70 percent of all schools have shown they're in compliance with the new plan, which means students are eating healthier meals.
But some researchers say the level of sugar in school meals is far from ideal, and even bigger challenges loom outside the cafeteria.
"One problem in schools is the birthday celebrations, sports events and teachers giving kids candy for correct answers," said Marion Nestle, author of "Food Politics: How the Food Industry Influences Nutrition and Health" and a nutrition professor at New York University. "Those are unregulated."
For its part, industry representatives at the Sugar Association, a Washington lobbying group, said the USDA based its final rules on "many important and practical considerations." For one, it said in a statement, "sugar makes many healthful foods palatable so children will eat them, which the science confirms helps increase intakes of many essential vitamins and minerals."
"We continue to emphasize that the most important consideration of a healthful diet is the nutritional value of the foods and beverages consumed, not the sugar content," the association said. "Portion control, monitoring caloric intake and being physically active are among the most important tools children can learn for long-term health."
Researchers say students' sugar consumption places them at greater risk for obesity, Type 2 diabetes and heart disease. Boys consume an average of about 360 calories – more than 22 teaspoons – of added sugars a day, according to a 2012 report by the Centers for Disease Control and Prevention. Girls average about 280 calories – more than 17 teaspoons – daily.
"We as a society have created this issue and become very dependent on sugar," said Michael Goran, director of the Childhood Obesity Research Center at the University of Southern California. "I think we have to work at various levels to rely less on sugar. One aspect of that is to have some kind of public health agreement to limit dietary sugar consumption."
Click for larger imageA student talks with cafeteria worker Sophia Villareal as she picks up breakfast at Brockton Avenue Elementary School in Los Angeles.The federal government caps the amount of fat and salt in school breakfasts and lunches but has no official limit on sugar.
Credit: Richard Hartog/For The Center for Investigative Reporting
Even if regulators eventually agree to restrict sugar in meals, schools would face the challenge of finding more healthful processed foods and the money to buy them. The federal government reimburses schools between 27 cents and $2.86 for each lunch served, depending on how much students can pay. Many school districts struggle to run their cafeterias with the current funding.
Schools have come to rely on revenue from vending machines, which Sharp says are one of the worst sources of sugary snacks and drinks on campus. He's optimistic about the new standards released by the USDA that require items sold at school vending machines and snack bars to meet minimal nutrient requirements and limit sodium, sugar and fat.
Starting in the 2014-15 school year, no more than 35 percent of the weight of a snack food will be allowed to come from sugar. Nearly 40 states, including California, already have implemented guidelines for school snacks.
But even as regulators tighten rules, other challenges arise.
"In L.A., there's some neighborhoods where street vendors come around the school at the start of school and during breaks," Goran said. "The students can easily buy a boatload of sugary products."
How much sugar is healthy?
For years, researchers have debated how much sugar can be consumed in a healthy diet. USDA guidelinessay calories from added sugars and solid fats should be limited to 5 to 15 percent of daily calories but provides no specific rule for sugars.
Meanwhile, the World Health Organization recommends that added sugars make up no more than 10 percent of daily calories. The American Heart Association recommends that women consume no more than 100 calories a day of added sugar (about 6 teaspoons) and men consume no more than 150 calories (roughly 9 teaspoons).
According to the CDC, American children consume about 16 percent of their daily calories from added sugars, which include white sugar, high-fructose corn syrup, honey and other sweeteners.
Some academics who believe that Americans are eating too much sugar blame the lack of regulations on the political clout of the food and beverage industry.
"Sugar is the only nutrient with no dietary reference intake, and it's because the food industry doesn't want it," said Dr. Robert Lustig, a pediatric endocrinologist at UC San Francisco. "They know when they add sugar to food, you buy more. So they don't want any limits. And they have very effectively lobbied the USDA to not have any limits."
Lustig is the author of "Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease" and has been on a crusade against sugar. He argues that it's addictive and toxic and that in the amounts consumed by Americans, sugar changes metabolism, raises blood pressure and damages the liver.
The Sugar Association argues that Lustig's research lacks scientific basis and that sugar consumption is correlated with, but not the proven cause of, health problems like Type 2 diabetes.
"We are not consuming enough of it (sugar) for it to have negative health impacts," said Megan Mitchell, a spokeswoman for the lobbying group. "If the science supported setting an upper limit intake on sugar, they (federal regulators) would do it. There has been no major body of science to come out in support of it. That's why it hasn't happened yet."
USDA officials say school meal regulations are based on independent scientific recommendations and input from all stakeholders. USDA officials declined to be interviewed but provided a statement that read in part: "We used expert guidance as well (as) public feedback to create the meal patterns in a way that not only promotes good nutrition, but also could be implemented in schools."
Some say political pushback from food and beverage companies is part of the problem, but regulating sugar is complicated. It can be difficult to differentiate and enforce rules for naturally occurring sugars and added sweeteners, said Wootan, of the Center for Science in the Public Interest.
Even so, Wootan has pushed for a federal standard for added sugars for 20 years and says she's confident it will happen eventually because scientific research supports it.
"These are extra calories that many children can't afford," Wootan said. "One-third of children are either overweight or obese. And it contributes to heart disease and diabetes. And in addition to that, oftentimes, the sugary food crowds out more healthy foods that kids need. So kids are overfed and undernourished."
In its statement, the Sugar Association said it "did not lobby or meet with anyone at the U.S. Department of Agriculture with respect to the school lunch rule, nor was the Association involved in the crafting of that rule." Rather, the association said, it submitted science-based comments during the rule-making process.
Schools boot flavored milks
Sugar is disappearing from Los Angeles school cafeterias.
The Los Angeles Unified School District made the controversial decision two years ago to remove chocolate and strawberry-flavored milks from lunch menus. And in the last few years, the district has cut sweeteners by about 30 percent, slimming down banana bread, coffee cakes and cereals it serves. Officials plan to eliminate all added sugars and high-fructose corn syrup in 2015.
"The (school) board has taken the position that we don't need regulation in the government to tell us what to do," said David Binkle, the district's director of food services. "We've seen enough statistical data and research that says sugar is not good for you in large consumption."
The Lemon Grove School District in San Diego County also made the move two years ago to eliminate chocolate and other flavored milks, and officials continue to hear complaints.
"The eighth-graders still do presentations to me about why they want their chocolate milk," said Robin McNulty, who directs nutrition services for the district. "I see where they're coming from. I appreciate it. But there is no need for children to have it at school."
Over the last several years, McNulty and her staff have replaced cookies, cakes and brownies with fresh fruit and whole-grain animal crackers. The staff does not add sugar to food they cook. Before purchasing processed foods, which make up about 40 percent of lunch entrees, they make sure sugar is not one of the top three ingredients.
"Research has come out saying a nourished child does better in school," McNulty said.
When McNulty wanted to buy a breakfast bar with whole grains and less sugar, she couldn't find what she wanted. So the district hired a local company to make one with whole oats and agave syrup.
"The hardest part is finding the healthier products we can purchase within our price point," McNulty said.
The few school districts that are aggressively reducing sweeteners say it's a constant struggle to balance students' tastes with their best interests.
At the Earlimart School District, about 70 miles southeast of Fresno, officials eliminated flavored milk two years ago and are working to select snacks and breakfast foods with less sugar.
Chef Jason Beach, who directs the district's food service, said he's looking into sugar-free graham crackers and 100 percent fruit juices.
"It's easier to set the menu if you have more sugary snacks," Beach said. "Your a la carte sales go up. And schools don't want to lose out on those sales. But I'm more worried about getting the kids healthy."