Category: Family Health

Last Reviewed: Jun 25, 2024

Schools are in a unique position to promote healthy eating and physical activity, with more than 95% of U.S. youth aged 5-17 years old attending school outside of the home. Schools can implement policies and practices that encourage healthy eating and physical activity during the school day, and can also help children and adolescents establish lifelong healthy patterns.

Healthy Eating During the School Day

Policies and programs guiding what foods and beverages are available in schools provide an important opportunity to improve child health. This is especially important for children from households with lower incomes and children who are members of racial/ethnic minority groups (who, on average, have less access to healthy food, poorer dietary quality, and higher risk for obesity compared to other children). [1]

School meals and competitive foods and beverages

In the U.S., federal assisted meal programs administered by the United States Department of Agriculture provide nutritionally adequate breakfasts, lunches, and afterschool snacks to children during the school year. The School Breakfast Program (SBP) serves meals to 14.6 million children, and the National School Lunch Program (NSLP) provides lunches and after-school snacks to more than 30 million children; 22 million receive those meals for free or at a reduced price. [2] Lower-income children participate in these programs at higher rates than other children, and can receive free or reduced-priced meals. [3]

The Healthy Hunger Free Kids Act (HHFKA) of 2010 authorized funding and set policies to improve the nutritional quality of food and beverages served to children through the SBP and NSLP. [4] HHFKA regulations required meal patterns for breakfast and lunch to increase fruits and vegetables and limit starchy vegetables, create age-specific recommended serving sizes, serve only low-fat or fat-free milk, and serve more whole grains, among other standards. [5] The HHFKA also, for the first time, established nutrition standards for competitive food and beverages sold outside of school meal programs as a la carte, from vending machines, or school stores. These “Smart Snacks” guidelines eliminated almost all sugary beverages, and placed limits on calories, sodium, and saturated fat and sugars on snacks. [6]

Implementation of HHFKA has been a major advance for child nutrition, [7-9] and several studies have found its implementation was associated with significant decreased risk of obesity among school-aged children and may have been particularly impactful for students in poverty, who tend to benefit the most from NSLP/SBP. [10-12] In the U.S., Canada, and the United Kingdom, nutrition standards for competitive food and beverages and school meals in the and have demonstrated positive health impacts, including reducing consumption of sugary beverages and unhealthy snacks, and increasing fruit intake. [13]

Increasing participation in school meals

To ensure that children who would benefit most from SBP and NSLP have access to these programs, it is important to consider how to increase student participation in school meals.  One promising approach is the adoption of universal free school meals (UFSM) policies. After a UFSM policy was temporarily introduced nationwide in 2020 during the COVID-19 pandemic, several states passed legislation to continue funding the program within their own states, and many others are considering adopting a UFSM model. UFSM models are associated with increased participation in school meals and reduced obesity risk. [14] In states without UFSM, there are more localized options for increasing access to school meals. The Community Eligibility Provision (CEP) is a non-pricing meal service option for schools and school districts in low-income areas that allow them to serve breakfasts and lunches at no cost to all enrolled students without collecting household application. Schools that adopt CEP are reimbursed based on the participation in other food assistance programs such as the Supplemental Nutrition Assistance Program and Temporary Assistance for Needy Families. Students in CEP districts would be provided free, healthy meals consistent with the HHFKA guidelines, and significantly reduce the administrative burden for school districts. [15]

Direct provision of fresh fruits and vegetables

In the U.S., the Fresh Fruit and Vegetable Program (FFVP) is another federally assisted program that provides free fresh fruits and vegetables to elementary school children during the school year. FFVP introduces children to new and different varieties of fresh fruits and vegetables, with the goal of increasing overall acceptance and consumption. FFVP prioritizes schools with the highest percentage of children eligible for free and reduced priced meals. [16] Other countries have also implemented direct provisions of fruits and vegetables in schools, including Canada, Denmark, Netherlands, Norway, and the United Kingdom. A meta-analysis of programs in these countries and the U.S. demonstrated that direct provision policies significantly increased fruit and vegetable intake. [13]

Recommendations for school meals and competitive foods in schools

• Provide competitive foods and beverages and school meals that meet nutrition standards






• Increase participation in school meals through programs such as Community Eligibility Provision and Universal School Breakfast






• States should implement nutrition standards that strengthen the federal standards






• Direct provision of healthful food and beverages such as fruits and vegetables






• Increase financial support for school meal programs from federal, state, and local governments

 Best practice guidance for school meals and competitive foods in schools

• Give students adequate time to eat






• Encourage staff to model healthy eating






• Incorporate nutrition education into school meal programs






• Ensure that food served at classroom parties and school functions, including fundraisers, meets competitive food standards






• Limit marketing of unhealthy foods






• School garden programs including nutrition and gardening education and hands-on gardening experiences






• Invest in cafeteria facilities to store, prepare, and display healthy foods






• Train food service staff in health food preparation techniques

Drinking Water Access During the School Day

Providing clean, safe drinking water in schools helps increase students’ overall water intake, maintain hydration, and reduce calorie intake if substituted for sugary drinks. [17-19] The HHFKA requires schools participating in the School Breakfast or and National School Lunch Program to make water available to students during meal times for free. [20] One study found that installation of water jet dispensers on school cafeteria lunch lines was a cost-effective strategy for preventing cases of childhood obesity. [21]

Physical Activity During the School Day

Children require at least 60 minutes of moderate to vigorous physical activity each day. Schools can help children get the recommended amount of daily physical activity by offering more frequent, higher quality and more active physical education and recess, and by promoting physical activity throughout the day. [22-26]

Active physical education

Health organizations recommend that schools provide 150 minutes per week of instructional physical education for school children and 225 minutes per week for middle and high school students throughout the school year. [27,28] In 2014, only 15% of elementary, 9% of middle, and 6% of U.S. high schools require students to take physical education classes on at least 3 days per week. [29] Furthermore, children often spend less than half of their time in physical education classes being physically active. [24,30] Active physical education focuses on making the time that children spend in class more active. Improving the quality of physical education classes will help children get more physical activity and encourage them to develop healthy habits.

Best practice guidance for physical activity during the school day  

• Provide daily physical education to children in grades K-12






• Provide a minimum minutes per week of participation in physical education






• Adopt physical education standards and curriculum






• Ensure that children spend most of their physical education time being physically active






• Hire licensed physical education teachers and offer them ongoing training






• Make sure that physical education requirements are not waived for other physical or academic activities






• Prohibit schools and districts from using physical activity as a form of punishment

Physical activity during recess

Daily recess during the school day is a relatively easy and low-cost way to help children be physically active. In addition to offering recess, it is important that the time that children spend in recess periods is physically active time. Unfortunately, since the mid-2000s, up to 40% of U.S. school districts have reduced or eliminated recess time. [21,31] Ways to increase physical activity during recess time include providing structured physical activity, the installation of playground markings, and/or the provision of portable play equipment. [32] 

Best practice guidance for recess during the school day

• Provide all k-12 students with recess daily






• Provide schools and students with adequate spaces, facilities, equipment, and supplies for recess






• Ensure that spaces and facilities for recess meet or exceed recommended safety standards






• Do not exclude students from recess for disciplinary reasons or academic performance in the classroom






• Schedule morning recess before lunch






• Provide staff members who lead or supervise recess with ongoing professional development

Active classrooms

Incorporating classroom physical activity can take place at any time and occurs at one or several brief periods during the school day. Physical activity in the classroom can be integrated into academic instruction or providing breaks from instruction designed for physical activity. In 2016, only 11% of U.S. school districts required elementary schools to provide regular classroom physical activity breaks; this was even lower for middle schools (8%) and high schools (2%). [33]

Best practice guidance for classroom physical activity in schools

• Integrate physical activity into planned academic instruction to reinforce academic concepts [34,35]






• Provide physical activity breaks outside of planned academic instruction






• Use classroom physical activity as a way to reinforce skills learned in physical education






• Ensure that barriers to classroom physical activity, such as lack of equipment or available space, are minimized.






• Do not withhold classroom physical activity from students as a disciplinary approach






• Provide teachers with ongoing professional development on classroom physical activity

A comprehensive school physical activity program

A Comprehensive School Physical Activity Program is the development, implementation, and evaluation of strategies to increase physical activity during the school day. With active physical education, active recess, and movement breaks in the classroom. [22] A coordinated effort in schools to help all students meet recommended levels of physical activity would help children grain skills and confidence to make regular physical activity a lifelong habit.

The 5 Components of a Comprehensive School Physical Activity Program [22]

1. Physical Education






2. Physical Activity During School: Recess and Movement Breaks in the Classroom






3. Family and Community Engagement






4. Staff Involvement






5. Physical Activity Before and After School

Last reviewed March 2024

Including protein-rich foods in your diet is vital for maintaining overall health and well-being. But how much protein do you need and what are the best sources of this essential macronutrient?

Why we need protein

Proteins are building blocks in the body. They make up bones, cartilage, muscle, blood, skin, enzymes, hormones, and vitamins. They’re essential for growth and development, repair and build cells and tissue such as muscle, and play an important role in body processes such as blood clotting, fluid balance, and the immune response.

Proteins are made from amino acids. There are some amino acids that our bodies can make on their own. These are called nonessential amino acids. But there are nine amino acids that our bodies must get by consuming foods that contain them. These are called essential amino acids, and they are necessary for normal body functioning.

What foods are high in protein?

We can get protein from plant or animal sources. Protein in our diet can come from meat, dairy products, nuts, some vegetables, and certain grains and beans.

Try to eat a variety of protein-rich foods to ensure you are meeting your daily protein needs as well as getting the vitamins, minerals, and other nutrients needed for optimal health. Proteins that come from animal sources, such as meat, eggs, and milk, as well as soy and quinoa, are called complete proteins. This means they contain all the essential amino acids the body needs and are the highest-quality protein sources.

You can also get essential amino acids from plant-based foods. However, most plant-based proteins do not contain all of the needed essential amino acids, and so are called incomplete proteins. If you avoid animal proteins, the best way to ensure you are consuming a healthy mix of amino acids is to enjoy a variety of plant-based proteins through the day.

Foods that are particularly high in protein include:

Lean meats such as chicken, turkey, beef, and pork are excellent sources of high-quality protein as well as important nutrients like iron and zinc. To avoid unhealthy saturated fat, opt for lean or low-fat meat options such as lean ground beef, pork loin, or skinless chicken breasts.

Fish like salmon, tuna, and mackerel are not only rich in protein but also contain omega-3 fatty acids, which are beneficial for heart health. Look for seafood options that are lower in methylmercury, such as salmon, anchovies, and trout.

Dairy products like milk, cheese, and yogurt are rich in protein, calcium, and other essential nutrients. Greek yogurt is a great option, as it is high in protein as well as nutrients such as calcium, vitamins, and minerals. Dairy products can be high in saturated fat, so choose low-fat dairy options and limit the amount of cheese you eat.

Beans, peas, and lentils include kidney beans, pinto beans, white beans, black beans, lima beans, fava beans, soybeans, chickpeas, black-eyed peas, pigeon peas, split peas, lentils, and edamame. These plant-based foods are excellent sources of protein as well as fiber, folate, potassium, iron, and zinc.

Nuts and seeds include almonds, hazelnuts, walnuts, peanuts, chia seeds, pumpkin seeds, sunflower seeds, and peanut butter. They are not only rich in protein but also provide healthy fats, vitamins, and minerals. Nuts are high in fat and calories, so be mindful of portion sizes.

Eggs contain all of the essential amino acids, making them a complete protein source. Eggs are also a source of vitamins, minerals, healthy fats, and antioxidants.

Quinoa is a plant-based protein source that is also a complete protein. A cup of cooked quinoa provides about 8 grams of protein and 5 grams of fiber. Quinoa is also a good source of minerals such as manganese, phosphorus, and copper.

Soy products such as tofu and tempeh are good sources of protein, especially for vegetarians and vegans. One-quarter cup of tofu provides seven grams of protein.

How much protein should you eat daily?

For the average adult, the Recommended Dietary Allowance (RDA) for protein or the amount you need to meet your basic nutritional requirements and not get sick, is 0.8 grams of protein per kilogram of body weight, or 0.36 grams per pound. For a person who weighs 75 kg (165 pounds), that comes to 60 grams of protein per day.

To determine your target daily protein intake, you can multiply your weight in pounds by 0.36, or use this online calculator.

It’s important to keep in mind that your daily protein need is not a fixed number. For example, your protein needs will fluctuate depending on your level of physical activity, and whether you are pregnant or breastfeeding.

Should I get my protein from animal or plant sources?

In order to get enough dietary protein in the most healthful way, nutritional guidelines have shifted away from specific amounts of daily protein, and toward the importance of eating healthier, protein-rich foods.

It’s important to think about the protein “package” when making protein choices because food containing protein also includes fats, carbohydrates, vitamins, minerals, sugar, sodium, additives, and other components.

While meat provides high-quality protein, some meats also provide unhealthy amounts of saturated fats and sodium. If you eat meat, it’s important to choose leaner meats and poultry. According to the United States Department of Agriculture (USDA), meats that are high in saturated fat include:

• fatty cuts of beef, pork, and lamb
• ground beef (75% to 85% lean)
• processed meats such as bologna, salami, sausages, hot dogs, bacon
• some poultry, such as duck.

A high-protein diet that is predominantly made up of red meat or processed meat is a cause for concern. Research has consistently found that both unprocessed and processed red meat are linked to higher risks of cardiovascular disease and diabetes. One meta-analysis found that replacing red meat with healthy plant proteins decreased the risk of cardiovascular disease.

For optimal health and nutrition, you should emphasize plant-based protein and protein from a variety of sources. The Mediterranean style of eating is one approach that emphasizes healthy protein sources.

Benefits of a higher protein diet

While most Americans consume more than enough protein, some people may benefit from a higher intake of protein.

To maintain or gain muscle mass

If you are over age 50, you should increase protein intake to one gram per kilogram of your body weight just to maintain muscle mass, which declines with age.

If you’re trying to gain muscle mass, a higher-protein diet can help support muscle repair and growth. When you exercise, muscle cells break down. Protein from food helps to repair the damage, ultimately strengthening muscles.

To lose weight

The value of high-protein diets for weight loss remains controversial. However, one meta-analysis found that a high-protein diet could lead to weight loss and prevent weight regain after weight loss. The authors note the need for future studies that follow patients for longer than one year for more insight into this issue.

Other benefits

One study found that eating plant-based protein was associated with lower odds of developing cognitive decline later in life. For every 5% of calories that came from plant protein instead of carbohydrates, researchers observed a 26% lower risk for developing dementia in study participants.

How much protein is too much?

The idea of an upper limit of protein intake is controversial. Some experts believe the recommended amounts are too low. Others believe we are overconsuming protein.

In general, the average person (not a body builder or an elite athlete) does not need high levels of protein and should not exceed 2 grams per kilogram; or about 125 grams per day for a 140-pound person.

A main concern with taking in too much protein is an overall dietary imbalance. Consuming excessive protein may lead to inadequate intake of carbohydrates and fats. It’s important to maintain a well-rounded diet that includes a balance of all three macronutrients for overall health.

In addition, if you increase your protein intake without increasing physical activity, you may be taking in too many calories without expending enough, which could result in weight gain.

There is also some evidence that eating a relatively high-protein diet can be problematic for individuals with pre-existing kidney conditions. A diet high in animal protein may pose a higher risk of kidney stones.