Put down the salt shaker

Sometimes, a small change can make an enormous difference.

When Broome County in upstate New York reduced the sodium content in school lunches by 300 mg a day, the effort cut a ton of salt out of kids' diets in a two-year period. Yep, a ton (or 2,381 pounds of salt, presenter Yvonne Johnston of New York's Binghamton University said during yesterday’s “Sodium in School Meals and the Local Food Environment” session).

Grant money and California’s year-round availability of fresh produce helped lead the sodium-reduction effort at the Los Angeles Unified School District, which serves more than 650,000 meals a day at more than 800 sites. And 80 percent of students qualify for free or reduced-price lunch, said Patricia Cummings of the Los Angeles County Department of Public Health's Division of Chronic Disease and Injury Prevention.

That school district has traditionally been on the forefront of healthy changes and has been working to adopt the Institute of Medicine’s recommendations on school meals. A preliminary evaluation of the sodium reduction piece found levels dropped in half for school breakfasts, from a whopping 1,064 mg in middle and high schools to 502 mg.

What helped? The school district’s food service team and board of education championed the policy and menu change, Cummings said. They also benefited from national momentum, including Centers for Disease Control and Prevention funding (such as a Community Transformation Grant) and Michelle Obama’s Let’s Move! campaign. Something she strongly recommended for others undertaking sodium reduction: taste testing for parents and kids. The school district served more than 30,000 meals as part of its taste testing, which was “really informative in finding out what the students liked and what they didn’t like.”

That’s not to say such change was or will be easy, both Cummings and Johnston said. For one, cost is a problem. Broome County found the popular grilled cheese and tomato soup offering was 53 percent more expensive in its reduced-sodium version.

“We have this challenge of looking at all the nutrients and micro-nutrients essential to health and putting it on a plate with little cents signs and figuring out the cost,” Johnston said. But connecting local growers with schools to improve the supply of local fruits and vegetables is a start.

Los Angeles County, when replacing high-sodium pepperoni pizza with choices like hummus and quinoa, found some kids really miss their pizza. Both school districts are looking for the right recipe for a lower-sodium pizza with whole grain crust. One idea: add garbanzo bean flour to the crust for a fiber and protein boost.

Like many public health movements, though, the effort to improve nutrition in school meals is one that demands all our support.

“This work at the local level is actually starting to create a demand (for lower-sodium foods)," Cummings said. “I think it’s this whole momentum nationwide and at the local level that’s really going to make a difference in lowering sodium.”

— D.C.