Abstract| Volume 45, ISSUE 4, SUPPLEMENT , S8, July 2013

Making the New Sodium School Meal Standards Work in Your Community: Lessons Learned from the Field


      To share lessons learned about barriers and facilitators to sodium reduction in school meals.

      Target audience

      Public health practitioners, school administrators and nutrition personnel.

      Theory, Prior Research, Rationale

      The school environment can significantly influence children’s health because many children consume over half of their calories at school. Yet, sodium levels in school meals exceed recommendations. The Healthy, Hunger Free Kids Act requires reductions of 25-50%. Public health and school leaders expect implementation challenges caused by limited availability, accessibility, and cost of products; necessary modifications to practices and infrastructure; and preparing palatable substitutes.


      In 2010, CDC launched the Sodium Reduction in Communities Program to reduce sodium through systems and environmental changes. Health departments in 3 diverse US communities collaborated with local districts to utilize dynamic, multi-level, community based approaches to sodium reduction in school meals.


      Evaluators conducted 29 semi-structured interviews with program staff and partners to collect implementation strategies, and facilitators and barriers to use.

      Conclusions and Implications

      Cross-site thematic analysis identified common strategies: engaging decision makers and food service personnel in planning and implementation; conducting menu and recipe analyses; embedding sodium reduction language in broader messaging; and revising recipes. Prior relationships between health departments and districts and joint commitment to improving meals facilitated implementation. Barriers included difficulties with procurement administration, and perceptions of cost and palatability of substitute items. Effectively redesigning school menus to the updated standards for sodium can be a cost-effective and efficient way to minimize children’s risk of developing hypertension. These early findings can assist with institutionalizing the revised standards and minimizing pitfalls of the process.


      Centers for Disease Control and Prevention.