PRACTICE APPLICATIONS
USDA Center for Nutrition Policy and Promotion Corner
Summer Meal Programs Provide an Opportunity
for Nutrition Education and Physical Activity
F
OR 20 YEARS, THE US DEPART-
ment of Agriculture’s Team
Nutrition initiative has sup-
ported the Child Nutrition Pro-
grams by providing training and
technical assistance resources for
foodservice, nutrition education for
children and their caregivers, and tools
to build school and community support
for healthy eating and physical activity.
Team Nutrition collaborates with the
Department’s Center for Nutrition Pol-
icy and Promotion to communicate key
consumer messages of the Dietary
Guidelines for Americans and MyPlate.
Under the Team Nutrition initiative,
evidenced-based curricula, parent ma-
terials, posters, eBooks, and more
have been made available to schools,
child care centers, and homes to sup-
port implementation of meal pattern
requirements for the National School
Lunch Program, School Breakfast Pro-
gram, and the Child and Adult Care
Food Program.
On March 31, 2016, the US Depart-
ment of Agriculture released its first
Team Nutrition resources designed
specifically for the Summer Food Ser-
vice Program and Seamless Summer
Option of the National School Lunch
Program (Summer Meal Programs). The
Summer Meal Programs provide free,
nutritious meals and snacks to help
children in low-income areas get the
nutrition they need to learn, play, and
grow throughout the summer months
when they are out of school. In 2015,
This article was written on behalf of
the USDA’s Team Nutrition by Alicie
Hogbin White, MS, RD, chief, Nutrition
Education and Promotion, Child
Nutrition Programs at the US Depart-
ment of Agriculture’s Food and Nutri-
tion Service in Alexandria, VA, and
Maya Edmonds Maroto, EdD, MPH,
RD, nutritionist at the US Department
of Agriculture’s Food and Nutrition
Service in Alexandria, VA.
http://dx.doi.org/10.1016/j.jand.2016.04.003
ª 2016 by the Academy of Nutrition and Dietetics.


the Summer Meal Programs provided Choose water instead of sugar-
meals at over 45,000 sites during the sweetened beverages.
program’s peak month of July, with a
Choose more fruits and vegeta-
total summer participation of approxi- bles at meals and snacks.
mately 3.8 million children. Many sum-
These behaviors are consistent with
mer meal sites also offer activities, such
those identified by Sliwa and col-
as educational activities, supervised
leagues4 as ways out-of-school time
free play, organized games or sports, and
settings can help prevent childhood
arts and crafts.1 As such, summer meal
obesity. The 2015-2020 Dietary Guide-
sites present an opportunity to educate
lines for Americans5 also indicate that
children about making healthful food
children consume too many added
choices and being physically active.
sugars and too few fruits and vegeta-
Offering healthy meals, nutrition
bles. Beverages account for almost half
education, and physical activity op-
(47%) of all added sugars consumed by
portunities at summer meal sites may
the US population. The Dietary Guide-
help mitigate seasonal differences in
lines identifies choosing beverages
weight gain. A review of literature by
with no added sugars, such as water, in
Baranowski and colleagues2 comparing
place of sugar-sweetened beverages as
school-year vs summertime changes in
an important strategy for reducing in-
child weight and physical activity
takes of added sugars. Low-fat or
found that that overweight and obese
nonfat milk or 100% fruit or vegetable
children tended to experience acceler-
juice also can be consumed within
ated weight gain during the summer,
recommended amounts in place of
while healthy-weight children gained
sugar-sweetened beverages.
less weight or no weight at all. Several
Vegetable consumption relative to
studies in the review also indicated
recommendations is lowest in the
that fitness improvements obtained
American population among boys ages 9
during the school year were lost during
to 13 years and girls ages 14 to 18 years. As
the summer. Other research has found
many fruits and vegetables are harvested
that children consume more sugar-
during the summer months, Summer
sweetened beverages, eat fewer vege-
Meal Programs provide an opportunity to
tables, and watch more television in
incorporate locally produced fruits and
the summer as compared to the school
vegetables and gardening activities into
year.3 While more research is needed
summer meal programming.
to understand these seasonal differ-
ences, helping children make healthy
food choices and be physically active is
important to helping children stay
DEVELOPMENT OF NUTRITION
healthy all year long. EDUCATION MATERIALS FOR
SUMMER MEALS
An audience-centered development
BEHAVIORAL OBJECTIVES FOR process was used to address the diversity
SUMMER NUTRITION of summer meal sites in terms of types of
EDUCATION settings, operating hours, number of
children participating, and the age range
Four key behaviors were identified as a
of children attending. Summer meal
focus for nutrition education efforts in
sites can serve children aged 18 years
summer meal settings:
and under and are located in a variety of

Get at least 60 minutes of phys- settings, including schools, parks, li-
ical activity each day. braries, community centers, churches,

Limit screen time to no more and migrant centers. Materials devel-
than 1 to 2 hours per day. oped include:
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS 905
PRACTICE APPLICATIONS

Figure. Take a Healthy Summer Break! infographic to increase awareness among families and community organizations of the
importance of healthy food choices and physical activity during the summer.

906 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS June 2016 Volume 116 Number 6


Summer Food, Summer Moves—
A step-by-step kit to help sum-
mer meal site operators use
creative themes, entertaining
games, and educational activities
to teach children and families
about nutrition and exercise.
The kit includes an operator’s
guide, educational posters, fam-
ily guides, an activity placement,
and promotional flyers. Available
at: http://www.fns.usda.gov/tn/
summer-food-summer-moves.

Take a Healthy Summer Break
Infographic—A dynamic social
media tool to share with parents/
caregivers and community part-
ners to highlight the importance
of healthy food choices and
physical activity during the sum-
mer (see the Figure). Available at:
http://www.fns.usda.gov/tn/take-
healthy-summer-break-infographic.

This Summer, Eat Smart to Play
Hard: A Parent’s Guide—A family-
friendly guide that provides
nutrition tips, an interactive
game, a recipe, and information
about summer meals. Available at:
http://www.fns.usda.gov/tn/summer-
eat-smart-play-hard-parents-guide.
FORMATIVE RESEARCH
Two types of formative research were
conducted to inform development of
the materials: (1) focus group testing of
materials with low-income parents;
and (2) field testing of the Summer
Food, Summer Moves kit at summer
meal sites.
Parent Focus Groups
Focus group interviews were conduct-
ed with low-income (185% of
poverty) parents (n¼53) of children
aged 5 to 17 years. A total of 10 groups
were held (5 in English and 5 in
Spanish) with parents and caregivers.
Overall, parents reported that chil-
dren consumed more foods and bev-
erages at home during the summer
compared to the school year. Several
parents reported that they had higher
grocery bills in the summer months.
Many parents also reported that their
children snack more, often on non-
nutrient dense foods, and engaged in
more screen time (ie, video games,
television, movies, computer time)
June 2016 Volume 116 Number 6
PRACTICE APPLICATIONS
during the summer compared to dur-
ing the school year.
Parents were asked to review a draft
of the Infographic and Parent Guide
to provide feedback on the clarity and
usefulness of the materials. When asked
to “grade” the materials on a scale from
“A” to “F”, more than 90% (n¼43 of 46)
of parents rated the Infographic and
Parent Guide as either an “A” or “B.”
Participants noted that they found in-
formation regarding screen time and
choosing water instead of sugar-
sweetened beverages to be particularly
captivating and useful. As a result of
parent feedback, changes were made
to simplify the interactive family chal-
lenge in the Parent Guide and the
recipe was replaced with one consid-
ered to be more familiar.
Summer Food, Summer Moves
Field Testing
A qualitative-quantitative research study
was designed with children aged 7 to
17 years and summer meal site opera-
tors. Study methodologies included
qualitative one-on-one interviews and
journals with site operators (n¼12),
and quantitative questionnaires, admin-
istered through one-on-one interviews,
with children (N¼115). Additional anal-
ysis included parent focus groups and
children’s taste test ballots. Site opera-
tors in three geographically diverse
areas conducted activities from the kit
during a 4- to 6-week period.
Children who participated in the pre-
and post-testing had statistically sig-
nificant gains in their knowledge of
the importance of choosing water over
sugar-sweetened beverages, identi-
fying the recommended amount of
physical activity that children need
each day, identifying sugar-sweetened
beverages, and naming the five
MyPlate food groups. Children were
significantly more confident in their
ability to choose fruits as snacks and
had a significant decrease in self-
reported soda consumption after
attending and participating in the
activities.
Overall, site operators enjoyed the
activities and believed they increased
site appeal for parents and children.
Some site operators felt uncomfortable
leading certain activities or games. As a
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
result, the kit was modified to include
tips for inviting older children to help
lead certain activities. Educational
posters and a MyPlate activity place-
mat were added to the kit as a result of
feedback from operators.
PRACTICE IMPLICATIONS
The Team Nutrition summer resources
are available for free through the Team
Nutrition website at http://teamnutrition.
usda.gov. Free printed materials will
be available this summer to sites
participating in the US Department of
Agriculture Child Nutrition Programs.
Registered dietitian nutritionists and
nutrition and dietetics interns can use
these materials to help encourage
families to adopt healthy eating and
physical activity behaviors during
the summer. Summer Meal Programs
offer an opportunity for incorporating
nutrition education and physical ac-
tivity programing along with a nutri-
tious meal. To learn more about
Summer Meal Programs, visit http://
www.fns.usda.gov/sfsp/summer-food-
service-program-sfsp.
References
1. Gordon A, Briefel R, Allshouse JE.
Feeding low-income children when school
is out—The Summer Food Service Program:
Executive summary. Washington, DC: Food
and Rural Economics Division, Economic
Research Service, US Department of Agri-
culture. Food Assistance and Nutrition
Research. Report No. 30. 2003. http://ers.
usda.gov/publications/fanrr-food-assistance-
nutrition-research-program/fanrr30.aspx.
Accessed November 10, 2015.
2. Baranowski T, O’Connor T, Johnston C, et al.
J. School year versus summer differences in
child weight gain: A narrative review. Child
Obes. 2014;10(1):18-24.
3. Wang Y, Vine S, Hsiao A, Rundle A,
Goldsmith J. Weight-related behaviors
when children are in school versus on
summer breaks: Does income matter? J Sch
Health. 2015;85(7):458-466.
4. Sliwa SA, Sharma S, Dietz WH, et al.
Healthy kids out of school: Using mixed
methods to develop principles for pro-
moting healthy eating and physical activity
in out-of-school settings in the United
States. Prev Chron Dis. 2014;11:140207.
http://dx.doi.org/10.5888/pcd11.140207.
Accessed January 11, 2015.
5. US Department of Health and Human Ser-
vices and US Department of Agriculture.
Dietary Guidelines for Americans 2015-2020.
8th Edition. December 2015. http://health.
gov/dietaryguidelines/2015/guidelines.
Accessed January 7, 2016.
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