ArticleHealth affairs (Project Hope)2020
Impact Of The Healthy, Hunger-Free Kids Act On Obesity Trends.
Article in Health affairs (Project Hope), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 73 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
73 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Multilevel Nutrition Interventions for Obesity Prevention Among Children With Intellectual and Developmental Disabilities: A Systematic Review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026Pooled it
- The Child and Adult Care Food Program and young children's health: a systematic review.Nutrition reviews · 2023Pooled it
- Pooled it
- Pooled it
- Using Social Media to Increase Participation in Universal Free School Meal Programs: An RCT With Parents of Elementary-Aged Children.American journal of preventive medicine · 2026Trial
- Prevalence of Use of Mobile Food Delivery Services During School Hours in the United States: Survey Study.Journal of medical Internet research · 2026Article
- Disseminating and Implementing the Science of Pediatric Obesity Treatment and Prevention.Obesity (Silver Spring, Md.) · 2026Article
- Effect of Herbs and Spices on Acceptance, Preference, and Intake of Vegetables Among Rural Adolescents.Nutrition reviews · 2026Article
- A comparative analysis of primary school meal nutrition across the low- and high-poverty boroughs of Inner London.BMC nutrition · 2026Article
- School Meals as a Strategy to Prevent Childhood Obesity and Advance Food Equity: A Narrative Review.Current obesity reports · 2026Review
- Nutrition in Pediatric Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Journal of nutrition and metabolism · 2026Review
- Understanding multi-level policy implementation in the national school lunch and breakfast programs: a mixed-methods and agent-based modeling protocol.Implementation science communications · 2025Article
- Association of Financial Distress With Nonmedical Out-of-Pocket Expenses in Those With Critical Illness.Hospital pediatrics · 2025Article
- Using implementation mapping to optimize the impact of Universal School meals: a type III hybrid implementation-effectiveness study protocol.Implementation science communications · 2025Article
- School Provision of Universal Free Meals and Blood Pressure Outcomes Among Youths.JAMA network open · 2025Article
- Drinking Water Availability in Public Schools: An Assessment of Four New Jersey School Districts.International journal of environmental research and public health · 2025Article
- Healthy Food Service Guidelines for Worksites and Institutions: A Scoping Review.International journal of environmental research and public health · 2025Article
- Kidney consequences of obesity.Pediatric nephrology (Berlin, Germany) · 2025Review
- School-Provided Meals and the Prevention of Childhood Obesity: A Small part of a Very Important Story.Current obesity reports · 2025Review
- Understanding implementation determinants of universal school meals through an equity-driven mixed methods approach.Implementation science communications · 2025Article
13 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issuedErratum.2020
Authors and funding
6 authors.
Funding
Abstract
The Healthy, Hunger-Free Kids Act of 2010 strengthened nutrition standards for meals and beverages provided through the National School Lunch, Breakfast, and Smart Snacks Programs, affecting fifty million children daily at 99,000 schools. The legislation's impact on childhood obesity is unknown. We tested whether the legislation was associated with reductions in child obesity risk over time using an interrupted time series design for 2003-18 among 173,013 youth in the National Survey of Children's Health. We found no significant association between the legislation and childhood obesity trends overall. For children in poverty, however, the risk of obesity declined substantially each year after the act's implementation, translating to a 47 percent reduction in obesity prevalence in 2018 from what would have been expected without the legislation. These results suggest that the Healthy, Hunger-Free Kids Act's science-based nutritional standards should be maintained to support healthy growth, especially among children living in poverty.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.