Universal School Lunch: A Recipe for Lower Blood Pressure

Every day, millions of kids line up for school lunch. But even in the same cafeteria, not every child has the same access to nutritious food. Universal free lunch programs eliminate that divide by making meals free for all students, and research suggests the benefits go beyond full stomachs and better focus. They also lower children’s blood pressure.

Around 11% of children in the United States have high blood pressure, the main drivers of which are obesity, inactivity, and poor diet. Many low-income, Black, and Hispanic children are at particularly high risk because poverty and structural racism shape the environment in which children live, learn, and eat. Since risk factors accumulate over time, high blood pressure in childhood can set the stage for heart and kidney disease later in life.

To counteract these risks, doctors suggest a diet low in sodium and saturated fats, and rich in fruits, vegetables, and low-fat dairy. In schools, the recommendations have been put into action through the U.S. Food and Drug Administration’s (FDA) National School Lunch and School Breakfast programs. Over the past decade, these programs have improved nutrition standards so meals are in line with doctors’ recommendations.

A free lunch may be one of the simplest and smartest investments we as a nation can make in our children’s future.

Traditionally, the school lunch and breakfast programs have been available only to families with incomes below a certain level. This is based on the assumption that people who make less than the threshold can’t afford food, but many families whose income is considered sufficient still struggle to afford food. And for eligible families, shame may prevent them from participating. As a result, many children who could benefit from free meals are left out. However, in 2014, the FDA introduced the Community Eligibility Provision. This program provides funding for schools with a high percentage of low-income students to serve free breakfast and lunch to every child, shifting school meals from a targeted benefit to a universal one.

To examine how universal free meal policies affect children’s heart health, Anna Localio and colleagues collected electronic health records from 156,000 children and adolescents, aged 4-18. They then linked the health records with the schools children attended. Their dataset included students from 1,025 schools (primarily located in California and Oregon) between 2013 and 2019. Researchers then compared the change in blood pressure among students at schools that adopted universal school lunch with those at schools that did not.

Over five years, schools that provided meals to everyone saw an 11% drop in students with high blood pressure. The decline was most pronounced among elementary school students, who are most likely to participate in school meal programs. Schools that joined the Community Eligibility Provision program earlier in the study saw the largest change, suggesting that access to healthy food over a longer period of time makes the biggest difference.

But these benefits currently hang in limbo. The One Big Beautiful Bill Act includes new restrictions on eligibility for the Supplemental Nutrition Assistance Program (SNAP). When the bill goes into effect in 2027, children who lose SNAP benefits will also lose access to free school meals. This, in turn, limits the number of schools that qualify for the Community Eligibility Provision.

Access to universal school meals is associated with lower blood pressure. Rolling back eligibility for these programs risks reversing those gains—particularly for the millions of families who fall through the cracks of other benefit programs. Many children who don’t qualify for the School Breakfast and Lunch programs would still benefit from receiving food at school.

In 2023, 18% of households with children did not have consistent access to enough food. Universal school meal programs ensure that all children can eat two meals per day. They also ease family food budgets, helping entire households become more food secure. A free lunch may be one of the simplest and smartest investments we as a nation can make in our children’s future.