initiatives, Congress directed the Centers for Disease Control and Prevention (CDC) to undertake a study with the Institute of Medicine (IOM) to make recommendations about nutrition standards for foods offered in competition with federally reimbursable meals and snacks. An ad hoc committee of the IOM was thus convened and charged to

• draw on literature regarding the availability, nutritional profile, and risks (including substitution) of school foods and beverages, including recent work by the Government Accountability Office, as appropriate;

• synthesize lessons learned from relevant research, development of federal nutrition standards for the National School Lunch and Breakfast Programs, and experience from the development of state- and local-based standards for foods and beverages offered outside federally reimbursable meals and snacks;

• consider whether a single set of nutrition standards is appropriate for elementary, middle, and high schools, or if more than one set is needed;

• develop nutrition standards based on nutritional science for foods and beverages, other than federally reimbursable meals and snacks, offered in school;

• consider how to ensure that foods and beverages offered in schools contribute to an overall healthful eating environment; and

• develop benchmarks to guide future evaluation studies of the application of the standards.

To initiate the study process, the committee developed a set of guiding principles to support the creation of a healthful eating environment for children in U.S. schools and to guide the deliberations and development of standards (Box S-1).

The committee also reviewed pertinent evidence, guided principally by the 2005 Dietary Guidelines for Americans (DGA). The DGA provides the most comprehensive science-based advice to promote health and reduce risk for major chronic diseases through diet and physical activity for the U.S. population two years of age and above. Although the scope of the DGA is quite broad, it does not cover all areas of importance to the committee’s work on nutrition standards for schools—for example, it lacks recommendations concerning caffeine and nonnutritive sweeteners. However, the DGA are diet-based recommendations, and competitive foods and beverages must be regarded individually. Thus standards were set for individual foods to increase the likelihood that students meet overall DGA recommendations.