Attention, parents! More than one in three middle school students who regularly eat school lunches are obese or overweight. They’re also more likely to have high LDL “bad” cholesterol levels than kids who bring lunch from home. The research suggests that efforts to provide healthier choices on school lunch menus still have a long way to go, says Elizabeth Jackson, MD, MPH, assistant professor of internal medicine at the University of Michigan Health System in Ann Arbor. “The school environment is an excellent opportunity we should not be missing to teach kids to make healthy choices, both in terms of food and exercise,” she tells WebMD.

That’s particularly important in middle school, as that’s when children start to become more independent, Jackson says. The choices they make then will shape their eating and exercise habits as they get older, she says.

The study involved 1,076 middle school students who filled out questionnaires asking what they ate, how much physical activity they got, and the number of hours they watched TV, played video games, and spent on the computer each day.

Then they were divided into three groups, depending on whether they said they “always” or “almost always” ate school lunches, “always” or “almost always” brought their midday meal from home, or sometimes did one and sometimes the other.

The findings were presented at the annual meeting of the American College of Cardiology.

School Lunch vs. Lunch From Home

Compared with kids who brought lunch from home, those who ate school lunches:

• Were more likely to be overweight or obese (38.2% vs. 24.7%)
• Were more likely to eat two or more servings of fatty meats like fried chicken or hot dogs daily (6.2% vs. 1.6%)
• Were more likely to have two or more sugary drinks a day (19% vs. 6.8%)
• Were less likely to eat at least two servings of fruits a day (32.6% vs. 49.4%)
• Were less likely to eat at least two servings of vegetables a day (39.9% vs. 50.3%)
• Had higher levels of LDL “bad” cholesterol

The school-lunch kids also were less likely to participate in active sports like basketball, moderate exercise like walking, or team sports than their home-fed counterparts. And they spent more time watching TV, playing video games, and using computers outside of school.

“One-third of kids in the U.S. are now overweight or obese, which means one-third of kids are at risk of heart disease and diabetes as they age. That scares me,” Jackson says.

“If we don’t do something now, the recent trend toward fewer deaths due to heart disease among U.S. adults is in jeopardy of reversing, she says.