• Posted October 3, 2025

Free School Meals Linked To Less High Blood Pressure Among Children

Universal free meal programs appear to improve kids’ heart health, a new study says.

The proportion of students with high blood pressure fell by nearly 11% over five years among schools that signed up for free meal programs, researchers recently reported in JAMA Network Open.

The better nutrition kids get from these free meals at school likely helped drive this improvement, along with healthy eating’s subsequent effects on children’s body weight, researchers said.

“Adoption of free meals is associated with decreases in average body mass index [BMI] scores and childhood obesity prevalence, which are closely linked to risk of high blood pressure,” said senior researcher Jessica Jones-Smith, a professor of health, society and behavior at the University of California Irvine’s Joe C. Wen School of Population & Public Health.

“So in addition to directly affecting blood pressure through provision of healthier meals, a second pathway by which providing universal free meals might impact blood pressure is through their impact on lowering risk for high BMI,” she said in a news release.

BMI is an estimate of body fat based on height and weight.

Unfortunately, cuts to food assistance programs are threatening this access to free school meals, researchers noted.

“We’re in a contentious time for public health, but it seems like there’s bipartisan support for healthy school meals,” said lead investigator Anna Localio, a postdoctoral research fellow in health systems and population health at the University of Washington in Seattle.

“There’s legislation being considered in a number of states to expand universal free meals, and these findings could inform that decision-making,” Localio said in the news release. “Cutting funding to school meals would not promote children’s health.”

High blood pressure in childhood is likely to carry on into adulthood, increasing a person’s risk for heart and kidney disease, researchers said in background notes.

The study focused on the Community Eligibility Provision (CEP), a 10-year-old federal program that enables universal free meal programs for schools in low-income communities.

The 2010 law that established the CEP also created stronger nutritional requirements for school meals, such that they now resemble the heart-health DASH diet promoted by the American Heart Association, researchers noted.

For the study, researchers obtained medical records for nearly 156,000 kids 4 to 18 and used their addresses to identify which of 1,052 schools they attended. Most were located in California and Oregon.

The team estimated the percentage of students with high blood pressure before and after schools opted into universal free meals, and compared those results against eligible schools not participating in the program.

Results showed that school participation in the CEP was tied to a nearly 3% decrease in the proportion of students with high blood pressure, corresponding to an almost 11% net drop over five years.

The study contradicts the common misperception that universally free school meals only help students from relatively higher-income families because poorer students would already receive free meals, researchers said. 

The kids included in the study mainly were in low-income households, with 85% covered by public insurance programs like Medicaid.

“Our findings suggest that there are benefits for lower-income children as well,” Jones-Smith said. “Potential mechanisms for this include decreasing the income-related stigma around eating school lunch by providing it free to all students and eliminating the time and paperwork burden of individually applying, thus decreasing barriers to participation in school meals.”

Schools are eligible to participate in the CEP if at least 25% of students are eligible for free meals through participation in means-tested safety net programs, researchers noted.

That means recent cuts to the Supplemental Nutrition Assistance Program (SNAP), the nation’s largest food assistance program, could affect schools’ access to CEP funding, researchers said.

More information

The Cleveland Clinic has more on high blood pressure in children.

SOURCES: University of Washington, news release, Sept. 29, 2025; JAMA Network Open, Sept. 25, 2025