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How can parents make their children's school lunches healthier? And what steps can parents take to ensure lunch food is safe, especially during the warmer months?

Many Americans are overweight, which can increase the risk of many diseases and health conditions, including hypertension, type 2 diabetes, and some cancers. Two National Health and Nutrition Examination Surveys from 1980-2004 show the number of overweight children in the U.S. ages 2 to 5 years increased from 5 percent to 14 percent; overweight kids ages 6 to 11 years increased from 7 percent to 19 percent; and overweight adolescents ages 12 to 19 years increased from 5 percent to 17 percent.

What can you do to buck this trend? Provide healthier foods at home and educate your children on better nutritional choices. Hopefully, your child will remember your sound advice when standing in the cafeteria lunch line. And many schools have instituted healthy guidelines for their cafeterias.

Here are some creative ideas for making the school lunches you pack healthier:

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  Include fruits and vegetables. It's likely that many kids are not eating the recommended servings per day (3½ cups for girls ages 9 to 13 and 4 cups for boys ages 9 to 13), so be sure to include these food groups at lunch
  
  
• • Toss in carrots and celery sticks and a low-fat dressing or dip to encourage eating them. Too time consuming to cut veggies? Buy a vegetable tray or veggie snack pack from the supermarket. These prepackaged veggies are convenient and may come with a low-fat dressing or dip.
    
    
  • Add darker-colored leafy lettuce, such as red or green leaf (not iceberg) to sandwiches.
    
    
  • Offer cherries, grapes, pineapple chunks, or other smaller fruit as a welcome change to apples and oranges.
    
    
  • Provide variety with a mix of dried fruit (such as apricots, banana chips, cranberries, mangoes, and raisins) with nuts. Nuts can also contribute vitamin E and omega 3s.
    
    
  • Add fruit (such as apples, bananas, and blueberries) or vegetables (such as carrots, zucchini, and other squashes) in muffins. Depending on the recipe, kids might not even notice the veggies.
    
    
• Avoid luncheon meats with lots of fat and sodium. Bologna and salami are two lunch meats that have quite a bit of fat. Many deli meats and prepackaged luncheon meats come in lower fat, lean, and lower-sodium versions.
  
  
• Incorporate leftovers. Instead of the same old luncheon meats or peanut butter and jelly, try packing a lunch with leftover pasta, soup, or chili. As a change, try whole-wheat pasta, barley soup, or vegetarian chili to give your child more whole grains and beans. Add vegetables to whole-wheat pasta to get more of this important food group.
  
  
• Try alternatives to white bread. Make sandwiches interesting with a variety of breads, pitas, or crackers, especially those with whole grain. This will help to achieve the 3 ounces of whole grains per day recommended by the U.S. Department of Agriculture. Also, low- or no-sodium and lower-fat crackers are healthier choices. Or make mini-wrap sandwiches using 4-inch whole-wheat tortillas or try flavored ones like spinach or red pepper.
  
  
• Pack milk or water, not juice or soda. It is best to limit juice and soda since they can be high in sugar and/or caffeine. Opt instead for low-fat milk, which is a good source of calcium, or water. But if your child only drinks juice, look for 100 percent juice or a fruit-and-veggie juice that kids actually might try. This is another way to help get those five servings a day of fruits and vegetables.
  
  
• Include portion-controlled snacks. These are OK on occasion, especially if the portion size is controlled (such as 100-calorie snack packs) and they are baked or whole grain. Other smart snacks are unsalted pretzels, applesauce (no added sugar), low-fat yogurt, unbuttered and unsalted popcorn, apple slices with peanut butter, graham crackers, gingersnap cookies, low- or reduced-fat string cheese, baked, whole-grain tortilla chips with salsa, and whole-grain cereal (not the sugary kind).
  
  Since September and October can be warm months, it is important to keep lunches safe from pathogens that can cause food-borne illness. Here are some tips on packing a safer lunch:
  
  
• • Make sure to wash your hands before preparing lunches, and remind kids to wash their hands before they eat. In case they forget, toss in some moist towelettes for hand cleaning.
    
    
  • Keep hot foods hot and cold foods cold. Always include a cold pack for foods that need refrigeration and those lunches that contain perishable ingredients, such as mayonnaise. If foods and drinks can be frozen, they will provide some extra protection and will thaw in the lunch box. An insulated, tightly sealed container, such as a Thermos, should be used for hot foods.
    
    
  • When packing perishables, choose an insulated lunch box or bag rather than paper. Paper bags might not maintain the temperature of the foods as well as the insulated kind. For tips on choosing a safe lunch bag, see Lunch boxes for back to school.
    
    
  • Tell your kids not to store their lunches in warm spots (near the classroom window or near the radiator during the colder months). Inquire whether the school has a refrigerator for students to store their lunch.
    
    
  • Pack foods that have a longer shelf life without refrigeration, such as bread, granola bars, trail mix, popcorn, baked chips, raw vegetables (such as carrots and celery), fresh or dried fruit, soy beverages (and other aseptically packaged drinks such as milk or juice boxes and bags), beef jerky, peanut butter, or nuts.
    
    
  • Wash and thoroughly dry insulated lunch boxes daily. This could help keep germs in check.
    
    
  • Remind kids to discard perishable leftovers such as meat, poultry, egg sandwiches, fresh-cut fruits and vegetables.