National School Lunch Program Participation and Sex Differences in Body Mass Index Trajectories of Children From Low-Income Families

Hernandez, Daphne C.; Francis, Lori A.; Doyle, Emily A.

doi:10.1001/archpediatrics.2010.253

Cited by 19 publications

(21 citation statements)

References 48 publications

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“…Similar to previous studies of school food influences on FVI (Hastert and Babey, 2009; Hernandez et al, 2011; Taber et al, 2013), we did not specifically measure which foods adolescents ate at school, and thus cannot directly ascertain the independent impact of meals offered through the National School Meal programs, a la carte menus, or other school food options, such as snack bars or vending machines. This limits our ability to determine which characteristics of school food environments contributed to the observed effects, and highlights an area for future study.…”

Section: Discussionmentioning

confidence: 99%

School food reduces household income disparities in adolescents' frequency of fruit and vegetable intake

Longacre

Drake

Titus

et al. 2014

Preventive Medicine

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Objective To examine whether school food attenuates household income-related disparities in adolescents’ frequency of fruit and vegetable intake (FVI). Method Telephone surveys were conducted between 2007–2008 with adolescent-parent dyads from Northern New England; participants were randomly assigned to be surveyed at different times throughout the year. The main analysis comprised 1,542 adolescents who typically obtained breakfast/lunch at school at least once/week. FVI was measured using 7-day recall of the number of times adolescents consumed fruits and vegetables. Fully adjusted linear regression was used to compare FVI among adolescents who were surveyed while school was in session (currently exposed to school food) to those who were surveyed when school was not in session (currently unexposed to school food). Results Mean FVI was 8.0 (SD=5.9) times/week. Among adolescents unexposed to school food, household income and FVI were strongly, positively associated. In contrast, among adolescents exposed to school food, FVI was similar across all income categories. We found a significant cross-over interaction between school food and household income in which consuming food at school was associated with higher FVI among adolescents from low-income households versus lower FVI among adolescents from high-income households. Conclusion School food may mitigate income disparities in adolescent FVI. The findings suggest that the school food environment positively influences FVI among low-income adolescents.

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Section: Discussionmentioning

confidence: 99%

School food reduces household income disparities in adolescents' frequency of fruit and vegetable intake

Longacre

Drake

Titus

et al. 2014

Preventive Medicine

View full text Add to dashboard Cite

show abstract

“…2-6 Some studies also suggested that students’ participation in the NSLP was positively associated with weight gain or risk of obesity. 7-10 The association between NSLP participation and obesity is likely due to selection bias 11-13 because the NSLP is inherently designed to benefit low-income children, who are at a higher risk of becoming obese. 14 Nonetheless, the NSLP may be a missed opportunity to improve participants’ weight status and reduce the health consequences of obesity.…”

mentioning

confidence: 99%

Association Between State Laws Governing School Meal Nutrition Content and Student Weight Status

Taber

Chriqui²,

Powell³

et al. 2013

JAMA Pediatr

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Importance This study assessed whether stronger school meal nutrition standards may improve student weight status. Results have immediate implications because of the ongoing implementation of new nutrition standards for the National School Lunch Program. Objective To determine if state laws with stricter school meal nutrition standards are inversely associated with adolescent weight status, while controlling for unmeasured state-level confounders. Design Quasi-experiment. Setting Public schools. Participants Four thousand eight hundred seventy eighth-grade students in 40 states. Students were categorized by type of school lunch they usually obtained (free/reduced price, regular price, or none). Interventions State laws governing school meal nutrition standards. States with standards that exceeded US Department of Agriculture (USDA) school meal standards were compared with states that did not exceed USDA standards. The parameter of interest was the interaction between state laws and student lunch participant status, ie, whether disparities in weight status between school lunch participants and nonparticipants were smaller in states with stricter standards. Main Outcome Measures Body mass index percentile and obesity status. Results In states that exceeded USDA standards, the difference in obesity prevalence between students who obtained free/reduced-price lunches and students who did not obtain school lunches was 12.3 percentage points smaller (95% CI, −21.5 to −3.0) compared with states that did not exceed USDA standards. Likewise, differences in mean body mass index percentile between those student populations were 11 units smaller in states that exceeded USDA standards (95% CI, −17.7 to −4.3). There was little evidence that students compensated for school meal laws by purchasing more sweets, salty snacks, or sugar-sweetened beverages from other school venues (eg, vending machines) or other sources (eg, fast food). Conclusions and Relevance Stringent school meal standards that reflect the latest nutrition science may improve weight status among school lunch participants, particularly those eligible for free/reduced-price lunches.

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“…However, participation in the NSLP was related to increased perception of availability and selection in school. Previous studies have shown mixed associations between NSLP participation and dietary behaviors (Baxter et al, 2010; Briefel, Wilson, et al, 2009; Hernandez, Francis, & Doyle, 2011; Paxton et al, 2012; Schanzenbach, 2009). Our research suggests that participation in the NSLP appears to improve teens' perceptions of their school's food environment, but high needs families may need education on availability and selection of healthy foods at home.…”

Section: Discussionmentioning

confidence: 94%

Postpartum Teens’ Perception of the Food Environments at Home and School

et al. 2015

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Background An environment that supports healthy eating is one factor to prevent obesity. However, little is known about postpartum teen's perceptions of their home and school environments and how this relates to dietary behaviors. Purpose This study explores the relationship between home and school environments and dietary behaviors for postpartum teens. Design Conducted cross-sectionally during 2007-2009 across 27 states; included 889 postpartum teens enrolled in Parents as Teachers Teen Program. Data included measures of sociodemographics and perceptions of school and home food environments. A 7-day recall of snack and beverage frequency assessed dietary behaviors. Logistic regression explored associations between baseline environment measures and dietary behaviors at baseline and post-intervention (approximately 5 months after baseline) for the control group. Results Respondents reported greater access and selection (i.e., variety of choices) of healthy foods and beverages at home than school. At baseline, fruit and vegetable intake was associated with home selection (1.9, 95% CI: 1.3-2.9) and availability (1.8, 95% CI: 1.3-2.6), sweet snack consumption was associated with selection (1.5, 95% CI: 1.0-2.1), and total snack consumption and sugar-sweetened beverage intake were associated with selection (snack: 2.1, 95% CI: 1.5-3.0; beverage: 1.7, 95% CI: 1.2-2.4) and availability (snack: 2.1, 95% CI: 1.4-3.1; beverage: 1.5, 95% CI: 1.0-2.3). Water intake at baseline and at the post-intervention for control group teens was associated with selection (1.6, 95% CI: 1.1-2.2). No significant associations were identified between the school environment and dietary behaviors. Conclusions Interventions should target improvements in the home environment for high risk, postpartum teens.

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National School Lunch Program Participation and Sex Differences in Body Mass Index Trajectories of Children From Low-Income Families

Cited by 19 publications

References 48 publications

School food reduces household income disparities in adolescents' frequency of fruit and vegetable intake

School food reduces household income disparities in adolescents' frequency of fruit and vegetable intake

Association Between State Laws Governing School Meal Nutrition Content and Student Weight Status

Postpartum Teens’ Perception of the Food Environments at Home and School

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