Advertisement

Availability of More-Healthy and Less-Healthy Food Choices in American Schools

A National Study of Grade, Racial/Ethnic, and Socioeconomic Differences

      Background

      The purposes of this study are to examine the extent to which (1) more-healthy and less-healthy food choices are available to American secondary students in their schools, and (2) there are differences in the availability of such foods as a function of grade, racial/ethnic background, and socioeconomic status (SES).

      Methods

      United States nationally representative samples of over 37,000 students in 345 secondary schools were surveyed in 2004 and 2005 as part of the Youth, Education, and Society (YES) study and the Monitoring the Future (MTF) study. In the YES study, school administrators and food service managers completed self-administered questionnaires on food policies and food offerings in their schools. In the MTF study, students in the same schools completed self-administered questionnaires. Data were analyzed in 2006.

      Results

      A greater percent of high school students have access to both more-healthy and less-healthy food choices than middle school students. Compared to white students, fewer black students have access to certain healthy foods (lowfat salty snacks, lowfat cookies and pastries). Hispanic high school students have greater access to regular ice cream and to fruits and vegetables. Otherwise the racial/ethnic group differences are modest. However, there is a positive linear association between SES (as indicated by parental education) and (1) access to most types of healthier snacks from vending machines, school/student stores, or snack bars/carts and (2) the number of healthier foods offered à la carte in the cafeteria. The association between SES and access to less-healthy snacks varies more by item.

      Conclusions

      Indisputably, less-healthy foods are more available than more-healthy foods in the nation’s schools. At a time when food and beverage offerings are under intense policy scrutiny, this study provides a comprehensive assessment of the types of foods made available to students. While it is encouraging to see schools offering healthy food alternatives, such as lowfat snacks and fruits and vegetables, the findings strongly suggest that the availability of more-healthy snacks needs to be increased, particularly for racial/ethnic minorities and youth of lower SES. Simultaneously, schools could considerably decrease the availability of less-healthy snack choices available to students. Future monitoring is needed to evaluate the effectiveness of the food industry’s recent agreement to play a role in helping to solve these problems.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • U.S. Department of Agriculture
        Food and nutrition service.
        USDA, Washington DC2005 (Available online at: http://www.fns.usda.gov/cnd/.)
        • General Accounting Office
        School meals programs: competitive foods are available in many schools; actions taken to restrict them differ by state and locality.
        (GAO-04-673) General Accounting Office, Washington DC2004 (Available online at: http://www.gao.gov/new.items/d04673.pdf.)
        • Molnar A.
        School commercialism hurts all children, ethnic minority group children most of all.
        J Negro Educ. 2003; 72: 371-378
        • General Accounting Office
        School lunch program: efforts needed to improve nutrition and encourage healthy eating.
        (GAO-03-506) General Accounting Office, Washington DC2003 (Available online at: http://www.gao.gov/new.items/d03506.pdf.)
        • Story M.
        • Hayes M.
        • Kalina B.
        Availability of foods in high schools: is there cause for concern?.
        J Am Diet Assoc. 1996; 96: 123-126
        • Wechsler H.
        • Brener N.D.
        • Kuester S.
        • Miller C.
        Food service and foods and beverages available at school: results from the School Health Policies and Programs Study 2000.
        J Sch Health. 2001; 71: 313-324
        • U.S. Department of Agriculture
        School Nutrition Dietary Assessment Study II.
        USDA, Washington DC2001 (Available online at: http://www.fns.usda.gov/oane/MENU/Published/CNP/FILES/SNDAIIfindsum.htm.)
        • U.S. Department of Agriculture
        The School Meals Initiative Implementation Study: Third Year Report.
        USDA, Washington DC2002 (Available online at: http://www.fns.usda.gov/oane/MENU/Published/CNP/FILES/SMIYear3.htm.)
        • Delva J.
        • O’Malley P.M.
        • Johnston L.D.
        Racial/ethnic and socioeconomic status differences in overweight and health-related behaviors among American students: national trends 1986–2003.
        J Adolesc Health. 2006; 39: 536-545
        • Johnston L.D.
        • O’Malley P.M.
        Obesity among American adolescents: tracking the problem and searching for causes.
        Institute for Social Research, Ann Arbor MI2003 (Available online at: http://www.yesresearch.org.)
        • Jolliffe D.
        Extent of overweight among U.S. children and adolescents from 1971 to 2000.
        Int J Obes. 2003; 28: 4-9
        • Kimm S.Y.
        • Obarzanek E.
        Childhood obesity: a new pandemic of the new millennium.
        Pediatrics. 2002; 110: 1003-1007
        • Ogden C.L.
        • Flegal K.M.
        • Carroll M.D.
        • Johnson C.L.
        Prevalence and trends in overweight among U.S. children and adolescents, 1999–2000.
        JAMA. 2002; 288: 1728-1732
        • Burgeson C.R.
        • Wechsler H.
        • Brener N.D.
        • Young J.C.
        • Spain C.G.
        Physical education and activity: results from the School Health Policies and Programs Study 2000.
        J Sch Health. 2001; 71: 294-304
        • Hoelscher D.M.
        • Day R.S.
        • Lee E.S.
        • et al.
        Measuring the prevalence of overweight in Texas schoolchildren.
        Am J Public Health. 2004; 94: 1002-1008
        • Nelson J.A.
        • Chiasson M.A.
        • Ford V.
        Childhood overweight in a New York City WIC population.
        Am J Public Health. 2004; 94: 458-462
        • Wang Y.
        Cross-national comparison of childhood obesity: the epidemic and the relationship between obesity and socioeconomic status.
        Int J Epidemiol. 2001; 30: 1129-1137
        • Johnston L.D.
        • O’Malley P.M.
        • Bachman J.G.
        • Schulenberg J.E.
        Monitoring the Future national survey results on drug use, 1975–2004.
        (NIH Pub. No. 05-5727) National Institute on Drug Abuse, Bethesda MD2005
        • Kish I.
        Survey sampling.
        John Wiley & Sons, Inc, New York1965
        • U.S. Department of Agriculture
        Menu planner for healthy school meals.
        USDA, Washington DC2005 (Available online at: http://schoolmeals.nal.usda.gov/Recipes/menuplan/menuplan.html.)
        • U.S. Department of Agriculture
        Team Nutrition.
        USDA, Washington DC2005 (Available online at: http://www.fns.usda.gov/tn/.)
        • O’Malley P.M.
        • Johnston L.D.
        • Delva J.
        • Bachman J.G.
        • Schulenberg J.E.
        Variation in obesity among American secondary school students by school and school characteristics.
        Am J Prev Med. 2007; 33: 1
        • Institute of Medicine (IOM)
        Nutrition standards for foods in schools: Leading the way toward healthier youth.
        (Prepublication Copy) The National Academy Press, Washington DC2007
        • Fleischhacker S.
        Food fight: The battle over redefining competitive foods.
        J Sch Health. 2007; 77: 147-152