A Vote for School Lunches: School Lunches Provide Superior Nutrient Quality than Lunches Obtained from Other Sources in a Nationally Representative Sample of US Children
Abstract
:1. Introduction
2. Materials and Methods
2.1. Dietary Intake
2.2. Statistical Analysis
3. Results
3.1. Dietary Intake by Age Group
3.2. Dietary Intake by Socioeconomic Status
3.3. Body Measures
4. Discussion
4.1. Quality of School-Provided Lunches Compared to Lunches Obtained Elsewhere by Age Group
4.2. Quality of School-Provided Lunches vs. Lunches Obtained Elsewhere by Socioeconomic Status
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- Ogden, C.L.; Carroll, M.D.; Fryar, C.D.; Flegal, K.M. Prevalence of Obesity Among Adults and Youth: United States, 2011–2014. NCHS Data Brief 2015, 219, 1–8. [Google Scholar]
- USDA Food and Nutrition Service (FNS). National School Lunch Program (NSLP). 2016. Available online: http://www.fns.usda.gov/nslp/national-school-lunch-program-nslp (accessed on 13 May 2017).
- Woo Baidal, J.A.; Taveras, E.M. Protecting progress against childhood obesity—The National School Lunch Program. N. Engl. J. Med. 2014, 371, 1862–1865. [Google Scholar] [CrossRef] [PubMed]
- USDA; Food and Nutrition Service. Nutrition Standards in the National School Lunch and School Breakfast Programs. Final Rule; USDA; Federal Registr: Washington, DC, USA, 2012; pp. 4088–4167.
- US Department of Health and Human Services; Centers for Disease Control and Prevention; National Center for Health Statistics. Healthy People 2010; U.S. Government Printing Office: Washington, DC, USA, 2013.
- US Department of Health and Human Services. Healthy People 2020. Available online: http://www.healthypeople.gov/2010/hp2020/default.asp (accessed on 3 November 2016).
- Condon, E.; Drilea, S.; Lichtenstein, C.; Mabli, J.; Madden, E.; Niland, K. Diet Quality of American School Children by National School Lunch Participation Status: Data from the National Health and Nutrition Examination Survey 2005–2010. 2015. Available online: http://www.fns.usda.gov/sites/default/files/ops/NHANES-NSLP05-10-Summary.pdf (accessed on 3 January 2016).
- Mancino, L.; Todd, J.E.; Guthrie, J.; Lin, B.H. How Food Away From Home Affects Children’s Diet Quality; EER-104; U.S. Deptartment of Agriculture, Economic Research Service: Washington, DC, USA, 2011.
- Crepinsek, M.K.; Gordon, A.R.; McKinney, P.M.; Condon, E.M.; Wilson, A. Meals offered and served in US public schools: Do they meet nutrient standards? J. Am. Diet. Assoc. 2009, 109 (Suppl. 2), S31–S43. [Google Scholar] [CrossRef] [PubMed]
- Clark, M.A.; Fox, M.K. Nutritional quality of the diets of US public school children and the role of the school meal programs. J. Am. Diet. Assoc. 2009, 109 (Suppl. 2), S44–S56. [Google Scholar] [CrossRef] [PubMed]
- Caruso, M.L.; Cullen, K.W. Quality and cost of student lunches brought from home. JAMA Pediatr. 2015, 169, 86–90. [Google Scholar] [CrossRef] [PubMed]
- Ahluwalia, N.; Dwyer, J.; Terry, A.; Moshfegh, A.; Johnson, C. Update on NHANES Dietary Data: Focus on Collection, Release, Analytical Considerations, and Uses to Inform Public Policy. Adv. Nutr. 2016, 7, 121–134. [Google Scholar] [CrossRef] [PubMed]
- National Health and Nutrition Examination Survey. Available online: https://www.cdc.gov/nchs/nhanes/index.htm (accessed on 4 June 2017).
- U.S. Department of Agriculture; Agricultural Research Service; Beltsville Human Nutrition Research Center; Food Surveys Research Group; U.S. Department of Health and Human Services; Centers for Disease Control and Prevention; National Center for Health Statistics. What We Eat in America NHANES 2013–2014; USDA: Hyattsville, MD, USA, 2014.
- Bowman, S.; Clemens, J.C.; Thoerig, R.C.; Friday, J.E.; Shimizu, M.; Moshfegh, A.J. Food Patterns Equivalents Database 2009-10: Methodology and User Guide; Food Surveys Research Group, Beltsville Human Nutrition Research Center; Agricultural Research Service; US Department of Agriculture: Beltsville, MD, USA, 2013.
- Vernarelli, J.A.; Mitchell, D.C.; Hartman, T.J.; Rolls, B.J. Dietary energy density is associated with body weight status and vegetable intake in U.S. children. J. Nutr. 2011, 141, 2204–2210. [Google Scholar] [CrossRef] [PubMed]
- Johnson, L.; Wilks, D.C.; Lindroos, A.K.; Jebb, S.A. Reflections from a systematic review of dietary energy density and weight gain: Is the inclusion of drinks valid? Obes. Rev. 2009, 10, 681–692. [Google Scholar] [CrossRef] [PubMed]
- Briefel, R.R.; Wilson, A.; Gleason, P.M. Consumption of low-nutrient, energy-dense foods and beverages at school, home, and other locations among school lunch participants and nonparticipants. J. Am. Diet. Assoc. 2009, 109 (Suppl. 2), S79–S90. [Google Scholar] [CrossRef] [PubMed]
n | Weighted n | % | |
---|---|---|---|
Sex | |||
Female | 1072 | 14,068,660 | 51.4 |
Male | 1118 | 13,309,781 | 48.6 |
Age Category | |||
4–8 years | 786 | 8,982,318 | 35.1 |
9–13 years | 825 | 9,824,053 | 38.5 |
≥14 years | 452 | 6,763,056 | 26.4 |
Race | |||
Non-Hispanic White | 615 | 15,470,648 | 56.5 |
African American | 579 | 3,993,140 | 14.6 |
Mexican-American | 484 | 3,724,629 | 13.6 |
Other | 512 | 4,190,024 | 15.3 |
Poverty-Income Ratio | |||
<130% | 1043 | 10,191,928 | 37.2 |
130–185% | 293 | 3,507,160 | 12.8 |
>185% | 854 | 13,679,354 | 50.0 |
Lunch Source | |||
Cafeteria at School | 1108 | 13,699,939 | 50.0 |
Other | 1082 | 13,678,503 | 50.0 |
Regularly Consume School Lunch | |||
No | 279 | 4,172,193 | 15.2 |
Yes | 1911 | 23,206,249 | 84.8 |
School Lunch Program Participation Subset—by Income | |||
Lunch Price | |||
Free/No cost | 1128 | 10,727,709 | 50.1 |
Reduced Price | 168 | 1,708,276 | 8.0 |
Full price | 513 | 8,993,561 | 41.9 |
Age Group | 4–8 Years | 9–13 Years | ≥14 | |||
---|---|---|---|---|---|---|
Adj. Mean | SE | Adj. Mean | SE | Adj. Mean | SE | |
Macronutrient Content | ||||||
Lunch Energy Content (kcal) | ||||||
School lunch | 369.9 | 15.3 | 410.8 | 18.2 | 560.2 | 47.7 |
Other lunch | 459.2 | 17.8 | 544.7 | 23.7 | 630.3 | 47.7 |
p-value | 0.0013 | <0.0001 | 0.41 | |||
Meal Portion (grams) | ||||||
School lunch | 246.6 | 11.7 | 252 | 34 | 240.4 | 9.3 |
Other lunch | 298.3 | 8.26 | 314.32 | 35.4 | 269.7 | 8.7 |
p-value | 0.006 | 0.0016 | 0.07 | |||
Meal Energy Density (kcal/g) | ||||||
School lunch | 1.97 | 0.07 | 2.04 | 0.08 | 2.19 | 0.1 |
Other lunch | 2.31 | 0.08 | 2.35 | 0.12 | 2.51 | 0.09 |
p-value | 0.0055 | 0.007 | 0.01 | |||
Meal carbohydrate s (g) | ||||||
School lunch | 44.0 | 2.1 | 47.0 | 1.8 | 58.0 | 4.1 |
Other lunch | 54.0 | 2.1 | 62.7 | 2.7 | 65.8 | 4.8 |
p-value | <0.0001 | 0.6 | 0.11 | |||
Meal protein (g) | ||||||
School lunch | 15.7 | 0.8 | 18.4 | 0.9 | 25.4 | 2.9 |
Other lunch | 17.2 | 0.8 | 21.7 | 1.0 | 26.0 | 2.5 |
p-value | 0.002 | <0.0001 | 0.30 | |||
Meal Total Fat (g) | ||||||
School lunch | 14.9 | 0.6 | 16.9 | 1 | 25.4 | 2.7 |
Other lunch | 19.9 | 1.1 | 23.5 | 1.3 | 29.6 | 2.7 |
p-value | 0.0004 | 0.0003 | 0.37 | |||
Saturated Fat (g) | ||||||
School lunch | 4.9 | 0.3 | 5.6 | 0.3 | 9.0 | 1.2 |
Other lunch | 6.4 | 0.4 | 7.1 | 0.4 | 8.2 | 1.0 |
p-value | 0.0075 | 0.0068 | 0.7 | |||
Lunch Food Pattern Equivalents and Other Nutrients of Concern | ||||||
Sodium (mg) | ||||||
School lunch | 771.7 | 36.8 | 825.7 | 48.7 | 1348.2 | 172.8 |
Other lunch | 874.5 | 44.8 | 1094.6 | 51.0 | 1278.2 | 148.8 |
p-value | 0.11 | 0.0004 | 0.81 | |||
Dietary fiber (g) | ||||||
School lunch | 3.7 | 0.2 | 3.7 | 0.2 | 4.3 | 0.3 |
Other lunch | 4.1 | 0.2 | 4.9 | 0.3 | 4.9 | 0.4 |
p-value | 0.21 | 0.0011 | 0.20 | |||
Added sugars (tsp. equiv.) 2 | ||||||
School lunch | 1.2 | 0.1 | 1.5 | 0.1 | 1.9 | 0.5 |
Other lunch | 2.2 | 0.2 | 2.6 | 0.3 | 2.4 | 0.6 |
p-value | <0.0001 | 0.003 | 0.64 | |||
Meal solid fats (g equiv.) | ||||||
School lunch | 8.0 | 0.6 | 8.5 | 0.5 | 14.2 | 2.5 |
Other lunch | 8.9 | 0.9 | 9.9 | 0.8 | 11.0 | 1.9 |
p-value | 0.51 | 0.13 | 0.42 | |||
Vegetables (cup equiv.) 3 | ||||||
School lunch | 0.26 | 0.02 | 0.29 | 0.04 | 0.34 | 0.05 |
Other lunch | 0.30 | 0.03 | 0.36 | 0.04 | 0.54 | 0.05 |
p-value | 0.18 | 0.26 | 0.007 | |||
Fruits (cup equiv.) 4 | ||||||
School lunch | 0.33 | 0.03 | 0.31 | 0.04 | 0.29 | 0.08 |
Other lunch | 0.28 | 0.04 | 0.22 | 0.04 | 0.13 | 0.07 |
p-value | 0.26 | 0.09 | 0.20 | |||
Grains (ounce equiv.) | ||||||
School lunch | 1.7 | 0.1 | 2.0 | 0.1 | 2.6 | 0.3 |
Other lunch | 2.0 | 0.1 | 2.4 | 0.1 | 2.7 | 0.3 |
p-value | 0.27 | 0.017 | 0.80 | |||
Whole Grains (ounce equiv.) | ||||||
School lunch | 0.05 | 0.02 | 0.11 | 0.02 | 0.13 | 0.03 |
Other lunch | 0.25 | 0.04 | 0.23 | 0.04 | 0.18 | 0.04 |
p-value | <0.0001 | 0.011 | 0.2 | |||
Refined Grains (ounce equiv.) | ||||||
School lunch | 1.69 | 0.14 | 1.89 | 0.1 | 2.44 | 0.27 |
Other lunch | 1.72 | 0.11 | 2.15 | 0.14 | 2.53 | 0.26 |
p-value | 0.002 | 0.385 | 0.63 | |||
Protein Foods (ounce equiv.) 5 | ||||||
School lunch | 1.1 | 0.1 | 1.2 | 0.1 | 1.8 | 0.4 |
Other lunch | 1.3 | 0.1 | 1.7 | 0.1 | 2.1 | 0.4 |
p-value | 0.19 | 0.014 | 0.64 |
Family SES | <130% PIR 1 | 130–185% PIR | >185% PIR | |||
---|---|---|---|---|---|---|
Eligible for Free/No-Cost Lunch | Eligible for Reduced Price Lunch | Full Price Lunch | ||||
Mean | SE | Mean | SE | Mean | SE | |
Lunch Energy Content (kcal) | ||||||
School lunch | 414.3 | 17.2 | 393.5 | 22.9 | 493.2 | 31.6 |
Other lunch | 654.0 | 32.9 | 458.2 | 43.3 | 539.5 | 36.6 |
p-value | <0.0001 | 0.20 | 0.27 | |||
Meal Portion (grams) | ||||||
School lunch | 234.6 | 8.6 | 232.0 | 16.5 | 234.9 | 15.8 |
Other lunch | 309.3 | 16.4 | 213.9 | 20.6 | 244.5 | 20.7 |
p-value | <0.0001 | 0.40 | 0.72 | |||
Meal Energy Density (kcal/g) | ||||||
School lunch | 1.90 | 0.03 | 1.95 | 0.09 | 2.14 | 0.07 |
Other lunch | 2.11 | 0.04 | 2.02 | 0.11 | 2.18 | 0.07 |
p-value | <.0001 | 0.65 | 0.58 | |||
Meal carbohydrate s (g) | ||||||
School lunch | 47.7 | 2.0 | 50.0 | 3.1 | 55.6 | 3.5 |
Other lunch | 71.0 | 4.3 | 52.7 | 5.3 | 63.2 | 4.4 |
p-value | <0.0001 | 0.60 | 0.11 | |||
Meal protein (g) | ||||||
School lunch | 18.2 | 1.0 | 15.4 | 1.1 | 21.4 | 1.9 |
Other lunch | 26.9 | 1.5 | 17.8 | 2.2 | 19.9 | 2.0 |
p-value | <0.0001 | 0.39 | 0.60 | |||
Meal Total Fat (g) | ||||||
School lunch | 17.1 | 0.9 | 15.2 | 1.0 | 20.8 | 1.6 |
Other lunch | 29.5 | 1.6 | 19.7 | 2.0 | 23.7 | 2.0 |
p-value | <0.0001 | 0.06 | 0.20 | |||
Saturated Fat (g) | ||||||
School lunch | 5.5 | 0.3 | 5.3 | 0.4 | 7.0 | 0.7 |
Other lunch | 9.2 | 0.5 | 6.2 | 0.7 | 6.7 | 0.7 |
p-value | <0.0001 | 0.38 | 0.74 | |||
Lunch Food Pattern Equivalents and Other Nutrients of Concern | ||||||
Sodium (mg) | ||||||
School lunch | 843.9 | 36.2 | 848.3 | 80.3 | 1010.1 | 88.9 |
Other lunch | 1333.7 | 73.1 | 902.0 | 114.1 | 983.6 | 122.0 |
p-value | <0.0001 | 0.67 | 0.87 | |||
Dietary fiber (g) | ||||||
School lunch | 3.9 | 0.2 | 4.0 | 0.4 | 3.9 | 0.3 |
Other lunch | 4.9 | 0.4 | 3.7 | 0.3 | 4.5 | 0.3 |
p-value | 0.016 | 0.42 | 0.06 | |||
Added sugars (tsp. equiv.) 2 | ||||||
School lunch | 1.7 | 0.3 | 1.8 | 0.2 | 1.8 | 0.3 |
Other lunch | 3.7 | 0.9 | 1.8 | 0.4 | 2.3 | 0.5 |
p-value | 0.0001 | 0.97 | 0.47 | |||
Meal solid fats (g equiv.) | ||||||
School lunch | 8.4 | 0.7 | 8.7 | 0.8 | 11.7 | 11.7 |
Other lunch | 13.1 | 1.1 | 9.2 | 1.6 | 9.1 | 9.1 |
p-value | 0.0002 | 0.84 | 0.18 | |||
Vegetables (cup equiv.) 3 | ||||||
School lunch | 0.28 | 0.02 | 0.25 | 0.06 | 0.19 | 0.04 |
Other lunch | 0.35 | 0.03 | 0.33 | 0.07 | 0.35 | 0.06 |
p-value | 0.025 | 0.40 | 0.01 | |||
Fruits (cup equiv.) 4 | ||||||
School lunch | 0.34 | 0.03 | 0.39 | 0.11 | 0.28 | 0.06 |
Other lunch | 0.12 | 0.02 | 0.17 | 0.07 | 0.23 | 0.07 |
p-value | <0.0001 | 0.07 | 0.60 | |||
Grains (ounce equiv.) | ||||||
School lunch | 1.8 | 0.1 | 1.9 | 0.2 | 2.5 | 0.2 |
Other lunch | 2.7 | 0.2 | 2.1 | 0.3 | 2.5 | 0.2 |
p-value | 0.002 | 0.52 | 0.80 | |||
Whole Grains (ounce equiv.) | ||||||
School lunch | 0.08 | 0.02 | 0.15 | 0.07 | 0.07 | 0.03 |
Other lunch | 0.13 | 0.06 | 0.07 | 0.03 | 0.24 | 0.04 |
p-value | 0.39 | 0.32 | <0.0001 | |||
Refined Grains (ounce equiv.) | ||||||
School lunch | 1.77 | 0.09 | 1.71 | 0.16 | 2.39 | 0.22 |
Other lunch | 2.58 | 0.18 | 2.02 | 0.32 | 2.29 | 0.15 |
p-value | 0.002 | 0.385 | 0.630 | |||
Protein Foods (ounce equiv.) 5 | ||||||
School lunch | 1.3 | 0.1 | 0.9 | 0.1 | 1.4 | 0.2 |
Other lunch | 2.0 | 0.2 | 1.2 | 0.2 | 1.5 | 0.3 |
p-value | 0.002 | 0.14 | 0.91 |
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Vernarelli, J.A.; O’Brien, B. A Vote for School Lunches: School Lunches Provide Superior Nutrient Quality than Lunches Obtained from Other Sources in a Nationally Representative Sample of US Children. Nutrients 2017, 9, 924. https://doi.org/10.3390/nu9090924
Vernarelli JA, O’Brien B. A Vote for School Lunches: School Lunches Provide Superior Nutrient Quality than Lunches Obtained from Other Sources in a Nationally Representative Sample of US Children. Nutrients. 2017; 9(9):924. https://doi.org/10.3390/nu9090924
Chicago/Turabian StyleVernarelli, Jacqueline A., and Brady O’Brien. 2017. "A Vote for School Lunches: School Lunches Provide Superior Nutrient Quality than Lunches Obtained from Other Sources in a Nationally Representative Sample of US Children" Nutrients 9, no. 9: 924. https://doi.org/10.3390/nu9090924