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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2007.10.005 Byline: Jill Hartstein, Karen W. Cullen, Kim D. Reynolds, Joanne Harrell, Ken Resnicow, Phyllis Kennel Abstract: We assessed the impact of a pilot middle school a la carte intervention on food and beverage purchases, kilocalories, fat, carbohydrate, and protein sold per student, and nutrient density of the foods sold. A la carte sales were obtained from six middle schools in three states for 1 baseline week and daily during the 6-week intervention. Intervention goals included reducing sizes of sweetened beverages and chips, and increasing the availability of water and reduced-fat/baked chips. Nutrients sold per day were computed and weekly nutrient means per student and per number of items sold were calculated and compared between baseline and week 6. Five schools achieved all goals at 6 weeks. Four schools showed increases in the percentage of kilocalories from protein and decreases in the amount of sweetened beverages sold; five showed substantial increases in water sales. Changes in regular chips varied by school. There were significant changes in energy density of foods sold. School foodservice changes in middle school snack bar/a la carte lines can be implemented and can lead to a reduction in the caloric density of foods purchased.

We assessed the impact of a pilot middle school a la carte intervention on food and beverage purchases, kilocalories, fat, carbohydrate, and protein sold per student, and nutrient density of the foods sold. A la carte sales were obtained from six middle schools in three states for 1 baseline week and daily during the 6-week intervention. Intervention goals included reducing sizes of sweetened beverages and chips, and increasing the availability of water and reduced-fat/baked chips. Nutrients sold per day were computed and weekly nutrient means per student and per number of items sold were calculated and compared between baseline and week 6. Five schools achieved all goals at 6 weeks. Four schools showed increases in the percentage of kilocalories from protein and decreases in the amount of sweetened beverages sold; five showed substantial increases in water sales. Changes in regular chips varied by school. There were significant changes in energy density of foods sold. School foodservice changes in middle school snack bar/a la carte lines can be implemented and can lead to a reduction in the caloric density of foods purchased.

The purpose of this formative evaluation was to examine the impact of an innovative inquiry-based science education curriculum for middle school students, called Choice, Control, and Change, that is designed to foster healthful eating and physical activity and a healthy weight through enhancing agency and competence. The 24-session curriculum helps students develop understandings about the interactions between biology, personal behavior, and the environment and personal agency through cognitive self-regulation skills in navigating today's complex food system and sedentary environment. An extended theory of planned behavior served as the design framework. The study used a pretest-posttest evaluation design involving 278 middle school students in 19 science classes within 5 schools. Based on paired t tests, students significantly improved on several curriculum-specific eating and physical activity behaviors: they decreased several sedentary activities and increased their frequencies of fruit and vegetable intake. They decreased the frequency of sweetened beverages, packaged snacks, and eating at a fast-food restaurant, and ate and drank smaller portions of some items. Their outcome beliefs and overall self-efficacy, but not their attitudes, became more positive. A strategy based on fostering personal agency, cognitive self-regulation, and competence can be effective in increasing healthful eating and physical activity behaviors in middle school children and should be explored further. Key Words: eating competence, personal agency, self-efficacy, overweight prevention, middle school students, nutrition education curriculum, inquiry-based learning, extended theory of planned behavior, science education

Objective There is growing interest in understanding the roles that fruit, vegetable, milk, breakfast, and soft drink consumption play in relation to adolescents' weight status. This study examines the relationship between weight status and dietary practices of middle school students. Design This study consists of secondary analysis of a cross-sectional survey given to 4,049 middle school students in central Kentucky. Methods Students' self-reported height and weight data, as well as 7-day recall of fruits, vegetables, milk, soft drinks, and breakfast consumption prior to completion of the survey, were collected. Self-reported height and weight were converted to body mass index (BMI) percentile according to Centers for Disease Control and Prevention's classification criteria. Outcome measures Measures included dietary consumption of fruits, vegetables, milk, soft drinks, and breakfast in relation to students' BMI percentile. Statistical analyses performed Descriptive statistics were extracted on demographics, BMI percentile, and food consumption. Bivariate analyses included [chi square] tests of association and Spearman rank correlation. Results Healthy weight was associated with consuming fruits, vegetables, breakfast, and milk. Underweight and healthy-weight students consumed more fruits than students who were at risk of being overweight and overweight. Healthy-weight students consumed more "other vegetables" than students who were at risk of being overweight and more "other vegetables" and carrots than overweight students. Underweight students consumed breakfast more often than all other students, and healthy-weight students consumed breakfast significantly more frequently than students at risk of being overweight and overweight. Finally, overweight students had a significantly lower consumption of milk than all other students. Conclusions Parents and school foodservice personnel should take these factors into consideration by developing menu strategies and tactics to encourage more healthful eating behaviors in children.

Our objective for this study was to examine the feasibility of instituting environmental changes during a 6-week pilot in school foodservice programs, with long-term goals of improving dietary quality and preventing obesity and type 2 diabetes in youth. Participants included students and staff from six middle schools in three states. Formative assessment with students and school staff was conducted in the spring of 2003 to inform the development of school foodservice policy changes. Thirteen potential policy goals were delineated. These formed the basis for the environmental change pilot intervention implemented during the winter/spring of 2004. Questionnaires were used to assess the extent to which the 13 foodservice goals were achieved. Success was defined as achieving 75% of goals not met at baseline. Daily data were collected on goal achievement using the schools' daily food production and sales records. Qualitative data were also collected after the pilot study to obtain feedback from students and staff. Formative research with staff and students identified potential environmental changes. Most schools made substantial changes in the National School Lunch Program meal and snack bar/a la carte offerings. Vending goals were least likely to be achieved. Only one school did not meet the 75% goal achievement objective. Based on the objective data as well as qualitative feedback from student focus groups and interviews with students and school staff, healthful school foodservice changes in the cafeteria and snack bar can be implemented and were acceptable to the staff and students. Implementing longer-term and more ambitious changes and assessing cost issues and the potential enduring impact of these changes on student dietary change and disease risk reduction merits investigation.

Objective Evaluate the validity and reliability of a short (10-item) calcium food frequency questionnaire (FFQ) for use with middle-school--aged (11 to 14 years of age) children. Design The calcium FFQ was completed twice, with 1 week between administrations. Three 24-hour dietary recalls were collected from each participant after the second administration of the calcium FFQ. Subjects/setting Students in an ethnically diverse middle school in Minneapolis, MN (n = 248). Main outcome measures Calcium intake estimates from the calcium FFQ and dietary recalls. Statistical analyses Correlations between calcium intake estimates from the first and second questionnaire administrations of the calcium FFQ were calculated and paired t tests were conducted to compare mean calcium intake estimates from each questionnaire administration. Mean intake estimates from the calcium FFQ and the dietary recalls were compared. Also, correlations between intake estimates from the calcium FFQ and the recalls were calculated. Results Correlation between calcium intake estimates derived from the first and second administration of the calcium FFQ was 0.74. Mean calcium intake estimates from the calcium FFQ and the average of the three dietary recalls were 856 mg/day and 993 mg/day, respectively (P<0.001). The correlation between calcium intake estimates derived from the calcium FFQ and the average of the recalls was 0.43. Conclusions Reliability of the FFQ was found to be good while validity was weaker, with calcium intake from the calcium FFQ moderately associated with estimates from dietary recalls. Where a brief instrument for assessing calcium intake of middle-school--aged children is needed, the calcium FFQ evaluated in this study may be useful.

Objective To identify correlates of calcium, dairy, and milk intakes among male and female adolescents. Design Cross-sectional study design. Adolescents self-reported measures pertaining to correlates on the Project EAT (Eating Among Teens) survey and completed a food frequency questionnaire at school. Subjects/setting Subjects were a total of 4,079 middle and high school students from Minneapolis/St Paul, MN, public schools. Statistical analyses performed Multiple linear regression models based on social cognitive theory were examined by sex. Results Male adolescents reported higher daily intakes of calcium (male: 1,217 [+ or -] 663 mg; female: 1,035 [+ or -] 588 mg; P<0.001), dairy servings (male: 2.9 [+ or -] 1.9; female: 2.4 [+ or -] 1.7; P<0.001), and milk servings (male: 2.0 [+ or -] 1.5; female: 1.5 [+ or -] 1.4; P<0.001) than female adolescents. Calcium intakes of male adolescents were significantly and positively related to availability of milk at meals, taste preference for milk, eating breakfast, higher socioeconomic status, and social support for healthful eating; intakes were significantly and inversely related to consumption of soft drinks and fast food. Among female adolescents, availability of milk at meals, taste preference for milk, eating breakfast, higher socioeconomic status, personal health/nutrition attitudes, and self-efficacy to make healthful food choices were significantly and positively related to intakes; intakes were significantly and inversely related to fast-food consumption. Models of calcium intake explained 71% of the variance in male adolescents and 72% of the variance in female adolescents. Conclusions Multicomponent interventions with a focus on the family environment are likely to be most effective in increasing calcium intakes among adolescents.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2005.08.033 Byline: Martha A. Marlette, Susan B. Templeton, Myna Panemangalore Abstract: Because plate waste reduces nutritional benefits of school lunches, the objective of this study was to determine the factors that influence waste. Lunches of 743 sixth graders in three middle schools were photographed after students made food selections and after eating. Sample items were purchased to determine initial portion weights. The Statistical Package for Social Sciences software (Base 10.0, 1995, SPSS Inc, Chicago, IL) was used for statistical analysis. Preparation method influenced acceptance rates and plate waste: Whole apples had lower acceptance (23%) and greater waste (62%) compared with applesauce (37% acceptance, 23% waste). Mashed potatoes and heated fries had similar acceptance (approximately 69%), but mashed potatoes were wasted less (19% vs 33%, respectively). Students who purchased competitive food items with lunch (n=250) had significantly greater waste of fruits (52% vs 36%, respectively, P=.0001), grain products (26% vs 14%, respectively, P=.009), meats (25% vs 16%, respectively, P=.015), and mixed dishes (30% vs 18%, respectively, P=.0001). Changing preparation methods and limiting availability of competitive food items may reduce plate waste.

Objective To assess the opinions and beliefs of parents and teachers of middle school students regarding the school food environment. Design Surveys mailed to parents and placed in teachers' school mailboxes included questions about adolescents' eating practices, food choice at school, and school-related food policies and practices. Subjects/Settings A convenience sample of parents (n=350; response rate: 350/526=66%) and teachers (n=490; response rate; 490/701=70%) of middle school students from 16 schools in the St Paul-Minneapolis metropolitan area who participated in the Teens Eating for Energy and Nutrition at School study. Statistical Analysis Descriptive statistics examined the prevalence of parents' and teachers' opinions and beliefs about adolescents' eating practices, food choice at school, and school-related food policies and practices. Results Most parents and teachers agreed that the nutritional health of students should be a school priority. However, only 18% of parents and 31% of teachers believed schools give adequate attention to student nutrition. Among both parents and teachers, 90% agreed that more healthy snacks and beverages should be available in school vending machines and on school a la carte lines. Conclusions Findings suggest that parents and teachers are concerned about the nutritional health of students and the "state of health" of the school food environment. Dietetic and other health professionals who work in school settings should actively engage parents and teachers in the process of affecting and monitoring policies and practices that foster a healthy school food environment. J Am Diet Assoc. 2005;105:233-239.

Objective: To assess the level of food safety knowledge, perceptions, and self-reported food-handling behaviors among middle school students. Design: Baseline questionnaire administered in class that assessed background characteristics, knowledge, behaviors, and perceptions related to food safety. Participants: 178 seventh and eighth grade students from 4 schools in central Pennsylvania. Main Outcome Measures: Food safety knowledge, perceptions, and self-reported food-handling behaviors. Analysis: Independent samples t test tested differences between genders and bivariate correlation analysis explored associations among knowledge, perceptions, and behavior (P < .05). Results: Food safety knowledge score was 7.2 [+ or -] 1.6 of a maximum of 10 points. Perceived self-efficacy and severity of a foodborne illness were high, but perceived susceptibility was low. Girls scored higher on the self-efficacy and severity scale (P < .01). Self-efficacy correlated positively with knowledge and behavior (P < .00(31) and severity with knowledge (P < .01). One fifth reported taking risks in food handling and one fifth reported having been sick because of something they ate. Conclusions and Implications: There is a disconnection between middle school students' food safety knowledge, perceptions, and behaviors. A need for relevant and motivating food safety education exists in this group. KEY WORDS: food safety, knowledge, behavior, perception, adolescent

Objective. To survey caffeine use by seventh-, eighth-, and ninth-graders and relate its use to age, sex, sleep characteristics, and day of week. Methods. Students kept a daily, 2-week diary of their sleep times and use of caffeine containing drinks and foods. Data were analyzed by fitted multiple regression models. Results. A total of 191 students participated. Caffeine intake ranged between 0 and 800 mg/d. Mean use over 2 weeks ranged up to 379.4 mg/d and averaged 62.7 mg/d (corrected for underrepresentation in our sample of boys, who consumed more caffeine). Higher caffeine intake in general was associated with shorter nocturnal sleep duration, increased wake time after sleep onset, and increased daytime sleep. Sleep Patterns. Mean bedtime was 10:57 PM, and mean wake time was at 7:14 AM. Older children delayed bedtime longer on weekends, and younger ones had longer nightly sleep durations. Sleep duration lengthened on weekends, reflecting the combined effects of the circadian timing system and a mechanism that regulates the duration of sleep. Caffeine (soda) consumption also increased on weekends, for reasons that may be primarily social. Conclusions. Regardless of whether caffeine use disturbed sleep or was consumed to counteract the daytime effect of interrupted sleep, caffeinated beverages had detectable pharmacologic effects. Limitation of the availability of caffeine to teenagers should therefore be considered. Pediatrics 2003;111:42-46; caffeine, sleep, soda, coffee, teenagers, adolescents., Caffeine has been called the most widely consumed psychoactive substance on earth. (1) It is used at least weekly by nearly all adults. (2) Barone and Roberts (3) have noted [...]

The potential impact of a school food policy change reducing sweetened beverage and high-fat, salty, and sweet food portions on energy consumption of middle-school students was assessed. Snack bar sales for one school year were obtained from 23 schools. Energy content was calculated for each item and energy savings from reduced portion size was determined. Per student, about 111 kcal per day was purchased; 47 kcal per day was saved when reduced portion sizes were substituted for the large servings. These findings should provide some assurance that changes in food portion sizes in school food environments could impact energy balance. J Am Diet Assoc. 2005;105:1952-1954.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2005.09.008 Byline: Karen Weber Cullen, Debbe I. Thompson Abstract: The potential impact of a school food policy change reducing sweetened beverage and high-fat, salty, and sweet food portions on energy consumption of middle-school students was assessed. Snack bar sales for one school year were obtained from 23 schools. Energy content was calculated for each item and energy savings from reduced portion size was determined. Per student, about 111 kcal per day was purchased; 47 kcal per day was saved when reduced portion sizes were substituted for the large servings. These findings should provide some assurance that changes in food portion sizes in school food environments could impact energy balance.

This article describes some of the approaches used and challenges encountered conducting nutrition education research in junior high schools. The Teens Eating for Energy and Nutrition at School (TEENS) study recruited 16 schools and over 3800 seventh graders to participate in an intervention to increase students' intakes of fruits, vegetables, and lower fat foods for the purpose of reducing their future risk of cancer. The TEENS intervention included a classroom curriculum as well as a school environment and family component. This article describes some of the issues faced in the design and implementation of the study including recruiting schools and teens, maximizing the number of students within each intervention school exposed to all components of the intervention, and implementing elements of nutrition education in a classroom setting. The methods used to meet these challenges and the success of the methods attempted are described. (JNE 33:49-54, 2001)

ABSTRACT Objective Children consume about one third of their daily energy at school, mostly from cafeteria food and bag lunches. Students also shop at student-run stores that generate revenue for [...]

THE SOURCE: 'Competitive Food Sales in Schools and Childhood Obesity: A Longitudinal Study' by Jennifer Van Hook and Claire E. Altman, in Sociology of Education, Jan. 2012. MORE THAN A [...]

Data were collected from 3179 seventh- and eighth-graders at 9 middle schools using a 71-item SPAN questionnaire, including food intake the previous day, food attitudes, and nutrition knowledge. Height and weight were measured to calculate body mass index (BMI).The prevalence of being overweight (BMI [greater than or equal to] 95th percentile for gender and age) was 23.2% among boys and 23.4% among girls, with 17.1% of boys and 19.7% of girls at risk of becoming overweight (BMI between 85th and 95th percentile). Breakfast consumption was compared to BMI using analysis of variance techniques. Boys had lower BMI than girls (23.1 [+ or -] 0.1 vs 23.6 [+ or -] 0.1), and for both groups, breakfast consumption was inversely related to BMI. For 'never,' 'sometimes,' and 'always having breakfast,' mean BMIs were 24.2 [+ or -] 0.3 versus 22.9 [+ or -] 0.2 versus 22.1 [+ or -] 0.2 for boys and 24.7 [+ or -] 0.3 versus 23.9 [+ or -] 0.2 versus 22.2 [+ or -] 0.2 for girls. More frequent meal consumption was also inversely related to BMI. For < 3 meals/day versus > 3 meals/day, mean BMIs were 23.7 [+ or -] 0.2 versus 22.0 [+ or -] 0.1 for boys and 24.3 [+ or -] 0.2 versus 22.4 [+ or -] 0.2 for girls. There was no interaction between gender and breakfast consumption or meal frequency. BMI was not correlated to intake of fruits and vegetables (P = .30), but BMI was correlated (P < .05) with intake of high-fat foods, milk, grains, sweets, and chips, although r values were small ([absolute value of r] [greater than or equal to] .12). Meal frequency and breakfast consumption may be important factors in managing weight in adolescents. This project was funded in part by grants from the Indiana State Department of Health and Dairy and Nutrition Council, Inc.

During the school year, children receive one third to one half of their daily calories at school; therefore, foods eaten at school have a substantial impact on a child's overall nutrition status. The objective of tiffs study was to investigate the school food environment. Initially, 3 focus groups were conducted with foodservice directors (FSDs) from urban, rural, and suburban schools to determine the most relevant issues in the school food environment. Then telephone interviews (n = 92) were conducted with principals and foodservice workers and directors from randomly selected middle schools throughout Colorado. Schools were matched within districts as having high or low participation in free or reduced-price school lunch. The primary influences on food options included pouring contracts and their influence on vending offerings, lack of enforcement of competitive food rules, fear of decreased revenue if more healthful foods were offered, and competition with off-campus entities. Numerous barriers to offering more healthful foods were noted. Many of the subjects offered suggestions for improvement, such as enforcing the competitive foods rule at the state or district level, bringing back nutrition education in the schools, and using price (lower for healthful items) to drive selection. In conclusion, it appears that the majority of principals and FSDs are concerned about what children are eating and are interested in an environment that promotes healthful eating; however, there are many significant barriers, particularly economic. Thus, there is an opportunity to facilitate changes in the school food environment as the two principal decision makers are interested in doing so.