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Objective: To use data from observations and interviews to document fourth-graders' preferences for, and consumption of, fruits compared to vegetables available as part of school lunches. Design: Observations and interviews were conducted for studies regarding the impact of time interval between eating and reporting on the accuracy of children's school lunch recalls. Subjects/Settings: Children were recruited from up to 4 schools in one district during 3 school years; 63% agreed to participate. Randomly selected children (n = 237) were each observed eating school lunch once and were interviewed (regarding items eaten and preferences for items eaten) within 1 1/2 hours or the next morning. Main Outcome Measures: Observed consumption of servings of items available as part of school lunch was recorded as none, taste, little bit, half, most, and all. Response options for preferences for items available as part of school lunch were liked not at all, a little, and a lot. Statistical Analyses Performed: Mixed-model analysis of variance. Results: Preferences were higher for fruits than vegetables. As preferences increased, consumption increased (P < .0001). Consumption of fruits compared to vegetables was similar after adjusting for preferences. Implications: Research is needed to understand how to increase children's preferences for vegetables as a means of increasing consumption. Key Words: fruits, vegetables, school lunch, preferences, consumption (J Nutr Educ Behav. 2002;34:166-171.)

Objective: To explore fourth-graders' school breakfast participation by gender and race (black, white) and examine the extent to which parents' responses to 'Does this child usually eat school breakfast?' reflected their children's participation. Design: Parents answered 'yes' or 'no' to the questions printed on consent forms. Observers documented which children participated in school breakfast on 26 to 51 randomly selected days per school during 24 weeks in the 1999-2000 school year. Subjects: 357 children recruited from all 22 fourth-grade classes from 6 schools in 1 public school district. Variables Measured: Participation rate, participation rate grouping [usually participated ([greater than or equal to] 50% of days observed), did not usually participate (< 50% of days observed)]. Statistical Analyses Performed: Komolgorov-Smirnov tests, McNemar's test. Results: Median participation rate was 37.5% overall. Distribution of participation rates differed significantly by race (K-S test, P < .001) but not gender. There was a significant difference in the percentage of parents who said 'yes' or 'no' compared to children's usual participation grouping (McNemar test, P < .001). Of parents who said 'yes,' 66% of children usually participated; of parents who said 'no,' 92% of children did not usually participate. Implications: Children, not parents, must be the source for learning about what children eat at school. Key Words: children, parents, School Breakfast Program participation (J Nutr Educ Behav. 2002;34:159-165)

Intermittent iron supplementation has been suggested as a replacement for daily iron supplements for reducing anemia in developing countries. The effects of once weekly and daily iron supplementation on hemoglobin (Hb), serum ferritin (SF), prevalence of anemia, weight and height are compared in this study. Primary schoolchildren (n = 397) from two selected schools in the Hat Yai rural area, southern Thailand, were recruited in 1999. All children received Albendazole and then randomly received ferrous sulfate (300 mg/tablet) either daily or weekly, or a placebo for 16 wk. The average increase in Hb was not significantly different between the daily (mean [+ or -] SD; 6.5 [+ or -] 6.0 g/L) and weekly (5.7 [+ or -] 6.3 g/L) groups. However, the average increase in SF was greater (P < 0.01) in the daily (mean : [+ or -] SD; 39.8 [+ or -] 30.3 [micro]g/L) than the weekly (13.4 [+ or -] 17.3 [micro]g/L) group. All cases of iron deficiency anemia were abolished in both daily and weekly groups, whereas no reduction in prevalence occurred in the placebo group. Height gain was greater in children who received weekly (mean [+ or -] SD; 2.6 [+ or -] 0.9 cm) than in those who received daily iron (mean [+ or -] SD; 2.3 [+ or -] 0.8 cm), (P < 0.01). Weight gain, weight-for-age and height-for-age were not significantly different among the intervention groups. It is concluded that a weekly iron dose is more effective than a daily dose in height gain but not in hematological improvement over 16 wk of supplementation. KEY WORDS: * iron supplementation * iron status * growth * schoolchildren

Objective: The purpose of this study was to identify and compare perceived benefits and barriers related to breakfast consumption and concerns about weight among children in schools with or without a Universal School Breakfast Program (USBP). Design: Teacher-administered survey at the end of a 3-year pilot program. Subjects/Settings: Fourth-, fifth-, and sixth-grade students in six USBP pilot schools (n = 827) and four control schools (n = 615). Control and pilot sites were matched by geographic location and socioeconomic status of students. Response rates were > 70%. Variables Measured: Perceptions of benefits and barriers related to breakfast consumption and weight-related concerns. Statistical Analyses Performed: Chi-square tests were used to assess statistical differences in categorical responses to survey items. Results: The majority of students perceived that eating breakfast provides benefits of increased energy and ability to pay attention in school. Commonly held perceptions of barriers to eating breakfast were lack of time and not being hungry in the morning. Compared with children in non-USBP schools, those in the USBP schools were less likely to wish they were thinner, to go on a diet, or skip breakfast because it might make them fat and more likely to believe that eating breakfast will give them energy and help them pay attention. Implications: Based on the results of this study, nutrition educators may find it helpful to develop educational materials and programs based on the reciprocal determinism construct of Social Learning Theory to promote breakfast consumption. The focus should be on practical strategies to address barriers and encourage behavioral changes for both children and their parents. KEY WORDS: school-aged children, benefits, barriers, breakfast consumption, Universal School Breakfast Program (USBP), Social Learning Theory

The influence of school-based nutrition programs on 4th graders and their parents was studied. Knowledge, self-efficacy and parent consumption were found to be more important than intervention by the schools.

In the U.S., child overweight is on the rise and is implicated in later adult chronic illness. Given that overweight is hardly tractable, prevention as compared to treatment is seen as a better alternative for lowering the risk of long-term health consequences. To increase the success of prevention efforts, many argue that programs must be 'culturally sensitive' and targeted toward specific populations at greater risk. However, there exists a limited understanding of how overweight is distributed across the landscape, among and within populations and groups. This paper reports the prevalence of overweight among 54 school children in a rural, Appalachian community with a high rate of poverty, and it compares boys to girls. Thirty-seven percent of boys and 10.3% of girls are overweight, based on the 90th percentile body mass index (BMI). Analysis of food intake indicates a pattern of food consumption that is high in fatty and sugary foods and low in fruit and vegetable consumption. Analysis of activity indicates that children report more low-intensity activity than high; that overweight children report more episodes of video/computer play compared to nonoverweight children; and that boys spend more time than girls in front of the computer/television screen. Keywords: children; growth; diet; Food Guide Pyramid; macronutrients; Kentucky

Objectives. A randomized school-based trial sought to increase fruit and vegetable consumption among children using a multicomponent approach. Methods. The intervention, conducted in 20 elementary schools in St. Paul, targeted a multiethnic group of children who were in the fourth grade in spring 1995 and the fifth grade in fall 1995. The intervention consisted of behavioral curricula in classrooms, parental involvement, school food service changes, and industry support and involvement. Lunchroom observations and 24-hour food recalls measured food consumption. Parent telephone surveys and a health behavior questionnaire measured psychosocial factors. Results. The intervention increased lunchtime fruit consumption and combined fruit and vegetable consumption, lunchtime vegetable consumption among girls, and daily fruit consumption as well as the proportion of total daily calories attributable to fruits and vegetables. Conclusions. Multicomponent school-based programs can increase fruit and vegetable consumption among children. Greater involvement of parents and more attention to increasing vegetable consumption, especially among boys, remain challenges in future intervention research. (Am J Public Health. 1998;88:603-609)

Objectives. This study examined the effects of a school-based intervention designed to promote the consumption of low-fat white milk at lunchtime in 6 elementary schools in an inner-city, primarily Latino neighborhood. Methods. A multifaceted intervention based on social marketing techniques was delivered at 3 randomly selected schools. The school was the unit of assignment and analysis; 6902 children were involved in the study. Milk selection and consumption were measured by sampling discarded milk and/or tallying milk carton disappearance at baseline, immediately postintervention, and at 3 to 4 months follow-up. Results. Immediately postintervention, the mean proportion of sampled milk cartons that contained low-fat milk increased in the intervention schools, from 25% to 57%, but remained constant at 28% in the control schools. Differences between intervention and control schools remained significant at 3 to 4 months follow-up. The intervention was not associated with a decrease in overall milk consumption. Conclusions. A school-based intervention can lead to significant increases in student consumption of low-fat milk. (Am J Public Health. 1998;88:427-433)

A study was conducted on the roles of dietary and non-dietary factors in malnutrition in children of 10-12 years of age. Questionnaires were given on each pupil's diet and meal pattern, class position and games aptitude and home characteristics. The results indicate that, among school-age children, caution should be exercised against overrating the health disadvantages from mild to moderate malnutrition and overblaming undernutrition.

The impact of zinc supplementation on susceptibility to Schistosoma mansoni reinfections among schoolchildren was investigated. A randomized, double-blind, placebo-controlled trial was used on 313 rural Zimbabwean schoolchildren. Findings revealed that there was no difference in reinfection rates between the zinc and placebo groups. However, the median intensity of S. mansoni reinfection, although low in both groups, was significantly lower in the zinc than in the placebo group.

The impact of zinc supplementation on growth and body composition among schoolchildren was studied in 313 rural Zimbabwean schoolchildren 11-17 years old using a randomized, double-blind, placebo-controlled trial. Findings indicated significant effects on weight gain, weight-for-age and arm muscle area-for-age for the first three months but no effects were seen over the full 12 months.

A study on the effects of energy intake at breakfast on school performance was conducted among 10-year-old children. The results revealed that voluntary physical endurance and the performance of creativity test are significantly better among subjects who took breakfast which meet 20% of the recommended daily energy intake compared to those who received less than 10% of the recommended values. It was also found that error rate in an addition task is negatively correlated, while the rate of working in a number checking task was positively correlated with energy intake from the low-energy breakfast. Less number of children complained of feeling bad and hungry during the morning classes when they took high energy breakfast.

A clinical study was conducted to assess the response of school children to an iron fortification program in relation to the levels of retinol in their blood. The results revealed that marginal vitamin A status affects the mobilization of stored iron but not its absorption. It was thus indicated that marginal deficiency in vitamin A in a population may limit the effectiveness of an iron intervention program and that vitamin A should be one of the primary considerations when implementing such nutritional programs.

The Family Food Challenge is a health and nutrition scheme for secondary schools which aims to encourage health promoting links between health professionals, teachers and local schools. It integrates oral health and nutrition, and is the result of findings that school children were eating too many high fat and high sugar foods, and not enough fruit and vegetables. The teaching pack includes photographs and illustrations and gives examples relevant to schoolchildren. It consists of a series of challenges, and a pilot pack is already being used in nine secondary schools in North East Hampshire.

The purpose of this article is to report on baseline intakes of 1874 third-grade children representing a subsample of the Child and Adolescent Trial for Cardiovascular Health (CATCH) cohort. Intakes were assessed using a single, food record-assisted, 24-hour recall. The sample is unique in that it is drawn from four states and includes students from various ethnic backgrounds. Nutrients of interest include total energy, sodium, dietary cholesterol, and percent of energy from total fat and saturated fat. At baseline, third-grade students were consuming above nationally recommended levels of energy from fat, saturated fat, and sodium. The CATCH findings show a mean energy intake of 2031 kcal with significant differences by sex. Significant differences by site were seen for percent of energy from total fat, saturated fat, and dietary cholesterol. Children from Minnesota consumed the lowest proportion of energy from total fat and saturated fat while children from Texas had the highest proportion of energy from total fat and saturated fat. Intake of dietary cholesterol was lowest in Minnesota and highest in Louisiana. Nutrient differences by ethnic group were seen only for energy, with African Americans having the highest energy intake and Hispanics having the lowest energy intake. The number of meals consumed from school food service significantly influenced children's nutrient intake; children consuming two meals from school food service had significantly greater intakes of energy, saturated fat, and dietary cholesterol compared to students consuming one or no meals from school food service. The results are compared to other national nutritional surveys of children.

Sharing meals together, both in terms of their social construction and the social rules which govern behaviour, is thought to be the essence of our sociality. Teaching and Learning about Food and Nutrition in Schools (reported by Burgess and Morrison in 1995) is an ESRC funded project, which, as part of the Nation's Diet Programme: The Social Science of Food Choice investigated food use and eating in schools. Prior to the project social scientists had seldom focused upon the social and educational contexts in which children and young people learned about food as classroom activity, as routinised eating in schools, or at the interface between home and school. It is at the meeting point of such interests that this paper on the social significance of eating together is framed. Interview and diary data from parents, 'dinner ladies' and pupils, in combination with research observations, are used to explore familial perspectives on the changing relationship between eating at home and school in two primary school case studies. The discussion of school eating arrangements highlights the complex issues underpinning the advocacy of school meals, not only in terms of nutritional impact but also in relation to the cross-cutting effects of institutional practice, socio-economic advantage and disadvantage, and cultural preference. The alleged decline of the 'proper' shared meal is also contested. Rather, the data show commensality being produced and reproduced in different forms.

The nutritional status of 89 school-aged children living and working on the streets of Jakarta, Indonesia was assessed. Seventy-nine percent of the children were children 'on' the street who still had regular contact with their families, whereas only 21% of the children were 'of' the street who had only remote or no contact with their families. The mother was more likely to be present in the home of the children on the street than in the home of the children of the street. The average earning of the children was between 2000 and 3000 rupiah/day (U.S.$1 =2000 Indonesian Rupiah). The distribution of height-for-age relative to the NCHS reference standard indicated that 52% of the children were stunted (below the third centile of the standard). However, the distribution of weight-for-height was close to that of the reference population standard, and only 7% of the children were wasted (below the third centile of the standard). Comparison of the data from these street children with those of other school-aged children living in Jakarta slums shows that street children weigh more and are taller than their socio-economic peers. Key words - nutritional status, poverty, street children, urban nutrition, Indonesia

Children from the lower socioeconomic status consume less macronutrients and breakfast cereal, more full fat milk and receive most of their energy from snacks, as a compared to children from high socioeconomic status. Most of the lower socioeconomic children take school lunches instead of home lunches. Higher socioeconomic children consume higher levels of vitamin A, beta-carotene, vitamin B1, B2, folate and total sugars, and lower levels of fats. The consumption of vitamin E is higher in lower socioeconomic children than in higher socioeconomic children.

The cognitive ability and memory of Peruvian schoolchildren may improve after eating a school breakfast. Compared to children who drank a diet soda, short-term memory skills were higher among those 54 schoolchildren who had a cake and milk beverage for breakfast. Attendance and vocabulary skills rose among those children at ten rural schools in the region who had eaten breakfast. Vocabulary scores were also higher in relation to higher body weight in proportion to height, a function of malnutrition and stunting.

Cardiovascular health interventions based on food service and physical education improvements at elementary schools in addition to family participation appears to decrease the fat intake and increase the vigorous physical activity of children. The Child and Adolescent Trial for Cardiovascular Health (CATCH) was implemented at 56 schools in diverse communities in California, Louisiana, Minnesota and Texas. An additional 40 non-intervention schools were used as controls. A total of 5106 students were followed from third through fifth grade. With intervention, the percentage of energy in school lunches derived from fat decreased and the intensity of physical exercise increased significantly compared to non-intervention. Students' reported fat intake decreased and their reported vigorous physical activity increased significantly with intervention. Serum cholesterol, blood pressure and body size were not found to change significantly with intervention.

School feeding programs exist in many countries, but few have been properly evaluated. In this study, the short-term effects of breakfast on children's cognitive functions were examined, The subjects were 97 undernourished (weight-for-age [less than or equal to]-1 SD of reference) and 100 adequately nourished (weight-for-age >-1 SD) children in four primary schools in rural Jamaica. The children were randomly assigned to a group provided with breakfast or a group given a quarter of an orange as a placebo, and then given a battery of four cognitive function tests. After a few weeks the treatments were reversed and the tests repeated. Undernourished children's performance improved significantly on a test of verbal fluency when they received breakfast, whereas that of the adequately nourished children did not change (breakfast X group interaction, P < 0.05). There were no other effects of breakfast on test scores. The findings extend those of a previous Jamaican study conducted under more controlled conditions, and support the targeting of school meals to undernourished children. INDEXING KEY WORDS: undernutrition; cognitive function; breakfast; humans

According to the leaders in the field of nutrition education, two of the best ways to improve the quantity and quality of childhood nutrition education are (a) more collaboration at […]

An assessment of nutrition education needs and learning preferences of students in grades 5, 8, and 11 was conducted to target instruction toward areas of highest need and strongest interest of students using teaching methods they prefer. This research evaluated students' knowledge, attitudes, and practices related to the Dietary Guidelines for Americans, including knowledge of the new Food Guide Pyramid; attitudes about school lunches and learning about nutrition; nutrition topics of interest; and preferred methods for learning about nutrition. Although results varied across grade level, generally students need to learn about the Food Guide Pyramid; the relationship between dietary fat, weight status, and health; and food sources of fat, salt, and fiber. They want to learn about personal health -- how to control weight, improve diet, and prevent disease -- using instructional methods that actively involve them. Results provide information relative to students' interest, understanding, and application of the Dietary Guidelines., National objectives for nutrition education of children have been identified by the US Dept. of Health and Human Services,[1] the US Dept. of Education,[2] and the Nutrition Education and Training [...]

A report released by the Dept. of Agriculture (USDA) has concluded that 99% of US schools need to improve the nutritional value of their meals. Schools are serving too much fatty food with high salt content while neglecting carbohydrates. As a result, the USDA along with Congress are working to develop plans and legislation to improve nutritional value of school meals. Some schools have already responded by increasing the volume of fresh fruit and vegetables in school cafeteria menus.

A school-based curriculum that encourages increased consumption of fruits and vegetables among schoolchildren was pilot-tested among 4th and 5th grade students at two elementary schools in Richmond, GA. The curriculum was developed in line with nutrition guidelines that encourage an increase in fruit and vegetable intake to prevent such chronic diseases as cardiovascular disease and cancer. An assessment of the curriculum shows that a more comprehensive intervention by the school is needed as school-based nutrition education does not seem to lead to an increase in fruit and vegetable consumption.

The mean values derived from food composition tables of select nutrients of school lunch items are accurate when compared with chemical studies on the same lunch items. Calculated values derived from a computerized nutrient database were compared with chemical analyses of 60 school lunch foods and recipes for five nutrients including total fat, saturated fat, mono-unsaturated fat, polyunsaturated fat and sodium. Computerized nutrient databases may be employed in nutrition programs such as Child and Adolescent Trial for Cardiovascular Health (CATCH).

Breakfast is important for children, although almost 300,000 children in the UK do not eat before going to school in the morning. More than 60% of children eat ready-to-eat (RTE) breakfast cereals, such as 'Cornflakes'. RTEs are more likely to be eaten by boys than girls, who prefer toast or bread. Breakfast can provide between 10-30% of the intake of several important nutrients daily. Problem-solving abilities were shown to be improved by eating breakfast in a study of children aged 9-11 years. However, the omission of breakfast led to improved attention span and short-term memory recall. In a study of Scottish 7-8 year olds, those eating RTE cereals had higher intakes of folate, nicotinic acid, vitamins B6 and B2, and had lower percentage energy derived from fat.

The availability of low-fat entrees may reduce the amount of fat consumed by children participating in an elementary school lunch program. Many children may choose a low-fat entree over a higher-fat entree if it is available. A study examined daily entree choices of children participating in a school lunch program with a choice of two entrees. A low-fat entree was offered 23% of the days during the six months preceding a dietary intervention program. Thirty-nine percent of the students chose the low-fat entree during this period. A low-fat entree was offered 71% of the days by the end of an eight-month intervention program, and 29% of the students chose it. The average number of calories from fat in a meal decreased from 36% to 30% after the start of the intervention program., Objective. To determine whether making a low-fat entree available as one of two choices in an elementary school lunch program would reduce the fat content of meals selected by children. Design. In this before-after trial, students had a daily choice between two entrees, one of which was sometimes low-fat. For 93% of school days during 14 consecutive school months, daily entree choices were recorded for 619976 student meals. The fat content of entrees was assessed with a computerized nutrient database supplemented by food manufacturer&apos;s data. Setting. Sixteen elementary schools in the Bellevue (Washington) School District. Participants. The number of students eating school lunch averaged 2440 per day, of whom 25% were less than 185% of poverty. Intervention. After a baseline period of 6 months, the intervention increased the number of days per month when one of the two entrees had 30% or fewer calories from fat. Main outcome measures. Data for the entire district were combined to estimate for each month the percent of students who selected low-fat entrees and the percent of calories from fat in the average meal selected by students. Results. During the 6 months before the intervention, a low-fat entree was available on 23% of days; it was selected by 39% of students; and the average meal selected by students had 36% of calories from fat. By the end of the 8-month intervention, a low-fat option was available on 71% of days; it was selected by 29% of students; and the fat content of the average meal dropped from 36% to 30% of calories from fat (P = .02). Conclusions. In this school district, many students, given the choice, selected low-fat entrees. Recommendations for dietary fat were met simply by the environmental intervention of increasing the availability of low-fat foods. Pediatrics 1993;91:1107-1111; child nutrition, food preferences, diet surveys, schools, dietary fat, child, nutrition.

The Year 2000 Goals for the U.S. identify a goal of five servings per day of fruits and vegetables (F&V), which is roughly double what children are currently eating. Focus group discussions (based on the reciprocal determinism concept in social learning theory) were conducted with 4th and 5th grade students, their parents, teachers, and school food service workers, in preparation for the design of a school nutrition education program to increase consumption of F&V. A social learning theory perspective was taken because it has been demonstrated to be useful in the design of effective school nutrition education programs. A theory-based protocol delineating the sequence of questions to be asked in each focus group was designed before each group met. Discussions were conducted with ten groups of students, two groups each of teachers and of parents, and one of school food service employees. Three general factors appeared to be most likely to increase F&V consumption in these children: increasing availability of F&V in the home, enhancing liking for vegetables, and providing skills in increasing F&V availability and in preparing F&V.

There is a movement underway by the American School Food Service Assn to see to the passage of the Universal Student Nutrition Act of 1993 that will provide both lunch and breakfast to all students regardless of income. It has been shown in studies that students that eat breakfast at school, do better in school. Two examples of successful breakfast programs are in place in Danbury, CT, and Albuquerque, MN. Currently there are about 50,000 school breakfast programs across the US.

This review examined the major school-based nutrition education research studies conducted during the decade of the 1980s. General nutrition education studies were based primarily on a knowledge-attitude-behavior approach, while disease reduction/health enhancement studies were behaviorally oriented and generally based on social learning theory. Research designs and methodologies have been greatly improved, compared with previous reviews. A major finding was that most studies involved only 10-15 hours of instruction over a 3-15 week period. These short studies resulted in a positive effect on cognitive outcomes such as nutrition knowledge, diet-related skills, behavioral expectations, and self-efficacy. The effect on attitudes was inconsistent but generally positive. The impact of general nutrition education programs on behavior was minimal. The impact of the more specifically targeted behavioral programs was slightly more positive but still inconsistent. Programs that were several years in duration resulted in changes in dietary intakes and physiological parameters. Teacher preparation increased the time spent on nutrition education. Parent involvement enhanced classroom instruction for younger children, particularly when it was of sufficient intensity and duration. The educational impact of modifying school lunch menus has received little study. Implications for practice and research are discussed.

School meals today are provided on a compromise basis; some pupils are charged and others are not. The compromise thus rejects two types of universalistic principles: allocating private benefits by the market and provision of merit goods collectively free of charge. The article examines, empirically and conceptually, the changing meaning of school meals; the demand and supply of school meals and the allocation of public subsidies to non-needy children; conflicting goals of expert nutritionists, egalitarians, redistributionists, efficient managers, and parents and children. The article concludes by considering political constraints on rationalising the programme in the name of universalistic principles. These constraints include the inheritance of commitments from previous governments, collective responsibility of spending and Treasury ministers; intra-party divisions between frontbench and backbench MPs; and low political salience of charging as an issue.