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      The costs and calorie content of à la carte food items purchased by students during school lunch

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          Abstract

          School environments influence student food choices. À la carte foods and beverages are often low nutrient and energy dense. This study assessed how much money students spent for these foods, and the total kilocalories purchased per student during the 2012–2013 school year. Six elementary and four intermediate schools in the Houston area provided daily food purchase transaction data, and the cost and the calories for each item. Chi-square analysis assessed differences in the number of students purchasing à la carte items by grade level and school free/reduced-price meal (FRP) eligibility. Analysis of covariance assessed grade level differences in cost and calories of weekly purchases, controlling for FRP eligibility. Intermediate grade students spent significantly more on à la carte food purchases and purchased more calories (both p < 0.001) than elementary school students. Lower socioeconomic status (SES) elementary and intermediate school students purchased fewer à la carte foods compared to those in higher SES schools (p < 0.001). Intermediate school students purchased more à la carte foods and calories from à la carte foods than elementary students. Whether the new competitive food rules in schools improve student food selection and purchase, and dietary intake habits across all grade levels remains unknown.

          Highlights

          • Intermediate schools offered >40 competitive food items.

          • Nine competitive food items were available in elementary schools.

          • Intermediate school students bought more competitive foods than younger students.

          • Intermediate school students spent more money on these foods than younger students.

          • Intermediate school students bought more calories than elementary students.

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          Most cited references21

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          A conceptual framework for early adolescence: a platform for research.

          Early adolescence (ages 10-14 years) is among the most neglected stages of development, yet there are few stages during the life course where changes are as dramatic. The present conceptual framework proposes four central goals to be achieved by early adolescence: engagement with learning, emotional and physical safety, positive sense of self/self-efficacy, acquisition of life/decision-making skills. The framework proposes an ecological model where the macro level factors (economic forces, historical events, national priorities, laws/policies/norms and values, national events, and political realities) all set the contexts that influence community, family, school and peer factors that all in turn influence the adolescent. Existing indicators for points of development are noted as are future areas of research priority.
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            Smarter lunchrooms can address new school lunchroom guidelines and childhood obesity.

            New US Department of Agriculture regulations have altered what foods schools offer for lunch, but schools cannot require students to eat specific foods. An intervention using the behavioral science principle known as "libertarian paternalism" led junior-senior high school students to eat more fruits and vegetables by making these foods more convenient, attractive, and normative. Copyright © 2013 Mosby, Inc. All rights reserved.
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              Pre-sliced fruit in school cafeterias: children's selection and intake.

              It is often assumed that children avoid fruit in school cafeterias because of higher relative prices and preferences for other foods. Interviews with children reveal that eating whole fresh fruit can be difficult for those with small mouths or braces. Older girls find whole fruits messy and unattractive to eat. To determine the effect of offering pre-sliced fruit in schools on selection and intake. Three of six schools were assigned randomly to serve apples in slices. Three control schools served apples whole. Selection, consumption, and waste of apples were measured prior to and during treatment. Cafeterias in six public middle schools in Wayne County NY in 2011. Participants included all students who purchased lunch on days when data were collected. Treatment schools were provided with a standard commercial fruit slicer, and cafeteria staff members were instructed to use it when students requested apples. Trained researchers recorded how much of each apple was consumed and how much was wasted in both control and treatment schools. Daily apple sales, percentage of an apple serving consumed per student, and percentage of an apple serving wasted per student. Data were analyzed in 2012. Schools that used fruit slicers to pre-slice fruit increased average daily apple sales by 71% compared to control schools (p<0.01). The percentage of students who selected apples and ate more than half increased by 73% (p=0.02) at schools that served pre-sliced fruit, and the percentage that wasted half or more decreased by 48% (p=0.03). Sliced fruit is more appealing to children than whole fruit because it is easier and tidier to eat. This study applies the principle of convenience from behavioral economics and provides an example of a scalable, low-cost environmental change that promotes healthy eating and decreases waste. Copyright © 2013. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.
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                Author and article information

                Contributors
                Journal
                Prev Med Rep
                Prev Med Rep
                Preventive Medicine Reports
                Elsevier
                2211-3355
                13 March 2018
                June 2018
                13 March 2018
                : 10
                : 162-166
                Affiliations
                [a ]Baylor CHI St. Luke's Hospital, 6720 Bertner Ave., Houston, TX 77030, United States
                [b ]University of Houston, Health Research Institute, Houston, TX 77204, United States
                [c ]Texas Woman's University, Department of Nutrition and Food Sciences, 6700 Fannin St., Houston, TX 77030, United States
                [d ]USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Department of Pediatrics, 1100 Bates St., Houston, TX 77030, United States
                Author notes
                [* ]Corresponding author. kcullen@ 123456bcm.edu
                Article
                S2211-3355(18)30041-X
                10.1016/j.pmedr.2018.03.004
                5984217
                6fcd0c8e-c6fe-4eea-87b1-48421be1ad86
                © 2018 Published by Elsevier Inc.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 14 November 2017
                : 1 February 2018
                : 9 March 2018
                Categories
                Regular Article

                national school lunch program,elementary schools,intermediate schools,à la carte foods,competitive foods,costs,calories

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