Objectives: Schools have an important role to play in obesity prevention, but little is known about the food environment in small, predominately rural schools. The primary purpose of this study was to compare the availability and student purchasing of foods sold outside of the reimbursable meals program through à la carte or vending (ie, competitive foods) in small (n=7) and large (n=6) Kansas high schools. Methods: A cross-sectional observational study design was used to capture the number of à la carte and vending items available and purchased, and the fat and energy content of all available and purchased items on a single school day between January and May 2005. Results: Small schools had significantly fewer vending machines than large schools (median 3.0 [range 2.0 to 5.0] vs 6.5 [range 4.0 to 8.0], P<0.01]. Vending and à la carte items at small schools contained a median of 2.3 fewer fat grams per item (P≤0.05), whereas vending products contained a median of 25 kcal fewer per item (P≤0.05) than at large schools. Significantly less fat (median -15.4 g/student) and less energy (median -306.8 kcal/student) were purchased per student from all competitive food sources and from à la carte (median -12.9 g fat and -323.3 kcal/student) by students in small schools compared to students in large schools (P≤0.05). Conclusions: The findings, which highlight less availability and lower energy content from competitive foods at small compared to large schools, have implications for understanding how small schools support their foodservice programs with limited dependence on competitive foods and the influence that food and nutrition professionals can have on school environments by providing more oversight into the nutritional quality of foods available.
Bibliographical noteFunding Information:
This study describes the school environment in small, rural schools and examines differences in competitive food availability and purchasing by school size. The findings, which highlight less availability and lower energy content from competitive food sources at small compared to large schools, have implications for understanding how small schools support their foodservice programs with limited dependence on competitive foods. Findings also have implications for understanding the role that food and nutrition professionals can play in improving the school environment by guiding school foodservice personnel and providing more oversight into product selection and the nutritional quality of available foods. Although more research is needed to understand how foodservice programs are funded at the local level, including the extent to which schools rely on competitive food sales to support their foodservice programs and how the sale of competitive foods affects federal funding for the NSLP, small schools may provide a model for how self-supported foodservice programs can be run with limited dependence on competitive food sales. This work was supported by a Pfizer New Faculty in Public Health Award to the first author (N.L.N.). C. Befort is an assistant professor, Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City T. Snow is a project manager, Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City A. McGrath Davis is an associate professor, Department of Behavioral Pediatrics, University of Kansas Medical Center, Kansas City J. Mahnken is an assistant professor, Department of Biostatistics, University of Kansas Medical Center, Kansas City Q. Hou is a teaching associate, Department of Biostatistics, University of Kansas Medical Center, Kansas City M. Story is a professor, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis J. S. Ahluwalia is the associate dean for clinical research, University of Minnesota Medical School, Minneapolis