Georgianna Mann

A Comparison of Fruits, Vegetables, Sugar-Sweetened Beverages, and Desserts in the Packed Lunches of Elementary School Children

BACKGROUND An estimated 40% of children bring a packed lunch to school. These lunches are not required to meet nutrition standards. The aim of this study was to compare differences in the nutritional quality of elementary packed lunches by the presence or absence of sugar-sweetened beverages (SSB), desserts, and fruits and vegetables (FVs). METHODS Observational data for prekindergarten and kindergarten packed lunches were collected from three schools in rural Virginia for 5 consecutive school days and analyzed for macro- and micronutrients and by the presence or absence of food and beverage items. RESULTS Of the 561 packed lunch observations collected, 41.7% contained no FV, 41.2% contained an SSB, and 61.1% contained a dessert. The nutrient profile of packed lunches with at least one fruit or vegetable had significantly higher levels of carbohydrate, fiber, sugar, vitamin A, and vitamin C. Packed lunches containing an SSB had significantly higher levels of sugar and vitamin C and significantly lower levels of protein, fiber, vitamin A, calcium, and iron. Packed lunches containing a dessert had significantly higher levels of energy, carbohydrate, fat, saturated fat, sodium, sugar, vitamin C, and iron and significantly lower levels of vitamin A. CONCLUSIONS Additional research is needed to fully understand parent and child motivations for packing lunches and the decision processes that influence the inclusion of food items. The development of packed lunch interventions, encouragement of National School Lunch Program participation, or enactment of school policies to increase the nutritional value of packed lunches is warranted.

Smart Snacks in School Legislation Does Not Change Self-Reported Snack Food and Beverage Intake of Middle School Students in Rural Appalachian Region

Objective: To assess the effects of the national Smart Snacks in School standards, which include nutrient and ingredient limitations for school competitive foods and beverages effective July, 2014, on student intake in low‐income rural Appalachian middle schools. Methods: Food‐frequency questionnaires were administered to students before and after implementation. Multiple ordinal logistic regression models were conducted to examine effects from year of data collection, grade, and free or reduced price lunch participation rates. Results: No significant changes were observed after implementation except a decrease in consumption of 1% or nonfat flavored milk at school. Conclusions and Implications: Smart Snacks in School standards did not result in significant dietary changes in this study. Longitudinal studies could evaluate long‐term impacts of nutrition standards.

The Availability of Competitive Foods and Beverages to Middle School Students in Appalachian Virginia Before Implementation of the 2014 Smart Snacks in School Standards

The study objective was to examine the nutritional quality of competitive foods and beverages (foods and beverages from vending machines and à la carte foods) available to rural middle school students, before implementation of the US Department of Agriculture’s Smart Snacks in School standards in July 2014. In spring 2014, we audited vending machines and à la carte cafeteria foods and beverages in 8 rural Appalachian middle schools in Virginia. Few schools had vending machines. Few à la carte and vending machine foods met Smart Snacks in School standards (36.6%); however, most beverages did (78.2%). The major challenges to meeting standards were fat and sodium content of foods. Most competitive foods (63.4%) did not meet new standards, and rural schools with limited resources will likely require assistance to fully comply.

National Food Affordability: A County-Level Analysis

The purpose of this study was to explore the sociodemographic factors that contribute to food affordability across space, with specific emphasis on rural and urban differences in the United States. A regression analysis was used to predict food affordability from several predictors in rural and urban areas, with a subanalysis of Appalachian and Delta counties. Rural households had significantly higher food expenditures to income ratios compared with urban counties; Appalachian and Delta counties had the highest on average food expenditure to income ratio. Affordable food buffers vulnerable families against food insecurity and subsequent chronic health issues, which are especially relevant in the Appalachian and Delta counties.