Consumption of Low-Nutrient, Energy-Dense Foods and Beverages at School, Home, and Other Locations among School Lunch Participants and Nonparticipants

Background Access to foods and beverages on school campuses, at home, and other locations affects children's diet quality, energy intake, and risk of obesity. Objectives To describe patterns of consumption of "empty calories"-low-nutrient, energy-dense foods, including sugar-sweetened beverages-by eating location among National School Lunch Program (NSLP) participants and nonparticipants. Design Cross-sectional study using 24-hour dietary recall data from the 2004-2005 third School Nutrition Dietary Assessment Study. Subjects/setting A nationally representative sample of 2,314 children in grades one through 12, including 1,386 NSLP participants. Statistical analyses performed Comparisons, using t tests, of the proportion of children consuming low-nutrient, energy-dense foods and beverages, mean daily energy and energy from low-nutrient, energy-dense foods, and energy density by NSLP participation status. Results On a typical school day, children consumed 527 "empty calories" during a 24-hour period. Eating at home provided the highest mean amount of energy from low-nutrient, energy-dense foods (276 kcal vs 174 kcal at school and 78 kcal at other locations). NSLP participants consumed less energy from sugar-sweetened beverages at school than nonparticipants (11 kcal vs 39 kcal in elementary schools and 45 kcal vs 61 kcal in secondary schools, P < 0.01), but more energy from low-nutrient, energy-dense solid foods such as french fries and higher-fat baked goods in secondary schools (157 kcal vs 127 kcal, P < 0.01). Participants were not more likely to consume sugar-sweetened beverages or low-nutrient, energy-dense foods at home or other locations. School lunch participants' consumption at school was less energy-dense than nonparticipants' consumption at school (P < 0.01). Energy density was highest for consumption at locations away from home and school. Conclusions Improving home eating behaviors, where the largest proportion of total daily and energy from low-nutrient, energy-dense foods are consumed (especially from sugar-sweetened beverages, chips, and baked goods) is warranted. At schools, consumption of energy from low-nutrient, energy-dense foods may be reduced by limiting access to competitive foods and beverages, enforcing strong school wellness policies, and minimizing the frequency of offering french fries and similar potato products and higher-fat baked goods in school meals or A la carte.