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The Pediatric Forum
Nov 2011

National School Lunch Program for All

Author Affiliations

Author Affiliation: Eastern Michigan University, School of Health Sciences, Ypsilanti.

Arch Pediatr Adolesc Med. 2011;165(11):1051. doi:10.1001/archpediatrics.2011.181

I am responding to the April 2011 article by Hernandez et al1 entitled “National School Lunch Program Participation and Sex Differences in Body Mass Index Trajectories of Children From Low-Income Families.” I believe the main exposure, participation in the National School Lunch Program, was incorrectly measured.

Hernandez et al used parental reports of whether children received free or reduced-price lunches at school as a measure of participation in the National School Lunch Program. Eligibility for free and reduced-price meals is based on income and is an indirect measure of socioeconomic status.

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