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October 1994

Characteristics of Children Selecting Low-Fat Foods in an Elementary School Lunch Program

Author Affiliations

From the Departments of Pediatrics (Drs Whitaker and Wright) and Medicine (Drs Koepsell and Psaty), University of Washington School of Medicine, the Robert Wood Johnson Clinical Scholars Program, University of Washington (Dr Koepsell), and the Departments of Health Services and Epidemiology (Drs Koepsell and Psaty), University of Washington School of Public Health and Community Medicine, Seattle; and Bellevue (Wash) Nutrition Services, Bellevue School District (Ms Finch).

Arch Pediatr Adolesc Med. 1994;148(10):1085-1091. doi:10.1001/archpedi.1994.02170100083016

Objective:  To describe the demographic characteristics of children that were associated with the selection of low-fat entrees available in a school lunch program.

Design:  For 5 consecutive months, we recorded student entree selections on the 46 days in which one of the two available lunch entrees was low fat (≤30% of calories from fat). Entree selections were tracked using a computerized meal-card system. The lunch menus did not indicate that one of the two entrees was low fat. Demographic and family characteristics were obtained from the school district's registration database and, in one school, from a household telephone survey.

Setting:  A school lunch program in two public elementary schools in Bellevue, Wash.

Participants:  Students who regularly eat school lunches (N=471). Sixty-five percent were from families with incomes less than 185% of the federal poverty level, and 49% were nonwhite.

Intervention:  None.

Main Outcome Measure:  The proportion of days that each student selected the low-fat entree.

Results:  Girls selected the low-fat entree more often than boys (33% of days vs 27% of days; P<.001), and the proportion of students selecting the low-fat entree increased with grade level (P=.003). Children were more likely to select low-fat entrees if a household member was known to have an elevated blood cholesterol level (P=.004). The proportion of students selecting the low-fat entree increased with maternal education level (P=.007), but children receiving free or reduced-price lunches (<185% of the federal poverty level) chose the low-fat entree as often as those receiving full-price lunches (30% of days vs 29% of days; P=.14). There were no significant differences in entree selection among races.

Conclusions:  Given a choice of low-fat school lunch entrees, girls, older children, and those who had family members with elevated cholesterol levels were most likely to select these entrees. While parental education level was directly related to the selection of low-fat entrees, race and family income had little association with entree selection.(Arch Pediatr Adolesc Med. 1994;148:1085-1091)