Caroline H. Guinn

The National Health and Nutrition Examination Survey’s food insecurity questionnaire was administered to 155 children (77 African American, 65 white, 13 “other” [7 Hispanic; 6 mixed races]) in grade 4 twice, 28–32 days apart. Test-retest reliabilities were modest and somewhat similar for assessment mode (classroom, interview) and subgroup variables (gender, race, socioeconomic status, academic achievement, body mass index percentile, social desirability). As academic achievement increased, white and other children reported less food insecurity, and African American children reported slightly less. As social desirability increased, white and African American children reported slightly more food insecurity, and other children reported substantially more. Although the questionnaire may be acceptable for use with diverse groups of children in grade 4, validation is needed.

Validation-study data were analysed to investigate retention interval (RI) and prompt effects on the accuracy of fourth-grade children’s reports of school-breakfast and school-lunch (in 24-h recalls), and the accuracy of school-breakfast reports by breakfast location (classroom; cafeteria). Randomly selected fourth-grade children at ten schools in four districts were observed eating school-provided breakfast and lunch, and were interviewed under one of eight conditions created by crossing two RIs (‘short’ – prior-24-hour recall obtained in the afternoon and ‘long’ – previous-day recall obtained in the morning) with four prompts (‘forward’ – distant to recent, ‘meal name’ – breakfast, etc., ‘open’ – no instructions, and ‘reverse’ – recent to distant). Each condition had sixty children (half were girls). Of 480 children, 355 and 409 reported meals satisfying criteria for reports of school-breakfast and school-lunch, respectively. For breakfast and lunch separately, a conventional measure – report rate – and reporting-error-sensitive measures – correspondence rate and inflation ratio – were calculated for energy per meal-reporting child. Correspondence rate and inflation ratio – but not report rate – showed better accuracy for school-breakfast and school-lunch reports with the short RI than with the long RI; this pattern was not found for some prompts for each sex. Correspondence rate and inflation ratio showed better school-breakfast report accuracy for the classroom than for cafeteria location for each prompt, but report rate showed the opposite. For each RI, correspondence rate and inflation ratio showed better accuracy for lunch than for breakfast, but report rate showed the opposite. When choosing RI and prompts for recalls, researchers and practitioners should select a short RI to maximise accuracy. Recommendations for prompt selections are less clear. As report rates distort validation-study accuracy conclusions, reporting-error-sensitive measures are recommended.

BACKGROUND A 2010 publication showed a positive relationship between children's body mass index (BMI) and energy intake at school‐provided meals (as assessed by direct meal observations). To help explain that relationship, we investigated 7 outcome variables concerning aspects of school‐provided meals: energy content of items selected, number of meal components selected, number of meal components eaten, amounts eaten of standardized school‐meal portions, energy intake from flavored milk, energy intake received in trades, and energy content given in trades. METHODS Fourth‐grade children (N = 465) from Columbia, SC, were observed eating school‐provided breakfast and lunch on 1 to 4 days per child. Researchers measured children's weight and height. For daily values at school meals, a generalized linear model was fit with BMI (dependent variable) and the 7 outcome variables, sex, and age (independent variables). RESULTS BMI was positively related to amounts eaten of standardized school‐meal portions (p < .0001) and increased 8.45 kg/m² per serving, controlling for other variables in the model. BMI was positively related to energy intake from flavored milk (p = .0041) and increased 0.347 kg/m² for every 100 kcal consumed. BMI was negatively related to energy intake received in trades (p = .0003) and decreased 0.468 kg/m² for every 100 kcal received. BMI was not significantly related to 4 outcome variables. CONCLUSIONS Knowing that relationships between BMI and actual consumption, not selection, at school‐provided meals explained the (previously found) positive relationship between BMI and energy intake at school‐provided meals is helpful for school‐based obesity interventions.

Analyses were conducted to examine variations in fourth-grade children’s participation in school-breakfast and school-lunch programs by weekday, month, socioeconomic status, absenteeism, sex, and school-breakfast location. Fourth-grade children were participants in a dietary-reporting validation study during the 2005–2006 or 2006–2007 school years in 17 or 8 schools, respectively, in one South Carolina school district. For the two respective school years, school-breakfast location was the classroom for six and seven schools, and for the remaining schools, the cafeteria. District administrative records provided information about 180 possible days of participation in the school-breakfast and school-lunch programs for each of 1,060 children (91% Black, 52% girls). The state’s Office of Research and Statistics linked data on school-meal participation with information about individual children’s socioeconomic status (eligibility for free or reduced-price school meals) and annual absenteeism from school. For school-provided breakfast, logistic regression showed participation rate differences by weekday (smallest for Monday [56.1%], largest for Wednesday [57.8%], p<0.0001), month (smallest for April [53.5%], largest for September [60.8%], p<0.0001), socioeconomic status (smallest for full-price status [27.5%], largest for free-meal status [63.4%], p<0.0001), school-breakfast location (smaller for breakfast located in the cafeteria [38%] than classroom [71%], p<0.0001), and absenteeism (p<0.0001). For school-provided lunch, logistic regression showed participation rate differences by weekday (smallest for Friday [81.9%], largest for Thursday [83.3%], p<0.0001), month (smallest for May [78.7%], largest for August [86.0%], p<0.0001), socioeconomic status (smallest for full-price status [72.1%], largest for free-meal status [84.9%], p<0.0001), and absenteeism (p<0.0001). There were no differences in participation rate by sex. Administrative participation records are used for forecasting purchasing and production. Using such records in research studies may provide insight into aspects of children’s participation in school-provided meals. Districts and managers are encouraged to share administrative records of children’s participation in school-provided meals with researchers.