title: Impact of the Pathways food service intervention on breakfast served in American-Indian schools.
abstract: BACKGROUND
  Pathways was a multisite, multicomponent obesity prevention intervention for American-Indian schoolchildren. The goal of the school breakfast and lunch component was to reduce fat content of school meals to 30% or fewer calories from fat without compromising dietary quality.
  
  
  METHODS
  An intensive 3-year intervention was implemented with school food service staff. Five consecutive days of school breakfast menu and recipe information was collected at 20 control and 19 intervention schools at four time intervals. Data were analyzed at nutrient and (in final year) food levels.
  
  
  RESULTS
  Average total fat decreased in intervention schools from 16.0 grams at baseline to 13.6 grams by end of study, compared with 16.6 and 16.7 grams at baseline and final measurement in control schools (P<0.030). Percentage of calories from saturated fat were also significantly reduced from 12.0 to 8.9%, compared with 12.1 to 10.6% in control schools (P<0.014). There were no significant differences in total energy or other nutrients by treatment condition across four time points. Food-level data revealed a consistent pattern of more lower-fat items served in intervention schools compared to control schools.
  
  
  CONCLUSIONS
  Pathways was successful in achieving its overall goal of reducing dietary fat in meals served for school breakfasts.
authors.affiliation: Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA. lcsabo@unm.edu
authors.forename: Leslie
authors.initials: L
authors.lastname: Cunningham-Sabo
authors.forename: M Patricia
authors.initials: MP
authors.lastname: Snyder
authors.forename: Jean
authors.initials: J
authors.lastname: Anliker
authors.forename: Janice
authors.initials: J
authors.lastname: Thompson
authors.forename: Judith L
authors.initials: JL
authors.lastname: Weber
authors.forename: Olivia
authors.initials: O
authors.lastname: Thomas
authors.forename: Kimberly
authors.initials: K
authors.lastname: Ring
authors.forename: Dawn
authors.initials: D
authors.lastname: Stewart
authors.forename: Harrison
authors.initials: H
authors.lastname: Platero
authors.forename: Linda
authors.initials: L
authors.lastname: Nielsen
mesh_terms: D002648:Child; D002664:Child Nutritional Physiological Phenomena; D005260:Female; D005522:Food Services / Q000592:standards*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D009753:Nutritive Value; D009765:Obesity / Q000208:ethnology* / Q000517:prevention & control*; D011322:Primary Prevention; D015397:Program Evaluation; D012574:Schools; D014481:United States