title: The school food environment associations with adolescent soft drink and snack consumption.
abstract: BACKGROUND
  Because students may purchase food and drinks in and around their schools, the school food environment may be important for obesity-related eating behaviors such as soft drink and snack consumption. However, research exploring the associations between school environments and specific eating behaviors is sparse.
  
  
  METHODS
  Associations of the availability of canteen food and drinks, the presence of food stores around schools, and individual cognitions (attitudes, norms, modeling, perceived behavioral control, and intentions) with soft drink and snack consumption were examined in a cross-sectional study (2005-2006) among 1,293 adolescents aged 12-15 years. Soft drink and snack consumption and related cognitions were assessed with self-administered questionnaires. The presence of food stores and the distance to the nearest food store were calculated within a 500-meter buffer around each school. Data on the availability of soft drinks and snacks in school canteens were gathered by observation. In 2007, multilevel regression models were run to analyze associations and mediation pathways between cognitions, environmental factors, and behaviors.
  
  
  RESULTS
  Adolescents' attitudes, subjective norms, parental and peer modeling, and intentions were positively associated with soft drink and snack consumption. There was an inverse association between the distance to the nearest store and the number of small food stores with soft drink consumption. These effects were mediated partly by cognitions.
  
  
  CONCLUSIONS
  This study provided little evidence for associations of environmental factors in the school environment with soft drink and snack consumption. Individual cognitions appeared to be stronger correlates of intake than physical school-environmental factors. Longitudinal research is needed to confirm these findings.
authors.affiliation: Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands. k.vanderhorst@erasmusmc.nl
authors.forename: Klazine
authors.initials: K
authors.lastname: van der Horst
authors.forename: Anna
authors.initials: A
authors.lastname: Timperio
authors.forename: David
authors.initials: D
authors.lastname: Crawford
authors.forename: Rebecca
authors.initials: R
authors.lastname: Roberts
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
authors.forename: Anke
authors.initials: A
authors.lastname: Oenema
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002253:Carbonated Beverages / Q000706:statistics & numerical data*; D002648:Child; D003071:Cognition; D003430:Cross-Sectional Studies; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009752:Nutritional Status; D010379:Peer Group; D011446:Prospective Studies; D012574:Schools; D012931:Social Environment