title: Nutritional quality of the diets of US public school children and the role of the school meal programs.
abstract: BACKGROUND
  Good nutrition is essential to healthy childhood. Because the school meal programs--the National School Lunch Program and the School Breakfast Program--are so widely available, they are in a unique position to influence the nutritional quality of children's diets.
  
  
  OBJECTIVE
  This article assesses the nutritional quality of the diets of US public school children and explores the relationship between children's participation in the school meal programs and the nutritional quality of their diets.
  
  
  METHODS
  Data were collected as part of the third School Nutrition Dietary Assessment Study (SNDA-III), a nationally representative study fielded during school year 2004-2005. Data on children's dietary intakes were collected through in-person 24-hour dietary recalls. Nutritional quality of children's diets was assessed by estimating the prevalence of inadequate and excessive intakes of energy and nutrients.
  
  
  METHODS
  The analysis is based on a nationally representative sample of 2,314 children in grades 1 through 12 from 287 public schools.
  
  
  METHODS
  Nutrient adequacy and excess were assessed by comparing usual nutrient intake distributions to Dietary Reference Intakes and the Dietary Guidelines for Americans 2005. Propensity score matching was used to examine the relationship between school meal program participation and the prevalence of inadequate and excessive intakes.
  
  
  RESULTS
  The majority of public school children in the United States had nutritionally adequate diets, but 80% had excessive intakes of saturated fat and 92% had excessive intakes of sodium. School meal program participation was associated with reduced prevalence of nutrient inadequacy but with increased prevalence of excessive sodium intakes.
  
  
  CONCLUSIONS
  School meal programs play an important role in the nutritional adequacy of children's diets. However, the association between program participation and excessive sodium intakes, along with the high prevalence of excessive saturated fat intakes among all students, suggest areas for improvement in the meals these programs provide.
authors.affiliation: Mathematica Policy Research, Inc, PO Box 2393, Princeton, NJ 08543, USA. MClark@Mathematica-mpr.com
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Clark
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Fox
mesh_terms: D000293:Adolescent; D002648:Child; D015362:Child Nutrition Disorders / Q000517:prevention & control; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology*; D002675:Child, Preschool; D004032:Diet / Q000592:standards*; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects; D002149:Energy Intake / Q000502:physiology; D005260:Female; D005522:Food Services / Q000592:standards*; D006801:Humans; D008297:Male; D011939:Mental Recall; D018673:Nutrition Policy; D009749:Nutrition Surveys; D009751:Nutritional Requirements; D009753:Nutritive Value; D012574:Schools; D012982:Sodium, Dietary / Q000008:administration & dosage* / Q000009:adverse effects; D014481:United States
chemical_list: D004041:Dietary Fats; D012982:Sodium, Dietary