title: Diet- and body size-related attitudes and behaviors associated with vitamin supplement use in a representative sample of fourth-grade students in Texas.
abstract: OBJECTIVE
  To examine diet- and body size-related attitudes and behaviors associated with supplement use in a representative sample of fourth-grade students in Texas.
  
  
  METHODS
  Cross-sectional data from the School Physical Activity and Nutrition study, a probability-based sample of schoolchildren. Children completed a questionnaire that assessed supplement use, food choices, diet-related attitudes, and physical activity; height and weight were measured.
  
  
  METHODS
  School classrooms.
  
  
  METHODS
  Representative sample of fourth-grade students in Texas (n = 5967; mean age = 9.7 years standard error of the mean [SEM] = .03 years, 46% Hispanic, 11% African-American).
  
  
  METHODS
  Previous day vitamin supplement consumption, diet- and body size-related attitudes, food choices, demographic factors, and physical activity.
  
  
  METHODS
  Multivariable logistic regression models, P < .05.
  
  
  RESULTS
  The prevalence of supplement use was 29%. Supplement intake was associated with physical activity. Girls who used supplements were more likely to report positive body image and greater interest in trying new food. Relative to nonusers, supplement users were less likely to perceive that they always ate healthful food, although supplement use was associated with more healthful food choices in boys and girls (P < .001).
  
  
  CONCLUSIONS
  The widespread use of supplements and clustering of supplement use with healthful diet and greater physical activity in fourth graders suggest that supplement use be closely investigated in studies of diet-disease precursor relations and lifestyle factors in children.
authors.affiliation: National Cancer Institute, Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health, Houston, TX, USA. goldyjg@yahoo.com
authors.forename: Goldy C
authors.initials: GC
authors.lastname: George
authors.forename: Deanna M
authors.initials: DM
authors.lastname: Hoelscher
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Nicklas
authors.forename: Steven H
authors.initials: SH
authors.lastname: Kelder
mesh_terms: D049628:Body Size; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D003430:Cross-Sectional Studies; D004032:Diet; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D009043:Motor Activity; D013334:Students; D011795:Surveys and Questionnaires; D013781:Texas; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D014815:Vitamins