title: Competitive foods in schools: availability and purchasing in predominately rural small and large high schools.
abstract: OBJECTIVE
  Schools have an important role to play in obesity prevention, but little is known about the food environment in small, predominately rural schools. The primary purpose of this study was to compare the availability and student purchasing of foods sold outside of the reimbursable meals program through à la carte or vending (ie, competitive foods) in small (n=7) and large (n=6) Kansas high schools.
  
  
  METHODS
  A cross-sectional observational study design was used to capture the number of à la carte and vending items available and purchased, and the fat and energy content of all available and purchased items on a single school day between January and May 2005.
  
  
  RESULTS
  Small schools had significantly fewer vending machines than large schools (median 3.0 [range 2.0 to 5.0] vs 6.5 [range 4.0 to 8.0], P<0.01]. Vending and à la carte items at small schools contained a median of 2.3 fewer fat grams per item (P< or =0.05), whereas vending products contained a median of 25 kcal fewer per item (P< or =0.05) than at large schools. Significantly less fat (median -15.4 g/student) and less energy (median -306.8 kcal/student) were purchased per student from all competitive food sources and from à la carte (median -12.9 g fat and -323.3 kcal/student) by students in small schools compared to students in large schools (P< or =0.05).
  
  
  CONCLUSIONS
  The findings, which highlight less availability and lower energy content from competitive foods at small compared to large schools, have implications for understanding how small schools support their foodservice programs with limited dependence on competitive foods and the influence that food and nutrition professionals can have on school environments by providing more oversight into the nutritional quality of foods available.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 1008, Kansas City, KS, 66160, USA. nnollen@kumc.edu
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Nollen
authors.forename: Christie
authors.initials: C
authors.lastname: Befort
authors.forename: Ann McGrath
authors.initials: AM
authors.lastname: Davis
authors.forename: Tricia
authors.initials: T
authors.lastname: Snow
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mahnken
authors.forename: Qingjiang
authors.initials: Q
authors.lastname: Hou
authors.forename: Mary
authors.initials: M
authors.lastname: Story
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena / Q000502:physiology; D003430:Cross-Sectional Studies; D004041:Dietary Fats / Q000008:administration & dosage*; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D005502:Food / Q000592:standards*; D005504:Food Analysis; D005509:Food Dispensers, Automatic / Q000706:statistics & numerical data*; D005522:Food Services / Q000706:statistics & numerical data*; D005523:Food Supply / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007615:Kansas; D008297:Male; D009753:Nutritive Value; D009765:Obesity / Q000453:epidemiology / Q000209:etiology; D011156:Population Density; D012424:Rural Population; D012574:Schools
chemical_list: D004041:Dietary Fats