title: Food insecurity: could school food supplementation help break cycles of intergenerational transmission of social inequalities?
abstract: OBJECTIVE
  The aim of our study was to investigate the moderating effect of school food programs in schools in disadvantaged neighborhoods on the association between household food insecurity and scholastic difficulties among adolescents.
  
  
  METHODS
  We analyzed data from the Social and Health Survey of Children and Adolescents in Quebec, Canada, which was conducted in 1999 and included 2346 adolescent students 13 and 16 years of age (and 1983 of their parents). Sample-weighted regression analyses were performed to determine the association between household food insecurity and school difficulties and to explore the moderating role of food supplementation programs with respect to this association.
  
  
  RESULTS
  Household food insecurity, which was linked to the indicators of family socioeconomic status, was strongly associated with the indicators of scholastic difficulties. This association disappeared for adolescents who benefited from food supplementation programs in schools in disadvantaged neighborhoods. The risk of school activity limitation decreased from OR = 2.76 (95% confidence interval [CI]: 1.41-5.41) to OR = 1.57 (95% CI: 1.35-3.40), the risk of below-average grades in the language of instruction decreased from OR = 2.19 (95% CI: 1.28-3.74) to OR = 0.59 (95% CI: 0.21-1.63), the risk of repeating a year decreased from OR = 2.14 (95% CI: 1.35-3.40) to OR = 0.87 (95% CI: 0.42-1.81), and the risk of self-rated poor academic performance decreased from OR = 1.74 (95% CI: 1.08-2.81) to OR = 0.81(95% CI: 0.37-1.78).
  
  
  CONCLUSIONS
  School food supplementation is a moderating factor in the association between household food insecurity and scholastic difficulties for adolescents.
authors.affiliation: INSERM U707, Research Group on the Social Determinants of Health and Healthcare, 27, rue Chaligny, Paris 75012, France. christelle.roustit@inserm.fr
authors.forename: Christelle
authors.initials: C
authors.lastname: Roustit
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hamelin
authors.forename: Francesca
authors.initials: F
authors.lastname: Grillo
authors.forename: Judith
authors.initials: J
authors.lastname: Martin
authors.forename: Pierre
authors.initials: P
authors.lastname: Chauvin
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004521:Educational Measurement; D004522:Educational Status; D005190:Family; D005191:Family Characteristics; D005260:Female; D005502:Food / Q000592:standards* / Q000706:statistics & numerical data; D005523:Food Supply / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011792:Quebec; D012189:Retrospective Studies; D012574:Schools; D012959:Socioeconomic Factors