title: What's in the lunchbox? Dietary behaviour of learners from disadvantaged schools in the Western Cape, South Africa.
abstract: OBJECTIVE
  To identify and describe factors associated with food shop (known as tuck shop in South Africa) and lunchbox behaviours of primary-school learners in South Africa.
  
  
  METHODS
  Analysis of data collected in 2008 from a cross-sectional survey.
  
  
  METHODS
  Sixteen primary schools in the Western Cape, South Africa.
  
  
  METHODS
  A total of 717 grade 4 learners aged 10-12 years.
  
  
  RESULTS
  A 24 h recall established that 69 % of learners carried a lunchbox to school and 49 % had consumed at least one item purchased from the school food shop/vendor. Most lunchboxes contained white bread with processed meat, whereas the most frequent food shop/vendor purchase comprised chips/crisps. Learners who carried a lunchbox to school had significantly lower BMI percentiles (P = 0·002) and BMI-for-age (P = 0·034), compared with their counterparts. Moreover, they were younger, had higher standard-of-living and dietary diversity scores, consumed more meals per day, had greater self-efficacy and came from predominantly urban schools, compared with those who did not carry a lunchbox to school. Learners who ate food shop/vendor purchases had a lower standard-of-living score and higher dietary diversity and meal scores. Only 2 % of learners were underweight, whereas 19 % were stunted and 21 % were overweight/obese (BMI ≥ 25 kg/m2).
  
  
  CONCLUSIONS
  Children who carried a lunchbox to school appeared to have greater dietary diversity, consumed more regular meals, had a higher standard of living and greater nutritional self-efficacy compared with those who did not carry a lunchbox to school.
authors: Centre for the Study of Social and Environmental Determinants of Nutrition, Human Sciences Research Council, 12th Floor, Plein Park Building, Plein Street, Cape Town 8001, South Africa. zabrahams@hsrc.ac.za
authors: Zulfa
authors: Z
authors: Abrahams
authors: Anniza
authors: A
authors: de Villiers
authors: Nelia P
authors: NP
authors: Steyn
authors: Jean
authors: J
authors: Fourie
authors: Lucinda
authors: L
authors: Dalais
authors: Jillian
authors: J
authors: Hill
authors: Catherine E
authors: CE
authors: Draper
authors: Estelle V
authors: EV
authors: Lambert
mesh_terms: D015992:Body Mass Index; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D003430:Cross-Sectional Studies; D004032:Diet; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences; D058870:Food, Organic; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D009752:Nutritional Status; D009765:Obesity; D011203:Poverty; D013019:South Africa; D011795:Surveys and Questionnaires