title: Explaining the positive relationship between fourth-grade children's body mass index and energy intake at school-provided meals (breakfast and lunch).
abstract: BACKGROUND
  A 2010 publication showed a positive relationship between children's body mass index (BMI) and energy intake at school-provided meals (as assessed by direct meal observations). To help explain that relationship, we investigated 7 outcome variables concerning aspects of school-provided meals: energy content of items selected, number of meal components selected, number of meal components eaten, amounts eaten of standardized school-meal portions, energy intake from flavored milk, energy intake received in trades, and energy content given in trades.
  
  
  METHODS
  Fourth-grade children (N = 465) from Columbia, SC, were observed eating school-provided breakfast and lunch on 1 to 4 days per child. Researchers measured children's weight and height. For daily values at school meals, a generalized linear model was fit with BMI (dependent variable) and the 7 outcome variables, sex, and age (independent variables).
  
  
  RESULTS
  BMI was positively related to amounts eaten of standardized school-meal portions (p < .0001) and increased 8.45 kg/m(2) per serving, controlling for other variables in the model. BMI was positively related to energy intake from flavored milk (p = .0041) and increased 0.347 kg/m(2) for every 100 kcal consumed. BMI was negatively related to energy intake received in trades (p = .0003) and decreased 0.468 kg/m(2) for every 100 kcal received. BMI was not significantly related to 4 outcome variables.
  
  
  CONCLUSIONS
  Knowing that relationships between BMI and actual consumption, not selection, at school-provided meals explained the (previously found) positive relationship between BMI and energy intake at school-provided meals is helpful for school-based obesity interventions.
authors.affiliation: Institute for Families in Society, University of South Carolina, 1600 Hampton Street, Suite 507, Columbia, SC 29208, USA. cguinn@mailbox.sc.edu
authors.forename: Caroline H
authors.initials: CH
authors.lastname: Guinn
authors.forename: Suzanne D
authors.initials: SD
authors.lastname: Baxter
authors.forename: Julie A
authors.initials: JA
authors.lastname: Royer
authors.forename: David B
authors.initials: DB
authors.lastname: Hitchcock
mesh_terms: D015992:Body Mass Index; D062408:Breakfast; D002648:Child; D002149:Energy Intake; D005260:Female; D005522:Food Services; D006801:Humans; D016014:Linear Models; D062409:Lunch; D008297:Male; D012574:Schools; D013022:South Carolina