title: Investigating the historic long-term population health impact of the US National School Lunch Program.
abstract: OBJECTIVE
  The present research aimed to compare historic participation in the US National School Lunch Program (NSLP) during childhood and subsequent prevalence of overweight and obesity among adults at the population level.
  
  
  METHODS
  Regression models examined cross-sectional, state- and age-based panel data constructed from multiple sources, including the Behavioural Risk Factor Surveillance System, US Congressional Record, US Census and the US Department of Agriculture. Models controlled for cohorts' racial/ethnic composition and state poverty rates.
  
  
  METHODS
  Adult-age cohorts (18-34, 35-49, 50-64 and 18-64 years) by US state over a 25-year period (1984-2008).
  
  
  METHODS
  The cohorts' prevalence of overweight and obesity was compared with the cohorts' estimated NSLP participation during schooling (1925-2007; the NSLP began in 1946).
  
  
  RESULTS
  Among adults aged 18-64 years, a one percentage-point increase in estimated NSLP participation during schooling between 1925 and 2007 was significantly associated with a 0·29 percentage-point increase in the cohort's later prevalence of overweight and obesity. Analysis of narrower age cohorts and different schooling periods produced mixed results.
  
  
  CONCLUSIONS
  The NSLP might have influenced population health historically. Longitudinal analysis of individuals from studies now underway will likely facilitate more robust conclusions about the NSLP's long-term health impact based on more recent experiences.
authors.affiliation: Social Policy Department,London School of Economics and Political Science,Houghton Street,London WC2A 2AE,UK.
authors.forename: Cora
authors.initials: C
authors.lastname: Peterson
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000266:history; D063105:Food Assistance / Q000266:history; D005522:Food Services / Q000266:history; D006262:Health; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D062409:Lunch; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000209:etiology* / Q000266:history; D050177:Overweight; D012574:Schools / Q000266:history; D014481:United States; D055815:Young Adult