title: Associations between the school food environment, student consumption and body mass index of Canadian adolescents.
abstract: BACKGROUND
  Increasing attention has been paid to the school food environment as a strategy to reduce childhood obesity. The purpose of this study was to examine associations between the school food environment, students' dietary intake, and obesity in British Columbia (BC), Canada.
  
  
  METHODS
  In 2007/08, principal responses about the school environment (N=174) were linked to grades 7-12 students (N=11,385) from corresponding schools, who participated in the BC Adolescent Health Survey. Hierarchical mixed-effect regression analyses examined the association between the school food environment and student's intake of sugar-sweetened beverages (SSBs), food consumption, and body mass index. Analyses controlled for school setting, neighborhood education level and student's age and sex.
  
  
  RESULTS
  School availability of SSBs was positively associated with moderate (Odds Ratio (OR)=1.15, 95% Confidence Interval (CI)=1.02-1.30) and high (OR=1.43, 95% CI=1.13-1.80) SSB intake as were less healthful school nutrition guidelines for moderate SSB consumers only (OR=0.65, 95% CI=0.48-0.88). Availability of SSBs at school and its consumption were positively associated with student obesity (OR=1.50, 95% CI=1.12-2.01 and OR=1.66, 95% CI=1.19-2.34, respectively) but not with overweight. In contrast, consumption of less healthful food was positively associated with overweight (OR=1.03, 95% CI=1.01-1.06).
  
  
  CONCLUSIONS
  The results of this study provide further evidence to support the important role of schools in shaping adolescents' dietary habits. Availability and consumption of SSBs, but not less healthful foods, at school were associated with higher adolescent obesity highlighting that other environments also contribute to adolescent obesity.
authors.affiliation: School of Population and Public Health, University of British Columbia, F508-4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada. lmasse@cfri.ubc.ca.
authors.forename: Louise C
authors.initials: LC
authors.lastname: Mâsse
authors.forename: Judith Evelyn
authors.initials: JE
authors.lastname: de Niet-Fitzgerald
authors.forename: Allison W
authors.initials: AW
authors.lastname: Watts
authors.forename: Patti-Jean
authors.initials: PJ
authors.lastname: Naylor
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Saewyc
mesh_terms: D000293:Adolescent; D001628:Beverages; D015992:Body Mass Index; D001955:British Columbia / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D005260:Female; D005522:Food Services; D006801:Humans; D016015:Logistic Models; D008297:Male; D018673:Nutrition Policy; D009749:Nutrition Surveys; D064427:Nutritive Sweeteners / Q000008:administration & dosage; D063766:Pediatric Obesity / Q000453:epidemiology*; D012111:Residence Characteristics; D012574:Schools; D012959:Socioeconomic Factors; D013334:Students; D055815:Young Adult
chemical_list: D064427:Nutritive Sweeteners