title: Foods and beverages offered in US public secondary schools through the National School Lunch Program from 2011-2013: Early evidence of improved nutrition and reduced disparities.
abstract: OBJECTIVE
  To present data on trends in foods and beverages offered through the National School Lunch Program (NSLP) in public middle and high schools in the years immediately preceding and following implementation of new NSLP standards.
  
  
  METHODS
  From 2011 to 2013, primary data collection through the annual Youth, Education, and Society study involved use of mailed questionnaires to obtain data on NSLP meals from schools attended by nationally representative samples of US 8(th), 10(th), and 12(th) grade students (N=792 middle schools and 751 high schools). Each school was weighted to represent the percentage of target grade students enrolled, thus allowing analyses examining changes over time in the percentage of students enrolled in (attending) schools with specified NSLP measure outcomes, as well as disparities in NSLP measures based on school characteristics.
  
  
  RESULTS
  Significantly more US secondary students attended schools with specified NSLP measures in 2013 than in 2011; increases were observed at both middle and high school levels. Increase rates for some NSLP measures were moderated by school characteristics; where this was the case, moderating associations decreased prior NSLP nutrition environment disparities that were especially evident in smaller schools and schools with higher percentages of minority students.
  
  
  CONCLUSIONS
  Meaningful improvements have been made in the nutritional content of NSLP meals offered to US secondary students; these improvements have reduced prior NSLP meal disparities associated with school characteristics. Schools will need continued help with implementation and compliance monitoring in order to have the best opportunity to improve the nutrition environments for US students.
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, MI, USA. Electronic address: yterry@umich.edu.
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: Terry-McElrath
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, MI, USA. Electronic address: pomalley@umich.edu.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: O'Malley
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, MI, USA. Electronic address: lloydj@umich.edu.
authors.forename: Lloyd D
authors.initials: LD
authors.lastname: Johnston
mesh_terms: D001628:Beverages / Q000592:standards*; D005502:Food / Q000592:standards*; D005518:Food Preferences / Q000523:psychology; D005522:Food Services / Q000592:standards*; D054624:Health Status Disparities; D006801:Humans; D062409:Lunch; D009749:Nutrition Surveys; D009753:Nutritive Value; D012424:Rural Population; D012574:Schools; D013334:Students; D014481:United States; D014505:Urban Population
keywords: Adolescent nutrition and obesity; National School Lunch Program; School meals; School nutrition; Secondary school; USDA standards