title: Missing Lunch is Associated with Lower Intakes of Micronutrients from Foods and Beverages among Children and Adolescents in the United States.
abstract: BACKGROUND
  In the United States, the lunch meal contributes more than 20% of the daily intakes of most micronutrients for children and adolescents consuming lunch. Seven percent to 20% of children and adolescents in the United States do not eat lunch on a given day.
  
  
  OBJECTIVE
  To identify differences in total micro- and macronutrient intakes of children consuming and missing lunch on a given day.
  
  
  METHODS
  Cross-sectional secondary analysis of the combined National Health and Nutrition Examination Surveys 2009-2010 and 2011-2012. Dietary intake was assessed using the first day 24-hour recall of each respondent.
  
  
  METHODS
  The National Health and Nutrition Examination Survey sample represents the total noninstitutionalized civilian population residing in the United States. The sample used in this study included 4,755 children aged 4 to 18 years with complete data for all analyses.
  
  
  METHODS
  Total day, lunch, and nonlunch micronutrients, macronutrients, solid fats, and added sugar intakes were examined.
  
  
  METHODS
  Linear regression models controlling for age, sex, race/ethnicity, household poverty status, and weekend were used to compare dietary intakes of lunch consumers and nonconsumers. Intakes from nonlunch sources were examined to determine the extent to which differences between lunch consumers and nonconsumers could be attributed to the lunch meal.
  
  
  RESULTS
  Missing lunch was associated with lower micronutrient intakes, with the lunch meal primarily responsible for the higher micronutrient intakes of lunch consumers compared with nonconsumers. Missing lunch was also associated with lower energy, fiber, and sodium intakes. Added sugar and solid fat intakes of lunch consumers and nonconsumers were not significantly different.
  
  
  CONCLUSIONS
  This study identifies potential concerns for children missing lunch with respect to micronutrient intakes and shows that the lunches consumed by children in the United States are an important source of essential nutrients, but also less healthful dietary components.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Mathias
authors.forename: Emma
authors.initials: E
authors.lastname: Jacquier
authors.forename: Alison L
authors.initials: AL
authors.lastname: Eldridge
mesh_terms: D000293:Adolescent; D001628:Beverages; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D019422:Dietary Sucrose / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D005502:Food; D006801:Humans; D062409:Lunch; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D009749:Nutrition Surveys; D012982:Sodium, Dietary / Q000008:administration & dosage; D014481:United States
chemical_list: D004041:Dietary Fats; D004043:Dietary Fiber; D019422:Dietary Sucrose; D018977:Micronutrients; D012982:Sodium, Dietary
keywords: Discretionary calories; Lunch quality; Meal patterns; Meal skipping; Nutrient inadequacy