title: Improvements and Disparities in Types of Foods and Milk Beverages Offered in Elementary School Lunches, 2006-2007 to 2013-2014.
abstract: BACKGROUND
  Children consume much of their daily energy intake at school. School district policies, state laws, and national policies, such as revisions to the US Department of Agriculture's school meals standards, may affect the types of foods and beverages offered in school lunches over time.
  
  
  METHODS
  This study evaluated changes and disparities in school lunch characteristics from 2006-2007 to 2013-2014. Data were obtained from annual cross-sectional surveys at 4,630 public elementary schools participating in the National School Lunch Program. Multivariate logistic regressions were conducted to examine lunch characteristics.
  
  
  RESULTS
  The percentage of schools regularly offering healthful items such as vegetables (other than potatoes), fresh fruit, salad bars, whole grains, and more healthful pizzas increased significantly from 2006-2007 to 2013-2014, and the percentage of schools offering less healthful items such as fried potatoes, regular pizza, and high-fat milks decreased significantly. Nevertheless, disparities were evident in 2013-2014. Schools in the West were significantly more likely to offer salad bars than were schools in the Northeast, Midwest, or South (adjusted prevalence: West, 66.3%; Northeast, 22.3%; Midwest, 20.8%; South, 18.3%). Majority-black or majority-Latino schools were significantly less likely to offer fresh fruit than were predominantly white schools (adjusted prevalence: majority black, 61.3%; majority Latino, 73.0%; predominantly white, 87.8%). Schools with low socioeconomic status were significantly less likely to offer salads regularly than were schools with middle or high socioeconomic status (adjusted prevalence: low, 38.5%; middle, 47.4%; high, 59.3%).
  
  
  CONCLUSIONS
  Much progress has been made in improving the quality of school lunches in US public elementary schools, but additional opportunities for improvement remain.
authors.affiliation: College of Education, Boise State University, 1910 University Dr, #1745, Boise, ID 83716. Email: lindseyturner1@boisestate.edu.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Turner
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona.
authors.forename: Punam
authors.initials: P
authors.lastname: Ohri-Vachaspati
authors.affiliation: Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Lisa
authors.initials: L
authors.lastname: Powell
authors.affiliation: Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Chaloupka
mesh_terms: D000818:Animals; D003430:Cross-Sectional Studies; D005522:Food Services / Q000592:standards*; D005638:Fruit; D016015:Logistic Models; D062409:Lunch; D008892:Milk; D015999:Multivariate Analysis; D012574:Schools / Q000706:statistics & numerical data*; D014481:United States; D016885:United States Department of Agriculture; D014675:Vegetables