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P084 The Relationship Between Middle-School Children's Body Mass Index, School Lunch Participation and Consumption

      Background

      One in five US school-aged children is obese. The National School Lunch program is crucial for children's intake, accounting for about 1/3 of total daily calories. Previous research on obesity and school-lunch consumption has not included middle school, an important time to establish lifestyle habits that persist into adulthood.

      Objective

      To explore the relationship between school-lunch participation and consumption with child body mass index (BMI) and BMI category.

      Study Design, Setting, Participants

      This is a secondary analysis of data collected from middle-school students in Birmingham, AL.

      Measurable Outcome/Analysis

      Child weight and height were measured and BMI calculated and categorized as 2 groups (underweight + healthy weight [<85th percentile], overweight + obese [≥85th percentile]). At pre- and post-lunch, researchers weighed and photographed school-lunch trays for 5 consecutive weekdays to capture amounts at pre and post. “Offer-versus-serve” was available so students could refuse some meal components. Mixed-effects regression explored BMI and logistic regression explored BMI category (dependent variables) with school lunch participation, pre-, post-amounts, and average consumption of school lunch as independent variables, age, gender, race/ethnicity, family income as fixed effects, and school site as a random effect.

      Results

      The sample included 288 students (mean age 12 years; 46% male; 36% White, 47% African American, 9% Hispanic/Latino, 8% Other/missing) from 15 schools, 6 school districts. There was no significant relationship between school-lunch participation and BMI/BMI category. However, pre-, post-amounts, and average consumption of school-lunch in grams were all significant (β=2.23, β=-2.29, and β=1.82 respectively, P <0.001) with BMI. The odds of being overweight/obese will increase by 48.3% with every 1 unit increase of the standardized average lunch consumption.

      Conclusions

      School-lunch consumption was positively related with BMI and BMI category among middle school children. As BMI and obesity risk increased, pre-amounts and average consumption were larger and post-amounts were smaller. Future analyses will assess the association of school-lunch food groups and energy intake with BMI.

      Funding

      Institute of Education Sciences, United States Department of Education

      SUPPLEMENTARY DATA

      Supplementary data related to this article can be found at https://doi.org/10.1016/j.jneb.2022.04.124.

      Appendix. SUPPLEMENTARY DATA