Sources of sodium, potassium, and energy in the diets of adolescents

Analysis of food diaries of 200 students in two boarding high schools indicated that 30% of their average daily sodium intake was contributed by bakery foods and ready-to-eat cereals. The next most important source of sodium (24%) was a category made up of food adjuncts, snack-type foods, soups, and beverages. The largest proportion of sodium in most foods had been added during food manufacture or preparation. Salt added at the table contributed less than 1% of the sodium in the diets of the teenagers. All students did not eat foods from all categories on their day of recording; 70% or more ate bakery products, dairy foods, food adjuncts, and meat, fish, poultry, and eggs. Changes in recipe formulations can decrease sodium content for a variety of bakery products, cereals, mixed dishes, snack-type foods, soups, and processed meats. It is therefore possible to make large reductions in dietary sodium without disturbing other nutrient values.     

Children's nutritional intake as part of the Eat Well Do Well scheme in Kingston‐upon‐Hull – a pilot study

In April 2004 Hull City Council introduced free healthy school meals for all primary and special schools in an attempt to reduce health inequalities. This pilot study aimed to compare nutritional intake between those children consuming a free healthy school meal and those consuming a packed lunch brought from home. The study compared two schools from different socio‐economic areas and considered the impact of lunch on total daily food and nutrient intakes in these children. Fieldwork was undertaken over five consecutive days in each school. Seven hundred and thirty‐five lunches were weighed and photographed before and after consumption to assess actual food intake vs. wastage. One hundred and forty‐seven children aged 8‐to‐11‐years participated from two primary schools. Five‐day food diaries were completed by a small number of participants (n = 20) receiving school meals (n = 10) and packed lunches (n = 10) from the two schools selected. While the lunches provided at the two schools met the majority of the nutritional guidelines for school meals, children ate only a small amount, often leaving the potatoes and vegetables behind; therefore, their intakes were below recommended levels. Children from both schools who opted for packed lunch consumed significantly more energy, fat, sugar and sodium but with this more micronutrients than children who had a free healthy school meal. Statistical differences (P < 0.01) were found between the two schools, with children from the less affluent school consuming less food from the school meal and therefore obtaining a lower nutrient intake from lunch than children from the more affluent school. Findings from a small number of food diaries suggest that the differences in intakes between those having a school meal and those having a packed lunch were compensated for by other food consumed during the day, such that daily nutrient intakes were not significantly different. This study suggests that many children may not be consuming sufficient amounts of the food provided in schools. Therefore, it cannot be assumed that the provision of school meals that conform to the School Food Trust guidelines will be of nutritional benefit to all children concerned. Bearing this in mind, more needs to be done to provide menus that are both healthy and enjoyable for children, so that they will want to consume the foods provided. Parents also need more advice regarding how they can provide their children with a healthy packed lunch, possibly via the introduction of a government‐led packed lunch policy, particularly in schools from areas of lower socio‐economic status. Although there was only a small sample of food diaries in this study, the findings suggest that socio‐economic demographics may exert more of an influence on the total daily nutrient intake of children than the type of lunch consumed.     

Sodium intake from meals and snacks consumed by college students

This investigation was designed to compute the total sodium intake from meals and snacks consumed by selected college students. Most students used carbonated beverages, candies, gums, cookies, and salted snack items. They consumed salted snack items mostly as evening snacks. Mean sodium intake was found to be 3,904 mg. for men and 2,628 mg. for women, without taking into consideration the use of table salt. Sodium density per kilocalorie per day was 1.40 and 1.41 for men and women, respectively, suggesting that the differences in intakes were due to women's lower caloric intake. Sodium intake was greater from regular meals than from snack foods. Evening snacks contributed more to the daily sodium intake than morning and afternoon snacks. It can be concluded that sodium intake of college students needs careful assessment. According to the Food and Nutrition Board, the most effective way to maintain intake within the suggested range is to reduce the amount of salt added at table or in cooking and to reduce moderately the selection of obviously salty foods (9). College students need to be made aware of the sodium content of foods they select for lunch, dinner, and evening snacks, as well as the amount of salt they add at the table.     

Vital Signs: Sodium Intake Among U.S. School-Aged Children — 2009–2010

Background

A national health objective is to reduce average U.S. sodium intake to 2,300 mg daily to help prevent high blood pressure, a major cause of heart disease and stroke. Identifying common contributors to sodium intake among children can help reduction efforts.

Methods

Average sodium intake, sodium consumed per calorie, and proportions of sodium from food categories, place obtained, and eating occasion were estimated among 2,266 school-aged (6–18 years) participants in What We Eat in America, the dietary intake component of the National Health and Nutrition Examination Survey, 2009–2010.

Results

U.S. school-aged children consumed an estimated 3,279 mg of sodium daily with the highest total intake (3,672 mg/d) and intake per 1,000 kcal (1,681 mg) among high school–aged children. Forty-three percent of sodium came from 10 food categories: pizza, bread and rolls, cold cuts/cured meats, savory snacks, sandwiches, cheese, chicken patties/nuggets/tenders, pasta mixed dishes, Mexican mixed dishes, and soups. Sixty-five percent of sodium intake came from store foods, 13% from fast food/pizza restaurants, 5% from other restaurants, and 9% from school cafeteria foods. Among children aged 14–18 years, 16% of total sodium intake came from fast food/pizza restaurants versus 11% among those aged 6–10 years or 11–13 years (p<0.05). Among children who consumed a school meal on the day assessed, 26% of sodium intake came from school cafeteria foods. Thirty-nine percent of sodium was consumed at dinner, followed by lunch (29%), snacks (16%), and breakfast (15%).

Implications for Public Health Practice

Sodium intake among school-aged children is much higher than recommended. Multiple food categories, venues, meals, and snacks contribute to sodium intake among school-aged children supporting the importance of populationwide strategies to reduce sodium intake. New national nutrition standards are projected to reduce the sodium content of school meals by approximately 25%–50% by 2022. Based on this analysis, if there is no replacement from other sources, sodium intake among U.S. school-aged children will be reduced by an average of about 75–150 mg per day and about 220–440 mg on days children consume school meals.     

Sodium and potassium intakes amongst free-living adult Nigerians

Sixteen adult male and female Nigerians, aged between 18 and 48 years, participated in a 7-d study designed to estimate mean daily intakes of sodium and potassium and to determine their food sources. Food logs were kept during the 7-d study period. Analysis of data showed a mean daily intake of 8.1 g table salt with a range of 3.8 to 18.1 g which provided a mean daily intake of 3.2 g sodium. Mean sodium intake from foods alone was 0.85 g +/- 0.08 while sodium nutrient density was 2.3 g/1000 kcal. Potassium intake was 2.86 g +/- 0.2 or 1.46 g/1000 kcal. Mean sodium/potassium ratio of the diets was 1.5. Discretionary use of salt was 82 per cent of total intake with table salt supplying 78 per cent. Cereals and products provided the highest proportion of natural sodium while starchy staples supplied over 40 per cent of the potassium in the diet.     

西南地区市售儿童预包装食品钠含量现状分析

目的 调查西南地区市售儿童预包装食品的钠含量水平现状,为减盐政策及高钠食品标准的制定提供数据支持。方法 选取西南地区大型超市、连锁便利店和零售店,采用拍照的方式收集儿童预包装食品的营养标签等信息。本次调查共收集4 588种儿童预包装食品,分为8种食物类别,27个亚类,采用中位数和四分位数描述食品的钠含量。本研究分别参照《中国居民膳食指南（2022）》和英国食品标准局（Food Standards Agency,FSA）高钠食品的标准,以及《食品安全国家标准预包装食品营养标签通则》（GB 28050—2011）中低钠食品的定义,对各类预包装食品进行钠含量分级。结果 27个亚类食品中有7个亚类食品为低钠食品（冲调类食品、糖果类、水果制品、乳类及其制品、饮料、冷饮、食糖）,其余类别均为中钠或高钠食品。两种钠含量分级标准的差异主要体现在调味品类的食醋中。儿童消费的方便食品、膨化食品、鱼禽肉蛋及其制品、各类调味品的钠含量均较高。结论 西南地区市售儿童预包装食品的钠含量仍处于较高水平,应继续加强减钠（盐）工作的实施,建立适合我国的高钠食品标准,促进儿童健康饮食。     

Dietary change, energy balance and body weight regulation among migrating students

This study was conducted to examine how subjects modulate their food intake and energy balance when they migrate from a low energy density food intake pattern to one of high energy density. It was hypothesised that an increase in the energy density of food consumed would result in increased body weight of the migrating subjects unless food intake and energy balance could be modulated. Food selection, food intake, basal metabolic rate (BMR) and anthropometric measurements were made on 53 female and 56 male newly arrived overseas students. All subjects were from Malaysia, but the data was collected at Oxford Brookes University where the subjects were studying. Food intake using 3-day food diaries and food frequency questionnaires (FFQs). BMR and anthropometric measurements including body weight were measured on arrival in the UK and after 3 and 6 months' stay. Student's t-tests and analysis of variance (ANOVA) were used to compare the data. A significant difference (P < 0.05) was found between the energy density of the foods consumed in Malaysia and after 3 and 6 months in the UK. There was also a significant decrease (P < 0.05) in protein consumed. However, there were no differences in total energy intake. From results of the FFQs, differences were found in food selection due mainly to the lack of availability of certain foods in UK supermarkets. No significant differences were found in the BMR and anthropometric measurements made at the start of the study and later assessments. It appears that Malaysian students are able to remain in energy balance and are weight stable at least during the first 6 months of residence in the UK, despite the wider choice of energy dense food available. This suggests that at least in the short term, subjects are able to modulate their food intake in response to changes in the energy densities and free choice of food.     

Dietary change,energy balance and body weight regulation among migrating students

This study was conducted to examine how subjects modulate their food intake and energy balance when they migrate from a low energy density food intake pattern to one of high energy density. It was hypothesised that an increase in the energy density of food consumed would result in increased body weight of the migrating subjects unless food intake and energy balance could be modulated. Food selection, food intake, basal metabolic rate (BMR) and anthropometric measurements were made on 53 female and 56 male newly arrived overseas students. All subjects were from Malaysia, but the data was collected at Oxford Brookes University where the subjects were studying. Food intake using 3-day food diaries and food frequency questionnaires (FFQs), BMR and anthropometric measurements including body weight were measured on arrival in the UK and after 3 and 6 months' stay. Student's t -tests and analysis of variance (ANOVA) were used to compare the data. A significant difference (P < 0.05) was found between the energy density of the foods consumed in Malaysia and after 3 and 6 months in the UK. There was also a significant decrease (P < 0.05) in protein consumed. However, there were no differences in total energy intake. From results of the FFQs, differences were found in food selection due mainly to the lack of availability of certain foods in UK supermarkets. No significant differences were found in the BMR and anthropometric measurements made at the start of the study and later assessments. It appears that Malaysian students are able to remain in energy balance and are weight stable at least during the first 6 months of residence in the UK, despite the wider choice of energy dense food available. This suggests that at least in the short term, subjects are able to modulate their food intake in response to changes in the energy densities and free choice of food.     

The Influence of Physical and Social Contexts of Eating on Lunch-Time Food Intake Among Southern Ontario,Canada, Middle School Students

BACKGROUND: Among students, little is known about the physical and social context of eating lunch. The objective of this study was to determine if food intake (including the type of food and beverages and portion sizes) was associated with specific aspects of the physical and social lunch environment (location, with whom lunch was consumed, who prepared the food, and where the food was originally purchased). METHODS: A total of 1236 participants (males = 659, females = 566) in grades 6 (n = 359), 7 (n = 409), and 8 (n = 463) from southern Ontario, Canada, completed the Food Behavior Questionnaire during the 2005–2006 academic year. RESULTS: A total of 8159 foods and 2200 beverages were consumed during the lunch meal, which contributed to 552 kcal (SD = 429) or 30% (SD = 16) of total daily energy intake (kcal/day). Higher amounts of energy, meats and alternatives, other foods, fried foods, and pizza were consumed when participants ate in between places or at a restaurant/fast food outlet (compared with at home or school, p < 0.05) and/or when prepared by friends or others (compared with themselves or family members, p < 0.05). A large number of participants (46%) reported consuming sugar-sweetened beverages during lunch, despite a school board–level policy restricting the sales of “junk food,” which appears to be brought from home. CONCLUSIONS: Our findings support schools in policy efforts that restrict fast food access (by leaving school grounds, preventing fast food companies from coming onto school grounds, or restricting sugar-sweetened beverage sales in vending machines) and that eating in between places should be discouraged.     

What are the key food groups to target for preventing obesity and improving nutrition in schools?

OBJECTIVE: To determine differences in the contribution of foods and beverages to energy consumed in and out of school, and to compare consumption patterns between school canteen users and noncanteen users. DESIGN: Cross-sectional National Nutrition Survey, 1995. SETTING: Australia. SUBJECTS ON SCHOOL DAYS: A total of 1656 children aged 5-15 y who had weekday 24-h dietary recall data. RESULTS: An average of 37% of total energy intake was consumed at school. Energy-dense foods and beverages such as fat spreads, packaged snacks, biscuits and fruit/cordial drinks made a greater contribution to energy intake at school compared to out of school (P< or =0.01). Fast foods and soft drinks contributed 11 and 3% of total energy intake; however, these food groups were mostly consumed out of school. Fruit intake was low and consumption was greater in school. In all, 14% of children purchased food from the canteen and they obtained more energy from fast food, packaged snacks, desserts, milk and confectionary (P< or =0.05) than noncanteen users. CONCLUSIONS:: Energy-dense foods and beverages are over-represented in the Australian school environment. To help prevent obesity and improve nutrition in schools, biscuits, snack bars and fruit/cordial drinks brought from home and fast food, packaged snacks, and confectionary sold at canteens should be replaced with fruit and water.     

Nutrient intakes and food consumption patterns among Ontario students in grades six, seven, and eight

BACKGROUND: The increased prevalence of overweight in Canadian children has stimulated interest in their lifestyle behaviours. The purpose of this research was to investigate dietary intake and food behaviours of Ontario students in grades six, seven, and eight. METHODS: Males and females from grades six to eight were recruited from a stratified random selection of schools from Ontario. Data were collected using the web-based "Food Behaviour Questionnaire", which included a 24-hour diet recall and food frequency questionnaire. Nutrients were analyzed using ESHA Food Processor and the 2001 Canadian Nutrient File database. Body Mass Index (BMI) was calculated based on self-reported weight and height, and classified according to the Centers for Disease Control BMI for age percentiles. RESULTS: The sample included males (n = 315) and females (n = 346) in grades 6, 7, and 8 from 15 schools in Ontario. According to Canada's Food Guide to Healthy Eating (CFGHE), median intakes were below recommendations for all participants, with the exception of meat and alternatives. Participants consumed a median of 54%, 15%, 31%, 11%, and 8% of total energy from carbohydrates, protein, total fat, saturated fat, and added sugars, respectively. Participants consumed 25% of total energy from foods from the "other" food group (CFGHE). Males had higher intakes of energy, carbohydrates, fat, saturated fat, monounsaturated fat, protein, thiamine, niacin, iron, and zinc than females (all p < 0.05), and consumed more grain products servings (p < 0.05). CONCLUSION: The high consumption of "other" foods, at the expense of nutrient-dense food groups, may ultimately be contributing to the increased weights in childhood and adolescence.     

Analysis of Sodium Content in 4082 Kinds of Commercial Foods in China

High-sodium intake is associated with the increased risk of hypertension and cardiovascular disease. Monitoring and analyzing the sodium content in commercial food is instructive for reducing sodium intake in the general population. The sodium content of 4082 commercial foods across 12 food groups and 41 food categories was collected and analyzed, including 4030 pre-packaged foods and 52 artisanal foods. The food group with the highest average sodium content (6888.6 mg/100 g) contained sauces, dressings, springs and dips, followed by bean products (1326.1 mg/100 g) and fish, meat and egg products (1302.1 mg/100 g). The average sodium content of all the collected commercial foods was 1018.6 mg/100 g. Meanwhile, the sodium content of non-alcoholic beverages (49.7 mg/100 g), confectionery (111.8 mg/100 g) and dairy products (164.1 mg/100 g) was much lower than the average sodium content of the 12 food groups. The sodium contents of different food groups and categories were significantly different. The proportion of high-sodium food (600 mg/100 g) was more than one-third of all the products. There are a few products marked with salt reduction on the package. Sixteen salt-reduced products were collected, which belong to the food category of soy sauce and account for 16% of all the soy sauce products. The average sodium content in salt-reduced soy sauce is 2022.8 mg/100 g lower than that of non-salt-reduced soy sauce products. These data provide a primary assessment with sodium content in commercial foods and potential improvements for the food industry to achievement the goal of sodium reduction.     

FOOD CONSUMPTION IN RURAL BURKINA FASO

Food diaries, kept by 13 households in Burkina Faso throughout one year, showed that rural people on average consumed between 1.8 and 2.9 meals per day typically consisting of a thick porridge, made from pearl millet or red sorghum, and a sauce of leaves mainly Corchorus spp. and Adansonia digitata, calyces from Bombax costatum, or groundnuts. Spices, such as chili, Parkia biglobosa "soumbala" and dried fish were frequently added. Vegetables and pulses were occasionally eaten, but meat and milk rarely so. Meals on average included 5.6 ingredients. The diet was monotonous with but a few frequently used products constituting the bulk of food intake. The study villages are presently changing from a traditional local based consumption pattern to an increased use of marketed products, because many traditional wild food products are increasingly difficult to find and imported products are becoming available from urban areas and fashionable to eat. In order to provide people with a well-balanced and nutritionally rich food intake and a high degree of food security, it is recommended that extension projects should work to secure the supply of nutritionally important traditional products and to diversify the food base by promoting the use of under-exploited secondary crops within existing land use systems.     

Maternal variables related to potentially high-sodium infant-feeding practices

Infant sodium intakes between 5 and 15 mEq per day for ages 0 to 6 months and between 11 and 33 mEq per day for ages 6 to 12 months are considered appropriate, safe, and adequate. Intakes exceeding these ranges should be avoided as a precautionary measure for infants who may be hereditarily predisposed to hypertension. The concern about high-sodium intakes is based on epidemiological findings of an association between such intakes by adults and hypertension. Feeding practices potentially associated with high-sodium intake were assessed in 87 white and 68 black mothers of a cross section of 1- to 12-month-old infants and were analyzed for associations with epidemiological correlates of hypertension. Lower frequency of breast feeding was reported by black mothers and by less educated mothers. Forward, stepwise regression analyses indicated that less education was also predictive of shorter breast-feeding duration, earlier introduction of solid foods, addition of salt to infant food, and use of salty foods as snacks. Addition of salt to infant food was also predicted by high maternal salt use and by positive family hypertension history; black mothers more often fed salty snacks. Considerable public attention has been drawn to the fact that commercial infant foods no longer contain added salt. This study implies a need for additional public attention to appropriate sodium levels in home-prepared and snack foods fed to infants.     

Schoolchildren's Consumption of Competitive Foods and Beverages,Excluding à la Carte*

BACKGROUND: Competitive foods/beverages are those in school vending machines, school stores, snack bars, special sales, and items sold à la carte in the school cafeteria that compete with United States Department of Agriculture (USDA) meal program offerings. Grouping à la carte items with less nutritious items allowed in less regulated venues may obfuscate analysis of the school competitive food environment. Excluding à la carte items from competitive foods, the objectives were to: (1) assess competitive food use by gender, ethnicity, eligibility for free or reduced-price meals, and participation in school meals programs, (2) determine differences between grade levels in energy intakes obtained from food sources, (3) determine the nutrient intake derived from competitive foods for students who consumed them, and (4) determine energy-adjusted differences in 24-hour nutrient intakes of protein, calcium, iron, and other selected nutrients between competitive food consumer and nonconsumers. METHODS: Competitive foods/beverages use, excluding à la carte items, was examined using the third School Nutrition Dietary Assessment Study (SNDA III), a nationally representative sample of 2309 schoolchildren in grades 1 to 12. Mean nutrient intakes were adjusted for energy intake and other covariates, and differences between consumers and nonconsumers of competitive items were determined using analysis of variance and sudaan . RESULTS: Excluding à la carte items, 22% of schoolchildren consumed competitive items in a representative school day and use was highest in high school. Consumers of competitive items other than à la carte had significantly higher mean energy, sugar intakes, and lower sodium, dietary fiber, B vitamins, and iron intakes than nonconsumers. CONCLUSIONS: Use of competitive foods/beverages, excluding à la carte, was detrimental to children's diet quality.     

全民减盐的科学证据与政策建议

大量科学证据显示,降低人群食盐摄入量或使用低钠富钾的代用盐可以降低血压,并进而减少心脑血管病的发生.中国人均食盐量严重超标,高血压患病率逐年升高,心脑血管疾病已成为我国居民的首要致死原因,制定行之有效的全民减盐政策在我国势在必行.本文通过全面回顾相关的科学证据及成本效果分析,借鉴国际减盐的行动与经验,基于我国饮食文化和现有的减盐行动,建议政府应倡导多部门合作的国家减盐专项行动,加强宣教力度,发挥餐饮业的作用,制定加工食品盐含量标准,鼓励低钠盐生产和营销,对特殊人群进行低钠盐价格补贴以及建立和完善监测评估及绩效考核与激励系统.     

深圳居民膳食结构与膳食营养素摄入状况研究

目的了解深圳居民的膳食结构、营养素摄入现状,为制定卫生政策和指导居民合理饮食提供科学依据。方法 2009年6—7月,运用多阶段整群随机抽样法,抽取深圳市8个行政区中73个社区,每个社区抽取120户居民中15岁以上常住居民（每户随机抽1人,共8 782人）,再从中抽取50%对象进行膳食调查。采用食物频率法获取调查对象过去1年各种食物食用频率和食用量。结果共调查3 500人。深圳居民平均每标准人日摄入豆类、水果、奶类分别为15.4、154.3、95.4 g,低于推荐食物摄入量;畜禽肉类、食用油、食盐分别为169.3、41.1、6.6 g,高于推荐食物摄入量。深圳居民每标准人日摄入能量2 537.8 kcal,占RNIs的112.8%;蛋白质、脂肪、碳水化合物的摄入量分别为86.01、10.7、293.2 g,提供能量的比例分别为13.6%、39.2%、47.2%;核黄素和硫胺素摄入量分别为1.2、1.0 mg,分别占RNIs的92.3%和76.9%;钙和钠的摄入量分别为689.74、129.9mg,分别占RNIs的86.2%和187.7%。动物性食物提供的蛋白质占48.8%,脂肪中动物性脂肪占54.7%。结论深圳居民能量、蛋白质、脂肪及大多数营养素的摄入量基本充足,但钙、核黄素和硫胺素的摄入仍然不足,且脂肪的摄入量过多,而碳水化合物的摄入量不足。仍需加强合理营养、平衡膳食的宣传教育,防止营养相关慢性病发病率持续上升。     

The effect of a healthy school tuck shop program on the access of students to healthy foods

The objective of this study was to evaluate the effect of a healthy school tuck shop program, developed as a way of creating a healthy and nutritional school environment, on students'' access to healthy foods. Five middle schools and four high schools (775 students) participated in the healthy school tuck shop program, and nine schools (1,282 students) were selected as the control group. The intervention program included restriction of unhealthy foods sold in tuck shops, provision of various fruits, and indirect nutritional education with promotion of healthy food products. The program evaluation involved the examination of students'' purchase and intake patterns of healthy foods, satisfaction with the available foodstuffs, and utilization of and satisfaction with nutritional educational resources. Our results indicated that among of the students who utilized the tuck shop, about 40% purchased fruit products, showing that availability of healthy foods in the tuck shop increased the accessibility of healthy foods for students. Overall food purchase and intake patterns did not significantly change during the intervention period. However, students from the intervention schools reported higher satisfaction with the healthy food products sold in the tuck shop than did those from the control schools (all P < 0.001), and they were highly satisfied with the educational resources provided to them. In conclusion, the healthy school tuck shop program had a positive effect on the accessibility of healthy food. The findings suggest that a healthy school tuck shop may be an effective environmental strategy for promoting students'' access to healthy foods.     

Food consumption in rural Burkina Faso

Food diaries, kept by 13 households in Burkina Faso throughout one year, showed that rural people on average consumed between 1.8 and 2.9 meals per day typically consisting of a thick porridge, made from pearl millet or red sorghum, and a sauce of leaves mainly Corchorus spp. and Adansonia digitata, calyces from Bombax costatum, or groundnuts. Spices, such as chili, Parkia biglobosa "soumbala" and dried fish were frequently added. Vegetables and pulses were occasionally eaten, but meat and milk rarely so. Meals on average included 5.6 ingredients. The diet was monotonous with but a few frequently used products constituting the bulk of food intake. The study villages are presently changing from a traditional local based consumption pattern to an increased use of marketed products, because many traditional wild food products are increasingly difficult to find and imported products are becoming available from urban areas and fashionable to eat. In order to provide people with a well-balanced and nutritionally rich food intake and a high degree of food security, it is recommended that extension projects should work to secure the supply of nutritionally important traditional products and to diversify the food base by promoting the use of under-exploited secondary crops within existing land use systems.     

Fruits, vegetables, milk, and sweetened beverages consumption and access to à la carte/snack bar meals at school

OBJECTIVES: We assessed the impact of access to school snack bars on middle school students' fruit, vegetable, milk, and sweetened beverage consumption. METHODS: Five hundred ninety-four fourth- and fifth-grade students completed lunch food records 4 times during a 2-year period. RESULTS: The fourth-grade cohort consumed fewer fruits, regular (not fried) vegetables, and less milk and consumed more sweetened beverages and high-fat vegetables during year 2. CONCLUSIONS: Middle school students who gained access to school snack bars consumed fewer healthy foods compared with the previous school year, when they were in elementary schools and only had access to lunch meals served at school. Healthy food choices and school policies that require healthier foods at school snack bars should be promoted.