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Children's
Diets in the Mid-1990's:
Dietary Intake and Its Relationship with
School Meal Participation
EXECUTIVE
SUMMARY
Children’s
diets may influence their lives in a
variety of ways, including affecting
their growth, health outcomes, and
cognitive development. The U.S.
Department of Agriculture has developed
several nutrition programs to promote
healthy eating among children, including
the National School Lunch Program (NSLP)
and the School Breakfast Program (SBP).
As of 1996 (the last year covered by
this study) approximately 26 million
students participated in the lunch
program and 6.6 million participated in
the breakfast program each school day.
By fiscal year 1999, average daily
participation was nearly 27 million for
the NSLP and was 7.3 million for the
SBP.
This report is
the first of two reports on the
nutrition of children using findings
from the analysis of the 1994_1996
Continuing Survey of Food Intake by
Individuals (CSFII). The key objectives
of the overall study are to describe the
diets of school-aged U.S. children as of
the mid-1990s, examine relationships
between children’s participation in
the school meal programs and their
dietary intake, and examine changes in
intake between the periods 1989-1991 and
1994-1996. This first report describes
children’s mean food and nutrient
intake, reports the percentage meeting
various dietary standards, and compares
the diets of participants and
nonparticipants in the school meal
programs. A second report focuses on
changes between the early and mid-1990s
in the dietary intake of children.
The 1994-1996
CSFII collected dietary intake and other
data from a nationally representative
sample of noninstitutionalized residents
of the United States. The analysis in
this report uses data from nearly
2,700 children ages 6 through 18 years
who completed two nonconsecutive days of
dietary intake interviews. Parents
assisted children ages 6 through 11
years in reporting their intakes; older
children reported their food and
beverage consumption independently.
The analysis
presented in this report includes
several important methodological
features. To address the issue of what
proportion of children meet various
dietary standards, we used statistical
methods to obtain unbiased estimates of
the distribution of usual intake using
two days of intake information for each
child. Since accepted reference
standards (Estimated Average
Requirements [EARs]) have not yet been
developed for nutrients other than the
B-vitamins, phosphorus, and magnesium,
we assigned reference standards derived
from the 1989 Recommended Dietary
Allowances (RDAs) or Adequate Intakes (AIs)
for the remaining nutrients.
Since the CSFII
provides no direct measure of school
meal participation status on the days of
dietary data collection, we determined
participation largely according to the
foods the student reported having
obtained and consumed from the school
cafeteria on that day. Finally, in
examining the relationship between
school meal participation and dietary
intake, we obtained regression-adjusted
mean food and nutrient intake estimates
after controlling for observable
characteristics of participants and
nonparticipants. Fifteen types of
variables were used in the regression
adjustment.
Children's
Dietary Intakes
On average,
students’ reported daily consumption
of food energy is less than the
Recommended Energy Allowance (REA),
especially among females. Mean food
energy intakes by males ranged from 96
to 97 percent of the REA, whereas
intakes by females ranged from 83 to 87
percent of the REA. These relatively low
reported intakes may have been the
result of underreporting of food intake
by children. Alternatively, the reported
intakes may have been accurate but the
children’s actual energy requirements
may have been lower than implied by the
REA due to low physical activity levels
among children.
Children’s
mean intakes of most vitamins and
minerals exceed the RDA; however, mean
intakes of vitamin E, folate, and zinc
are less than this dietary standard.
In addition, children’s mean intake of
calcium is below the AI and children’s
median intakes of vitamin A and
magnesium are below the RDA.
Mean daily
intakes of many vitamins and minerals
relative to dietary standards differ
greatly by age and gender. Despite
the differences, for vitamin C and for B
vitamins other than folate, mean intakes
for all groups are well in excess of the
RDA. For folate and the other vitamins
and minerals, one or more age/gender
group has a mean intake less than the
RDA. Females ages 14 to 18 have the
lowest mean intakes of vitamins and
minerals.
Nearly all
children meet the reference standard for
most B vitamins, but many children of
all ages are at risk of inadequate
intakes of folate, magnesium, zinc, and
vitamins A and E. In addition, a large
proportion of children have calcium
intakes well below the AI level. Particularly
large proportions of children have low
intakes of several of these nutrients.
For example, fewer than half of all
children meet the reference standards
for folate and calcium and between half
and two-thirds meet the standards for
vitamin E, magnesium, and zinc.
Teenage
girls are at especially high risk of
having low vitamin and mineral intakes.
For three nutrients (folate, calcium,
and magnesium), fewer than 15 percent of
14-to 18-year-old females meet reference
standards. Half or just over half of
these teenage girls meet the reference
standards for vitamin A, vitamin E,
iron, phosphorus, and zinc. Females ages
9 to 13 also tend to have low intakes of
the same set of vitamins and minerals as
teenage girls. In general, children aged
6 to 8 (both males and females) are
likely to meet the standards for
vitamins and minerals; the exceptions to
this are vitamin E and zinc.
Non-Hispanic
blacks and "others" are at
increased risk of low or inadequate
intakes of folate, magnesium, calcium,
phosphorus, and vitamin A. Hispanics
and "others" are at increased
risk of low or inadequate intake of
vitamin E. Household income did not
appear to be consistently related to
risk of inadequate intake.
Most
children take fewer than the recommended
number of servings of the five major
food groups, especially in relation to
their energy requirements. Only 2
percent of children meet Food Guide
Pyramid servings recommendations for all
five major food groups. Girls ages 14 to
18 have especially low intakes of fruits
and dairy products, and this is
consistent with their low mean nutrient
intakes. Overall, the percentages of
children meeting the recommended number
of food group servings are 14 percent
for fruit, 17 percent for meat, 20
percent for vegetables, 23 percent for
grain, and 30 percent for milk.
Children are
heavy consumers of regular or diet soda.
Overall, 56 to 85 percent of children
(depending on age and gender) consume
soda on any given day. Teenage males
are especially heavy consumers of soda,
with over a third consuming more than
three servings a day.
Small
percentages of children meet the
recommendations for intake of total fat,
saturated fat, fiber, and sodium.
Fewer than one-third of females ages 14
to 18 meet the recommendations for total
fat and saturated fat intake, but even
smaller percentages of children meet
these recommendations among the other
age/gender groups. Among 9- to
13-year-old males, for example, only 14
percent meet the total fat
recommendation and 6 percent meet the
saturated fat recommendation. Young
children are most likely to meet the
recommendations for sodium and fiber.
Black
children are very unlikely to meet
recommendations for total fat, saturated
fat, and sodium intake. Only 7
percent of black children limit their
total fat intake to 30 percent or less
of food energy, 5 percent limit their
saturated fat intake to less than 10
percent of food energy, and 11 percent
limit their sodium intake to 2,400 mg.
Non-Hispanic whites and
"others" are the racial/ethnic
groups most likely to meet
recommendations for total fat, saturated
fat, and cholesterol.
Children’s
diets are high in added sugars. For all
children, added sugars--including sugars
used as ingredients in processed foods
or added to foods as they are
consumed--contribute a mean of 20
percent of total food energy.
Differences as a percentage of calories
are relatively small for the age/gender
groups. However, absolute mean intake of
added sugars ranges from 19 teaspoons
for females ages 6 to 8 years to 36
teaspoons/day (3/4 cup) for males ages
14 to 18 years.
Compared
with lunch and 24-hour intake, breakfast
tends to be substantially higher in
nutrient density for vitamins and
minerals. Breakfast contributes a
higher percentage of essential nutrients
relative to its energy contribution than
do lunch and other meals during the day.
Furthermore, children’s intakes of
fat, saturated fat, and sodium are
closer to being in line with dietary
recommendations at breakfast than at
other meals during the day. However,
substantial proportions of children skip
breakfast. Nearly 20 percent of females
ages 14 to 18 skipped breakfast on both
days for which intake was reported,
which may contribute to their low mean
intake of nutrients.
Relationship
Between School Meal Program
Participation and Dietary Intake
The school
meal programs play a substantial role in
the diets of school-aged children.
On average, however, children get much
more food away from school than at
school. Because many children do not
participate in the school meal programs,
foods from the school cafeteria (most,
but not all of which are offered as part
of the NSLP or SBP) contribute a mean of
19 percent of the daily food energy
intake of all children on school days;
children get the rest of their food
elsewhere. On the other hand, SBP
participants, most of whom also consume
a school lunch, obtain about half of
their food energy for the day from
school cafeteria foods.
NSLP
participation is associated with higher
mean intakes of food energy and of many
nutrients, both at lunch and over 24
hours. After controlling for
observable characteristics, NSLP
participants consume a mean of 94
percent of the REA over 24 hours (on
school days), whereas nonparticipants
consume 88 percent. Relative to
nonparticipants, participants consume
greater amounts of vitamins B6,
vitamin B12, thiamin,
riboflavin, calcium, phosphorus,
magnesium, and zinc. The differences in
the 24-hour intake of these nutrients
are largely explained by the differences
in participants’ and nonparticipants’
intakes of all foods at lunch.
NSLP
participants continue to have higher
mean intakes of total fat, saturated
fat, and sodium than nonparticipants,
both at lunch and over 24 hours.
Total fat intake from all foods consumed
at lunch is 37 percent of food energy
for participants and 32 percent for
nonparticipants, while saturated fat
intake is 15 and 11 percent,
respectively. These findings are
consistent with reports from earlier
studies. Higher intakes of fat at lunch
almost entirely explain the 24-hour
differences in fat intake between the
two groups. Participants’ intakes at
lunch may have included a la carte foods
sold in the school cafeteria and other
foods in addition to foods that were
part of the school lunch.
NSLP
participants have substantially lower
intakes of added sugars than do
nonparticipants. At lunch, added
sugars contribute 13.2 percent of food
energy for participants and 22.9 percent
for nonparticipants. Nonparticipants
also consume significantly more added
sugars over 24 hours. This difference
leads to a corresponding difference in
carbohydrate intake--participants’
carbohydrate intake as a percentage of
food energy is lower than that of
nonparticipants.
NSLP
participants are more likely than
nonparticipants to consume vegetables,
milk and milk products, and meat and
meat substitutes, both at lunch and over
24 hours; they also consume less soda
and/or fruit drinks. Participants
consume an average of 1.3 servings of
vegetables at lunch compared with 0.6
servings by nonparticipants. Similarly,
participants consume more milk servings
at lunch than do nonparticipants (0.8
versus 0.2 servings). Perhaps as a
substitute for milk, nonparticipants
consume an average of 0.4 servings of
soda and 0.3 servings of fruit drinks at
lunch, compared with 0.2 and 0.1,
respectively, for participants.
SBP
participation is associated with higher
intakes of food energy, calcium,
phosphorus, and vitamin C. These
higher intakes are evident over 24
hours, not just at breakfast. For
example, participants’
regression-adjusted mean food energy
intake is 96 percent of the REA,
compared with 90 percent among
nonparticipants. Significantly larger
percentages of participants than
nonparticipants meet reference standards
for vitamin C, vitamin B12, thiamin, and
calcium. The favorable findings for
vitamin C and calcium may be related, in
part, to participants’ much higher
intakes of fruit and milk.
Students who
participate in both the school breakfast
and school lunch programs have higher
mean intakes of food energy, seven
vitamins and minerals, total fat,
saturated fat, fiber, and sodium than do
students who participate in neither
program. Participants are
significantly more likely to meet the
dietary standards for the intake of
vitamin C, vitamin B6, vitamin B12,
thiamin, riboflavin, calcium, iron,
magnesium, phosphorus and zinc. On the
other hand, participants are less likely
to meet fat and sodium guidelines. For
example, 15 percent of participants and
32 percent of nonparticipants have daily
intakes of saturated fat less than 10
percent of food energy. Intake of added
sugars is lower for participants.
Compared with students who participate
in neither program, participants in both
programs consume (at breakfast and
lunch) more than twice as many servings
of milk and of fruit and vegetables
combined and one-quarter the number of
servings of soda and fruit drinks.
Improvements
in the school meal programs can be a
positive step in promoting healthy
eating among children. In
particular, improvements are needed to
promote children’s intakes that are
consistent with dietary recommendations
related to intake of fat, saturated fat,
sodium, and fiber.
January
2001
Last modified: 12/04/2008
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