Students choosing fat-free chocolate milk during school lunch consume more calories, total sugar, protein, minerals and vitamins at lunch.

OBJECTIVE: To examine how milk consumption varies by milk choice and measure the association of milk choice on the nutritional and energetic content of National School Lunch Program (NSLP) lunches. DESIGN: An observational plate waste study using the Digital Photography of Foods Method. SETTING: Data were collected from two suburban South Carolina schools in one district during February and March 2013. PARTICIPANTS: Totally, 968 NSLP lunches selected by 619 kindergarten to fifth grade students. RESULTS: Most students chose chocolate milk (75 %). A multinomial logit model indicated milk choice varied significantly by sociodemographic characteristics. An ordinary least square regression indicated that consumption rates of low-fat white milk were 8·5 % lower than fat-free chocolate milk (P = 0·039) and milk consumption rates varied statistically by sociodemographic characteristics. Ordinary least square regressions found that the consumption of energies and nutrients from NSLP lunches varied with sociodemographic characteristics and milk choice; students selecting chocolate milk consumed 58 more energies (P < 0·001) and 10 more grams of total sugar (P < 0·001) than students selecting low-fat white milk from their NSLP lunches. Students consumed statistically similar energies and nutrients from the non-milk components of their meals. CONCLUSIONS: Students selecting chocolate milk consumed more energies and nutrients from their NSLP lunches with the increases in consumption attributed to the milk component of the meal. The findings have implications for recent changes to NSLP guidelines that allow schools to offer both low-fat and fat-free flavoured milk, reversing the previous ban on low-fat flavoured milk under the Healthy, Hunger-Free Kids Act.

Selection and consumption of lunches by National School Lunch Program participants.

The Healthy, Hunger-Free Kids Act of 2010 requires schools participating in the National School Lunch Program (NSLP) to offer a variety of healthy food options each day. Using digital photography data collected from two suburban elementary schools in the spring of 2013, we examine NSLP participant's selection and consumption of all five NSLP lunch components ((1) milk, (2) vegetable, (3) fruit, (4) meat/meat alternate (MA), and (5) grain). We use logit regressions to analyze the selection of the various lunch components by race/ethnicity, gender, grade, and household income level. In addition, ordinary least squares regressions are used to analyze the selection and consumption of calories contained in the chosen lunch and by lunch component. Selection and consumption varied by race, ethnicity, gender, and eligibility for free or reduced-price lunch. For example, black students consumed fewer calories than white students, black and Hispanic students consumed fewer calories from milk than white students, and free and reduced-price lunch eligible students consumed more calories from milk and fewer calories from grains. Using National Health and Nutrition Examination Survey (NHANES) data, we determine that school lunches are an important part of school-day food intake for NSLP participants. These results provide guidance for making changes within a cafeteria's offerings to increase the selection of healthy foods.

How and why weight stigma drives the obesity 'epidemic' and harms health.

BACKGROUND: In an era when obesity prevalence is high throughout much of the world, there is a correspondingly pervasive and strong culture of weight stigma. For example, representative studies show that some forms of weight discrimination are more prevalent even than discrimination based on race or ethnicity. DISCUSSION: In this Opinion article, we review compelling evidence that weight stigma is harmful to health, over and above objective body mass index. Weight stigma is prospectively related to heightened mortality and other chronic diseases and conditions. Most ironically, it actually begets heightened risk of obesity through multiple obesogenic pathways. Weight stigma is particularly prevalent and detrimental in healthcare settings, with documented high levels of 'anti-fat' bias in healthcare providers, patients with obesity receiving poorer care and having worse outcomes, and medical students with obesity reporting high levels of alcohol and substance use to cope with internalized weight stigma. In terms of solutions, the most effective and ethical approaches should be aimed at changing the behaviors and attitudes of those who stigmatize, rather than towards the targets of weight stigma. Medical training must address weight bias, training healthcare professionals about how it is perpetuated and on its potentially harmful effects on their patients. CONCLUSION: Weight stigma is likely to drive weight gain and poor health and thus should be eradicated. This effort can begin by training compassionate and knowledgeable healthcare providers who will deliver better care and ultimately lessen the negative effects of weight stigma.

Body Size and Social Self-Image among Adolescent African American Girls: The Moderating Influence of Family Racial Socialization.

Social psychologists have amassed a large body of work demonstrating that overweight African American adolescent girls have generally positive self-images, particularly when compared with overweight females from other racial and ethnic groups. Some scholars have proposed that elements of African American social experience may contribute to the maintenance of these positive self-views. In this paper, we evaluate these arguments using data drawn from a panel study of socio-economically diverse African American adolescent girls living in Iowa and Georgia. We analyze the relationship between body size and social self-image over three waves of data, starting when the girls were 10 years of age and concluding when they were approximately 14. We find that heavier respondents hold less positive social self-images but also find that being raised in a family that practices racial socialization moderates this relationship.

The Relationship between Body Size and Depressed Mood: Findings from a Sample of African American Middle School Girls.

The relationship between body weight and depression among adolescent females has been the subject of considerable attention from researchers. The risk of experiencing this distress, however, is not equally distributed across members of all racial groups. African American girls are generally more satisfied with their bodies and thus may be less vulnerable to experiencing depression as a result of weight concerns. Several scholars have suggested that membership in African American culture provides social resources that protect black females from experiencing high levels of weight-based psychological distress. We examine the relationship between body size and depression and the potentially moderating role of African American cultural experiences using data from the Family and Community Health Study (FACHS). Assessing a cohort of 342 African American girls ages 12-14, we found support for a link between weight and depression. There was no evidence, however, that exposure to African American culture moderated this relationship.

Neighborhood environments and self-rated health in Mainland China, Japan and South Korea.

Neighborhood environments are considered crucial determinants of self-rated health. Previous research has documented a positive association between the quality of neighborhood environments and health status. However, the relationship between neighborhood environments and health status in East Asian countries has received far less attention. This study examined the relationship between the three main types of neighborhood environments (built, natural, and social) and self-rated health in Mainland China, Japan, and South Korea. It also compared the neighborhood effects on self-rated health across the three countries. Our analytical sample included 3,675, 2,390, and 1,500 respondents in China, Japan, and South Korea respectively from the 2010 East Asian Social Survey. Ordinal Logistic Regression models were estimated for each country and the country differences were tested. This study found that neighborhood built, natural and social environments are positively associated with self-rated health in China, Japan and South Korea. These effects vary somewhat by country, and neighborhood social environment has the strongest association with self-rated health in Japan, followed by South Korea and then China. The similar relationship between perceived neighborhood environments and self-rated health across the three countries underscores the prevalent impact of perceived neighborhood environments on health. The greater association between social environment and self-rated health in Japan suggests the greater need of community based support system in an aging society not only for the older people, but also for the general population, especially those who are living in poor neighborhood social environment.

The Role of Body Size in Mate Selection among African American Young Adults.

A profusion of studies have demonstrated that body size is a major factor in mate selection for both men and women. The particular role played by weight, however, has been subject to some debate, particularly with respect to the types of body sizes deemed most attractive, and scholars have questioned the degree to which body size preferences are constant across groups. In this paper, we drew from two perspectives on this issue, Sexual Strategies Theory and what we termed the cultural variability perspective, and used survey data to examine how body size was associated with both casual dating and serious romantic relationships. We used a United States sample of 386 African American adolescents and young adults between ages 16 and 21, living in the Midwest and Southeast, and who were enrolled in either high school or college. Results showed that overweight women were more likely to report casually dating than women in the thinnest weight category. Body size was not related to dating status among men. Among women, the results suggest stronger support for the cultural variability argument than for Sexual Strategies Theory. Potential explanations for these findings are discussed.

Exploring the impact of skin tone on family dynamics and race-related outcomes.

Racism has historically been a primary source of discrimination against African Americans, but there has been little research on the role that skin tone plays in explaining experiences with racism. Similarly, colorism within African American families and the ways in which skin tone influences family processes is an understudied area of research. Using data from a longitudinal sample of African American families (n = 767), we assessed whether skin tone impacted experiences with discrimination or was related to differences in quality of parenting and racial socialization within families. Findings indicated no link between skin tone and racial discrimination, which suggests that lightness or darkness of skin does not either protect African Americans from or exacerbate the experiences of discrimination. On the other hand, families displayed preferential treatment toward offspring based on skin tone, and these differences varied by gender of child. Specifically, darker skin sons received higher quality parenting and more racial socialization promoting mistrust compared to their counterparts with lighter skin. Lighter skin daughters received higher quality parenting compared with those with darker skin. In addition, gender of child moderated the association between primary caregiver skin tone and racial socialization promoting mistrust. These results suggest that colorism remains a salient issue within African American families. Implications for future research, prevention, and intervention are discussed.