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.