Stronger State School Nutrition Laws Are Associated With Healthier Eating Behaviors and Optimal Weight Status in US Adolescents.

PURPOSE: To investigate relationships of farm-to-school, school meal, and competitive food state laws with eating behaviors and weight status and to examine interaction between different types of state laws. DESIGN: Observational cohort study. SETTINGS: US adolescents. PARTICIPANTS: The NEXT study is a nationally representative sample of adolescents assessed annually for 7 years. Data (N = 2751) from students attending public schools from the first (W1) and third (W3) assessment waves (2010 and 2012), occurring during grades 10 and 12, respectively, of the NEXT study were included. MEASURES: Eating behaviors and weight status of adolescents were linked with Classification of Laws Associated with School Students scoring for state laws. ANALYSIS: Regression analyses examined associations of laws with intake and weight status, accounting for complex survey design and school-level clustering. RESULTS: Adolescents in states with strong farm-to-school laws had greater W1 whole fruit, lower soda, and snack intakes versus those in states with no laws. Strong school meal laws were associated with lower W1 soda intake. Adolescents in states with strong competitive food laws had lower soda intake and overweight/obesity odds than those in states with no laws in W3. Strong farm-to-school laws were inversely associated with W3 overweight/obesity odds only in states with strong competitive food laws. CONCLUSIONS: Stronger laws governing school nutrition were related to healthier eating behaviors and optimal weight status in this nationally representative sample of adolescents. Further, farm-to-school laws may be more effective in reducing obesity when combined with strong competitive food legislation.