BACKGROUND Research on the association between school meal consumption and overall dietary intake post-Healthy Hunger-Free Kids Act implementation is limited. OBJECTIVE This study examines the association between frequency of participating in the National School Lunch and School Breakfast Programs and children's dietary intakes. DESIGN The Healthy Communities Study was a cross-sectional observational study conducted between 2013 and 2015. PARTICIPANTS AND SETTING US children aged 4 to 15 years (n=5,106) were included. MAIN OUTCOME MEASURES Dietary measures were assessed using the National Health and Nutrition Examination Survey Dietary Screener Questionnaire. Dietary intake included fruit and vegetables, fiber, whole grains, dairy, calcium, total added sugar, sugar-sweetened beverages, and energy-dense foods of minimal nutritional value. STATISTICAL ANALYSIS Multivariate statistical models assessed associations between frequency of eating school breakfast or lunch (every day vs not every day) and dietary intake, adjusting for child- and community-level covariates. RESULTS Children who ate school breakfast every day compared with children who ate 0 to 4 days/wk, reported consuming more fruits and vegetables (0.1 cup/day, 95% CI: 0.01, 0.1), dietary fiber (0.4 g/day, 95% CI: 0.2, 0.7), whole grains (0.1 oz/day, 95% CI: 0.05, 0.1), dairy (0.1 cup/day, 95% CI: 0.05, 0.1), and calcium (34.5 mg/day, 95% CI: 19.1, 49.9). Children who ate school lunch every day, compared with those who ate less frequently, consumed more dairy (0.1 cup/day, 95% CI: 0.1, 0.2) and calcium (32.4 mg/day, 95% CI: 18.1, 46.6). No significant associations were observed between school meal consumption and energy-dense nutrient-poor foods or added sugars. CONCLUSIONS Eating school breakfast and school lunch every day by US schoolchildren was associated with modestly healthier dietary intakes. These findings suggest potential nutritional benefits of regularly consuming school meals.

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每天吃校餐与更健康的膳食摄入量有关：健康社区研究

背景 关于学校膳食消费与健康无饥饿儿童法案实施后总体膳食摄入量之间关联的研究是有限的。目的 本研究检验参加全国学校午餐和学校早餐计划的频率与儿童饮食摄入量之间的关系。设计 健康社区研究是一项横断面观察性研究，于 2013 年至 2015 年期间进行。参与者和地点为 4 至 15 岁的美国儿童 (n=5,106)。主要结局指标 使用国家健康和营养检查调查膳食筛查问卷评估膳食指标。膳食摄入量包括水果和蔬菜、纤维、全谷物、乳制品、钙、总添加糖、含糖饮料和营养价值最低的高能量食物。统计分析 多变量统计模型评估了吃学校早餐或午餐的频率（每天与不是每天）和饮食摄入量之间的关联，并针对儿童和社区层面的协变量进行调整。结果 每天吃学校早餐的儿童与每周吃 0 至 4 天的儿童相比，报告食用更多的水果和蔬菜（0.1 杯/天，95% CI：0.01，0.1）、膳食纤维（0.4 克/天，95 % CI：0.2、0.7）、全谷物（0.1 盎司/天，95% CI：0.05、0.1）、乳制品（0.1 杯/天，95% CI：0.05、0.1）和钙（34.5 毫克/天，95 % CI：19.1、49.9）。每天吃学校午餐的儿童与吃得较少的儿童相比，摄入更多的乳制品（0.1 杯/天，95% CI：0.1, 0.2）和钙（32.4 mg/天，95% CI：18.1, 46.6）。没有观察到学校膳食消耗与能量密集、营养不足的食物或添加糖之间存在显着关联。结论 美国学童每天吃学校早餐和学校午餐与适度健康的饮食摄入量有关。这些发现表明定期食用学校膳食的潜在营养益处。