Abstract
BACKGROUND: Home access to fruits/vegetables (FV) is a consistent predictor of adolescent FV intake, but many adolescents face barriers to home access. PURPOSE: To determine if state laws that require FV in school meals are positively associated with FV intake, particularly among students with limited home access to FV. METHODS: Student data on home food access and FV intake were obtained from the National Youth Physical Activity and Nutrition Study (n=9574) and linked to state laws regarding FV requirements for school meals. All data were collected in 2010. Ordinary least-squares models were utilized in 2012 to estimate differences in intake between states with different FV laws, overall and by whether students had access to various foods at home (FV, unhealthy snacks). Models were weighted to account for the sample design and controlled for race, gender, age, fast-food intake, and school lunches consumed per week. RESULTS: The association between FV requirement laws and FV intake was strongest among students without regular home access to FV. Particularly among students who had home access to only unhealthy snacks and who regularly consumed school meals, mean FV intake was 0.45 and 0.61 cups/day higher, respectively (95% CIs=0.07, 0.84 and 0.21, 1.00), in states with FV requirements. Students with access to healthier foods at home tended to consume more FV, but such disparities in intake were smaller in states with FV laws. CONCLUSIONS: Laws that require FV in school meals may improve FV intake, particularly among students with limited access to healthy foods at home.