Abstract
PURPOSE: To examine the association between food sold in school vending machines and the dietary behaviors of students. METHODS: The 2005-2006 U.S. Health Behavior in School-aged Children survey was administered to 6th to 10th graders and school administrators. Dietary intake in students was estimated with a brief food frequency measure. School administrators completed questions regarding food sold in vending machines. For each food intake behavior, a multilevel regression analysis modeled students (level 1) nested within schools (level 2), with the corresponding food sold in vending machines as the main predictor. Control variables included gender, grade, family affluence, and school poverty index. Analyses were conducted separately for 6th to 8th and 9th-10th grades. RESULTS: In all, 83% of the schools (152 schools; 5,930 students) had vending machines that primarily sold food of minimal nutritional values (soft drinks, chips, and sweets). In younger grades, availability of fruit and/or vegetables and chocolate and/or sweets was positively related to the corresponding food intake, with vending machine content and school poverty index providing an explanation for 70.6% of between-school variation in fruit and/or vegetable consumption and 71.7% in sweets consumption. Among the older grades, there was no significant effect of food available in vending machines on reported consumption of those food. CONCLUSION: Vending machines are widely available in public schools in the United States. In younger grades, school vending machines were either positively or negatively related to the diets of the students, depending on what was sold in them. Schools are in a powerful position to influence the diets of children; therefore, attention to the food sold at school is necessary to try to improve their diets.