The Impact of the Availability of School Vending Machines on Eating Behavior during Lunch: The Youth Physical Activity and Nutrition Survey

• Published in: Journal of the American Dietetic Association 2010-10, Vol.110 (10), p.1532-1536
• Main Authors: Park, Sohyun, PhD, MS, Sappenfield, William M., MD, MPH, Huang, Youjie, MD, DrPh, Sherry, Bettylou, PhD, RD, Bensyl, Diana M., PhD, MA
• Format: Article
• Language: English
• Subjects: Adolescent; Analysis; Beverages - statistics & numerical data; Blacks; candy; Carbonated Beverages - statistics & numerical data; Chi-Square Distribution; Child; childhood obesity; Choice Behavior; confidence interval; crackers; Cross-Sectional Studies; dietary surveys; Eating disorders; eating habits; Feeding Behavior; Female; Florida - epidemiology; food choices; Food Dispensers, Automatic - statistics & numerical data; Food Dispensers, Automatic - utilization; food processing equipment; Food Services - statistics & numerical data; Food Services - utilization; Gastroenterology and Hepatology; Health Behavior; Hispanics; Humans; Internal Medicine; issues and policy; Logistic Models; lunch; Male; middle school students; middle schools; morbidity; Nutrition; Obesity - epidemiology; Obesity - etiology; physical activity; public health; public schools; races; regression analysis; Risk Factors; school lunch; School lunches; Schools; Smoking; smoking (habit); snacks; soft drinks; Students - psychology; Students - statistics & numerical data; Vending machines; youth
• ISSN: 0002-8223; 2212-2672; 1878-3570; 2212-2680
• DOI: 10.1016/j.jada.2010.07.003

Abstract Childhood obesity is a major public health concern and is associated with substantial morbidities. Access to less-healthy foods might facilitate dietary behaviors that contribute to obesity. However, less-healthy foods are usually available in school vending machines. This cross-sectional study examined the prevalence of students buying snacks or beverages from school vending machines instead of buying school lunch and predictors of this behavior. Analyses were based on the 2003 Florida Youth Physical Activity and Nutrition Survey using a representative sample of 4,322 students in grades six through eight in 73 Florida public middle schools. Analyses included χ2 tests and logistic regression. The outcome measure was buying a snack or beverage from vending machines 2 or more days during the previous 5 days instead of buying lunch. The survey response rate was 72%. Eighteen percent of respondents reported purchasing a snack or beverage from a vending machine 2 or more days during the previous 5 school days instead of buying school lunch. Although healthier options were available, the most commonly purchased vending machine items were chips, pretzels/crackers, candy bars, soda, and sport drinks. More students chose snacks or beverages instead of lunch in schools where beverage vending machines were also available than did students in schools where beverage vending machines were unavailable: 19% and 7%, respectively ( P ≤0.05). The strongest risk factor for buying snacks or beverages from vending machines instead of buying school lunch was availability of beverage vending machines in schools (adjusted odds ratio=3.5; 95% confidence interval, 2.2 to 5.7). Other statistically significant risk factors were smoking, non-Hispanic black race/ethnicity, Hispanic ethnicity, and older age. Although healthier choices were available, the most common choices were the less-healthy foods. Schools should consider developing policies to reduce the availability of less-healthy choices in vending machines and to reduce access to beverage vending machines.