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Fiber intake is similar among children eligible for the National School Lunch

Program regardless of Free-, Reduced- or Full-Price meal qualification status

Genevieve Murstig, Tricia Maloney, Justin Hunt, Dietetic Internship Program, Graduate Program in Human Nutrition, Oregon Health &
Science University (OHSU), Portland, OR
Introduction BMI Percentage: Percentages were calculated using MedCalc 3000 BMI Figure 3 Conclusion
calculator. Height, weight, and sex were used to determine BMI
There are few studies that have reported on dietary fiber intake in percentage. Dietary Fiber as a percent of the Adequate Intake • There was no significant difference in fiber intake (g/1000 kcal)
children, although diets with an adequate intake of fiber are associated Among Children Participating in the NSLP between the two groups (p=0.443).
with a lower risk of chronic disease, improved digestion, and lower body NSLP Eligibility: Participants were sorted into categories of free or • Children eligible for free lunch had a mean fiber intake of 8.12 ± 2.8,
weight. When studying the nutritional and dietary fiber intake of school- reduced/full price based on question "Do you receive free lunch or pay Percent Daily Dietary Fiber Intake
and the children eligible for reduced/full-price had a mean fiber intake
reduced or full price?" in NHANES data. 30.0
aged children in the United States, it is vital to examine the National of 8.18± 2.6.

Percentage of Children
Free Lunch Program
25.0
School Lunch Program (NSLP) because it can contribute significantly to a Reduced/Paid Lunch Program • There were several outliers as seen in Figure 2, however, they showed
child's overall energy, nutrient and fiber intakes. Statistical Analyses performed: 20.0
no correlation with age, sex, energy consumption or NSLP eligibility.
• One-sided, two sample equal variance t-test (p<0.05) were used to 15.0
Specific Aims: compare the average fiber intake of the two groups. 10.0
• The average intake of fiber for each child was converted to a
• To determine if children who are eligible for free lunch through the NSLP • Correlation test was used to determine if a relationship existed between 5.0
percentage based on the recommended AI of 14g/1000kcal, as
have a lower intake of dietary fiber than children who qualify for fiber intake and BMI percentile. 0.0
depicted in Figure 3.
0 10 20 30 40 50 60 70 80 90 100 120 130 140 150
reduced price lunch or pay full price. • Odds ratio was used to determine how likely a child eligible for free • Both groups had a similar intake, with over 90% consuming 70% or less
Percent of Recommended Daily Intake
• To determine if low fiber intake has a correlation to higher BMI lunch was to have a lower fiber intake as compared to a child eligible for of the recommendations.
percentage. reduced/full-price. • Mean BMI percentile for the free lunch group was 68 ± 29.2.
• Mean BMI percentile for the reduced/full-price group was 66 ± 30.7.
Hypotheses: Results Figure 4
25
Free Lunch Program • There was no correlation between BMI and dietary fiber intake in free
R² = 0.00204
lunch program (R2=2 x 10-3) or the reduced/paid lunch program
• Children who are eligible for free lunch will have a lower mean fiber Table 1. Participant Characteristics (R2=3.6 x 10-6) as shown in Figures 4 and 5
20
intake than other children.
• The odds ratio was calculated to be 0.84 (95% CI, 0.34, 2.1) (P =

Daily Dietary Fiber


Reduced/paid
• Children with a lower dietary fiber intake will have a higher BMI Free Lunch Lunch 15 0.71). These results are depicted in Figure 6.
Variable Mean ± SD Mean ± SD • We reject our hypotheses.
percentage.
N 452 249 • Fiber intake does not appear to relate to price paid for school lunch.
10
Sex (M:F) 227:225 127:122 • BMI does not correlate with fiber intake and may have other
Methods confounding variables like life style and overall diet.
Age (years) 9 ±2 9 ±2 5
Weight (kg) 35 ± 13 35 ± 12
Study Design: The study participants were selected from the National Clinical Significance:
Height (cm) 135 ± 12 135 ± 13 0
Health and Nutrition Examination Survey (NHANES) 2013-2014 dataset. 0 20 40 60 80 100 • Trend of under-consumption of fiber in 97% of the children 6-11 years
The dataset contains self-reported dietary data using two 24 multi-pass BMI %ile 68 ± 29 66 ± 31
BMI Percentile of age.
dietary recalls via in-person and telephone interviews. Energy intake
1793 ± 484 1816 ± 461 • Educate on the importance of a healthy eating pattern high in fruits,
(kcal)
Fiber intake vegetable, and whole grains.
Figure 1 Participant Selection (g/1000 kcal)
8 ±3 8 ±3 Figure 5 Reduced/Paid Lunch Program
Reduced/Paid • An increase in the consumption of fiber reduces the later risk of
25 developing chronic diseases such as obesity, diabetes, cardiovascular
` 10, 175 NHANES
Excluded 8,803 disease, and certain cancers.
2013-2014 participants R² = 3.6E-06
< 6 and >11 years Figure 2 • Developing healthy patterns during childhood is critical in ensuring the
20
old wellbeing of the population both now and in the future.
1,372 ages 6-11 yo Excluded 252
Fiber Intake
Daily Dietary Fiber Consumption
Daily Dietary Fiber

not on program/missing 15 Future Research:


1,120 on free, reduced, full- data • Further research is necessary to determine the health implications
price lunch Excluded 378 related to low fiber intake in children.
missing 1 day of meal data 10 • Suggestions for additional research include longitudinal studies tracking
742 data for both days dietary intake of children over time and the incidence of chronic
Excluded 41 disease.
<500 and >3500 kcal 5
701 energy consumption • Other suggestions include analyzing how the recent changes in the
btw 500-3,500 kcal NSLP have affected the fiber intake of children.
0 • Examine how school lunch fits into the overall diet of school age
Study Variables:
0 20 40 60 80 100 children. This information should be assessed to possibly adjust the
BMI Percentile goals of the NSLP and public health policy for children.
Total Energy Intake (kcal/d): Total energy was calculated by averaging the total 14
reported dietary energy intake from the two dietary recalls. Figure 6 Odds of Children on NSLP
likely to have lower fiber consumption Acknowledgements
Average Dietary Fiber Intake (g/1000kg): Dietary fiber was calculated by averaging the
total reported dietary fiber intake (g) from two days and dividing by the mean total We would like to thank Dr. Diane Stadler, PhD, RD, LD Director, Graduate
energy intake (kcal) and multiplying by 1000. The recommended Adequate Intake(AI) of Programs in Human Nutrition, Lexie Jackson, MS RDN, LD, CDE, Supervised
fiber is 14g per 1000 kcal. Practice Coordinator & Instructor and Laura Zeigen, MA, MLIS, MPH, AHIP
for their support and guidance.
0 1 2 3 4
Odds Ratio

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