|dc.description.abstract||Background: Federal nutritional guidelines apply to school foods provided through the national school lunch and breakfast
programs, but few federal regulations apply to other foods and drinks sold in schools (labeled "competitive foods"), which are
often high in calories, fat and sugar. Competitive food policies among school districts are increasingly viewed as an important
modifiable factor in the school nutrition environment, particularly to address rising rates of childhood overweight. Congress
passed legislation in 2004 requiring all school districts to develop a Wellness Policy that includes nutrition guidelines for
competitive foods starting in 2006-2007. In addition, the Institute of Medicine (IOM) recently published recommendations for
schools to address childhood obesity.
Methods: Representatives of school districts with the largest student enrollment in each state and D.C. (N = 51) were
interviewed in October-November 2004 about each school district's nutrition policies on "competitive foods." District policies
were examined and compared to the Institute of Medicine's recommendations for schools to address childhood obesity.
Information about state competitive food policies was accessed via the Internet, and through state and district contacts.
Results: The 51 districts accounted for 5.9 million students, representing 11% of US students. Nineteen of the 51 districts (39%)
had competitive food policies beyond state or federal requirements. The majority of these district policies (79%) were adopted
since 2002. School district policies varied in scope and requirements. Ten districts (53%) set different standards by grade level.
Most district policies had criteria for food and beverage content (74%) and prohibited the sale of soda in all schools (63%); fewer
policies restricted portion size of foods (53%) or beverages (47%). Restrictions more often applied to vending machines (95%),
cafeteria � la carte (79%), and student stores (79%) than fundraising activities (47%). Most of the policies did not address more
comprehensive approaches to the school nutrition environment, such as nutrition education (32%) or advertising to students
(26%), nor did they include guidelines on physical education (11%). In addition, few policies addressed monitoring (32%) or
consequences for non-compliance (11%). No policy restricted foods sold for after-school fundraising or required monitoring
physical health indicators (e.g. BMI).
Conclusion: When compared to the Institute of Medicine's recommendations for schools' role in preventing obesity, none of
the nutrition policies among each state's largest school district had addressed all the recommendations by 2004�2005.
Nutritionists, nurses, pediatricians, parents, and others concerned about child health have an unprecedented opportunity to help
shape and implement more comprehensive school district nutrition policies as part of the Congressional requirement for a
"Wellness Policy" by 2006-2007.||en_US