Differences in nutrient intake associated with state laws regarding fat, sugar, and caloric content of competitive foods.

OBJECTIVE: To determine whether nutrient intake is healthier among high school students in California, which regulates the nutrition content of competitive foods sold in high schools, than among students in states with no such standards.
DESIGN: Cross-sectional study.
SETTING: California and 14 states without high school competitive food nutrition standards in the 2009-2010 school year. PARTICIPANTS: A total of 680 high school students sampled in February through May 2010 as part of the National Youth Physical Activity and Nutrition Study.
INTERVENTIONS: State laws governing fat, sugar, and caloric content of competitive foods sold in vending machines, school stores, and cafeterias (à la carte). MAIN OUTCOME MEASURES: Several measures of nutrient intake assessed by 24-hour recall, overall and stratified by location of consumption (school, home, other).
RESULTS: On average, California students reported consuming less fat, sugar, and total calories at school than students in states with no competitive food nutrition standards. California students also reported less at-school intake of vitamins and minerals. All at-school differences in nutrient intake were null after adjusting for total caloric intake; California students consumed a lower proportion of their daily calories in school (21.5%) than students in other states (28.4%). Mean overall intake was lower in California for most measures that were analyzed, particularly added sugars.
CONCLUSIONS: California high school students consumed lower quantities of fat, sugar, and calories in school than students in states with no competitive food nutrition standards, but the nutrition composition of California students' in-school diet was similar. Policy initiatives should promote competitive foods that are consistent with the Dietary Guidelines for Americans.