Pediatric obesity in Texas: does the Texas Public School Nutrition Policy affect child nutrition?

A significant increase in the incidence of pediatric obesity has been reported in Texas. This study evaluated how effectively the Texas Public School Nutrition Policy promoted the understanding of proper nutrition by fourth-grade schoolchildren and their parents in three school districts in Bell County and Harris County. Fourth-grade schoolchildren were surveyed at two times (T1, T2) during the spring semester of the 2004-2005 school year to assess their dietary intake, their health-related quality of life (HRQOL), and their understanding and satisfaction with the Texas Public School Nutrition Policy. Participating students' parents also were surveyed. The overall obesity rate in surveyed children averaged 26.1%. No significant difference was found between HRQOL scores for obese and normal-weight children, although HRQOL scores for normal-weight children were significantly lower than those in previous population studies of healthy children. In addition, the HRQOL scores of obese and healthy children increased significantly from T1 to T2 for Bell County but only for healthy children in Harris County. Children from Bell County were more likely to eat food from the cafeteria while children from Harris County were more likely to eat food brought from home. Parents of minority children reported that they were more likely to change dietary habits at home as a result of the Texas Public School Nutrition Policy. Obese children were less likely than normal-weight children to try to lose weight. This study suggests that lunch intake varies considerably in Texas, and state policy should try to institute more uniform nutrition guidelines for all school districts. Because minority children are at increased risk of obesity, the preliminary findings that their parents are more likely to change their dietary habits at home are very encouraging.