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Fast food sales on high school campuses: results from the 2000 California High School Fast Food Survey. (Commentaries).

Article Excerpt
Concern about adolescent obesity has increased in the past two decades due to studies that indicate up to a twofold increase in the youth obesity rate. (1-3) According to the National Research Council, (4) more than 80% of obese adolescents remain obese as adults. Obese teens face an increased risk for serious health problems that do not commonly occur during childhood, including high blood pressure, high blood cholesterol levels, and abnormal glucose tolerance. (5) Adolescent health problems related to obesity can lead to chronic diseases in adulthood, such as heart disease, cancer, and Type 2 diabetes. (6) Obese adolescents also suffer from psychological stress, discrimination, and low self-esteem. (5)

Genetics can play a role in obesity, but dietary factors also are essential to consider. Generally, teens in the United States follow eating patterns that do not meet national dietary recommendations. More than 84% consume more than the recommended 30% of daily calories from fat, (7) and 90% exceed the recommendation for no more than 10% of daily calories from saturated fat. (8) Fewer than five percent of teens eat the recommended five daily servings of fruits and vegetables. (8) Some experts believe poor teen diets have been influenced by the easy availability of fast foods high in calories and fat. (9)

Over the past decade, fast foods have become increasingly common on high school campuses. These fast foods or a la carte food items offered at schools are not subject to nutrient standards like meals sold under the USDA National School Lunch Program (NSLP). Although NSLP meals are available to all students at a low cost, a variety of school environment factors prompt students to choose foods sold outside the NSLP.

The 2000 California High School Fast Food Survey sought to describe types of fast food being sold on California high school campuses, factors that influence such sales, and the economic and policy issues associated with them. Findings from the survey will be used by public health intervention and advocacy programs in their work on adolescent nutrition and physical activity issues.

SURVEY METHODOLOGY

A self-administered survey instrument was created and pretested with a small sample of food service directors. The survey included 19 multiple-choice questions and one open-ended question, and it was designed to take no more than 15 minutes to complete. Survey topics included availability of fast food; specific locations and times for fast food sales; economic issues associated with fast food sales; policy issues associated with fast food sales; identification of decision makers involved with fast food sales; sales of branded versus nonbranded fast foods; and fast food advertising and promotion rights.

The survey was mailed to all public school district food service directors in California with at least one high school in their district (n = 323) in March 1999. To improve the survey response rate, a second mailing of the survey was sent to nonrespondents approximately three weeks after the initial mailing. As an incentive, food service directors were offered a free cookbook featuring recipes from premier California chefs and a summary of the survey results.

Follow-up telephone interviews also were conducted with 50 food service directors who responded to the self-administered survey. The interview sample included a geographic mix of districts, with representation from urban, rural, and suburban communities....