Out of Sight, Out of Mind: How Availability Affects Healthy Choices

If you're trying to eat healthier and help your family do the same, choose better foods to have in the house and advocate for better choices in your kids' schools.
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Back in 2007, the Institute of Medicine recommended specifically that each school district limit their students' opportunities to choose foods that are not nutritionally approved. To recap:

"The approved foods [available for purchase in schools] include those that derive less than 35 percent of their total calories from fat and less than 10 percent of calories from saturated fats. They should be trans-fat free, get less than 35 percent of their total calories from sugars (with an exception made for certain types of yogurt), and contain less than 200 milligrams of salt per serving."

Clearly the goal in limiting children's access to these unapproved foods was to improve their diet. Faced with fewer junk food options, however, did they make better choices?

Researchers at the Arnold School of Public Health in South Carolina looked at information gathered from the Early Childhood Longitudinal Study, which included more than 10,000 fifth grade children attending 2,065 elementary schools (J Nutr 139: 142-144, 2009). These children responded to a questionnaire which asked about what they had eaten in the past week and specifically asked about green salad, carrots, potatoes (other than French fries or potato chips), other vegetables (not specifically mentioned already) and fruit (not fruit juices).

This information was correlated with statements from the schools' administrators, who told the investigators whether students were able to buy certain foods while at school. These foods included chocolate or other candy; cookies or pastries that are not non-fat; ice cream or frozen yogurt that are not non-fat; and various breadstuffs. Those schools that did not make any of the mentioned foods available for the students to purchase were labeled "restricted," while schools that made even one of the items available for purchase were labeled "unrestricted."

The researchers then compared the diets of the children who attended unrestricted schools with those who attended restricted schools. And they found, not too surprisingly, that those children whose schools did not offer junk foods were more likely to eat more fruits and vegetables than those students who attended schools where they could buy junk food. The difference, however, was fairly small -- children at schools who made junk food available to them were only 10 percent less likely to eat fruit one to three times per day than those children who went to the "restricted" schools.

That said, it's all too easy to point the finger at schools and the food options they offer and blame them for our children's diets. But the truth is that schools are only part of the puzzle.

What about at home?

Did you know that the food you keep at home provides 72 percent, by weight, of all food that you eat? This is assuming that you do not prepare most meals at home. If you do make most of your meals at home (breakfast and dinner made at home and taking your lunch with you to work or school), then 93 percent of the food you eat comes from what is kept in your home.

So what? Of course your food comes from what you have at home. Researchers at Rutgers University wondered if there was a difference in what foods were actually in the home between those families with overweight members and those families who were all of normal weight (Appetite 2009; 52:479-484).

One hundred mothers with at least one child 12 years of age or younger were recruited to participate in the study. These women were all primarily responsible for all meal planning, grocery shopping and meal preparation, and were either married or living with a domestic partner. In addition, the family unit ate dinner at home at least three times per week.

To assess the quality of food kept in the home, the investigators conducted an inventory of the food in each participant's home. Yes, they literally went into the home and counted every food item in the house, with the exception of such items as condiments and seasonings, bulk items like flour and sugar, baby foods, pet foods, alcoholic beverages and leftovers. The specific item and its amount by weight was recorded for each food, then the investigators computed the total number of calories, protein, fat, saturated fat and so forth present for all foods in the house. They then divided that total by the recommended daily allowance (for an adult) of each nutrient. This yielded the number of days' worth of the nutrient that was present in each household. The researchers then had a standardized unit of the different nutrients in foods so that each household could be fairly compared with others.

Each family member had his or her Body Mass Index calculated by the researchers, who then were able to compare the number of days' worth of nutrients from households with overweight or obese parents (either mother, partner or both) with the nutrients from households of normal-weight parents.

While all homes tended to keep the same amounts of nutrients on hand, the differences were in what forms of foods those nutrients were in. For example, those homes with overweight parents tended to have their carbohydrates in the form of frozen potatoes (like tater tots or french fries) or frozen vegetables with an included sauce (like broccoli with cheese sauce or brussel sprouts with butter sauce). Fresh and frozen meats also supplied much of the protein, total fat and saturated fats in overweight households as opposed to normal-weight households.

The take-home message here might seem overly obvious: both adults and children will eat what's available to them. If you're trying to eat healthier and help your family do the same, use this to your advantage: Choose better foods to have in the house and advocate for better choices in your kids' schools. You and your family will be healthier (and maybe even weigh less).