This study examined differences in consumption of sweetened beverages, high fat foods, fruits and vegetables and fast food restaurant use by gender, race/ethnicity and SES among students attending alternative high schools. Similar to general adolescent populations, the AHS students reported high consumption of sweetened beverages, high fat foods and low consumption of fruits and vegetables (6
). However, a higher percentage of the AHS students consumed high fat foods and reported more frequent fast food restaurant use, and a lower percentage consumed ≥ 5 daily servings of fruits and vegetables, as compared to findings from previous studies with youth in the general US population (10
). In this population of AHS students, only 23% consumed five or more daily servings of fruits and vegetables as compared to 29% of students attending traditional high schools (15
Unlike previous studies, regular soda consumption was significantly higher among higher SES than lower SES students (12
). A study that examined demographic differences of dietary behaviors among 3,201 adolescents between the ages of 11 and 20 years found high consumption of sugar added beverages among youth in low SES, as it was measured by a three-category scale of family income (12
). The difference in the assessment of SES between our study and other studies may have contributed to the different outcome in the association of SES and dietary practices. In this study, females reported consuming regular soda almost twice as frequently as males, contrary to most studies indicating higher soft drink consumption among males (31
). Although the observed association was not statistically significant at the less than 0.05 level, this finding is worthy of further investigation.
Black students had higher consumption of sports drinks and other sweetened beverages than white students, which is similar to other studies that found higher sweetened beverage consumption among black than other adolescents (12
). There are individual and socio-economic factors characteristic of adolescents attending alternative high schools that may contribute to high consumption of sweetened beverages. According to a national study by Miech and colleagues (20
), energy from sweetened beverage consumption among adolescents was significantly associated with higher poverty and older age (15-17 years); both of these factors are common among students in the present study. Consumption of sweetened beverages among youth is of great concern. National data suggest a 123% increase in the mean consumption of soft drinks among all children ages 6-17 years between 1977 and 1998 (34
). This increase in soda consumption parallels the increase in childhood overweight and obesity (8
Similar to other studies, black students in our study frequented fast food restaurants more often than all other students (6
). Also, females frequented fast food restaurants twice as often as males; other studies have found mixed results in regards to gender and fast food restaurant use (29
). In a study of black adults, women and those in the youngest age group (20-39 years) reported a higher frequency of fast food restaurant use than males and participants in all other age groups (39
). Since more than one-third of students in our study were older than 18 years, it is likely that they share similar behavioral patterns with young adults, including more financial independence. High fat food consumption was significantly higher among black students than white students. In addition, the black students’ mean fat score of almost 50, which represents fat intake as a percent of daily calories, indicates a high fat intake of >35% of energy from fat (25
Fast food consumption is strongly correlated with consumption of total fat, saturated fat, carbohydrates, and added sugars (40
). While purchasing food at a fast food restaurant does not necessarily imply eating a high fat food item, according to previous findings, hamburgers and French fries top the list in terms of sales volume in fast food restaurants (42
). This finding has been further supported by the significant positive association of frequency of fast food restaurant use and high fat food intake among adolescents (29
). In a study by French and colleagues, fast food restaurant use of three days or more a week was positively associated with adolescent consumption of high fat foods and soft drinks and negatively associated with fruits and vegetables (29
). In this study, more frequent fast food restaurant use and high fat food consumption among black students may point to the excess availability of fast food establishments and the limited availability of healthier foods, especially in urban, racially diverse communities (44
A major finding that emerges from this study is that black students reported higher consumption of sweetened beverages, high fat foods and fast food restaurant use than all other students. Unhealthy dietary practices among black youth is of great concern considering the higher rates of overweight and obesity among this group, as compared to all other youth (22
). Although the diets of most adolescents can be improved, our findings emphasize that minorities, in particular will greatly benefit from nutrition education and health programming that focuses on fostering a school environment that promotes availability of healthy food alternatives.
In this study, the low percentage of AHS students that consumed five or more daily servings of fruits and vegetables was similar to findings from the Youth Risk Behavior Surveillance Survey 2005 representing adolescents in the general population (45
). According to the 2005 Dietary Guidelines for Americans, 9 servings (4.5 cups) of fruits and vegetables a day are recommended for a reference 2000 calorie diet (46
). Considering the 3.6 servings of fruits and vegetables consumed a day by AHS students in this study, even fewer students would meet the new dietary recommendations of fruits and vegetables. Since there were no demographic differences in the consumption of fruits and vegetables, all students would equally benefit from innovative ways to increase consumption of these foods.
The strengths and limitations of this research should be considered when interpreting the results. Strengths of this study included a diverse sample of adolescents with respect to gender, race/ethnicity and SES and the use of measures that have been previously tested in other adolescent populations. This study is one of the few studies to report dietary practices by gender, race/ethnicity and SES among alternative high school students. Even though the student participation rate was 36%, the demographic distribution of our sample closely resembled the study schools (male= 51%; black=42%, white=39%; low SES=56%). Limitations included the cross-sectional nature of the study that only considers the associations between demographic variables and dietary practices rather than a directional or causal path. Although the demographic distribution of our sample resembles national data of AHS students (15
), it included only students in the Twin Cities area of Minnesota, thus limiting the generalizability of the findings. The six-item questionnaire used to measure fruit and vegetable consumption assesses usual intake over the past year. As compared with the 24-hour dietary recalls, the six-item questionnaire underestimated the prevalence of fruit and vegetable intake among urban adolescents, however it performed equally to the Harvard Food Frequency Questionnaire (26
). Although dietary practices may differ among racial groups, non-white and non-black groups were categorized as other due to the small sample size. Finally, students who decided not to participate may differ from the ones who participated in regard to demographic factors and dietary practices.