Sweetened beverage availability and consumption among rural high school students in Tennessee

BACKGROUND: Compared to urban areas, obesity rates are greater in rural communities. Sweetened beverages and energy-dense snack consumption are common behaviors among youth that contribute to excessive weight gain. In 2004, Tennessee lawmakers passed legislation requiring nutritional standards for food items sold to elementary and middle school students. Extending this legislation to high schools has been under consideration. The purpose of this study was to assess the food consumption behaviors of rural high school students in Tennessee (TN).

METHODS: Proportion sampling strategies were used to select 39 schools. Self-administered questionnaires were completed by principals (n=39) and students in participating schools (n=2016). Key variables of interest were sweetened beverage and snack consumption and the use of school vending machines.

RESULTS: Descriptive analyses indicated that sweetened beverage intake was consistent across Tennessee. Eighteen percent of students in West TN consumed 4-6 sodas per week while 14% and 20% of students in Middle TN and East TN, respectively, reported similar intake levels. High caffeinated beverage consumption was also consistent. Over one quarter of the students drank between 1-3 caffeinated beverages weekly. Approximately one third of students in each region purchased sweetened beverages at least once during a week from school vending machines.

CONCLUSIONS: The findings suggest that high schools can be important sites to modify sweetened beverage consumption patterns. This is particularly salient in rural areas where the array of food choices can be narrow. Nutrition policies in high schools can help to reduce the disproportionate levels of obesity in rural areas.