Student access to competitive foods in elementary schools: trends over time and regional differences.

OBJECTIVE To examine the availability of competitive foods in elementary schools. DESIGN Nationally representative mail-back survey. SETTING United States public and private elementary schools during the 2006-2007, 2007-2008, 2008-2009, and 2009-2010 school years. PARTICIPANTS Survey respondents at 2647 public and 1205 private elementary schools. MAIN OUTCOME MEASURE The availability of foods offered in competitive venues. RESULTS Elementary school students' access to foods in competitive venues on campus (vending machines, school stores, snack bars, or à la carte lines) remained constant over time. As of the 2009-2010 school year, approximately half of all public and private elementary school students could purchase foods in 1 or more competitive venues on campus. Sugary foods were available to almost all students with access to competitive foods on campus. Public elementary school students in the South had more access to competitive food venues and greater availability of salty and sweet products in those venues compared with students in other parts of the country; however, they also had greater availability of healthier foods, such as fruits and vegetables. CONCLUSIONS Many elementary school students can purchase competitive foods on campus. Most students with access to competitive venues could purchase sweet products, but healthier foods were less widely available.