Wide availability of high-calorie beverages in US elementary schools.

OBJECTIVE To examine the availability of beverages for sale in elementary schools. DESIGN Nationally representative mail-back survey. SETTING U.S. public and private elementary schools during the 2006-2007, 2007-2008, and 2008-2009 school years. PARTICIPANTS Survey respondents at elementary schools. MAIN OUTCOME MEASURE Availability of beverages offered in competitive venues and school lunches. RESULTS Public elementary school students' access to beverages for sale in any competitive venue on campus (vending machines, stores, snack bars, and/or à la carte) increased from 49.0% in 2006-2007 to 61.3% in 2008- 2009 (P < .01). The percentage of public school students with access to only beverages allowed by the Institute of Medicine guidelines for competitive beverages (i.e., water, 100% juice, and 1% or nonfat milk) increased from 10.0% to 16.1% (P < .01). Access to higher-fat milk (2% or whole milk) in school lunches decreased from 77.9% of public school students in 2006-2007 to 68.3% in 2008-2009 (P < .001). Flavored milk was available at lunch on most days for 92.1% of public school students. CONCLUSIONS As of the 2008-2009 school year, high-calorie beverages and beverages not allowed by national guidelines were still widely available in elementary schools.