Assessment of the national school lunch program in a subset of schools in San Juan, Puerto Rico: participants vs. non-participants.

OBJECTIVE: Extensive evaluations of the national school lunch program (NSLP) have been carried out on the U.S. mainland. Puerto Rico, a commonwealth of the U.S. is a participant in this program, but has never been included in assessment studies. Herein, we present assessment information and compare results with comparable mainland studies. METHODS: Multiple 24-hr recall questionnaires were administered to groups of participating (P) and non-participating (NP) children in the lunch program at 3 educational levels. Comparisons were made for children within the study as well as between comparable children in mainland studies for total intake of several macro- and micro-nutrients, contribution of the lunch to the total daily intake and adherence to U.S. Recommended Dietary Allowances (RDA's) or to Dietary Reference Intakes (DRI's) including acceptable macronutrient distribution ranges (AMDR's). RESULTS: Target intakes were met by P for % of the RDA of energy from protein, for all water soluble vitamins, iron, zinc and cholesterol. P did not achieve target intakes for total energy, energy from carbohydrates and fat nor for fat soluble vitamins, calcium, magnesium, phosphorus, potassium and fiber. Recommended levels were exceeded for sodium, total fat and saturated fat. Comparing P vs NP, the vast majority of both groups fell within AMDR recommendations for macronutrients but not all micronutrients. CONCLUSION: For the most part, our results parallel those obtained in the National sample however, results suggest that P in the lunch program in Puerto Rico have a healthier intake of several nutrients than NP students. The unique feature of this study is that it is the first assessment of the NSLP in a completely Hispanic population.

Validation and reproducibility of a semi-quantitative food frequency questionnaire for use in Puerto Rican children.

OBJECTIVE: Knowledge of the diet of specific populations is of importance in the assessment of nutrient intake. Herein, we assess the reproducibility and validity of an interviewer-administered food frequency questionnaire (FFQ) in Puerto Rican children at two educational levels--elementary (ES) and high school (HS). METHODS: The FFQ contained 97 items including supplements. It was administered twice (FFQ1 and FFQ2) within a 2 week interval between which three dietary food records (DFR's) were collected. In all, 94 ES children (40 boys and 54 girls) and 89 HS children (42 boys and 47 girls) participated in this IRB-approved study. RESULTS: Results showed correlations between FFQ1 and FFQ2 for representative macro- and micronutrients lower than reported in the literature. Correlation coefficients were higher for HS (mean R = 0.43) compared to ES (mean R = 0.21) and higher for girls than for boys at both school levels. Results for validation also showed lower correlations between the FFQ2 and DFR's compared to other studies, which was higher in HS students (mean R = 0.34) compared to ES students (mean R = 0.10). However, these same nutrients were cross-classified into equivalent quartiles for both the FFQ and DFR with an accuracy of about 66%. CONCLUSION: We have designed and validated a FFQ, appropriate for use in Puerto Rican schoolchildren to estimate energy intake in younger students and energy and micronutrients in older students. The significance of this research is that there is now an updated instrument for use in dietary studies in Puerto Rican youth.