How do children's eating patterns and food choices change over time? Results from a cohort study

Purpose. The purpose of this study was to investigate the change in eating patterns and food choices in a cohort of students as they moved from the third to the eighth grade. Design. Dietary behaviors and food choices were abstracted from 24-hour recalls and compared across grade levels. Setting. The setting for the study was elementary and junior high schools. Subjects. The subjects were a cohort of 291 students from Minnesota. Measures. Individual 24-hour dietary recalls from a cohort of students were collected in the third, fifth and eighth grades. Results. As students moved from elementary to junior high and middle school, their consumption of breakfast, fruits, vegetables, and milk decreased. Soft drink consumption increased. In the third grade, nearly 99% of the cohort reported eating breakfast; by the eighth grade, 85% reported eating breakfast. Fruit consumption fell by 41% between the third and the eighth grades while vegetable consumption fell by 25%. The proportion of beverage coming from soft drinks more than tripled between the third and the eighth grades with concomitant reductions in milk and fruit juice consumption. Conclusions. Family, school, and community-wide efforts are needed to promote healthful eating patterns and food choices among adolescents. Our research indicates that nutrition education is needed in the elementary and middle school years. In addition, we need to work on improving teens' social and physical environments to encourage and facilitate their choice of healthy foods.