Childhood obesity is widely recognized as one of the most critical and challenging health crises facing the United States and the world. One of the key strategies to reverse childhood obesity is to improve the nutrition and physical activity environments in schools. In this issue of the Archives, we receive sobering news about competitive foods in schools, ie, foods from vending machines, stores, snack bars, or a la carte lines that compete with school meals. Competitive foods are often low in nutritional value and high in sugar, fat, and calories. Their availability may increase stigmatization of and decrease participation in the school meal program, and they send mixed messages about healthful nutrition.1 Turner and Chaloupka2 report their results from surveys of a national sample of elementary schools conducted annually from 2006-2007 to 2009-2010. Despite recognition of the potential adverse effects of competitive foods in schools,1,3 they found that about half of elementary school students had access to competitive foods at school with no significant change during the 4 years of the survey. Access to fruit, salads, and vegetables also did not increase across the surveys.2 However, they report that the US Department of Agriculture is currently developing regulations regarding competitive foods and beverages sold in schools. What should those regulations be and what evidence has the scientific community provided to inform their development? What is the likelihood that standards for competitive foods will help reverse the childhood obesity epidemic?
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