These discrepancies (6% of the items served), however, appeared to be minimal. Finally, because our plate waste assessment was limited to middle school students in LAUSD, our findings may not generalize to other student populations within the District

or elsewhere in the U.S. Taken together, the study findings and limitations support the need to further assess the collective impacts of these and other school-based healthy food procurement practices on health, including collecting more information on downstream outcomes such as body mass index. Given that children consume a substantial amount of their daily nutrients in school, school-based interventions to increase Hydroxychloroquine cell line access to healthier food options are an important component of a comprehensive strategy for improving childhood nutrition. In order to ensure the effectiveness of such practices, students need to have opportunities to become receptive to menu changes and consume the healthy food being offered

and served. While institutional policies to increase access to a wider range of healthy food choices are a critical first step toward achieving this, simply offering these options may not be sufficient. More research and evaluation of complementary interventions to increase consumption of healthier foods are needed to help guide these and other institutional policy and practice decisions. The authors declare that there are no conflicts of interest. The authors thank the evaluation teams at WestEd, including project leads Barbara Dietsch, Oxalosuccinic acid PhD and Sara Griego, MS, and at the Division KRX0401 of Cancer Prevention and Control Research in the UCLA Fielding School of Public Health, including Tammy Liu, MPH, for their contributions to the collection of the plate waste data. The analysis was conducted as part of program assessment activities at the Los Angeles County Department

of Public Health, with partial support from the Centers for Disease Control and Prevention (CDC) Cooperative Agreement No. 1U58DP002485-01. William J. McCarthy was supported by the National Institutes of Health Grant No. 1P50HL105188 during the project. The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Los Angeles County Department of Public Health, the Centers for Disease Control and Prevention, or the organizations mentioned in the text. Users of this document should be aware that every funding source has different requirements governing the appropriate use of funding. Under the U.S. law, no Federal funds are permitted to be used for lobbying or to influence, directly or indirectly, specific pieces of pending or proposed legislation at the federal, state, or local level. Organizations should consult appropriate legal counsel to ensure compliance with all rules, regulations, and restriction of any funding sources.