Competitive food availability in schools before and after the onset of COVID-19: an interrupted time series analysis

Purpose: School meal programs often offer competitive foods (CF), sold during lunch outside school meals and/or in vending machines. Although required to meet nutrition guidelines, CF are often less nutritious than school meals, and their presence is associated with lower meal participation. This study examines the prevalence of CF in public schools before and after COVID-19. Methods: Surveys examining the school food environment were conducted in public schools in 4 New Jersey cities, from school year (SY) 2014-15 to SY 2023-24. Prevalence of CF was assessed using an interrupted time series analysis, comparing pre- and post-COVID-19 years. Results: < 0.001). Discussion: Findings suggest that COVID-related school nutrition policy changes, including Universal Fee Meals and increased reimbursements, likely reduced CF availability. Identifying strategies to limit CF could contribute to healthier school food environments.