The school food environment has the ability to increase the consumption of fruit and vegetables in rural adolescents. This study used a survey to allow adolescents in seven rural counties to self-report their fruit and vegetable intake as well as utilizing the USDA Mathematica tool and the School Nutrition and Meal Cost Study audits to evaluate what food and beverage products were actually available to adolescents. By using these two measures, associations between fruit and vegetable intake and availability of healthy and unhealthy foods were determined. The availability of healthy snacks and beverages was found to be associated with sugar-sweetened beverage intake in adolescents (p < 0.001); the availability of unhealthy snacks and beverages was associated with fruit and vegetable intake in adolescents (p < 0.001); the school marketing of water bottle stations and/or water dispenser availability was associated with sugar- sweetened beverage intake in adolescents (p < 0.001). Increasing the availability and school marketing of healthy foods and beverages in rural schools may be an effective way to improve fruit and vegetable consumption in adolescents.

Social networks play a significant role in adolescent decision making, specifically when it comes to dietary outcomes. This study, granted by the United States Department of Agriculture (USDA), assessed the connectivity of these social networks and the impact they have on fruit and vegetable, added sugar and sugar sweetened beverage consumption. Additionally, the relationship between shopping companionship and dietary choices was studied. Positive and negative associations were found among adolescents who shop with parents or friends. It was also found that those adolescents with greater social network cohesion were found to have more negative dietary outcomes. Divulging further into the relationships within adolescent social networks may improve fruit and vegetable and decrease added sugar consumption within rural communities.