{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:46:37Z","timestamp":1792161997753,"version":"4.4.0"},"reference-count":33,"publisher":"American Diabetes Association","issue":"5","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"National Institute of Minority Health Disparities, Southern California Center for Chronic Disease Research and Prevention","award":["P50 MD017344"],"award-info":[{"award-number":["P50 MD017344"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Prediabetes is an emerging public health concern among U.S. adolescents, yet nationally representative, up-to-date data on dietary contributors remain limited. Especially, the role of overall dietary intake and school meal participation (providing a substantial portion of daily calories in school children) has not been comprehensively evaluated. This study examined cross-sectional associations between school meal participation, overall dietary intake, and prediabetes (defined as having HbA1c and\/or fasting glucose values within the prediabetes range) in the most recent nationally representative samples of U.S. adolescents, assessing differences by obesity status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>National Health and Nutrition Examination Survey data (2017\u20132020, 2021\u20132023) were analyzed, including adolescents (aged 12\u201318 years) with complete fasting glucose and HbA1c data (n = 802). Multivariable modified Poisson regression models evaluated associations between school meal participation (breakfast and lunch), dietary intake (food groups and nutrients), and prediabetes. Effect modification by obesity status was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Prediabetes prevalence was 33.8% (SE 3.0) and obesity prevalence was 20.96% (SE 1.44). School breakfast participation at least once a week was associated with higher prediabetes prevalence (prevalence ratio [PR] 1.3 (95% CI 1.01\u20131.66), while school lunch participation was not. Higher vitamin E and B6 intake was linked to lower prediabetes prevalence (PR 0.96, 0.94\u20130.99; 0.9, 0.81\u20130.99). Higher fruit intake was inversely (PR 0.96, 0.92\u20130.99) associated with prediabetes among adolescents with obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>School breakfast participation and specific dietary components were associated with prediabetes risk in U.S. adolescents. While confirmation is needed, the nutritional quality of school breakfasts may represent an important intervention target.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/doc26-0084","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T16:29:20Z","timestamp":1789489760000},"page":"938-946","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["School Meal Participation, Overall Dietary Intake, and Prediabetes Prevalence Among U.S. Adolescents: Insights From the National Health and Nutrition Examination Survey (2017\u20132023)"],"prefix":"10.2337","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2666-5380","authenticated-orcid":false,"given":"Alexandra","family":"Descarpentrie","sequence":"first","affiliation":[{"name":"Department of Pediatrics, The Saban Research Institute, Children\u2019s Hospital Los Angeles, University of Southern California 1 , Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevan","family":"Esaian","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Saban Research Institute, Children\u2019s Hospital Los Angeles, University of Southern California 1 , Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Lustig","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California 2 , San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"LaTorre","sequence":"additional","affiliation":[{"name":"Eat Real Certified, Inc. 3 , San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya L.","family":"Alderete","sequence":"additional","affiliation":[{"name":"Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health 4 , Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0513-2666-588X","authenticated-orcid":false,"given":"Juan","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago 5 , Chicago, IL"},{"name":"Department of Pediatrics, Northwestern University Feinberg School of Medicine 6 , Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6897-6961","authenticated-orcid":false,"given":"Michael I.","family":"Goran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Saban Research Institute, Children\u2019s Hospital Los Angeles, University of Southern California 1 , Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"2026101610024064400_B1","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/1753-0407.13291","article-title":"Global prevalence of prediabetes in children and adolescents: a systematic review and meta-analysis","volume":"14","author":"Han","year":"2022","journal-title":"J Diabetes"},{"key":"2026101610024064400_B2","doi-asserted-by":"crossref","first-page":"263","DOI":"10.5409\/wjcp.v12.i5.263","article-title":"Prediabetes in children and adolescents: an updated review","volume":"12","author":"Ng","year":"2023","journal-title":"World J Clin Pediatr"},{"key":"2026101610024064400_B3","unstructured":"Centers for Disease Control and Prevention\n          . 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