Food Intake during School Lunch Is Better Explained by Objectively Measured Eating Behaviors than by Subjectively Rated Food Taste and Fullness: A Cross-Sectional Study.

School lunches contribute significantly to students' food intake (FI) and are important to their long-term health. Objective quantification of FI is needed in this context. The primary aim of this study was to investigate how much eating rate (g/min), number of food additions, number of spoonfuls, change in fullness, food taste, body mass index (BMI), and sex explain variations in school lunch FI. The secondary aim was to assess the reliability of repeated FI measures. One hundred and three (60 females) students (15⁻18 years old) were monitored while eating lunch in their normal school canteen environment, following their usual school schedules. A subgroup of students (n = 50) participated in a repeated lunch (~3 months later). Linear regression was used to explain variations in FI. The reliability of repeated FI measurements was assessed by change in mean, coefficient of variation (CV), and intraclass correlation (ICC). The regression model was significant and explained 76.6% of the variation in FI. Eating rate was the strongest explanatory variable, followed by spoonfuls, sex, food additions, food taste, BMI, and change in fullness. All explanatory variables were significant in the model except BMI and change in fullness. No systematic bias was observed in FI (-7.5 g (95% CI = -43.1⁻28 g)) while individual students changed their FI from -417 to +349 g in the repeated meal (CV 26.1% (95% CI = 21.4⁻33.5%), ICC 0.74 (95% CI = 0.58⁻0.84)). The results highlight the importance of objective eating behaviors for explaining FI in a school lunch setting. Furthermore, our methods show promise for large-scale quantification of objectively measured FI and eating behaviors in schools.