- OBJECTIVE: Despite calls for children to lower their consumption of food high in fat and sugar (FHFS) and food of minimal nutritional value (FMNV), such foods are heavily marketed to and consumed by children. This study provides the first nationally representative survey to measure the nature and extent of marketing activities in American public schools. METHOD: A stratified random sample of 313 U.S. primary school officials reported their schools' participation in marketing activities with corporations that sell FHFS and FMNV for the academic year 2003-2004. They also reported whether their schools would be forced to reduce programs if marketing was prohibited and their attitude toward increased regulation of marketing for FHFS and FMNV. RESULTS: According to school officials, 37.7% of primary schools nationwide participated in fundraising, 31.6% participated in incentive programs, and 16.3% participated in exclusive agreements with a corporation that sells FHFS or FMNV. In addition, 87.5% of school officials reported that their schools would not be forced to reduce programs if marketing was prohibited, and 53.7% supported the increased regulation of FHFS and FMNV marketing. CONCLUSION: American primary schools participate extensively in corporate-sponsored marketing for foods whose high consumption may lead to obesity and its attendant health risks.