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To understand the phenomenon of the rapidly increasing prevalence of overweight and obese children and youth, it is especially important to examine the school food environment, the role of structural factors in shaping this environment, and the resulting nutrition and health outcomes. The paper examines research on school food environments in the US and Canada. It notes evidence of widespread availability of poor nutrition products in both environments and delineates reasons for the situation, and examines initiatives presently being undertaken in a number of jurisdictions in both countries to encourage healthy eating in schools. Empirical data are presented from a pilot study of high schools in the Canadian province of Ontario. The study documents the extent of student purchasing of nutrient-poor foods and beverages, and the structural factors internal and external to the school that appear …