The sale of second servings and/or a la carte purchases made by elementary students participating in the National School Lunch Program (NSLP) was investigated in this mixed methods case study. The percentage of elementary students in one school district who purchase second servings and/or a la carte items, in addition to the regularly purchased school lunch, was assessed with data disaggregated based on age and demographics. In addition, five cafeteria managers were interviewed about the process of selling extra food items to elementary age children. Results of this study indicate that a la carte sales at the elementary level are significant, with 29.53% of the elementary population purchasing a la carte food items during the period studied. In addition to a la carte sales, 18-369 second servings of main entree items were sold each day. Additionally, interviews with cafeteria managers indicated the importance of having and offering a variety of food choices to children to supplement the budget. These extra food items are a hidden phenomenon within the NSLP and the implication of the additional daily calories on childhood obesity should be carefully considered in future revisions of the Healthy, Hunger-Free Kids Act of 2010. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]