The outcomes of [project name removed for blinding - subsequently documented as XX] Determining the effects of a behavioural and an environmental intervention on water and sugar sweetened beverage consumption in adolescents: A randomised controlled trial

Effectiveness of nutrition interventions in Australian secondary schools: A systematic review

ISSUE ADDRESSED

Dietary intake of Australian adolescents is suboptimal. Schools are an ideal setting for health promotion initiatives to develop healthy lifestyle behaviours among adolescents. However, we do not know which nutrition-focused, school-based interventions are effective at improving health outcomes in adolescents in Australia. Therefore, the aim was to evaluate the effect of nutrition interventions on health outcomes in Australian secondary school students.

METHODS

MEDLINE, EMBASE, CINAHL, ERIC and Informit were systematically searched on 4th November 2022. Studies in any language evaluating nutrition interventions implemented in Australian secondary schools were included. Studies evaluating interventions conducted in primary schools or outside the school setting were excluded, as were any grey literature, systematic reviews and meta-analyses. Screening and data extraction were performed in duplicate. Quality was assessed using the Mixed Methods Appraisal Tool.

RESULTS

Thirteen studies (n = 27 224) reporting on nutrition interventions implemented in Australian secondary schools were included. Studies were conducted in five different states and a capital territory within Australia and were mostly randomised controlled trials. Most studies reported a significant improvement on nutrition-related health outcome measures (dietary behaviour n = 6, nutritional knowledge and attitudes n = 4 and anthropometric n = 1).

CONCLUSIONS

This review found limited studies reporting on nutrition interventions in Australian secondary schools. However, most were shown to be effective in improving nutrition-related health outcomes. SO WHAT?: Since there were limited studies in peer-reviewed journals, more research in this area is needed to confirm the effectiveness of nutrition interventions in Australian secondary schools and to assess long-term effects on student's health outcomes.

Thirsty? Choose Water! A regional perspective to promoting water consumption in secondary school students

OBJECTIVE

Adolescents are high consumers of sugar-sweetened beverages (SSB), which contribute to overweight and obesity - a significant public health issue. Evidence suggests that replacing SSB with water and school-based interventions can reduce consumption. This study examines the acceptability of a previously trialled intervention (Thirsty? Choose Water!) in regional and remote secondary schools.

DESIGN

An open-label randomised controlled trial using a two-by-two factorial design tested the outcomes of a behavioural and/or environmental intervention on SSB and water consumption.

SETTING

Regional and remote secondary schools (public, catholic and independent) within the boundaries of two regional Local Health Districts within New South Wales.

PARTICIPANTS

Twenty-four schools participated in the study. The target group was year 7 students (n 1640) - 72 % of eligible students completed baseline data. The study followed students into year 8 (n 1188) - 52 % of eligible students completed post-intervention data. Forty teachers undertook training to deliver the intervention.

RESULTS

Interventions showed high levels of acceptability. Students demonstrated changes in knowledge, attitudes and consumption behaviours. Multivariable ordinal logression analysis demonstrated that all interventions increased the odds of students increasing their water consumption (though not statistically significant). Conversely, the combined (OR: 0·75; 95 % CI: 0·59, 0·97) or environmental intervention (OR: 0·68; 95 % CI: 0·51, 0·90) had greater odds of reducing SSB consumption and was statistically significant.

CONCLUSIONS

This study builds on recent Australian evidence regarding the impact of school-based interventions on water and SSB consumption. In this study, despite a minor intervention change, and the impacts of fires, floods and COVID-19 on study implementation, the interventions were highly regarded by the school communities with positive outcomes.

The Association between Maternal Sugar-Sweetened Beverage Consumption and Infant/Toddler Added Sugar Intakes

Intake of added sugars during early life is associated with poor health outcomes. Maternal dietary intake influences the intake of their children, but little research investigates the relationship between maternal sugar sweetened beverage (SSB) and infant/toddler added sugar intakes. Our objective was to explore the relationship between maternal total sugars and SSB intakes and infant/toddler added sugar intakes. This cross-sectional study (n = 101) of mother-infant dyads measured maternal dietary intake by food frequency questionnaire and infant intake by three 24-h dietary recalls. Pearson’s correlations explored the relations between maternal total sugars and SSB intakes and infant added sugar intakes. Hierarchical stepwise regressions determined if maternal total sugars and SSB intakes explained the variation in infant added sugar intakes after accounting for known risk factors for early introduction of added sugars. Maternal total sugars (r = 0.202, p = 0.043) and SSB (r = 0.352, p < 0.001) intakes were positively correlated with infant/toddler added sugar intakes. In the hierarchical models, maternal total sugar intakes did not account for more variance in infant added sugar intakes (β = 0.046, p = 0.060), but maternal SSB intake was a significant contributor of infant added sugar intakes (β = 0.010, p = 0.006) after accounting for confounders. Interventions to reduced maternal SSB consumption may help reduce infant/toddler added sugar intakes.