1
|
Matela H, Yadav SS, Menon K. Robust implementation of school food policy is needed to improve nutritional outcomes of children in European and Western Pacific countries: A systematic review. Nutrition 2024; 122:112373. [PMID: 38428219 DOI: 10.1016/j.nut.2024.112373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/19/2024] [Accepted: 01/27/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE The present systematic review explored compliance status with school food policies in Europe and the Western Pacific regions, challenges and facilitators of policy compliance, and its impact on children's diets and nutrient intakes. RESEARCH METHODS An electronic search for full-text research articles published between January 2009 and July 2023 was conducted in Science Direct and PubMed scientific databases. RESULTS A total of 659 titles and abstracts were screened, and final data was extracted from 34 included studies. Results showed low compliance with the school food policy in Europe and the Western Pacific regions. The European schools chad better compliance than the Western Pacific, and supportive interventions improved policy adherence. Impact assessment studies reported that the implementation of the school food policy increased fruit and vegetable consumption, thus increasing nutrient intakes (vitamin A, vitamin D, iron, calcium, folate, and dietary fibers). However, its impact on the availability and consumption of foods high in fat, sugar, and salt (HFSS) was less conclusive. The effects of the policy on the school food environment indicated no significant improvement. CONCLUSION Results highlighted the need for additional support and surveillance at the school level to ensure adequate policy compliance.
Collapse
Affiliation(s)
- Hema Matela
- Symbiosis Institute of Health Sciences (SIHS), Symbiosis International (Deemed University) (SIU), Lavale, Pune, Maharashtra, India
| | - Surabhi Singh Yadav
- Symbiosis Institute of Health Sciences (SIHS), Symbiosis International (Deemed University) (SIU), Lavale, Pune, Maharashtra, India
| | - Kavitha Menon
- Symbiosis Institute of Health Sciences (SIHS), Symbiosis International (Deemed University) (SIU), Lavale, Pune, Maharashtra, India.
| |
Collapse
|
2
|
Czarniecka-Skubina E, Hamulka J, Jeruszka-Bielak M, Gutkowska K. Do Food and Meal Organization Systems in Polish Primary Schools Reflect Students' Preferences and Healthy and Sustainable Dietary Guidelines? The Results of Qualitative Research for the Junior-Edu-Żywienie (JEŻ) Project. Foods 2023; 13:61. [PMID: 38201089 PMCID: PMC10778281 DOI: 10.3390/foods13010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
The school environment, together with that of the family, shapes students' eating behaviors, and is an important element of formal and informal nutrition education. The informal and practical dimensions can be realized through the food and meals offered/sold in school canteens, shops, and vending machines. As children and adolescents spend 6-10 h/day in schools and consume at least two meals there, the school food environment is important from a public health perspective. The aim of this study is to assess food and meal organization in primary schools in Poland. The study was conducted using individual in-depth interviews (IDIs) involving 24 school headmasters and 24 representatives of people employed in school canteens or catering companies involved in meal organization in schools. The nutritional food on offer at schools is important for shaping students' food preferences and choices, consequently influencing the development, functioning, and health of this subpopulation. The school environment can be an ideal place for hands-on nutrition education. In addition to the knowledge provided, there must be a consistent message concerning the provision of nutrition information to students between the teachings of parents, teachers, and, indirectly, the food and meals available at school. Our qualitative study is confirmed by the results of quantitative research to better understand the organization of nutrition and the problems and needs of primary schools in this area.
Collapse
Affiliation(s)
- Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland; (J.H.); (M.J.-B.)
| | - Marta Jeruszka-Bielak
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland; (J.H.); (M.J.-B.)
| | - Krystyna Gutkowska
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland;
| |
Collapse
|
3
|
Monroy-Parada DX, Prieto-Castillo L, Ordaz-Castillo E, Bosqued MJ, Rodríguez-Artalejo F, Royo-Bordonada MÁ. [Map of school nutritional policies in Spain]. GACETA SANITARIA 2020; 35:123-129. [PMID: 31926755 DOI: 10.1016/j.gaceta.2019.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/17/2019] [Accepted: 10/19/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To systematically describe the school nutritional policies of the 17 autonomous communities of Spain. METHOD Through a search of bibliographic databases, web pages and other official information systems, 183 documents of interest were identified. Information was systematically collected with the SNIPE (school nutrition index of programme effectiveness) questionnaire, adapted to Spain, and validated by reference staff of the regional government's health and education ministries. RESULTS The main objective of the policies is to prevent obesity and improve the nutrition of schoolchildren. The 17 autonomous communities cover the school canteen service, 11 cafeteria and vending machines, and 9 the breakfast service. All communities use the Consensus Document on School Food as a reference for the content of the menu and the nutritional quality of the products offered at the school; however, only 4 of them have regulated these aspects. The evaluation of policy objectives ranges from 58.8% of the autonomous communities for food supply to 5.9% for rotation and menu quality. CONCLUSION Although all the autonomous communities have standards for the school menu, the standards for the rest of the food supply vary across them; also, evaluation of objectives is scarce and only 4 communities have approved mandatory regulations. Nutritional standards should be reviewed according to current scientific knowledge and enacted by law, in compliance with the current legislation (Act 17/2011).
Collapse
Affiliation(s)
- Doris Xiomara Monroy-Parada
- Escuela Nacional de Salud, Instituto de Salud Carlos III, Madrid, España; Servicio de Medicina Preventiva y Salud Pública, Complejo Hospitalario Universitario de Albacete, Albacete, España.
| | - Leandro Prieto-Castillo
- Servicio de Promoción de la Salud, Dirección General de Salud Pública, Consejería de Sanidad de Castilla y León, Valladolid, España
| | | | - María José Bosqued
- Escuela Nacional de Salud, Instituto de Salud Carlos III, Madrid, España
| | - Fernando Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, Madrid, España
| | | |
Collapse
|
4
|
Royo-Bordonada MÁ, Rodríguez-Artalejo F, Bes-Rastrollo M, Fernández-Escobar C, González CA, Rivas F, Martínez-González MÁ, Quiles J, Bueno-Cavanillas A, Navarrete-Muñoz EM, Navarro C, López-García E, Romaguera D, Morales Suárez-Varela M, Vioque J. [Food policies to prevent obesity and the main non-transmissible diseases in Spain: where there's a will there's a way]. GACETA SANITARIA 2019; 33:584-592. [PMID: 31585770 DOI: 10.1016/j.gaceta.2019.05.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION In Spain, one third of all children and two-thirds of adults suffer from excess weight, a condition that generates a direct excess medical cost of 2000 million Euros. Obesogenic food environments cause obesity by promoting the consumption of sugar-sweetened beverages and ultra-processed foods. Accordingly, we propose five priority policies capable of reversing the epidemic of obesity and related non-communicable diseases through the creation of healthy food environments. THE POWER (PODER IN SPANISH) OF FOOD POLICIES Advertising (Publicidad): regulation of unhealthy food and drink advertisements carried by all media and targeted at children, and prohibition of sponsorships of congresses, conferences or sports events and endorsements by scientific associations or health professionals. Supply (Oferta): promotion of a 100% healthy supply of goods on sale in vending machines sited at educational, health and sports centres. Demand (Demanda): levying a tax of at least 20% on sugar-sweetened beverages, accompanied by subsidies or reduced taxes on healthy foods and availability of drinking water free of charge at all public venues and areas. Labelling (Etiquetado): effective application of the Nutri-Score through the use of incentives, regulation and public-tender mechanisms. Reformulation (Reformulación): revising and redrawing reformulation agreements with the industry, setting more ambitious goals and mandatory compliance. A FINAL THOUGHT These five proposed interventions, all of which have been successfully applied in other countries, will serve to raise population awareness and have a positive impact on health and the economy, through reducing the health care costs of obesity and enhancing work productivity. These measures should form part of a wide-ranging transformation of the food system, with agri-food policies that foster the sustainable production of healthy foods.
Collapse
Affiliation(s)
| | - Fernando Rodríguez-Artalejo
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Maira Bes-Rastrollo
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, España; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España
| | | | - Carlos A González
- Unidad de Nutrición y Cáncer, Instituto Catalán de Oncología, Barcelona, España
| | - Francisco Rivas
- Unidad Municipal de Salud y Consumo, Ayuntamiento de Guadix, Guadix (Granada), España; Grupo de Investigación Aula Internacional de Biomedicina, Ética y Derechos Humanos (GI111), Universidad Nacional de Educación a Distancia, Madrid, España
| | - Miguel Ángel Martínez-González
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, España; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Department of Nutrition, Harvard TH Chan School of Public Health, Boston (Massachusetts), USA
| | - Joan Quiles
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Dirección General de Salud Pública, Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, España
| | - Aurora Bueno-Cavanillas
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, España; Instituto de Investigación Biosanitaria de Granada (ibs Granada), Granada, España
| | - Eva M Navarrete-Muñoz
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, ISABIAL-FISABIO, Alicante, España
| | - Carmen Navarro
- Departamento de Ciencias Sociosaniarias, Universidad de Murcia, Murcia, España; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, España
| | - Esther López-García
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Dora Romaguera
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, España
| | - María Morales Suárez-Varela
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Medicina Preventiva y Salud Pública, Ciencias de la Alimentación, Toxicología y Medicina Legal, Facultad de Farmacia, Universitat de Valencia, Valencia, España
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, ISABIAL-FISABIO, Alicante, España
| | | |
Collapse
|
5
|
Socioeconomic Inequalities in the Retail Food Environment around Schools in a Southern European Context. Nutrients 2019; 11:nu11071511. [PMID: 31277242 PMCID: PMC6683257 DOI: 10.3390/nu11071511] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/25/2019] [Accepted: 07/02/2019] [Indexed: 12/14/2022] Open
Abstract
Across Europe, excess body weight rates are particularly high among children and adolescents living in Southern European contexts. In Spain, current food policies appeal to voluntary self-regulation of the food industry and parents’ responsibility. However, there is no research (within Spain) assessing the food environment surrounding schools. We examined the association between neighborhood-level socioeconomic status (NSES) and the spatial access to an unhealthy food environment around schools using both counts and distance measures, across the city of Madrid. We conducted a cross-sectional study citywide (n = 2443 census tracts). In 2017, we identified all schools (n = 1321) and all food retailers offering unhealthy food and beverages surrounding them (n = 6530) using publicly available data. We examined both the counts of retailers (within 400 m) and the distance (in meters) from the schools to the closest retailer. We used multilevel regressions to model the association of neighborhood-level socioeconomic status (NSES) with both measures, adjusting both models for population density. Almost all schools (95%) were surrounded by unhealthy retailers within 400 m (median = 17 retailers; interquartile range = 8–34). After adjusting for population density, NSES remained inversely associated with unhealthy food availability. Schools located in low-NSES areas (two lowest quintiles) showed, on average, 29% (IRR (Incidence Rate Ratio) = 1.29; 95% CI (Confidence Interval) = 1.12, 1.50) and 62% (IRR = 1.62; 95% CI = 1.35, 1.95) more counts of unhealthy retailers compared with schools in middle-NSES areas (ref.). Schools in high-NSES areas were farther from unhealthy food sources than those schools located in middle-NSES areas (β = 0.35; 95% CI = 0.14, 0.47). Regulating the school food environment (within and beyond school boundaries) may be a promising direction to prevent and reduce childhood obesity.
Collapse
|