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Izadi B, Moradi Z. Examining school nutrition policies and their effect on the promotion of low-nutrient foods in the context of sports advertising. Nutrition 2024; 123:112392. [PMID: 38554460 DOI: 10.1016/j.nut.2024.112392] [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: 11/10/2023] [Revised: 02/05/2024] [Accepted: 02/05/2024] [Indexed: 04/01/2024]
Abstract
OBJECTIVES Despite recommendations to implement nutrition standards in schools, low-nutrient foods and high-energy drinks are still some of the most important challenges for school management and students' purchasing and consumption behavior. In this regard, the aim of the present study is to examine school nutrition policies and their effect on the promotion of low-nutrient foods in the context of sports advertising. METHODS A partial least square technique with SmartPLS 3.0 and bootstrapping with 500 resamples was used to examine the effect of food marketing on school nutrition policies and students' nutritional involvement. Online surveys were done through The Iranian Educational Network of students and measured on a 5-point Likert scale. The survey questionnaire consisted of 3 scales to measure the following: school nutrition policies, advertising of low-nutrient foods, and student nutritional involvement. RESULTS Results from a sample of 382 Iranian high school students revealed that low-nutrient food advertising has a significant effect on student consumption, and the greatest overall effect on students' nutritional involvement. School nutrition policies were affected by media, endorsement, and the environmental advertising, whereas school financial capabilities had the greatest direct effect on students' nutritional involvement. CONCLUSIONS These findings suggest that advertising through sports media plays a mediating role in school nutrition policies and student nutritional involvement. Policy changes to restrict food marketing for young people must include both television and non-broadcast media.
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Affiliation(s)
- Behzad Izadi
- Department of Physical Education, University of Kurdistan, Sanandaj, Iran.
| | - Zanyar Moradi
- Department of Physical Education, University of Kurdistan, Sanandaj, Iran
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Fielding-Singh P, Fan JX. Dietary Patterns Among US Children: A Cluster Analysis. J Acad Nutr Diet 2024; 124:700-712. [PMID: 38081384 DOI: 10.1016/j.jand.2023.12.001] [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: 09/23/2022] [Revised: 11/13/2023] [Accepted: 12/05/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Most children in the United States consume low-quality diets. Identifying children's dietary patterns and their association with sociodemographic characteristics is important for designing tailored youth dietary interventions. OBJECTIVE This study's objective was to use cluster analysis to investigate children's dietary patterns and these patterns' associations with sociodemographic characteristics. DESIGN Data from two cycles (2015-2016 and 2017-2018) of the National Health and Nutrition Examination Survey were evaluated to examine dietary patterns. PARTICIPANTS AND SETTING Participants included 3,044 US youth aged 2 to 11 years who completed at least 1 valid 24-hour diet recall. MAIN OUTCOME MEASURES The main outcome measures were Healthy Eating Index (HEI) 2015 component and composite scores. STATISTICAL ANALYSES PERFORMED A cluster analysis was performed on standardized scores of 11 components of the HEI-2015 to identify dietary patterns. One logistic analysis combined the two higher-HEI score clusters and the 2 lower-HEI score clusters to form a 3-category variable of higher-, medium-, and lower-HEI score clusters. Another logistic analysis contrasted 2 higher- and then the 2 lower-HEI clusters with each other to examine sociodemographic factors contributing to cluster membership. RESULTS Five clusters were identified, each displaying a distinct dietary pattern. Older, non-Hispanic Black, and overweight children had higher odds of being in the higher-HEI clusters than the medium-HEI cluster. Being older and non-Hispanic Black were linked to higher odds of being in the lower-HEI clusters than the medium-HEI cluster. Conversely, being Mexican American and living with a college-educated reference person were associated with lower odds of being in the lower-HEI clusters compared with the medium-HEI cluster. Among the higher-HEI clusters, Mexican American and Asian American children had higher odds of being in the Pescatarian cluster. Among the lower-HEI clusters, children who were racially or ethnically minoritized had lower odds of being in the Excess Sugar cluster. CONCLUSIONS Children in this study displayed different dietary patterns, with key sociodemographic variation.
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Affiliation(s)
| | - Jessie X Fan
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah
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Silva M, Rodrigues SSP, Correia DM, Rei MCC, Severo M, Costa AIA, Torres DPM, Lopes CMM. Eating out of home in Portugal: characterisation and effects on dietary intake. Br J Nutr 2024:1-13. [PMID: 38772907 DOI: 10.1017/s0007114524000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024]
Abstract
This cross-sectional study aims to describe and compare energy, nutrient intake and food consumption according to eating location and by age groups using data from the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015/2016). Dietary intake was estimated by two non-consecutive days of food diaries (children)/24-h recalls (other age groups), and four eating location categories were defined according to the proportion of meals consumed at out-of-home locations: Home (at least 80 % of meals at home), Other Homes, School or Work and Restaurants and Other Places. The majority of meals (69·1 %) were consumed at home. Meals were also often taken at school by children and adolescents and in restaurants and similar outlets by adults and elderly. Children and adolescents in the School or Work category ate more fruit, vegetables and pulses and cereals and starchy tubers, whereas adults in this category ate more red and processed meats, sugar-sweetened beverages and sweets. Compared with Home category, Restaurants and Other Places was associated with worse diet adequacies among children (β = -1·0; 95 % CI = -2·0, -0·04), adolescents: (β = -2·4; 95 % CI = -3·2, -1·5) and adults (β = -1·3; 95 % CI = -1·6, -1·0) reflecting higher intakes of energy, fat, trans-fatty acids and SFA, and Na. The elderly consumed more free sugars and fat when eating out of home in general. Overall, findings reflect important variation in nutrient profiles by eating location, with meals taken at school or work contributing to higher consumption of nutrient-dense foods and those taken in restaurants and other similar settings implying higher consumption of energy-dense foods.
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Affiliation(s)
- Mariana Silva
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sara Simões Pereira Rodrigues
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Daniela Macedo Correia
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Mariana Correia Castro Rei
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Ana Isabel Almeida Costa
- CATÓLICA-LISBON School of Business and Economics, Portuguese Catholic University, Lisbon, Portugal
| | - Duarte Paulo Martins Torres
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Carla Maria Moura Lopes
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
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Finistrella V, Gianni N, Fintini D, Menghini D, Amendola S, Donini LM, Manco M. Neophobia, sensory experience and child's schemata contribute to food choices. Eat Weight Disord 2024; 29:25. [PMID: 38587606 PMCID: PMC11001701 DOI: 10.1007/s40519-024-01657-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 04/02/2024] [Indexed: 04/09/2024] Open
Abstract
PURPOSE The aim of the present review is to analyze dynamic interactions between nutrigenomics, environmental cues, and parental influence, which can all lead to children's neophobic reactions and its persistence in time. METHODS We reviewed studies available on electronic databases, conducted on children aged from birth to 18 years. We also considered official websites of Italian Institutions, providing advice on healthy eating during infancy. RESULTS Modern day societies are faced with an eating paradox, which has severe and ever-growing implications for health. In face of a wider availability of healthy foods, individuals instead often choose processed foods high in fat, salt and sugar content. Economic reasons surely influence consumers' access to foods. However, there is mounting evidence that food choices depend on the interplay between social learning and genetic predispositions (e.g., individual eating traits and food schemata). Neophobia, the behavioral avoidance of new foods, represents an interesting trait, which can significantly influence children's food refusal. Early sensory experiences and negative cognitive schemata, in the context of primary caregiver-child interactions, importantly contribute to the priming of children's food rejection. CONCLUSIONS As neophobia strongly affects consumption of healthy foods, it will be relevant to rule definitively out its role in the genesis of maladaptive food choices and weight status in longitudinal studies tracking to adulthood and, in meanwhile, implement early in life effective social learning strategies, to reduce long-term effects of neophobia on dietary patterns and weight status. LEVEL OF EVIDENCE Level II, controlled trials without randomization.
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Affiliation(s)
- Viviana Finistrella
- Unit of Predictive and Preventive Medicine, Bambino Gesù Children's Hospital, IRCCS, Via F. Baldelli 38, 00146, Rome, Italy
| | - Nicoletta Gianni
- Unit of Predictive and Preventive Medicine, Bambino Gesù Children's Hospital, IRCCS, Via F. Baldelli 38, 00146, Rome, Italy
| | - Danilo Fintini
- Endocrinology and Diabetology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Department of Neurological and Psychiatric Science, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy
| | - Silvia Amendola
- Child and Adolescent Neuropsychiatry Unit, Department of Neurological and Psychiatric Science, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy
| | | | - Melania Manco
- Unit of Predictive and Preventive Medicine, Bambino Gesù Children's Hospital, IRCCS, Via F. Baldelli 38, 00146, Rome, Italy.
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LoPresto LM, Cassady DL, Dove MS. Evaluation of School Wellness Policies in Low-Income California Districts After the 2016 USDA Final Rule. THE JOURNAL OF SCHOOL HEALTH 2024; 94:327-335. [PMID: 38087398 PMCID: PMC10939874 DOI: 10.1111/josh.13422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/20/2023] [Accepted: 11/14/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND Districts with federal nutrition programs must have an updated local school wellness policy (LSWP) to promote nutrition, physical activity, and student wellness. This study evaluates factors associated with LSWP quality among low-income districts. METHODS In 2018, we collected LSWPs from websites of 200 randomly selected, county-stratified, low-income-serving California public districts. Multivariable linear regression assessed associations between district characteristics, model LSWP use (national, state, none), and adoption date on policy quality. RESULTS On the WellSAT 3.0 scale of 0-100, mean (95% CI) comprehensiveness was 65.0 (63.2-66.7) and strength was 37.3 (35.3-39.2). Nearly verbatim adoption of model LSWPs was high (68.5% state model, 13.0% a national model). Half were adopted before mandated updates. District size (≥1000 students) and national model LSWP adoption were associated with higher comprehensive scores. National model LSWP adoption was associated with higher strength scores in updated policies compared with those not updated. IMPLICATIONS LSWPs have improved school food and activity environments, but district engagement in LSWP is low. Integration into education frameworks that reduce learning barriers could provide synergy for re-engagement. CONCLUSIONS High adoption of model policies and low update compliance indicate little district engagement in LSWP. Mixed methods studies of districts with high-quality LSWP are needed.
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Affiliation(s)
- Lynnea M LoPresto
- Department of Public Health Sciences, School of Medicine, University of California, Davis, CA
| | - Diana L Cassady
- Department of Public Health Sciences, School of Medicine, University of California, Davis, CA
| | - Melanie S Dove
- Department of Public Health Sciences, School of Medicine, University of California, Davis, CA
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Wong JE. Clarifying the Scope: Addressing Misinterpretations of Our Study on Self-Reporting Food Intake in Malaysian Primary School Children. J Nutr 2024; 154:1478-1479. [PMID: 38360114 DOI: 10.1016/j.tjnut.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Affiliation(s)
- Jyh Eiin Wong
- From the Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
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Iqbal AJ, Touheed H, Samiullah FNU. Unmasking Dietary Disclosures: Examining Food Intake Accuracy in Malaysian Primary School Children Aged 7-9 Years. J Nutr 2024; 154:1476-1477. [PMID: 38360115 DOI: 10.1016/j.tjnut.2023.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/31/2023] [Indexed: 02/17/2024] Open
Affiliation(s)
- Areeba Jawaid Iqbal
- Suleman Roshan Medical College Tandoadam, Tando Adam, Sanghar, Sindh, Pakistan.
| | - Hajira Touheed
- Suleman Roshan Medical College, Tando Adam, Sanghar, Sindh, Pakistan
| | - F N U Samiullah
- Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Sindh, Pakistan
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Sanchez-Vaznaugh EV, Matsuzaki M, Acosta ME, Vasanth S, Dugay ER, Sánchez BN. "Competitive" food and beverage policies and weight status: A systematic review of the evidence among sociodemographic subgroups. Obes Rev 2024; 25:e13678. [PMID: 38151337 PMCID: PMC10947922 DOI: 10.1111/obr.13678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 09/30/2023] [Accepted: 11/13/2023] [Indexed: 12/29/2023]
Abstract
Prior studies identified variable associations between competitive food and beverage policies (CF&B) and youth obesity, potentially due to differences across population subgroups. This review summarizes the evidence on associations between CF&B policies and childhood obesity within gender, grade level/ age, race/ethnicity, and/or socioeconomic levels. PubMed, EMBASE, CINAHL, and ERIC database searches identified studies published in English in Canada and the United States between January 1, 2000, and February 28, 2022. Of the 18 selected studies, six were cross-sectional, two correlational, nine were before/after designs, and one study utilized both a cross-sectional and pre-post design. Twelve studies reported findings stratified by a single sociodemographic factor, with grade level/age as the most frequently reported. Although the evidence varied, greater consistency in direction of associations and strengths of evidence were seen among middle school students. Six studies reported findings jointly by multiple sociodemographic subgroups with evidence suggesting CF&B associations with slower rate of increase or plateaus or declines in obesity among multiple subgroups, though the strengths of evidence varied. Over the past two decades, there have been relatively limited subgroup analyses on studies about CF&B policies and childhood obesity. Studies are needed with stronger designs and analyses disaggregated, particularly by race/ethnicities and socioeconomic factors, across places and time.
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Affiliation(s)
- Emma V Sanchez-Vaznaugh
- Department of Public Health, Health Equity Institute, San Francisco State University and Center for Health Equity, University of California, San Francisco, California, USA
| | - Mika Matsuzaki
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Maria Elena Acosta
- Department of Public Health, San Francisco State University, San Francisco, California, USA
| | - Sahana Vasanth
- Department of Public Health, San Francisco State University, San Francisco, California, USA
| | - Erika Rachelle Dugay
- Department of Public Health, San Francisco State University, San Francisco, California, USA
| | - Brisa N Sánchez
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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Ávila Arcos MA, Shamah Levy T, Del Monte Vega MY, Chávez Villasana A, Ávila Curiel A. Convenience stores: an obesogenic promoter in a metropolitan area of northern Mexico? Front Nutr 2024; 11:1331990. [PMID: 38510710 PMCID: PMC10950971 DOI: 10.3389/fnut.2024.1331990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction The prevalence of obesity in the Mexican school-age (5-11 years old) population increased from 8.9 to 18.1% between 1999 and 2022. Although overweight and obesity (OW + Ob) is a complex and multifactorial phenomenon, alongside its increasing trend, changes in eating patterns as a result of obesogenic environments that promote higher energy intake have been documented. The objective of the present study was to detect possible associations between schools and their proximity to and density of convenience stores in Monterrey, Mexico from 2015 to 2018. Materials and methods Anthropometric data were obtained from a subset of measurements of the National Registry of Weight and Height (RNPT) performed in the Monterrey Mexico metropolitan area in 2015 and 2018, and obesity prevalence was computed and classified into quintiles at the school level. Convenience store data were obtained from the National Directory of Economic Units (DNUE). The analyses consisted of densities within 400-800 m buffers, distance to the nearest stores, and cartographic visualization of the store's kernel density versus OW + Ob hotspots for both periods. Results A total of 175,804 children in 2015 and 175,964 in 2018 belonging to 1,552 elementary schools were included in the study; during this period, OW + Ob prevalence increased from 38.7 to 39.3%, and a directly proportional relationship was found between the quintiles with the higher OW + Ob prevalence and the number of stores for both radii. Hotspots of OW + Ob ranged from 63 to 91 between 2015 and 2018, and it was visually confirmed that such spots were associated with areas with a higher density of convenience stores regardless of socioeconomic conditions. Conclusion Although some relationships between the store's proximity/density and OW + Ob could be identified, more research is needed to gather evidence about this. However, due to the trends and the magnitude of the problem, guidelines aimed at limiting or reducing the availability of junk food and sweetened beverages on the school's periphery must be implemented to control the obesogenic environment.
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Affiliation(s)
- Marco Antonio Ávila Arcos
- Center for Research on Evaluation and Surveys, National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - Teresa Shamah Levy
- Center for Research on Evaluation and Surveys, National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - Marti Yareli Del Monte Vega
- Applied Nutrition and Nutritional Education Department, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Adolfo Chávez Villasana
- Applied Nutrition and Nutritional Education Department, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Abelardo Ávila Curiel
- Applied Nutrition and Nutritional Education Department, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
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Ahmed M, Richardson A, Riad J, McPherson C, Sellen DW, Malik VS. Impact of the COVID-19 pandemic on the adaptability and resiliency of school food programs across Canada. Front Public Health 2024; 11:1296620. [PMID: 38235159 PMCID: PMC10791823 DOI: 10.3389/fpubh.2023.1296620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/06/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction Following the sudden closure of schools due to the pandemic in 2020, many school food program (SFP) operators lost their operating venues and had to innovate to continue distributing meals to children. Our objective was to assess the impact of the COVID-19 pandemic on the delivery, adaptability, and resiliency of school food programs across Canada by conducting a systematic rapid review. Materials and methods Systematic literature searches identified newspaper articles and social media sources related to the adaptations and challenges faced by school food programs across Canada in response to the COVID-19 pandemic. Included sources were assessed and thematically categorized according to the dimensions of the Analysis Grid for Environments Linked to Obesity (ANGELO) and Getting To Equity (GTE) frameworks to identify factors impacting the delivery, adaptability, and resiliency of school food programs in Canada. Results School food programs in Canada made various efforts to meet existing and new challenges associated with the delivery of these programs to keep feeding school children, particularly those most vulnerable, during the pandemic. Distribution of food kits, prepared meals and gift cards/coupons were successful pathways in ensuring support for food accessibility to students and their families. Increased collaborations between community members and organizations/stakeholders to help maintain food delivery or collectively offer new modes to deliver foods were most frequently cited as key to facilitating school food programming. However, maintenance and sustainability related to operating costs and funding were identified as key challenges to successful school food programming. Conclusion Our study highlights the swift and substantial transformation school food programs,, underwent in response to the pandemic, driven by the urgent need to ensure that students still had access to nutritious meals and the importance of policy and resource support to bolster the adaptability and resiliency of these programs. Findings on facilitators and challenges to school food programs during the early months of the COVID-19 pandemic can inform development of guidelines to design a robust national Canadian school food program and help make existing programs more sustainable, adaptable, and resilient.
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Affiliation(s)
- Mavra Ahmed
- Joannah and Brian Lawson Centre for Child Nutrition, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alana Richardson
- Joannah and Brian Lawson Centre for Child Nutrition, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jessica Riad
- Joannah and Brian Lawson Centre for Child Nutrition, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Chelsea McPherson
- Joannah and Brian Lawson Centre for Child Nutrition, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Daniel W. Sellen
- Joannah and Brian Lawson Centre for Child Nutrition, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Vasanti S. Malik
- Joannah and Brian Lawson Centre for Child Nutrition, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Sang Iii CJ, de Visser R, Krallman R, Pai CW, Montgomery D, Moser CA, Kline-Rogers E, DuRussel-Weston J, Eagle KA, Chinapaw M, Jackson EA. Cardiometabolic Risk and Dietary Behaviors in Middle-School Children Consuming School-Sourced Lunch. Acad Pediatr 2023; 23:1605-1613. [PMID: 37543082 DOI: 10.1016/j.acap.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/25/2023] [Accepted: 07/29/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE Childhood obesity remains a major public health issue. This study assessed the association between school-sourced lunches and cardiometabolic risk factors in middle-school students. METHODS Data from health behavior surveys and physiologic screenings in a Michigan middle-school wellness program between 2005 and 2019 were used to analyze the association of school lunch consumption with cardiometabolic risk factors (overweight/obesity, non-fasting lipids/glucose, blood pressure) and dietary behaviors (fruit/vegetable consumption, intake of sugar-sweetened beverages/foods). Students were divided into three groups based on their responses to the survey item if they 1) always, 2) sometimes, or 3) never consumed school-sourced lunches. Groups were compared using descriptive statistics and chi-squared tests. RESULTS Students consuming school-sourced lunches were more likely to have overweight or obesity, without significant differences in total, HDL, or LDL cholesterol. There was no difference in non-fasting glucose levels, blood pressure, or resting heart rate. Students consuming school sourced lunch were more likely to have increased sugary and fatty food or beverage consumption. Students consuming school sourced lunch were more likely to attend school in a low or middle socioeconomic status region. CONCLUSIONS In this large cohort of middle-school children, consuming school-sourced lunches was associated with a greater prevalence of overweight and obesity and consumption of fatty foods and sugary beverages. School-based interventions should target methods to reduce consumption of sugary beverages and unhealthy snacks and promote consumption of fruits and vegetables, particularly among high-risk individuals.
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Affiliation(s)
- Charlie J Sang Iii
- Division of Cardiology (CJ Sang III), Department of Medicine, University of North Carolina at Chapel Hill
| | - Rosa de Visser
- Michigan Clinical Outcomes Research and Reporting Program (R de Visser, R Krallman, C-W Pai, D Montgomery, E Kline-Rogers, and EA Jackson), Michigan Medicine, Ann Arbor, Mich; Amsterdam UMC (M Chinapaw), Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Health Behavior and Chronic Diseases and Methodology, Amsterdam, the Netherlands
| | - Rachel Krallman
- Michigan Clinical Outcomes Research and Reporting Program (R de Visser, R Krallman, C-W Pai, D Montgomery, E Kline-Rogers, and EA Jackson), Michigan Medicine, Ann Arbor, Mich
| | - Chih-Wen Pai
- Michigan Clinical Outcomes Research and Reporting Program (R de Visser, R Krallman, C-W Pai, D Montgomery, E Kline-Rogers, and EA Jackson), Michigan Medicine, Ann Arbor, Mich
| | - Daniel Montgomery
- Michigan Clinical Outcomes Research and Reporting Program (R de Visser, R Krallman, C-W Pai, D Montgomery, E Kline-Rogers, and EA Jackson), Michigan Medicine, Ann Arbor, Mich
| | - Cydni A Moser
- Operations Administration, Mayo Clinic (CA Moser), Phoenix, Ariz
| | - Eva Kline-Rogers
- Michigan Clinical Outcomes Research and Reporting Program (R de Visser, R Krallman, C-W Pai, D Montgomery, E Kline-Rogers, and EA Jackson), Michigan Medicine, Ann Arbor, Mich
| | | | - Kim A Eagle
- Division of Cardiovascular Medicine (KA Eagle), Department of Internal Medicine, Michigan Medicine, Ann Arbor, Mich
| | - Mai Chinapaw
- Amsterdam UMC (M Chinapaw), Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Health Behavior and Chronic Diseases and Methodology, Amsterdam, the Netherlands
| | - Elizabeth A Jackson
- Michigan Clinical Outcomes Research and Reporting Program (R de Visser, R Krallman, C-W Pai, D Montgomery, E Kline-Rogers, and EA Jackson), Michigan Medicine, Ann Arbor, Mich; Division of Cardiovascular Disease (EA Jackson), Department of Medicine, University of Alabama at Birmingham.
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Olsson C, Hörnell A, Waling M. High availability of vegetables and fruit through government-funded school lunch is not reflected in 4th grade pupils' intake. Food Nutr Res 2023; 67:9405. [PMID: 37533447 PMCID: PMC10392862 DOI: 10.29219/fnr.v67.9405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 08/04/2023] Open
Abstract
Background An increased intake of vegetable and fruit (VF) through school meals can contribute to the prevention of non-communicable diseases. Objective The purpose of this study was to investigate what types of VF 4th grade pupils (10-11 years old) choose, how much they eat when they are given the opportunity to serve themselves from the daily vegetable buffet available at lunch, and whether this varies with socioeconomic background and gender. Design A cross-sectional study design was used where pupils' VF intake was measured during 5 days with a photographic method. In total, 196 pupils from nine public schools participated. Results The results show that pupils on average ate less than one type of VF per day from the vegetable buffet. Girls, pupils with a higher socio-economic status (SES) and those with a more frequent VF intake at home, ate more types of VF per day from the vegetable buffet than their counterparts. The median intake of VF from the vegetable buffet was generally low, 20.4 g/day. The intake was two thirds higher for pupils with higher SES in comparison with pupils with lower SES; 25 g/day versus14 g/day (P = 0.001). No gender differences in grams per day of VF were identified (P = 0.123). Discussion This study indicates that a well-stocked vegetable buffet as part of government-funded school lunch does not automatically contribute substantially to the recommended daily intake of VF among a sample of 4th grade pupils in a high-income country like Sweden. Conclusions The results of the study can be interpreted as a missed opportunity to increase the intentional consumption of VF among pupils in a way that would have implications for public health as well as attenuating differences between socioeconomic groups.
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Affiliation(s)
| | | | - Maria Waling
- Maria Waling Department of Food, Nutrition and Culinary Science, SE-901 87 Umeå, Sweden.
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13
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Vonk L, Eekhout I, Huijts T, Levels M, Jansen MWJ. School health promotion and the consumption of water and sugar-sweetened beverages in secondary schools: a cross-sectional multilevel study. BMC Public Health 2023; 23:1296. [PMID: 37407939 DOI: 10.1186/s12889-023-16123-7] [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: 01/13/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Overweight among adolescents remains a serious concern worldwide and can have major health consequences in later life, such as cardiovascular diseases and cancer. Still, 33% of secondary school adolescents in the Netherlands consume sugar-sweetened beverages daily and over 26% do not consume water every day. The Dutch Healthy School program was developed to support schools in stimulating healthier lifestyles by focusing on health education, school environments, identifying students' health problems, and school policy. We examined the variation between secondary schools regarding the daily consumption of water and sugar-sweetened beverages and whether this variation can be explained by differences between schools regarding Healthy School certification, general school characteristics, and the school population. METHODS We performed a cross-sectional multilevel study. We used data from the national Youth Health Monitor of 2019 on secondary schools (grades 8 and 10, age range about 12 to 18 years) of seven Public Health Services and combined these with information regarding Healthy School certification and general school- and school population characteristics. Our outcomes were daily consumption of water and sugar-sweetened beverages. In total, data from 51,901 adolescents from 191 schools were analysed. We calculated the intraclass correlation to examine the variation between schools regarding our outcomes. Thereafter, we examined whether we could explain this variation by the included characteristics. RESULTS The school-level explained 4.53% of the variation in the consumption of water and 2.33% of the variation in the consumption of sugar-sweetened beverages. This small variation in water and sugar-sweetened consumption could not be explained by Healthy School certification, yet some general school- and school population characteristics did: the proportion of the school population with at least one parent with high educational attainment, the educational track of the adolescents, urbanicity (only for water consumption) and school type (only for sugar-sweetened beverages consumption). CONCLUSIONS The low percentages of explained variation indicate that school-level characteristics in general (including Healthy School certification) do not matter substantially for the daily consumption of water and sugar-sweetened beverages. Future research should examine whether school health promotion can contribute to healthier lifestyles, and if so, under which level of implementation and school conditions.
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Affiliation(s)
- Lisanne Vonk
- Academic Collaborative Center for Public Health Limburg, Public Health Service South Limburg, P.O. Box 33, 6400 AA, Heerlen, The Netherlands.
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Iris Eekhout
- Expertise Center Child Health, Netherlands Organisation for Applied Scientific Research (TNO), P.O. Box 3005, 2301 DA, Leiden, The Netherlands
| | - Tim Huijts
- Research Centre for Education and the Labour Market (ROA), School of Business and Economics, Maastricht University, Postbus 616, 6200 MD, Maastricht, The Netherlands
- Centre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), P.O. Box 8900, NO-7491, Trondheim, Norway
| | - Mark Levels
- Research Centre for Education and the Labour Market (ROA), School of Business and Economics, Maastricht University, Postbus 616, 6200 MD, Maastricht, The Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health Limburg, Public Health Service South Limburg, P.O. Box 33, 6400 AA, Heerlen, The Netherlands
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
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14
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Shaw S, Barrett M, Shand C, Cooper C, Crozier S, Smith D, Barker M, Vogel C. Influences of the community and consumer nutrition environment on the food purchases and dietary behaviors of adolescents: A systematic review. Obes Rev 2023; 24:e13569. [PMID: 37081719 PMCID: PMC10909420 DOI: 10.1111/obr.13569] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 02/16/2023] [Accepted: 03/27/2023] [Indexed: 04/22/2023]
Abstract
Adolescence is a period of increased autonomy over decision-making, including food choices, and increased exposure to influences outside the home, including the food environment. This review aims to synthesize the evidence for the influence of community nutrition environments, spatial access to food outlets, and consumer nutrition environments, environments inside food outlets, on adolescent food purchasing and dietary behaviors in high-income countries. Six databases were searched for articles published before January 2023. Results were synthesized using a vote-counting technique and effect direction plots that record the direction of the effect in relation to the anticipated relationship with health. Thirty-four observational and two intervention studies met the inclusion criteria. In the 13 studies assessing adolescent exposure to healthy community nutrition environments, results did not show clear associations with dietary and purchasing outcomes. Thirty studies assessed adolescents' exposure to unhealthy community nutrition environments with the majority (n = 17/30, 57%) reporting results showing that greater exposure to food outlets classified as unhealthy was associated with less healthy food purchases and dietary intakes. Inconsistent results were observed across the seven studies investigating associations with the consumer environment. Further research in these areas, including more high-quality intervention studies, may help to develop policy strategies to improve adolescents' dietary behaviors.
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Affiliation(s)
- Sarah Shaw
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonSO16 6YDUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSO16 6YDUK
| | - Millie Barrett
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonSO16 6YDUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSO16 6YDUK
- Centre for Food Policy, CityUniversity of LondonNorthampton SquareLondonEC1V0HBUK
| | - Calum Shand
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonSO16 6YDUK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonSO16 6YDUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSO16 6YDUK
| | - Sarah Crozier
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonSO16 6YDUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSO16 6YDUK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre2 Venture Road, ChilworthSouthamptonSO16 7NPUK
| | - Dianna Smith
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre2 Venture Road, ChilworthSouthamptonSO16 7NPUK
- Geography and Environmental ScienceUniversity of SouthamptonSouthamptonSO17 1BJUK
| | - Mary Barker
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonSO16 6YDUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSO16 6YDUK
- School of Health SciencesFaculty of Environmental and Life SciencesUniversity of SouthamptonSouthamptonSO17 1BJUK
| | - Christina Vogel
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonSO16 6YDUK
- NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSO16 6YDUK
- Centre for Food Policy, CityUniversity of LondonNorthampton SquareLondonEC1V0HBUK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre2 Venture Road, ChilworthSouthamptonSO16 7NPUK
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15
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Kotova MB, Maksimov SA, Drapkina OM. Gender, Age, Family and Territorial Features of Dietary and Physical Activity Patterns in Russian Youths. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095779. [PMID: 35565174 PMCID: PMC9104441 DOI: 10.3390/ijerph19095779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Identifying dietary and physical activity (PA) patterns in Russian youths and examining their dependence on gender, age, family characteristics and area of residence features. The research involved 783 school students 10-17 years of age and their parents living in the cities of Moscow and Murmansk. Using the principal component analysis, four integral indices were identified that characterized the habits and dietary patterns, PA and lifestyle. Boys, compared with girls, were more likely to consume unhealthy foods but less likely to practice malnutrition. Within the age ranges of 13-15 years old and 16-17 years old, the proportions of school students with a poor sleep pattern and low PA were higher than in children 10-12 years of age. In smoking families, children were less likely to consume healthy foods and more likely to eat unhealthy foods. In Murmansk school students, compared with their Moscow peers, a reduction in both sleep time and PA was observed less often. Our study demonstrated that the most significant factors of a balanced and healthy diet, rational daily routine and lifestyle in school students were their gender and age characteristics, as well as some contextual factors.
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Affiliation(s)
- Marina B. Kotova
- National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, 10 Bld. Petroverigskiy Lane, 101990 Moscow, Russia; (M.B.K.); (O.M.D.)
| | - Sergey A. Maksimov
- National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, 10 Bld. Petroverigskiy Lane, 101990 Moscow, Russia; (M.B.K.); (O.M.D.)
- Correspondence: ; Tel.: +7-985-333-0261
| | - Oksana M. Drapkina
- National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, 10 Bld. Petroverigskiy Lane, 101990 Moscow, Russia; (M.B.K.); (O.M.D.)
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Impact of the external school food environment on the associations of internal school food environment with high schoolers’ diet and body mass index. Public Health Nutr 2022; 25:3086-3095. [DOI: 10.1017/s1368980022000994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Objective:
To examine associations of school food availability with student intake frequency and BMI, and whether the number of neighborhood food outlets modifies these associations.
Design:
Baseline assessment of a nationally representative cohort study of U.S. 10th graders. Students reported intake frequency of fruits and vegetables (FV), snacks, and soda. BMI was calculated from measured height and weight. Administrators of 72 high schools reported the frequency of school availability of FV, snacks, and soda. The number of food outlets within 1 km and 5 km were linked with geocoded school addresses. Data were analyzed using adjusted linear and logistic mixed models with multiple imputation for missing data.
Setting:
U.S. 2009-2010.
Participants:
2,263 U.S. 10th graders from the Next Generation Health Study (NEXT).
Results:
Greater school FV availability was positively associated with student FV intake. Food outlets within 5 km of schools (but not 1 km) attenuated the association of school FV availability with student intake; this was no longer significant at schools with >58 food outlets within 5 km. School food availability was not associated with student BMI or student snack or soda intake.
Conclusions:
School food availability was associated with student intake of FV, but not with snacks, soda, or BMI. Attenuation of the observed associations by the school neighborhood food environment indicates a need to find ways to support healthy student eating behaviors in neighborhoods with higher food outlet density.
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17
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Alkhunain N, Moore JB, Ensaff H. Online Pre-Order Systems for School Lunches: Insights from a Cross-Sectional Study in Primary Schools. Nutrients 2022; 14:nu14050951. [PMID: 35267926 PMCID: PMC8912561 DOI: 10.3390/nu14050951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 01/27/2023] Open
Abstract
Schools are increasingly using online pre-order systems for children to select school meals in advance. This study aimed to explore how children use and interact with these systems. Using a combination of direct observation and an online questionnaire, the operation of these systems in four UK primary schools was examined. This included how the menu options were displayed, how these were selected by children (4–11 years), and the interactions between children and others when making food selections. Where possible, most children pre-ordered their school lunch in the classroom, and differences in the food choice process among children were observed. These apparently related to children’s ages; older children (8–11 years) showed more independence when making food selections, whereas younger children were often supported by others. Most parents reported that their child was the decision maker when pre-ordering the school lunch, and the role of children in the selection of school lunches was evident. This may be accentuated by the online pre-order systems, and given the likely expansion of these systems in schools, there is an opportunity to implement interventions to influence children towards specific or different meal options from the school menu.
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Affiliation(s)
- Nahlah Alkhunain
- Nutritional Sciences and Epidemiology, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; (N.A.); (J.B.M.)
- Clinical Nutrition, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
| | - Jennifer Bernadette Moore
- Nutritional Sciences and Epidemiology, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; (N.A.); (J.B.M.)
| | - Hannah Ensaff
- Nutritional Sciences and Epidemiology, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; (N.A.); (J.B.M.)
- Correspondence:
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18
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Zhang Z, Jackson SL, Steele EM, Gillespie C, Yang Q. Relationship Between Ultraprocessed Food Intake and Cardiovascular Health Among U.S. Adolescents: Results From the National Health and Nutrition Examination Survey 2007-2018. J Adolesc Health 2022; 70:249-257. [PMID: 34716093 PMCID: PMC10063320 DOI: 10.1016/j.jadohealth.2021.09.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/14/2021] [Accepted: 09/22/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Studies of the association between ultraprocessed foods (UPF) and cardiovascular disease risk factors have been mainly focused on the adult population. This study examined the association between usual percentage of calories (%kcal) from UPF and the American Heart Association's seven cardiovascular health (CVH) metrics among U.S. adolescents aged 12-19 years. METHODS We used data from the National Health and Nutrition Examination Survey 2007-2018 (n = 5,565). The NOVA food system was used to classify UPF according to the extent and purpose of food processing. Each CVH metric was given a score of 0, 1, or 2 (poor, intermediate, or ideal health, respectively). Scores of six metrics were summed (excluding diet) to categorize CVH as low (0-7), moderate (8-10), or high (11-12). The National Cancer Institute's methods were used to estimate usual %kcal from UPF. Multivariable linear regression and multinomial logistic regression were used to evaluate the association between UPF and CVH. RESULTS Among youth, 12.1% had low CVH, 56.3% moderate, and 31.6% high. The mean usual %kcal from UPF was 65.7%. Every 5% increase in calories from UPF was associated with .13 points lower CVH scores (p < .001). Comparing Q2, Q3, and Q4 to Q1 of UPF intake, the adjusted odds ratios for low versus high CVH were 1.43 (95% confidence interval 1.16-1.76), 1.86 (1.29-2.66), and 2.59 (1.49-4.55), respectively. The pattern of association was largely consistent across subgroups. CONCLUSIONS U.S. adolescents consume about two thirds of daily calorie from UPF. There was a graded inverse association between %kcal from UPF and CVH score.
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Affiliation(s)
- Zefeng Zhang
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Sandra L Jackson
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Euridice Martinez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Cathleen Gillespie
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Quanhe Yang
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Andueza N, Navas-Carretero S, Cuervo M. Effectiveness of Nutritional Strategies on Improving the Quality of Diet of Children from 6 to 12 Years Old: A Systematic Review. Nutrients 2022; 14:nu14020372. [PMID: 35057552 PMCID: PMC8781853 DOI: 10.3390/nu14020372] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023] Open
Abstract
Dietary habits, that are formed during childhood and consolidated in adulthood, are known to influence the development of future chronic diseases such as metabolic syndrome or type 2 diabetes. The aim of this review was to evaluate the effectiveness of nutritional interventions carried out in recent years focused on improving the quality of the diet of the child population. A systematic search of the PubMed and Scopus databases was performed from January 2011 until September 2021. A total of 910 articles were identified and screened based on their title, abstract and full text. Finally, 12 articles were included in the current systematic review. Of those, in six studies the intervention was based on the provision of healthy meals and in the other six studies the intervention focused on modifying the school environment. Six of the studies selected included other components in their intervention such as nutritional education sessions, physical activity and/or families. A wide variety of methods were used for diet assessments, from direct method to questionnaires. The results suggest that interventions that modify the school environment or provide different meals or snacks may be effective in improving children’s dietary patterns, both in the short and long term. Further research is necessary to evaluate the real effectiveness of strategies with multidisciplinary approach (nutritional sessions, physical activity and family’s involvement).
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Affiliation(s)
- Naroa Andueza
- Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.A.); (M.C.)
- Center for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.A.); (M.C.)
- Center for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Institute of Health Carlos III, 28029 Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
- Correspondence: ; Tel.: +34-948425600
| | - Marta Cuervo
- Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.A.); (M.C.)
- Center for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
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20
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Song S, Ishdorj A, Dave JM. Gender Differences in Nutritional Quality and Consumption of Lunches Brought from Home to School. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413168. [PMID: 34948778 PMCID: PMC8700912 DOI: 10.3390/ijerph182413168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/08/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022]
Abstract
Gender difference in the lunches brought from home to school and the amount consumed by elementary and intermediate school students were examined using data collected from 12 schools in Texas. The amount and nutritional quality of food items brought and consumed was evaluated, by comparing the results to the 2012 school meal standards, and Dietary Reference Intakes (DRIs). Almost all lunches brought from home contained grain and meat/meat alternatives, and the amount brought and consumed exceeded the NSLP standards. The majority of students did not bring fruits, vegetables, and whole grain foods, but those who brought consumed most of what they brought. Among elementary school students, only 9% of boys and 14% of girls brought vegetables and the amount brought and consumed did not meet the standards. Although carbohydrate and protein consumption were adequate for boys and girls, the intakes of micronutrients and fiber did not meet the requirements across both genders at both school levels. Overall, lunches brought from home were not well balanced and did not meet NSLP standards and DRIs. It is imperative to identify strategies to improve the nutritional quality of lunches brought from home considering gender difference in food choice and educating parents and children on what is a healthy well-balanced lunch.
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Affiliation(s)
- Siwan Song
- Department of Agricultural Economics, Texas A&M University, 2124 TAMU, College Station, TX 77843, USA;
| | - Ariun Ishdorj
- Department of Agricultural Economics, Texas A&M University, 2124 TAMU, College Station, TX 77843, USA;
- Correspondence:
| | - Jayna M. Dave
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA;
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21
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Callender C, Velazquez D, Adera M, Dave JM, Olvera N, Chen TA, Alford S, Thompson D. Perspectives of Black and Hispanic Children Living in Under-Resourced Communities on Meal Preparation and Grocery Shopping Behaviors: Implications for Nutrition Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12199. [PMID: 34831953 PMCID: PMC8618219 DOI: 10.3390/ijerph182212199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 11/22/2022]
Abstract
Minority children living in under-resourced communities are at the greatest risk for obesity and poor diet quality. Child involvement in meal preparation may be a helpful strategy to improve diet quality. This paper explores minority children's perspectives regarding this. Eighteen children participated in a mixed methods study (online surveys, telephone interviews). Descriptive statistics were calculated for child demographic and psychosocial factors. Thematic analysis was used to code and analyze the interviews. Most children reported having cooking experience (83%) and cooking with family (94%) and exhibited high cooking self-efficacy (21.8 ± 2.9) and positive cooking attitudes (25.7 ± 4.4). Children reported helping with meal preparation (50%) and grocery shopping (41%) sometimes. The qualitative data further supported the results obtained from the children's psychosocial factors. Most children noted the importance of learning to cook with an emphasis on life skills. Children also shared their level of involvement in cooking and grocery shopping. Most children reported using technology when cooking to find demonstration videos and recipes. These findings highlight that minority children participate in meal preparation and grocery shopping. Their perspectives are important for the development of nutrition education programs to achieve equitable dietary outcomes in minority families living in under-resourced communities.
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Affiliation(s)
- Chishinga Callender
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA; (C.C.); (D.V.); (M.A.); (J.M.D.)
| | - Denisse Velazquez
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA; (C.C.); (D.V.); (M.A.); (J.M.D.)
| | - Meheret Adera
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA; (C.C.); (D.V.); (M.A.); (J.M.D.)
| | - Jayna M. Dave
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA; (C.C.); (D.V.); (M.A.); (J.M.D.)
| | - Norma Olvera
- Psychological, Health and Learning Sciences Department, University of Houston, 3657 Cullen Boulevard Room 491, Houston, TX 77204, USA; (N.O.); (T.A.C.)
| | - Tzuan A. Chen
- Psychological, Health and Learning Sciences Department, University of Houston, 3657 Cullen Boulevard Room 491, Houston, TX 77204, USA; (N.O.); (T.A.C.)
- Health Research Institute, University of Houston, 4849 Calhoun Road, Houston, TX 77204, USA
| | - Shana Alford
- Common Threads, 222 W. Merchandise Mart Plaza, Suite 1212, Chicago, IL 60654, USA;
| | - Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA; (C.C.); (D.V.); (M.A.); (J.M.D.)
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22
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Musicus AA, Thorndike AN, Block JP, Rimm EB, Bleich SN. Prevalence and nutritional quality of free food and beverage acquisitions at school and work by SNAP status. PLoS One 2021; 16:e0257879. [PMID: 34644334 PMCID: PMC8514130 DOI: 10.1371/journal.pone.0257879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 09/13/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The dual burden of poor diet quality and food insecurity makes free food-food acquired at no cost-a very important part of the nutrition safety net for low-income families. The goal of this study was to determine the national prevalence and nutritional quality of free food acquired separately in two settings: 1) by children at school; and 2) by employees at work; both stratified by participation in the Supplemental Nutrition Assistance Program (SNAP). METHODS Using National Household Food Acquisition and Purchase Survey data (2012; n = 4,826 U.S. households containing 5,382 employed adults and 3,338 school-aged children), we used survey-weighted proportions to describe free food acquisition and linear regression to compare the 2010 Healthy Eating Index (HEI-2010) for free/non-free food acquisition events (i.e., meals) by SNAP status. Analyses were conducted in 2019-2020. RESULTS SNAP households had more free acquisition events (29.6%) compared to non-SNAP households (<185% federal poverty level (FPL) = 22.3%; ≥185%FPL = 21.0%, p's<0.001). For SNAP-participant children, free acquisition events at school had a higher mean HEI-2010 compared to non-free acquisition events at school (50.3 vs. 43.8, p = 0.033) and free acquisition events by SNAP-non-participant children ≥185%FPL at school (50.3 vs. 38.0, p = 0.001). Free and non-free acquisition events at work had relatively low HEI-2010s, with no differences by SNAP status. CONCLUSIONS Over one fifth of all food acquisition events were free, but free food acquisitions at school and work were relatively unhealthy. For children participating in SNAP, free food acquired at school had higher nutritional quality. Improving the dietary quality of free foods could improve the health of families, especially those participating in SNAP.
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Affiliation(s)
- Aviva A. Musicus
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Anne N. Thorndike
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jason P. Block
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Eric B. Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Sara N. Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Johansen C, Reynolds KD, Xie B, Palmer P. Exploring Potential Mediation Pathways on the Relationship Between Acculturation and Body Mass Index (BMI) Among Latino Adolescents. HISPANIC HEALTH CARE INTERNATIONAL 2021; 20:89-97. [PMID: 34291690 DOI: 10.1177/15404153211029893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Positive associations have been observed between acculturation and body mass index (BMI), but the mediators of this relationship are not well established. Acculturation researchers have called for investigating the influence of socio-contextual variables as mediators. The objective of this study was to test the mediating effects of salty snacks, sweet snacks, physical activity, and sedentary behavior on the relationship between acculturation and BMI among Latino adolescents. METHODS Adolescents who self-identified as Latino (n = 431) at public high schools in Southern California were recruited and completed a self-report survey. A bootstrapped multiple mediation model was used to test mediation pathways. RESULTS Acculturation was positively associated with physical activity (B = 0.09, p < .05). The indirect effects of salty snacks, sweet snacks, physical activity, and sedentary behavior were not associated with BMI, suggesting no mediation. CONCLUSIONS Future research should examine additional mediating variables on the relationship between acculturation and BMI.
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Affiliation(s)
- Christopher Johansen
- School of Community and Global Health, Claremont Graduate University, CA, USA.,Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV, USA
| | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, CA, USA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, CA, USA
| | - Paula Palmer
- School of Community and Global Health, Claremont Graduate University, CA, USA
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24
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Evenhuis IJ, Vyth EL, van Nassau F, Veldhuis L, Westerman MJ, Seidell JC, Renders CM. What Do Secondary Schools Need to Create Healthier Canteens? The Development of an Implementation Plan. Front Public Health 2021; 9:683556. [PMID: 34249845 PMCID: PMC8261152 DOI: 10.3389/fpubh.2021.683556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/27/2021] [Indexed: 01/22/2023] Open
Abstract
Introduction: The Netherlands Nutrition Centre developed guidelines to improve the availability and accessibility of healthier food products in Dutch canteens. This paper describes the development of an implementation plan to facilitate implementation of Guidelines for Healthier Canteens in Dutch secondary schools. Materials and Methods: In cooperation with stakeholders (i.e., school/caterer managers/employees, school canteen advisors, researchers) and based on theory, we developed an implementation plan in three steps. First, we identified factors that impede/facilitate stakeholders to create a healthier school canteen during 14 interviews. Second, 25 experts discussed and prioritized these identified factors in an expert meeting. Third, we translated these factors into tools to be included in the implementation plan, by making use of behavior change taxonomies and evidence-based implementation strategies. Results: The plan aims to support stakeholders in implementing healthier school canteens and consists of five tools: (1) tailored advice based on an online questionnaire to assess schools' and stakeholders' context and the Canteen Scan (i.e., an online tool to assess the availability and accessibility of food/drink products); (2) communication materials with information and examples; (3) online community for support by sharing experiences/questions; (4) digital newsletter as reminder/support; (5) fact sheet with students' needs/wishes to tailor the canteen. Discussion: This study illustrates how collaboration between science, policy and practice resulted in a tailored implementation plan aimed to support schools to adhere to school canteen policy. This development serves as a good example for researchers, health promotion policymakers, and practitioners how to create an implementation plan that fits the needs of stakeholders.
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Affiliation(s)
- Irma J. Evenhuis
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Ellis L. Vyth
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | | | - Marjan J. Westerman
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Jacob C. Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Carry M. Renders
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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25
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O'Mahony B, Kerins C, Murrin C, Kelly C. Barriers and facilitators to the implementation of nutrition standards for school food: a mixed-methods systematic review protocol. HRB Open Res 2021; 3:20. [PMID: 32743340 PMCID: PMC7372527 DOI: 10.12688/hrbopenres.13041.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 06/30/2024] Open
Abstract
Background: The importance of nutrition during childhood and the high prevalence of child and adolescent obesity has resulted in several countries implementing nutritional standards for school food as a way of providing healthy school food environments. Yet, there has been less focus on the barriers and facilitators influencing the process of implementing school food standards. This mixed-methods systematic review aims to address this evidence gap by synthesising the empirical evidence on the factors that may influence the implementation of school food standards. Methods: This mixed-methods systematic review will use qualitative, quantitative and mixed-methods evidence from peer-reviewed publications retrieved from the following databases; PubMed, CINAHL, Scopus, EMBASE, Medline, PsycINFO and Web of Science. Grey literature will be accessed through Google Scholar, Open Access Theses and Dissertations, OpenGrey, RIAN, EThOS, ProQuest, WorldCat, Networked Digital Library of Theses and Dissertations, and public health organisation websites will also be accessed. Screening reference lists and citation chaining of all included studies will also be undertaken. No restrictions on publication date or language will be applied, however, only primary research studies relevant to supply-side stakeholders will be eligible for inclusion. Study quality will be assessed using the Mixed Methods Appraisal Tool. Study titles and abstracts will be screened to decide whether the full-text manuscript should be retrieved. For screening reliability, a second review author will assess a random sample of 20%. Kappa statistics will be used to assess inter-rater reliability, with values of 0.75 and higher representing high agreement. Two authors will independently extract data and factors reported to influence implementation. This will be synthesized using the Theoretical Domains Framework. Discussion: A comprehensive understanding of these factors can provide guidance to relevant stakeholders to enhance the adoption, implementation and sustainability of nutrition standards for school meals. Systematic review registration: PROSPERO CRD42019117904.
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Affiliation(s)
- Breda O'Mahony
- Home Economics Department, St. Angela's College, Sligo, Ireland
- Discipline of Health Promotion, National University of Ireland Galway, Galway, Ireland
| | - Claire Kerins
- Discipline of Health Promotion, National University of Ireland Galway, Galway, Ireland
| | - Celine Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Colette Kelly
- Health Promotion Research Centre, School of Health Sciences, National University of Ireland Galway, Galway, Ireland
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26
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O'Mahony B, Kerins C, Murrin C, Kelly C. Barriers and facilitators to the implementation of nutrition standards for school food: a mixed-methods systematic review protocol. HRB Open Res 2021; 3:20. [PMID: 32743340 PMCID: PMC7372527 DOI: 10.12688/hrbopenres.13041.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The importance of nutrition during childhood and the high prevalence of child and adolescent obesity has resulted in several countries implementing nutritional standards for school food as a way of providing healthy school food environments. Yet, there has been less focus on the barriers and facilitators influencing the process of implementing school food standards. This mixed-methods systematic review aims to address this evidence gap by synthesising the empirical evidence on the factors that may influence the implementation of school food standards. Methods: This mixed-methods systematic review will use qualitative, quantitative and mixed-methods evidence from peer-reviewed publications retrieved from the following databases; PubMed, CINAHL, Scopus, EMBASE, Medline, PsycINFO and Web of Science. Grey literature will be accessed through Google Scholar, Open Access Theses and Dissertations, OpenGrey, RIAN, EThOS, ProQuest, WorldCat, Networked Digital Library of Theses and Dissertations, and public health organisation websites will also be accessed. Screening reference lists and citation chaining of all included studies will also be undertaken. No restrictions on publication date or language will be applied, however, only primary research studies relevant to supply-side stakeholders will be eligible for inclusion. Study quality will be assessed using the Mixed Methods Appraisal Tool. Study titles and abstracts will be screened to decide whether the full-text manuscript should be retrieved. For screening reliability, a second review author will assess a random sample of 20%. Kappa statistics will be used to assess inter-rater reliability, with values of 0.75 and higher representing high agreement. Two authors will independently extract data and factors reported to influence implementation. This will be synthesized using the Theoretical Domains Framework. Discussion: A comprehensive understanding of these factors can provide guidance to relevant stakeholders to enhance the adoption, implementation and sustainability of nutrition standards for school meals. Systematic review registration: PROSPERO
CRD42019117904
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Affiliation(s)
- Breda O'Mahony
- Home Economics Department, St. Angela's College, Sligo, Ireland.,Discipline of Health Promotion, National University of Ireland Galway, Galway, Ireland
| | - Claire Kerins
- Discipline of Health Promotion, National University of Ireland Galway, Galway, Ireland
| | - Celine Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Colette Kelly
- Health Promotion Research Centre, School of Health Sciences, National University of Ireland Galway, Galway, Ireland
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27
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Conde-Caballero D, Rivero-Jimenez B, Mariano-Juarez L. Memories of hunger, continuities, and food choices: An ethnography of the elderly in extremadura (Spain). Appetite 2021; 164:105267. [PMID: 33933550 DOI: 10.1016/j.appet.2021.105267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/15/2021] [Accepted: 04/11/2021] [Indexed: 11/18/2022]
Abstract
Food choices are a complex subject of study. This study reviews existing literature on the topic, while also offering new perspectives. It introduces empirical materials that suggest the existence of continuities between childhood memories of food insecurity and current nutritional choices and practices among older adults. This is a qualitative study, based on grounded theory, which explores memories of hunger in the aftermath of the Spanish Civil War through ethnographic fieldwork conducted in 12 rural localities in Extremadura (Spain) - analysing current food practices and ideologies among surviving post-war children and tracing continuities between the past and the present. It provides results in the field of food continuities and shows how experiences and memories of hunger have an impact on food choices many decades later Data analysis and interpretation revealed three main categories: food memories of the so-called "years of hunger"; present-day food practices; and continuities between past and present. The inductive-deductive analysis revealed enduring memories that shaped present-day attitudes towards food - i.e. maximisation of ingredients and "zero-waste" practices; conspicuous consumption at particular times of the year; the central role of bread; and even certain food taboos. More than seventy years later, memories of deprivation and hunger are still pervasive and permeate present-day dietary practices and choices.
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Affiliation(s)
- David Conde-Caballero
- Department of Nursing, Faculty of Nursing and Occupational Therapy, Avenida de La Universidad S/n, 10003, Cáceres, Spain.
| | - Borja Rivero-Jimenez
- Department of Computer Systems and Telematics Engineering, Polytechnic School, Avenida de La Universidad S/n, 10003, Cáceres, Spain.
| | - Lorenzo Mariano-Juarez
- Department of Nursing, Faculty of Nursing and Occupational Therapy, Avenida de La Universidad S/n, 10003, Cáceres, Spain.
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28
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van Nee RL, van Kleef E, van Trijp HCM. Dutch Preadolescents' Food Consumption at School: Influence of Autonomy, Competence and Parenting Practices. Nutrients 2021; 13:nu13051505. [PMID: 33946949 PMCID: PMC8145952 DOI: 10.3390/nu13051505] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 02/07/2023] Open
Abstract
Eating habits appear to become less healthy once children move into adolescence. Adolescence is characterized by increasing independence and autonomy. Still, parents continue influencing adolescents' eating habits. This cross-sectional study used a Self-Determination Theory perspective to examine how parents can support preadolescents' food-related autonomy and competence and how these factors are associated with healthy eating motivation and food consumption at school. In addition, the effect of relative healthy food availability at home on preadolescents' food consumption at school was explored. In total, 142 Dutch preadolescents (mean age 12.18) and 81 parents completed questionnaires. The results showed that preadolescents perceived themselves as having higher food-related autonomy and lower competence to eat healthily as compared to their parents' perceptions. A path analysis was conducted to test the hypothesized model. Although parental support was positively associated with food-related autonomy, higher food-related autonomy was related to less healthy food intake at school. On the other hand, competence to eat healthily indirectly affected preadolescents' healthy intake ratio through their healthy eating motivation. Finally, the relative availability of healthy options at home was positively associated with preadolescents' healthy intake ratio outside the home. Findings from the study advance the understanding of individual and environmental factors that influence eating habits during the key life period of early adolescence. The results may inform interventions aiming to guide preadolescents to make healthy food choices on their own.
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Oh S, Lee SY, Kim DY, Woo S, Kim Y, Lee HJ, Jang HB, Park SI, Park KH, Lim H. Association of Dietary Patterns with Weight Status and Metabolic Risk Factors among Children and Adolescents. Nutrients 2021; 13:nu13041153. [PMID: 33807269 PMCID: PMC8065894 DOI: 10.3390/nu13041153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 02/05/2023] Open
Abstract
Unhealthy dietary patterns are associated with obesity in children and adolescents. However, few studies have investigated the relationships between dietary patterns and obesity-related metabolic disorders among Asians. We identified dietary patterns in children and adolescents and examined the associations between these patterns and obesity, insulin resistance, and metabolic syndrome in South Korea. This study is a cross-sectional design. We used baseline data from an intervention study of 435 Korean children and adolescents aged 6–17 years. Insulin resistance was assessed as HOMA-IR ≥ 2.6. Metabolic syndrome was diagnosed by cardiovascular disease risk factor clustering. Dietary intakes were estimated using 3-day food records. Factor analysis was used to obtain dietary patterns, and we examined the associations between dietary patterns and obesity-related markers adjusted for potential covariates. Three dietary patterns were identified as fast food and soda (FFS), white rice and kimchi (WRK), and oil and seasoned vegetable (OSV) patterns. Compared with participants in the lower intake of FFS pattern, those in the top intake were associated with a higher waist circumference (WC) (β = 1.55), insulin level (β = 1.25), and body mass index (BMI) (β = 0.53) and it was positively associated with HOMA-IR ≥ 2.6 (OR = 2.11; 95% CI: 1.227–3.638) (p < 0.05). WRK pattern was associated with lower weight and higher HDL cholesterol, and the OSV pattern was associated with a lower weight, WC, and insulin level (p < 0.05). The FFS pattern showed a positive relation with WC, serum insulin, and BMI, and the other two dietary patterns indicated a preventive effect of those parameters. The FFS pattern was associated with significantly elevated insulin resistance among children and adolescents.
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Affiliation(s)
- Seulki Oh
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yong-in 17104, Korea; (S.O.); (S.Y.L.)
| | - So Yeong Lee
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yong-in 17104, Korea; (S.O.); (S.Y.L.)
| | - Do-Yeon Kim
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Korea;
| | - Sarah Woo
- Department of Family Medicine, Hanllym University Sacred Heart Hospital, Anyang 14068, Korea;
| | - YoonMyung Kim
- University College, Yonsei University International Campus, Incheon 21983, Korea;
| | - Hye-Ja Lee
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Chungbuk 28159, Korea; (H.-J.L.); (H.B.J.); (S.I.P.)
| | - Han Byul Jang
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Chungbuk 28159, Korea; (H.-J.L.); (H.B.J.); (S.I.P.)
| | - Sang Ick Park
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Chungbuk 28159, Korea; (H.-J.L.); (H.B.J.); (S.I.P.)
| | - Kyung Hee Park
- Department of Family Medicine, Hanllym University Sacred Heart Hospital, Anyang 14068, Korea;
- Correspondence: (K.H.P.); (H.L.); Tel.: +82-31-380-3805 (K.H.P.); +82-31-201-2343 (H.L.)
| | - Hyunjung Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yong-in 17104, Korea; (S.O.); (S.Y.L.)
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Korea;
- Correspondence: (K.H.P.); (H.L.); Tel.: +82-31-380-3805 (K.H.P.); +82-31-201-2343 (H.L.)
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Abstract
We aimed to evaluate the association between eating context patterns and ultraprocessed food consumption at two main meal occasions in a representative sample of UK adolescents. Data were acquired from 4-d food records of adolescents aged 11-18 years, who participated in the 2014-2016 UK National Diet and Nutrition Survey (n 542). The eating context was assessed considering the location of the meal (lunch and dinner) occasion, the individuals present, whether the television was on and if the food was consumed at a table. Ultraprocessed foods were identified using the NOVA classification. Exploratory factor analysis was used to identify eating context patterns for lunch and dinner. Linear regression models adjusted for the covariates were utilised to test the association between eating context patterns and the proportion of total daily energy intake derived from ultraprocessed foods. Their contribution was about 67 % to energy intake. Three patterns were retained for lunch ('At school with friends', 'TV during family meal' and 'Out-of-home (no school)'), and three patterns were retained for dinner ('Watching TV alone in the bedroom', 'TV during family meal' and 'Out-of-home with friends'). At lunch, there was no significant association between any of the three patterns and ultraprocessed food consumption. At dinner, the patterns 'Watching TV alone in the bedroom' (coefficient: 4·95; 95 % CI 1·87, 8·03) and 'Out-of-home with friends' (coefficient: 3·13; 95 % CI 0·21, 6·14) were associated with higher consumption of ultraprocessed food. Our findings suggest a potential relationship between the immediate eating context and ultraprocessed food consumption by UK adolescents.
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Williams N, Mann G, Cafer A, Evers C, Kaiser K. “Bring back the salad bar”: perceptions of health in rural delta middle school students. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2021.1894298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Natalie Williams
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS 38677, USA
| | - Georgianna Mann
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS 38677, USA
| | - Anne Cafer
- University of Mississippi, University, MS 38677543, Lamar Hall, USA
| | - Charles Evers
- School of Medicine, 1670 University Blvd, University of Alabama, Birmingham, USA
| | - Kimberly Kaiser
- Department of Legal Studies, M302 Mayes, University of Mississippi, University, MS 38677, USA
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Patte KA, Cole AG, Qian W, Magier M, Vine M, Leatherdale ST. Are closed campus policies associated with adolescent eating behaviours? Health Promot Chronic Dis Prev Can 2021; 41:73-84. [PMID: 33688693 PMCID: PMC8011479 DOI: 10.24095/hpcdp.41.3.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The effectiveness of school nutrition regulations may be undermined by food environments surrounding schools. Given challenges in regulating external retail, some have recommended policies that ensure students are unable to leave school property during the day (closed campus policies; CCP). We aimed to examine whether CCP are associated with student eating behaviours. METHODS We used student and school-administrator survey data from the 60 610 Grades 9 to 12 students and 134 Canadian secondary schools that participated in Year 7 (2018/19) of the COMPASS study. Multiple ordinal regression models tested school CCP as a predictor of weekday dietary behaviours (0-5 days), controlling for student-level (grade, sex, spending money, ethnicity) and school-level (urbanicity, province, area median household income, vending machines) covariates. RESULTS CCP were reported by 16 schools. Students who attended CCP schools reported eating lunch purchased from fast food outlets or other restaurants and drinking sugar-sweetened beverages (SSBs; soft drinks and sports drinks; sweetened coffee or tea drinks) on fewer weekdays, but consumed snacks from school vending machines on more weekdays, relative to students at open campus schools. No significant differences were observed in student reports of eating home-packed or school cafeteria lunches or snacks purchased off-campus. CONCLUSION CCP may help improve adolescent diets by reducing SSB and lunchtime fast food consumption on weekdays; however, students already purchasing food may shift from off-campus to within-school options, highlighting the importance of ensuring healthy school food environments and encouraging students to bring home-prepared lunches. Future studies using experimental longitudinal designs are needed to determine the effect of CCP on various health behaviours and outcomes.
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Affiliation(s)
- Karen A Patte
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Adam G Cole
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Wei Qian
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Megan Magier
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Michelle Vine
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Fulkerson JA, Horning ML, Barr-Anderson DJ, Linde JA, Sidebottom AC, Lindberg R, Friend S, Flattum C, Freese RL. Universal childhood obesity prevention in a rural community: Study design, methods and baseline participant characteristics of the NU-HOME randomized controlled trial. Contemp Clin Trials 2021; 100:106160. [PMID: 33002598 PMCID: PMC8011038 DOI: 10.1016/j.cct.2020.106160] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 01/19/2023]
Abstract
Childhood obesity is a major health concern in the United States (US) and those living in rural communities are at higher risk than their urban counterparts. Few prevention trials have engaged whole families of school-age children in community settings, and none to date have promoted family meals, family activity and healthful home environments in rural settings through a rigorous, randomized controlled trial (RCT). The New Ulm at HOME (NU-HOME) study recruited 114 parent/child dyads in a two-arm (intervention versus wait-list control) RCT to test the efficacy of a family meals-focused program aimed to prevent excess weight gain among 7-10 year-old children in rural Minnesota. The NU-HOME program was adapted from a previously tested program for urban families through a unique community collaboration. The program included 7 monthly in-person sessions for all family members. Parents also participated in 4 motivational goal-setting phone calls. The primary outcome measures were age- and sex-adjusted child body mass index (BMI) z-score, percent body fat, and incidence of overweight and obesity post-intervention. Secondary outcomes included quality of food and beverage availability in the home; family meals and snacks; children's dietary intake quality (e.g., Healthy Eating Index (HEI)-2015, fruits and vegetables, sugar-sweetened beverages, snacks); and children's screen time and weekly minutes of moderate-to-vigorous physical activity, total physical activity, and sedentary behavior. The NU-HOME RCT was a collaborative effort of academic and health system researchers, interventionists and community leaders that aimed to prevent childhood obesity in rural communities through engagement of the whole family in an interactive intervention.
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Affiliation(s)
- Jayne A Fulkerson
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
| | - Melissa L Horning
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
| | - Daheia J Barr-Anderson
- School of Kinesiology, University of Minnesota, 1900 University Ave SE, Cooke Hall 209, Minneapolis, MN 55455, USA.
| | - Jennifer A Linde
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2(nd) St., Suite 300, Minneapolis, MN 55454, USA.
| | - Abbey C Sidebottom
- Care Delivery Research, Allina Health, 710 East 24(th) Street, MR 43402, Minneapolis, MN 55404, USA.
| | - Rebecca Lindberg
- Minneapolis Heart Institute Foundation, 920 East 28(th) Street, Suite 100, Minneapolis, MN 55407, USA
| | - Sarah Friend
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
| | - Colleen Flattum
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2(nd) St., Suite 300, Minneapolis, MN 55454, USA.
| | - Rebecca L Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, 717 Delaware Street, SE, Minneapolis, MN 55414, USA.
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Examining the consumer restaurant environment and dietary intake in children. Prev Med Rep 2020; 20:101274. [PMID: 33354495 PMCID: PMC7744926 DOI: 10.1016/j.pmedr.2020.101274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/09/2020] [Accepted: 11/24/2020] [Indexed: 12/03/2022] Open
Abstract
Within the away-from-home food environment there is a need to account for individual exposure (e.g., frequency of visitation) to that environment. The present study examined the consumer environment in both proximal and visited restaurants and their association with childrens’ diet quality and anthropometrics. A cross-sectional analysis used baseline data from the Neighborhood Impact on Kids (NIK) study (2007–2009). Participants were 6–12-year-olds living in King County, WA and San Diego County, CA. This analysis (conducted 2019–2020) examined relationships between nearby restaurant count, Nutrition Environment Measures Survey in Restaurants (NEMS-R) within the child’s block group, and weighted NEMS-R scores based on the restaurant where the child ate most frequently in relation to child energy intake, Healthy Eating Index (HEI-2010) total score and anthropometrics. Children’s HEI-2010 scores were associated with NEMS-R scores within block groups, with children in the lowest NEMS-R tertile having significantly higher HEI scores than participants in the middle tertile. Weighted NEMS-R scores were significantly associated with waist circumference, with children in the highest NEMS-R tertile having a lower waist circumference than children in the lowest tertile. Nearby restaurant count was not associated with children’s diet quality or anthropometrics. Our findings suggest the relationship between nutrition environment and child diet and anthropometrics varied depending on how nutrition environment was defined. However, findings may be limited by the low frequency of eating out reported in this sample. Food environment measures that account for individual-level behavior are needed to better understand the influence of food environments on diet and anthropometrics
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O'Mahony B, Kerins C, Murrin C, Kelly C. Barriers and facilitators to the implementation of nutrition standards for school food: a mixed methods systematic review protocol. HRB Open Res 2020; 3:20. [DOI: 10.12688/hrbopenres.13041.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 11/20/2022] Open
Abstract
Background: The importance of nutrition during childhood and the high prevalence of child and adolescence obesity has resulted in several countries implementing nutritional standards for school food as a way of providing healthy school food environments. Yet there has been less focus on the barriers and facilitators influencing the process of implementing school food standards. This mixed methods systematic review aims to address this evidence gap by synthesising the empirical evidence on the factors that may influence implementation of school food standards. Methods: This mixed methods systematic review will use qualitative, quantitative and mixed methods evidence from peer reviewed publications retrieved from the following databases; PubMed, CINAHL, Scopus, EMBASE, Medline, PsycINFO and Web of Science. Grey literature will be accessed through Google Scholar, Open Access Theses and Dissertations, OpenGrey, RIAN, EThOS, ProQuest, WorldCat, Networked Digital Library of Theses and Dissertations, and public health organisation websites will also be accessed. Screening reference lists and citation chaining of all included studies will also be undertaken. No restrictions on publication date or language will be applied, however, only primary research studies relevant to supply-side stakeholders will be eligible for inclusion. Study quality will be assessed using the Mixed Methods Appraisal Tool. Study titles and abstracts will be screened to decide whether the full text manuscript should be retrieved. For screening reliability, a second review author will assess a random sample of 20%. Kappa statistics will be used to assess inter-rater reliability, with values of 0.75 and higher representing high agreement. Two authors will independently extract data and factors reported to influence implementation. This will be synthesized using the Theoretical Domains Framework. Discussion: A comprehensive understanding of these factors can provide guidance to relevant stakeholders to enhance the adaption, implementation and sustainability of nutrition standards for school meals. Systematic review registration: PROSPERO CRD42019117904
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Savage JS, Adams EL, Rollins BY, Bleser JA, Marini ME. Teaching families to manage intake of candy in the home: Results from a feasibility study using multiphase optimization strategy (MOST). Obes Sci Pract 2020; 6:649-659. [PMID: 33354343 PMCID: PMC7746962 DOI: 10.1002/osp4.446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/07/2020] [Accepted: 07/26/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Excess intake of desserts/sweets high in added sugars, such as candy, is linked with greater obesity risk. Parents often limit their childrens' intake of these sweet foods using controlling feeding practices, such as restriction; yet, restrictive feeding practices are counterproductive for childrens' self-regulation of energy intake. OBJECTIVE This study developed a family-based behavioural intervention that taught parents alternatives to restrictive feeding practices and encouraged children to consume candy in moderation. METHODS Using the multiphase optimization strategy (MOST), parent-child dyads (N = 37) were randomized into one of eight conditions that included a combination of intervention components delivered over 4 weeks: home supply, parent shared decision making, child mindfulness and child attention control strategies. RESULTS Retention rate at follow-up was high (95%). Among parents who received parent shared decision making, 86.4% reported the structured-based candy routine they set with their child was easy to follow. Most children reported child mindfulness (95%) and attention control (89.5%) strategies were easy to play. Children recalled 4.1 ± 1.8 of the six mindfulness strategies and 2.7 ± 1.6 of the five attention control strategies at follow-up. Eating in the absence of hunger tended to be lower for children who received parent shared decision making and child mindfulness components. CONCLUSION This intervention was feasible and well-implemented in the home environment. Findings will inform future, larger interventions designed to test similar strategies on childrens; eating behaviours and self-regulation.
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Affiliation(s)
- J. S. Savage
- Center for Childhood Obesity ResearchPenn State UniversityUniversity ParkPennsylvaniaUSA
- Department of Nutritional SciencesPenn State UniversityUniversity ParkPennsylvaniaUSA
| | - E. L. Adams
- Center for Childhood Obesity ResearchPenn State UniversityUniversity ParkPennsylvaniaUSA
- Department of Nutritional SciencesPenn State UniversityUniversity ParkPennsylvaniaUSA
| | - B. Y. Rollins
- Center for Childhood Obesity ResearchPenn State UniversityUniversity ParkPennsylvaniaUSA
| | - J. A. Bleser
- Center for Childhood Obesity ResearchPenn State UniversityUniversity ParkPennsylvaniaUSA
| | - M. E. Marini
- Center for Childhood Obesity ResearchPenn State UniversityUniversity ParkPennsylvaniaUSA
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Habbab RM, Bhutta ZA. Prevalence and social determinants of overweight and obesity in adolescents in Saudi Arabia: A systematic review. Clin Obes 2020; 10:e12400. [PMID: 32827192 DOI: 10.1111/cob.12400] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/02/2020] [Accepted: 07/26/2020] [Indexed: 11/29/2022]
Abstract
Obesity in adolescents has a serious impact later in life in the form of disturbances in health and wellbeing. We aimed to evaluate the prevalence of overweight and obesity (Ow/Ob) in Saudi adolescents and to construct an ecological model of social determinants (SDs) of Ow/Ob and evaluate current evidence of their effect on Saudi adolescents. A systematic review of literature reported up until 31 December 2018 on Ow/Ob and factors that can influence them in Saudi adolescents was conducted. Fifty-one studies with n = 97 666 adolescents (55.6% males) were reviewed. The prevalence of Ow/Ob started off high and continued to increase over time. Most of the 49 reviewed SDs reports, from 19 studies, showed positive association between SDs constructed ecological model and Ow/Ob in Saudi adolescents. The prevalence of Ow/Ob among adolescents is a major public health problem in Saudi Arabia, is growing at an alarming rate and SDs play a significant role in this problem, and should be considered in all strategies targeting it. The constructed ecological model for SDs of Ow/Ob in adolescents can serve as a useful exploratory tool that helps investigating the multi-faceted aetiology of adolescent Ow/Ob and facilitates the development of effective intervention and prevention programmes.
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Affiliation(s)
- Reem M Habbab
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Clinical Nutrition, Ministry of National Guard Health Affairs, King Abdullah Specialized Children's Hospital, Riyadh, Saudi Arabia
| | - Zulfiqar A Bhutta
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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Abstract
OBJECTIVE To determine nutritional adequacy of school lunch and to assess the impact of food waste on nutrient intake of primary schoolchildren. DESIGN The weighing method was used for evaluating initial servings and plate waste for lunch. Energy and nutritional contents of meals served, consumed and wasted were estimated using the software Food Processor Plus. The mean nutritional value of food served and consumed was compared with dietary guidelines. SETTING Portuguese public primary schools in the city of Porto. PARTICIPANTS All 525 fourth-grade children, aged from 9 to 10 years old, attending to twenty-one public primary schools. RESULTS Overall, school lunches served did not meet the dietary guidelines for energy and nutrients, as only 12·5 % of the evaluated meals were adequate for energy, 33·5 % for proteins, 11·9 % for carbohydrates and 57·1 % for lipids. The majority of meals served were below the age-specific lower limit, namely for energy (83·7 %) and carbohydrates (86·8 %). The only exception, also unbalanced, was observed for proteins, as 42·4 % of lunches served exceeded the recommended upper limit. Furthermore, lunches served and consumed by children did not meet the dietary guidelines for fibre and for the micronutrients evaluated. Children wasted 26 % of the energy content provided in lunches, corresponding to 91·5 kcal, 25 % of proteins and 29 % of carbohydrates supplied. CONCLUSIONS The lunches served and consumed by children at school canteens failed to meet nutritional standards. These results are not only a consequence of inadequate food portions served but also a result of the high plate waste values observed.
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Mohammadi S, Su TT, Jalaludin MY, Dahlui M, Azmi Mohamed MN, Papadaki A, Jago R, Toumpakari Z, Majid HA. School-Based Intervention to Improve Healthy Eating Practices Among Malaysian Adolescents: A Feasibility Study Protocol. Front Public Health 2020; 8:549637. [PMID: 33072694 PMCID: PMC7536333 DOI: 10.3389/fpubh.2020.549637] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/19/2020] [Indexed: 01/15/2023] Open
Abstract
Introduction: School environments can influence students' dietary habits. Hence, implementing a healthy canteen intervention programme in schools is a recommended strategy to improve students' dietary intake. This study will evaluate the feasibility of providing healthier food and beverage options in selected secondary schools in Malaysia by working with canteen vendors. It also will assess the changes in food choices before and after the intervention. Methods: A feasibility cluster randomised controlled study will be conducted in six secondary schools (intervention, n = 4; control, n = 2) comprising of rural and urban schools located in Selangor and Perak states in Malaysia. Four weeks of intervention will be conducted among Malaysian adolescents aged 15 years old. Two interventions are proposed that will focus on providing healthier food options in the canteen and convenience shops in the selected schools. Interventions 1 and 2 will entail training the canteen and school convenience shop operators. Intervention 2 will be applied to subsidise the cost of low energy-dense kuih (traditional cake), vegetables, and fruits. The control group will continue to sell the usual food. Trained dietitians will audit the canteen menu and food items sold by the school canteen and convenience shops in all schools. Anthropometric measurements, blood pressure and dietary assessment will be collected at baseline and at the end of 4-week intervention. Focus group discussions with students and in-depth interviews with headmasters, teachers, and school canteen operators will be conducted post-intervention to explore intervention acceptability. Under this Healthy School Canteen programme, school canteens will be prohibited from selling “red flag” foods. This refers to foods which are energy-dense and not nutritious, such as confectionery and deep-fried foods. They will also be prohibited from selling soft drinks, which are sugar-rich. Instead, the canteens will be encouraged to sell “green flag” food and drinks, such as fruits and vegetables. Conclusion: It is anticipated that this feasibility study can provide a framework for the conception and implementation of nutritional interventions in a future definitive trial at the school canteens in Malaysia.
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Affiliation(s)
- Shooka Mohammadi
- Department of Social and Preventive Medicine, Faculty of Medicine, Centre of Population Health, University of Malaya, Kuala Lumpur, Malaysia
| | - Tin Tin Su
- Department of Social and Preventive Medicine, Faculty of Medicine, Centre of Population Health, University of Malaya, Kuala Lumpur, Malaysia.,South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | | | - Maznah Dahlui
- Department of Social and Preventive Medicine, Faculty of Medicine, Centre of Population Health, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Nahar Azmi Mohamed
- Department of Sports Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Zoi Toumpakari
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Hazreen A Majid
- Department of Social and Preventive Medicine, Faculty of Medicine, Centre of Population Health, University of Malaya, Kuala Lumpur, Malaysia.,Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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Blondin SA, AlSukait R, Bleiweiss-Sande R, Economos CD, Tanskey LA, Goldberg JP. Processed and Packed: How Refined Are the Foods That Children Bring to School for Snack and Lunch? J Acad Nutr Diet 2020; 121:883-894. [PMID: 33023852 DOI: 10.1016/j.jand.2020.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Increasing consumption of highly processed foods has been associated with adverse health outcomes among children. In the US, children consume up to half of their daily energy intake at school. OBJECTIVES We sought to characterize foods that children bring from home to school according to processing level and to evaluate the effectiveness of a school-based intervention, Great Taste Less Waste (GTLW), in reducing the proportion of energy brought from highly processed foods from home compared with control. DESIGN Secondary data analysis of a 7-month school-based, cluster-randomized trial. PARTICIPANTS/SETTING Third- and fourth-grade students (n = 502, mean age: 9.0 ± 0.62 years) at 10 public elementary schools in Eastern Massachusetts (school year 2012-2013). INTERVENTION GTLW included a 22-lesson classroom curriculum, homework activities, monthly parent newsletters, a food shopping and packing guide for parents, food demonstrations, school-wide announcements, and a poster contest. MAIN OUTCOME MEASURES The energy content of foods brought to school was estimated from digital photographs, and foods were assigned to 1 of 3 processing levels (less processed or unprocessed, moderately processed, or highly processed) based on an established classification system. STATISTICAL ANALYSES PERFORMED The percentage of energy brought from foods categorized into each processing level was calculated and compared pre- and postintervention using hierarchical linear models. RESULTS Most of the food brought from home to school was highly processed (70% of food energy brought). Foods categorized as snack foods and desserts contributed the greatest percentage of total energy to the highly processed category at baseline and follow-up (72% and 69%, respectively). Energy from foods brought for snack tended to be more highly processed than those brought for lunch. No significant differences were observed from pre- to postintervention in the GTLW group compared with control for the percentage of energy brought from highly processed foods in adjusted models (β: -1.1, standard error: 2.2, P = .6) or any other processing level. CONCLUSIONS Highly processed foods were prevalent in home-packed lunches and snacks, and these patterns persisted after a targeted intervention. Further research is needed to identify strategies to improve the healthfulness of foods brought from home to school.
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Tan ML, Laraia B, Madsen KA, Johnson RC, Ritchie L. Community Eligibility Provision and School Meal Participation among Student Subgroups. THE JOURNAL OF SCHOOL HEALTH 2020; 90:802-811. [PMID: 32754916 DOI: 10.1111/josh.12942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/07/2020] [Accepted: 05/26/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The National School Lunch and Breakfast Programs help to reduce food insecurity and improve nutrition. The Community Eligibility Provision (CEP) enables high-poverty schools to offer breakfast and lunch at no cost to all students. This study examines associations between CEP and participation among students eligible for free or reduced-price meals ("FRPM"), possibly eligible ("near-cutoff"), or ineligible ("full-price"). METHODS Using data from the 2013-2015 Healthy Communities Study, we compared school breakfast and lunch participation between 842 students in K-8 at 80 CEP schools and 1463 students at 118 schools without CEP. Cross-sectional difference-in-difference (DID) models compared meal participation among near-cutoff and full-price groups to that in the FRPM group. RESULTS Overall, FRPM students had high participation in school lunch and breakfast at both types of schools. In adjusted DID models, lunch participation among near-cutoff students was 12 points higher in CEP versus comparison schools (p < .05). Among full-price students, breakfast participation was 20 points higher and lunch participation 19 points higher in CEP than comparison schools (p < .001). CONCLUSIONS Community Eligibility Provision improves access to school breakfast and lunch in high-poverty schools, particularly for students who are near or above the cutoff for FRPM eligibility.
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Affiliation(s)
- May Lynn Tan
- Assistant Deputy Director, , Evidence for Action, University of California, San Francisco, 3333 California Street Suite 465, San Francisco, CA 94118
| | - Barbara Laraia
- Professor, , University of California, Berkeley School of Public Health, 2121 Berkeley Way, Berkeley, CA 94720
| | - Kristine A Madsen
- Associate Professor, , University of California, Berkeley School of Public Health, 2121 Berkeley Way, Berkeley, CA 94720
| | - Rucker C Johnson
- Chancellor's Professor, , University of California, Berkeley Goldman School of Public Policy, 2607 Hearst Ave, Berkeley, CA 94720
| | - Lorrene Ritchie
- Director and Cooperative Extension Specialist, , University of California Agriculture and Natural Resources, 1111 Franklin St, 10th Floor, 10123, Oakland, CA, 94607
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Ortega A, Bejarano CM, Cushing CC, Staggs VS, Papa AE, Steel C, Shook RP, Sullivan DK, Couch SC, Conway TL, Saelens BE, Glanz K, Frank LD, Cain KL, Kerr J, Schipperijn J, Sallis JF, Carlson JA. Differences in adolescent activity and dietary behaviors across home, school, and other locations warrant location-specific intervention approaches. Int J Behav Nutr Phys Act 2020; 17:123. [PMID: 32993715 PMCID: PMC7526379 DOI: 10.1186/s12966-020-01027-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/16/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Investigation of physical activity and dietary behaviors across locations can inform "setting-specific" health behavior interventions and improve understanding of contextual vulnerabilities to poor health. This study examined how physical activity, sedentary time, and dietary behaviors differed across home, school, and other locations in young adolescents. METHODS Participants were adolescents aged 12-16 years from the Baltimore-Washington, DC and the Seattle areas from a larger cross-sectional study. Participants (n = 472) wore an accelerometer and Global Positioning Systems (GPS) tracker (Mean days = 5.12, SD = 1.62) to collect location-based physical activity and sedentary data. Participants (n = 789) completed 24-h dietary recalls to assess dietary behaviors and eating locations. Spatial analyses were performed to classify daily physical activity, sedentary time patterns, and dietary behaviors by location, categorized as home, school, and "other" locations. RESULTS Adolescents were least physically active at home (2.5 min/hour of wear time) and school (2.9 min/hour of wear time) compared to "other" locations (5.9 min/hour of wear time). Participants spent a slightly greater proportion of wear time in sedentary time when at school (41 min/hour of wear time) than at home (39 min/hour of wear time), and time in bouts lasting ≥30 min (10 min/hour of wear time) and mean sedentary bout duration (5 min) were highest at school. About 61% of daily energy intake occurred at home, 25% at school, and 14% at "other" locations. Proportionately to energy intake, daily added sugar intake (5 g/100 kcal), fruits and vegetables (0.16 servings/100 kcal), high calorie beverages (0.09 beverages/100 kcal), whole grains (0.04 servings/100 kcal), grams of fiber (0.65 g/100 kcal), and calories of fat (33 kcal/100 kcal) and saturated fat (12 kcal/100 kcal) consumed were nutritionally least favorable at "other" locations. Daily sweet and savory snacks consumed was highest at school (0.14 snacks/100 kcal). CONCLUSIONS Adolescents' health behaviors differed based on the location/environment they were in. Although dietary behaviors were generally more favorable in the home and school locations, physical activity was generally low and sedentary time was higher in these locations. Health behavior interventions that address the multiple locations in which adolescents spend time and use location-specific behavior change strategies should be explored to optimize health behaviors in each location.
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Affiliation(s)
- Adrian Ortega
- Clinical Child Psychology Program and Schiefelbusch Institute for Life Span Studies, University of Kansas, 1000 Sunnyside Avenue, Lawrence, Kansas, USA
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, 610 E. 22nd Street, Kansas City, MO, USA
| | - Carolina M Bejarano
- Clinical Child Psychology Program and Schiefelbusch Institute for Life Span Studies, University of Kansas, 1000 Sunnyside Avenue, Lawrence, Kansas, USA
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, 610 E. 22nd Street, Kansas City, MO, USA
| | - Christopher C Cushing
- Clinical Child Psychology Program and Schiefelbusch Institute for Life Span Studies, University of Kansas, 1000 Sunnyside Avenue, Lawrence, Kansas, USA
| | - Vincent S Staggs
- Biostatistics & Epidemiology, Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, USA
| | - Amy E Papa
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, 610 E. 22nd Street, Kansas City, MO, USA
| | - Chelsea Steel
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, 610 E. 22nd Street, Kansas City, MO, USA
| | - Robin P Shook
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, 610 E. 22nd Street, Kansas City, MO, USA
| | - Debra K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Sarah C Couch
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Terry L Conway
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Brian E Saelens
- Department of Pediatrics, University of Washington & Seattle Children's Research Institute, Seattle, Washington, USA
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Lawrence D Frank
- School of Community and Regional Planning, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelli L Cain
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - James F Sallis
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Jordan A Carlson
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, 610 E. 22nd Street, Kansas City, MO, USA.
- School of Medicine, University of Missouri-Kansas City, Kansas City, USA.
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Farhangi MA, Nikniaz L, Khodarahmi M. Sugar-sweetened beverages increases the risk of hypertension among children and adolescence: a systematic review and dose-response meta-analysis. J Transl Med 2020; 18:344. [PMID: 32891165 PMCID: PMC7487688 DOI: 10.1186/s12967-020-02511-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/27/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In the current systematic review and meta-analysis, we summarized the studies that evaluated the effects of sugar-sweetened beverages (SSBs) intake on blood pressure among children and adolescents. METHODS In a systematic search from PubMed, Scopus, Embase and Cochrane electronic databases up to 20 April 2020, the observational studies that evaluated the association between sugar-sweetened beverages intake and hypertension, systolic or diastolic blood pressure (SBP, DBP) were retrieved. RESULTS A total of 14 studies with 93873 participants were included in the current meta-analysis. High SSB consumption was associated with 1.67 mmHg increase in SBP in children and adolescents (WMD: 1.67; CI 1.021-2.321; P < 0.001). The difference in DBP was not significant (WMD: 0.313; CI -0.131- 0.757; P = 0.108). High SSB consumers were 1.36 times more likely to develop hypertension compared with low SSB consumers (OR: 1.365; CI 1.145-1.626; P = 0.001). In dose-response meta-analysis, no departure from linearity was observed between SSB intake and change in SBP (P-nonlinearity = 0.707) or DBP (P-nonlinearity = 0.180). CONCLUSIONS According to our finding, high SSB consumption increases SBP and hypertension in children and adolescents.
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Affiliation(s)
| | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Khodarahmi
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
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Kolahdooz F, Nader F, Jang SL, McKeen J, Daemi M, Johnston N, Sharma S. Dietary Adequacy among Multi-Ethnic Urban Youth in Edmonton: Findings from the Wellness and Health in Youth - Aboriginal and All Communities in Transition NOW (WHY ACT NOW) Project. J Am Coll Nutr 2020; 40:535-544. [PMID: 32804593 DOI: 10.1080/07315724.2020.1805042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The development of obesity and chronic diseases in adulthood often results from a childhood pattern of dietary excesses. This study aimed to identify dietary inadequacies and excesses of multiethnic youth in Edmonton. METHODS A cross-sectional survey of a convenience sample of 473 multiethnic youth between 11 and 18 years was conducted in 12 schools in Edmonton between October 2013 and March 2014. Data were analyzed to determine for each participant mean daily energy and nutrient intakes, dietary adequacy, and nutrient densities. Participants were divided by self-identified ethnicity (Indigenous, European, African and Middle Eastern, and Asian). RESULTS For all nutrients examined, the mean percentage of calories from fat was higher among European (31.7%) and Indigenous youth (31.8%) compared to African and Middle Eastern (28.3%) and Asian youth (29.0%), while Asian youth had the highest percentage of calories from protein (17.7%) compared to other ethnic groups (Indigenous = 15.5%; African & Middle Eastern = 16.5%; European = 16.2%). The majority of youth fell below the recommended values for dietary fiber (83.3-92.0%), vitamins D (84.4-90.2%), and E (89.5-92.0%). More than 50% fell below the dietary reference intakes (DRIs) for vitamin A, vitamin B5, calcium, and magnesium; >30% were below the DRI for folate, zinc, and vitamins B6, and C. The diet of girls contained a greater density of fiber compared to boys (9.3 vs. 8.0 g/1000 kcal; p-value = 0.002). CONCLUSIONS Inadequate dietary intake is evident among the majority of multiethnic youth in Edmonton. There is a need to develop strategies to reduce the burden of poor nutrition status for youth.
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Affiliation(s)
- Fariba Kolahdooz
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Forouz Nader
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Se Lim Jang
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jennifer McKeen
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Maryam Daemi
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Nora Johnston
- Alberta Centre for Active Living, University of Alberta, Edmonton, AB, Canada
| | - Sangita Sharma
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Vatanparast H, Islam N, Masoodi H, Shafiee M, Patil RP, Smith J, Whiting SJ. Time, location and frequency of snack consumption in different age groups of Canadians. Nutr J 2020; 19:85. [PMID: 32799862 PMCID: PMC7429728 DOI: 10.1186/s12937-020-00600-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/31/2020] [Indexed: 01/06/2023] Open
Abstract
Background The location and time of snack consumption may influence the composition, nutrient content and portion sizes of snacks. In this study, we aimed to determine and compare the time, location and frequency of snack consumption among different age groups of Canadians. Methods Nationally representative dietary data from the 2015 Canadian Community Health Survey (CCHS) were used (19,677 participants aged ≥2 years). Dietary data were obtained using 24-h dietary recalls. Participants were categorized according to the frequency of snack consumption (1 time, 2–3 times, ≥4 times). The snack consumption over 24 h was divided into four time periods: before 10 am, 10 am to 3 pm, 3 pm to 8 pm and 8 pm to 12 am. Meal and snack location was categorized as at home; someone else’s home; restaurants; and other. Results Snacking 2–3 times per day was the most common reported frequency (53.0%). Snacking at home (73.0%) was more prevalent than snacking away from home (27.0%). The most frequently reported time for snacking among Canadians was 3 pm to 8 pm (36.3%), and the least frequently reported time was before 10 am (8.1%). Snacking contributed to a high proportion of Milk and Alternatives (23.7%) and Vegetables and Fruit (23.4%) food groups and lesser proportions of Grain Products (15.4%) and Meat & Alternatives (9.4%) food groups among Canadians. Conclusions Home is the main location, 3 pm to 8 pm is the main time, and 2–3 times per day is the most common reported frequency for snacking. A full understanding of snacking behaviors is needed in order to develop targeted strategies to improve the quality of snack food choices.
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Affiliation(s)
- Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada. .,School of Public Health, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada.
| | - Naorin Islam
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada
| | | | - Mojtaba Shafiee
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada
| | - Rashmi Prakash Patil
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada
| | - Jessica Smith
- Bell Institute of Health and Nutrition, General Mills, Minneapolis, MN, 55427-3870, USA
| | - Susan J Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada
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Bardin S, Washburn L, Gearan E. Disparities in the Healthfulness of School Food Environments and the Nutritional Quality of School Lunches. Nutrients 2020; 12:E2375. [PMID: 32784416 PMCID: PMC7468741 DOI: 10.3390/nu12082375] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/31/2020] [Accepted: 08/05/2020] [Indexed: 01/18/2023] Open
Abstract
The Healthy, Hunger-Free Kids Act (HHFKA), a public law in the United States passed in 2010, sought to improve the healthfulness of the school food environment by requiring updated nutrition standards for school meals and competitive foods. Studies conducted since the passage of the HHFKA indicate improvements in the food environment overall, but few studies have examined whether these improvements varied by the socioeconomic and racial/ethnic composition of students in schools. To better understand the extent of disparities in the school food environment after HHFKA, this paper examined differences in the healthfulness of school food environments and the nutritional quality of school lunches by the school poverty level and racial/ethnic composition of students using data from the School Nutrition and Meal Cost Study. Results from chi-square analyses showed lower proportions of high poverty, majority black, and majority Hispanic schools had access to competitive foods, while higher proportions of these schools had a school wellness policy in addition to a district wellness policy. The overall nutritional quality of school lunches, as measured by total Healthy Eating Index (HEI)-2010 scores, did not vary significantly across school types, although some HEI component scores did. From these findings, we concluded that there were disparities in the school food environment based on the socioeconomic and racial/ethnic composition of students in schools, but no significant disparities in the overall nutritional quality of school lunches were found.
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Affiliation(s)
- Sarah Bardin
- Mathematica, 955 Massachusetts Avenue, Suite 801, Cambridge, MA 02139, USA;
| | - Liana Washburn
- Mathematica, 1100 First Street, NE, 12th Floor, Washington, DC 20002, USA;
| | - Elizabeth Gearan
- Mathematica, 955 Massachusetts Avenue, Suite 801, Cambridge, MA 02139, USA;
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Franse CB, Boelens M, Fries LR, Constant F, van Grieken A, Raat H. Interventions to increase the consumption of water among children: A systematic review and meta-analysis. Obes Rev 2020; 21:e13015. [PMID: 32167233 PMCID: PMC7317453 DOI: 10.1111/obr.13015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 02/21/2020] [Indexed: 12/17/2022]
Abstract
The aim of this study was to conduct a systematic review and meta-analysis on the effectiveness of interventions to increase children's water consumption. A systematic literature search was conducted in seven electronic databases. Studies published in English before 18 February 2019 that evaluated any type of intervention that measured change in water consumption among children aged 2 to 12 years by applying any type of design were included. Of the 47 interventions included in the systematic review, 24 reported a statistically significant increase in water consumption. Twenty-four interventions (17 randomized controlled trials and seven studies with other controlled designs) were included in the meta-analysis. On average, children in intervention groups consumed 29 mL/d (confidence interval [CI] = 13-46 mL/d) more water than did children in control groups. This effect was larger in eight interventions focused specifically on diet (MD = 73 mL/d, CI = 20-126 mL/d) than in 16 interventions focused also on other lifestyle factors (MD = 15 mL/d, CI = 1-29 mL/d). Significant subgroup differences were also found by study setting and socioecological level targeted but not by children's age group, intervention strategy, or study design. In conclusion, there is evidence that, on average, lifestyle interventions can lead to small increases in children's daily water consumption. More research is needed to further understand the specific intervention elements that have the greatest effect.
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Affiliation(s)
- Carmen B. Franse
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | - Mirte Boelens
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | | | | | - Amy van Grieken
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | - Hein Raat
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
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Rasyidah G, Wafa SW. A quantitative assessment of school environment as viewed by teachers. Heliyon 2020; 6:e04059. [PMID: 32551377 PMCID: PMC7292914 DOI: 10.1016/j.heliyon.2020.e04059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/15/2019] [Accepted: 05/20/2020] [Indexed: 11/25/2022] Open
Abstract
Background There is evidence suggesting that the school environment does have prominent contributions to the rise of childhood obesity. Aim The objective of this study was to assess the school environment by interviewing the teachers and compare the school environment score between rural and urban schools in Terengganu, Malaysia. Methods Thirty-two teachers from 16 primary schools in Terengganu were interviewed using a set of validated Malay version “School Environmental Mapping” questionnaire. A total of 76 items consisting of four domains of school environment factor: physical (what is available) with 41 items; economic (what the costs are) with nine items; political (what the rules are) with nine items; and socio-cultural (what the attitudes and beliefs are) with 17 items. Every item was questioned using an initial closed question followed by an open question when the criteria were not met or need further information regarding those particular items. Results The present study revealed that the school environment of school in state of Terengganu is still low and not satisfied. Based on the schoolteacher's information and observation, there are significant barriers to promoting healthy eating and physical activity at school e.g. limited financial and budget allocation; lack of school facilities; lack of manpower to organise and monitor the programme; lack of participation and cooperation from parents; and no enforcement and serious action from authorized personnel on street hawkers near the school. This is reflected by the score achieved for 16 schools in Terengganu was only 63.05%. The political environment indicated the highest score among the domains, which was 77.78%, whereas, the lowest score was an economic environment (50.00%). Upon comparing between the urban and rural areas, the present study reported that there was a significant difference between school settings (p < 0.001) for an overall school environment, in which the rural areas had a significantly higher score than urban counterparts (64.86% vs 59.34%, p < 0.001). For each domain of the school environment, the findings showed that only two domains (physical and political environment) were significantly different between school settings. Conclusion This study revealed that the level of a healthy school environment among schools in both settings is still not satisfied. Addressing the obesogenic elements of school environments is one of the strategies in prevention since the school environments exert a great influence on children's behaviour.
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Affiliation(s)
- G Rasyidah
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Kuala Nerus, Terengganu, Malaysia
| | - S W Wafa
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Kuala Nerus, Terengganu, Malaysia
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Wafa SW, Ghazalli R. Association between the school environment and children's body mass index in Terengganu: A cross sectional study. PLoS One 2020; 15:e0232000. [PMID: 32330177 PMCID: PMC7182194 DOI: 10.1371/journal.pone.0232000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 03/26/2020] [Indexed: 12/01/2022] Open
Abstract
With the on-going interest in implementing school policies to address the problem of childhood obesity in Malaysia, there is urgent need for information about the association between school environment and children’s weight status. This study aims to investigate the association between school environmental factors (physical, economic, political and sociocultural) with BMI of school children in Terengganu. The school environment factors were assessed using a set of validated whole-school environmental mapping questionnaires, consisting of 76 criteria with four domains; physical environment (41 criteria), economic environment (nine criteria), political environment (nine criteria) and sociocultural environment (17 criteria). This involved face-to-face interview sessions with 32 teachers from 16 schools (eight rural and eight urban). In addition, 400 school children aged between 9 and 11 years of the selected schools were assessed for BMI (WHO 2007 reference chart), dietary intake (food frequency questionnaire (FFQ)) and physical activity level (physical activity questionnaire for children (PAQ-C)). Multiple regression was used to examine the association between school environment factors and BMI of the school children. Seven school environment criteria were found to be associated with BMI of school children when it was adjusted for calorie intake and physical activity level. About 33.4% of the variation in BMI of school children was explained by health professional involvement, simple exercise before class, encouragement to walk/ride bicycle to/from school, no high-calorie food sold, healthy options of foods and drinks at tuck shop, availability of policy on physical activity and training teacher as a role model. Policy makers should make urgent actions to address the obesogenic features of school environments. It should strive towards setting up healthy school environment and improving school curricula to promote healthy behaviours among the school children.
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Affiliation(s)
- Sharifah Wajihah Wafa
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
- * E-mail:
| | - Rasyidah Ghazalli
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
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Enablers and barriers to implementation of and compliance with school-based healthy food and beverage policies: a systematic literature review and meta-synthesis. Public Health Nutr 2020; 23:2840-2855. [PMID: 32317047 DOI: 10.1017/s1368980019004865] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Schools have been recognised as a potential setting for improving young peoples' food and beverage choices; however, many schools fail to adhere to healthy food and beverage policy standards. The current study aimed to explore the enablers and barriers to effective implementation of and compliance with school-based food and beverage policies. DESIGN Systematic review and meta-synthesis. Eight electronic databases were searched for articles in June 2019. Studies were eligible for inclusion if they reported on implementation and/or compliance of school-based food and/or beverage policies with outcomes relating to enablers and/or barriers. This review had no restrictions on study design, year of publication or language. Seventy-two full-text articles were assessed for eligibility, of which twenty-eight were included in this review. SETTING Studies conducted globally that focused on schools. PARTICIPANTS School-based healthy food and beverage policies. RESULTS Financial (cost of policy-compliant foods, decreased profit and revenue), physical (availability of policy-compliant foods, close geographical proximity to unhealthy food outlets) and social (poor knowledge, understanding, and negative stakeholders' attitudes towards policy) factors were the most frequently reported barriers for policy implementation. Sufficient funding, effective policy communication and management, and positive stakeholders' attitudes were the most frequently reported enablers for policy implementation. CONCLUSIONS There is a need for better communication strategies, financial and social support prior to school-based food policy implementation. Findings of this review contribute to a thorough understanding of factors that underpin best practice recommendations for the implementation of school-based food policy, and inform those responsible for improving public health nutrition.
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