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Improving adolescents' dietary behaviours in the school-setting: challenges and opportunities. Proc Nutr Soc 2023:1-14. [PMID: 36916515 DOI: 10.1017/s0029665123002197] [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: 02/16/2023]
Abstract
Adolescence is a critical time of physical, psychological and social development, and thus, optimal nutritional intakes are required during this life stage. Despite this, adolescence is recognised as a period of nutritional vulnerability, with many reportedly failing to meet current dietary guidelines. The school-setting presents a favourable environment to intervene and promote positive dietary behaviours and is also inclusive regardless of socio-economic status. However, a lack of consensus exists on how best to utilise schools to facilitate improvements in dietary behaviours among this age group. Whilst previous research has focused on identifying the factors motivating dietary choices within the school-setting, less is known on the optimum strategies to enhance these dietary choices which could positively contribute to the design of future interventions. It is reported that adolescents have good nutritional knowledge, although this does not appear to be a central consideration when making their dietary choices. Alternative factors at the individual (taste, visual appeal, familiarity, food quality, price, portion size, value for money, time/ convenience), social (peer influence), physical (product placement) and macro environment (food availability) levels have been frequently cited as important influences on adolescents' dietary choices in school. Although school-based interventions have shown potential in achieving positive dietary change among adolescents, more research is needed to determine the most effective methods in improving dietary behaviours in schools. This review summarises the key factors which influence adolescents' school-based dietary choices and the effectiveness of previously conducted interventions, identifying promising components for consideration when developing future dietary interventions within the school-setting.
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Lalchandani NK, Poirier B, Crabb S, Miller C, Hume C. School lunchboxes as an opportunity for health and environmental considerations: a scoping review. Health Promot Int 2023; 38:daac201. [PMID: 36715703 PMCID: PMC9885980 DOI: 10.1093/heapro/daac201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Very little research has focussed on children's school lunchboxes from both a health and environment standpoint. This scoping review explores studies that considered children's lunchbox food consumption trends at school and the environmental impacts of lunchbox contents. We conducted a scoping review of peer-reviewed literature with a focus on lunchboxes of children in preschool or primary school settings that contained food packed from home, through the lens of food and nutrition in combination with environmental outcomes-particularly food and/or packaging waste. The review included 10 studies, with articles from Australia, USA, Spain, New Zealand and the UK. Half of them were intervention studies aiming to shift knowledge levels and attitudes of teachers, parents and children with regard to reducing packaged food choices and food waste, and improving dietary habits. Acknowledging the complexity of lunchbox packing and consumption practices, this review recommends the consideration of socio-ecological influences on children's health and sustainability behaviour, and mobilizing their pro-environmental agency.
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Affiliation(s)
| | - Brianna Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia
| | - Shona Crabb
- School of Public Health, University of Adelaide, Adelaide 5000, Australia
| | - Caroline Miller
- School of Public Health, University of Adelaide, Adelaide 5000, Australia
- Health Policy Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide 5000, Australia
| | - Clare Hume
- School of Public Health, University of Adelaide, Adelaide 5000, Australia
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McCormick BJJ, Scalco A, Craig T, Whybrow S, Horgan GW, Macdiarmid JI. Modelling population responses to workplace minimum dietary standards introduced as workers return after social lockdowns. BMC Public Health 2022; 22:2390. [PMID: 36539744 PMCID: PMC9763797 DOI: 10.1186/s12889-022-14729-x] [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: 03/30/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Diet norms are the shared social behaviours and beliefs about diets. In many societies, including the UK, these norms are typically linked to unhealthy diets and impede efforts to improve food choices. Social interactions that could influence one another's food choices, were highly disrupted during the lockdowns in response to the COVID-19 pandemic. A return to workplaces and re-establishment of eating networks may present an opportunity to influence dietary norms by introducing minimum dietary standards to in workplaces, which could then spread through wider home and workplace networks. METHODS An agent-based model was constructed to simulate a society reflecting the structure of a city population (1000 households) to explore changes in personal and social diet-related norms. The model tracked individual meal choices as agents interact in home, work or school settings and recorded changes in diet quality (range 1 to 100). Scenarios were run to compare individuals' diet quality with the introduction of minimum dietary standards with degrees of working from home. RESULTS The more people mixed at work the greater the impact of minimum standards on improving diet norms. Socially isolated households remained unaffected by minimum standards, whereas household members exposed directly, in workplaces or schools, or indirectly, influenced by others in the household, had a large and linear increase in diet quality in relation to minimum standards (0.48 [95% CI 0.34, 0.62] per unit increase in minimum standards). Since individuals regressed to the new population mean, a small proportion of diets decreased toward lower population norms. The degree of return to work influenced the rate and magnitude of change cross the population (-2.4 points [-2.40, -2.34] in mean diet quality per 20% of workers isolating). CONCLUSIONS These model results illustrate the qualitative impact social connectivity could have on changing diets through interventions. Norms can be changed more in a more connected population, and social interactions spread norms between contexts and amplified the influence of, for example, workplace minimum standards beyond those directly exposed. However, implementation of minimum standards in a single type of setting would not reach the whole population and in some cases may decrease diet quality. Any non-zero standard could yield improvements beyond the immediate adult workforce and this could spill between social contexts, but would be contingent on population connectivity.
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Affiliation(s)
- Benjamin J. J. McCormick
- grid.7107.10000 0004 1936 7291Rowett Institute, University of Aberdeen, Ashgrove Rd. W, Aberdeen, AB25 2ZD UK
| | - Andrea Scalco
- grid.7107.10000 0004 1936 7291Rowett Institute, University of Aberdeen, Ashgrove Rd. W, Aberdeen, AB25 2ZD UK
| | - Tony Craig
- grid.43641.340000 0001 1014 6626The James Hutton Institute, Craigiebuckler, Aberdeen, AB15 8QH UK
| | - Stephen Whybrow
- grid.7107.10000 0004 1936 7291Rowett Institute, University of Aberdeen, Ashgrove Rd. W, Aberdeen, AB25 2ZD UK
| | - Graham. W. Horgan
- grid.450566.40000 0000 9220 3577Biomathematics and Statistics Scotland, Ashgrove Rd. W, Aberdeen, AB25 2ZD UK
| | - Jennie I. Macdiarmid
- grid.7107.10000 0004 1936 7291Rowett Institute, University of Aberdeen, Ashgrove Rd. W, Aberdeen, AB25 2ZD UK
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MEMİŞ T, KABARAN S. Effects of Online Nutrition Training Program About Mediterranean Diet on Anthropometric Measurements and Diet Quality in Overweight and Obese Adolescent Girls. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.1056470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Objective: This study was conducted to evaluate the effect of an online nutrition training program about the Mediterranean diet for 8 weeks in overweight and obese female high school students on anthropometric measurements and diet quality.
Methods: A total of 86 students between the ages of 14-18 years were included in the study, and they were divided into two groups as nutrition training (n=44) and control groups (n=42). The Mediterranean Diet Quality Index (KIDMED) scores were calculated and anthropometric measurements of groups were taken by the dietician at the beginning and at the end of the study.
Results: The KIDMED score of the nutrition training group was 4.59±2.40 at the beginning, later on it increased to 7.43±2.57 after the program (p= .001). After the program, it was determined that the difference between the KIDMED scores of the nutrition training and control groups were statistically significant (p= .034), however the decrease in body weight (p= .09), BMI (p= .64), and waist circumference (p= .06) were similar between groups.
Conclusion: As a result of the study, it can be said that online nutrition training program about the Mediterranean diet for 8 weeks may affect the diet quality positively of overweight and obese female adolescents, but long-term programs should be planned to determine the effects on anthropometric measurements.
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Ryan D, Holmes M, Ensaff H. Adolescents' dietary behaviour: The interplay between home and school food environments. Appetite 2022; 175:106056. [PMID: 35447162 DOI: 10.1016/j.appet.2022.106056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/05/2022] [Accepted: 04/14/2022] [Indexed: 12/29/2022]
Abstract
In the UK, school food standards have looked to improve the nutritional profile of school food provision and the choices made; however, adolescents' choices tend to bias towards micronutrient poor and energy dense options. This study aimed to explore how adolescents make their school food choices, along with how they engage with their environments whilst selecting food. Seven focus group interviews took place with adolescents (n = 28; 13-14 years) in a secondary school in Northern England. Discussions with participants were audio-recorded, transcribed verbatim and then analysed using an inductive thematic approach. Six themes emerged from the data: (1) parents' and adolescents' roles in the home food environment, (2) burgeoning food autonomy, (3) school food choice factors, (4) social aspects of school food, (5) home versus school, (6) food knowledge & beliefs. Adolescents identified two distinct environments during the focus group discussions: the home and school environments. Adolescents juxtaposed the two, in terms of food provision, food choices, rules and customs surrounding food choice. This juxtaposition emerged as an indirect but important influence on adolescents' school food choices. The school and home environments both (in)directly influence adolescents' school food choices, which involve an integration of multiple, often conflicting influences. Adolescents may adopt a number of unhelpful dietary rationalisations as they try to manage and reconcile these influences. Consultation, together with consideration of relevant food choice models, is required to identify opportunities to influence adolescents' food choices at school.
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Affiliation(s)
- D Ryan
- Nutritional Sciences and Epidemiology, School of Food Science & Nutrition, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - M Holmes
- Nutritional Sciences and Epidemiology, School of Food Science & Nutrition, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - H Ensaff
- Nutritional Sciences and Epidemiology, School of Food Science & Nutrition, University of Leeds, Leeds, LS2 9JT, United Kingdom.
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Parnham JC, Chang K, Millett C, Laverty AA, von Hinke S, Pearson-Stuttard J, de Vocht F, White M, Vamos EP. The Impact of the Universal Infant Free School Meal Policy on Dietary Quality in English and Scottish Primary School Children: Evaluation of a Natural Experiment. Nutrients 2022; 14:1602. [PMID: 35458164 PMCID: PMC9029848 DOI: 10.3390/nu14081602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 02/02/2023] Open
Abstract
The Universal Infant Free School Meal (UIFSM) policy was introduced in September 2014 in England and January 2015 in Scotland and offered all infant schoolchildren (ages 4-7 years) a free school lunch, regardless of income. Yet, impacts of UIFSM on dietary intakes or social inequalities are not known. A difference-in-differences study using the National Diet and Nutrition Survey assessed pooled pre-UIFSM (2010-2014) and post-UIFSM (2014-2017) dietary data. English or Scottish infant schoolchildren (4-7 years; n = 458) were the intervention group, with junior schoolchildren (8-11 years; n = 401) as controls. We found that implementation of UIFSM led to an increase in infant schoolchildren having a school meal. Impacts on key food groups such as fruit and vegetables or sweetened beverages were not seen. However, there was evidence that the UIFSM policy lowered consumption of foods associated with packed lunches, such as crisps, and some nutrients, such as total fat and sodium. Policy impacts differed by income group, with larger effect sizes in low-income children. In conclusion, evaluation of UIFSM demonstrated some improvements in dietary quality but the findings suggest school meal quality needs to be improved to fully realise the benefits of UIFSM.
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Affiliation(s)
- Jennie C. Parnham
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London W6 8RP, UK; (K.C.); (C.M.); (A.A.L.); (E.P.V.)
| | - Kiara Chang
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London W6 8RP, UK; (K.C.); (C.M.); (A.A.L.); (E.P.V.)
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London W6 8RP, UK; (K.C.); (C.M.); (A.A.L.); (E.P.V.)
| | - Anthony A. Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London W6 8RP, UK; (K.C.); (C.M.); (A.A.L.); (E.P.V.)
| | - Stephanie von Hinke
- Erasmus School of Economics, Erasmus University Rotterdam, 3062 PA Rotterdam, The Netherlands;
- School of Economics, University of Bristol, Priory Road Complex, Bristol BS8 1TU, UK
| | - Jonathan Pearson-Stuttard
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London SW7 2AZ, UK;
- Northumbria Healthcare NHS Foundation Trust, Newcastle upon-Tyne NE27 0QJ, UK
- Health Analytics, Lane Clark & Peacock LLP, London W1U 1DQ, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1QU, UK;
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK;
| | - Eszter P. Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London W6 8RP, UK; (K.C.); (C.M.); (A.A.L.); (E.P.V.)
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Current influences on adolescents’ food choices within the school setting and opportunities for improvement: a qualitative study. Proc Nutr Soc 2022. [DOI: 10.1017/s0029665122000349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Rose K, O'Malley C, Brown L, Ells LJ, Lake AA. 'Pizza every day - why?': A survey to evaluate the impact of COVID-19 guidelines on secondary school food provision in the UK. NUTR BULL 2021; 46:160-171. [PMID: 34149313 PMCID: PMC8206956 DOI: 10.1111/nbu.12496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 12/02/2022]
Abstract
The nutritional requirements of adolescence and the reported poor UK eating behaviours of young people are a significant public health concern. Schools are recognised as an effective ‘place’ setting to enable improvement to nutrition outcomes. The COVID‐19 pandemic resulted in UK school closures from March 2020. In re‐opening in September 2020, schools were required to meet guidelines to ensure the minimised impact of COVID‐19 on the population (DfE 2020). We aimed to evaluate the impact of COVID‐19 school guidelines on secondary and post‐16 (16–18 years) food provision. An online survey was posted on 8th October to 1st December 2020, targeted at young people, parents and staff of secondary/post‐16 education establishments in the UK. Two hundred and fifty‐two responses were received, of which 91% reported a change in their school food provision, 77% reported time for lunch was shortened and 44% indicated the provision was perceived as less healthy during September 2020 (post‐lockdown school return) compared with March 2020 (pre‐lockdown). Analyses demonstrated that time, limited choice and healthiness impacted negatively upon young people's school food experience. The COVID‐19 pandemic has presented a huge challenge to the delivery of healthy school food to young people. Therefore, schools require more support in following national food standards and incorporating nutrition education and behaviour change strategies within current guidelines.
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Affiliation(s)
- Kelly Rose
- Centre for Public Health Research School of Health and Life sciences Teesside University Middlesbrough UK.,Fuse - Centre for Translational Research in Public Health Newcastle upon Tyne UK
| | - Claire O'Malley
- Centre for Public Health Research School of Health and Life sciences Teesside University Middlesbrough UK.,Fuse - Centre for Translational Research in Public Health Newcastle upon Tyne UK
| | - Laura Brown
- Centre for Public Health Research School of Health and Life sciences Teesside University Middlesbrough UK
| | - Louisa Jane Ells
- School of Clinical and Applied Sciences Leeds Beckett University Leeds UK
| | - Amelia A Lake
- Centre for Public Health Research School of Health and Life sciences Teesside University Middlesbrough UK.,Fuse - Centre for Translational Research in Public Health Newcastle upon Tyne UK
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