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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] [What about the content of this article? (0)] [Affiliation(s)] [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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de Visser R, Sylvester R, Rogers R, Kline-Rogers E, DuRussel-Weston J, Eagle KA, Jackson EA. Changes in School Health Program Improve Middle School Students' Behaviors. Am J Health Behav 2016; 40:568-77. [PMID: 27561859 DOI: 10.5993/ajhb.40.5.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the effectiveness of environmental activities in a school-based health program among 6th grade students (N = 2315). METHODS Students enrolled in Project Healthy Schools, a school-based health program designed to reduce childhood obesity and improve cardiovascular health, completed a health questionnaire on recent lifestyle choices including diet, physical activity, and sedentary behaviors. Baseline and follow-up data were compared between students who received educational lessons and students who received educational lessons and additional activities in the schools' environment. We calculated descriptive and one-way ANOVA statistics. RESULTS Students at schools with educational lessons and environmental activities reported more fruit intake (p = .046), fewer sugary beverages (p = .054) and servings of fatty/sugary foods (p = .002), and more moderate physical activity (p = .009) compared to students with educational lessons only. No beneficial effect was observed in decreasing TV viewing time. Mobile device time increased in both groups. CONCLUSIONS The present study suggests school-based health programs combining educational lessons and additional environmental activities may improve diet and physical activity in middle school children to a greater degree than educational lessons alone.
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Affiliation(s)
| | | | - Robert Rogers
- University of Michigan Health System, Ann Arbor, MI, USA
| | | | | | - Kim A Eagle
- University of Michigan Health System, Ann Arbor, MI, USA
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