Abstract
Objective: In 2012, the US government overhauled school nutrition standards, but few studies have evaluated the effects of these standards at the national level. The current study examines the impact of the updated school nutrition standards on dietary and health outcomes of schoolchildren in a nationally representative data set. Design: Difference-in-differences. We compared weekday fruit and vegetable intake between students with daily school lunch participation and students without school lunch participation before and after implementation of updated school nutrition standards using a multivariable linear regression model. Secondary outcomes included weekday solid fat and added sugar (SoFAS) intake and overweight and obesity prevalence. We adjusted analyses for demographic and family socio-economic factors. Setting: USA. Participants: K-12 students, aged 6-20 years (n 9172), from the National Health and Nutrition Examination Survey, 2005-2016. Results: Implementation of updated school nutrition standards was not associated with a change in weekday fruit and vegetable intake (β = 0·02 cups, 95 % CI -0·23, 0·26) for students with daily school lunch participation. However, implementation of the policy was associated with a 1·5 percentage point (95 % CI -3·0, -0·1) decline in weekday SoFAS intake and a 6·1 percentage point (95 % CI -12·1, -0·1) decline in overweight and obesity prevalence. Conclusions: Changes to US school nutrition standards were associated with reductions in the consumption of SoFAS as well as a decrease in overweight and obesity in children who eat school lunch. However, we did not detect a change in weekday intake of fruits and vegetables associated with the policy change.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 3016-3024 |
| Number of pages | 9 |
| Journal | Public Health Nutrition |
| Volume | 23 |
| Issue number | 16 |
| DOIs | |
| State | Published - Nov 1 2020 |
Funding
Acknowledgements: None. Financial support: J.J. completed the study and manuscript under training grants no. D33HP25766 and no. T32HP32715 from the Health Resources and Services Administration. Conflict of interest: There are no conflicts of interest.. Authorship: J.J. cleaned and conducted analyses on all data and wrote the manuscript draft. L.L.M., H.C., A.H. and M.R.L. advised on the study design and analysis and contributed to the manuscript. Ethics of human subject participation: The National Health and Nutrition Examination Survey was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures involving research study participants were approved by the National Center for Health Statistics Research Ethics Review Board. Written informed consent was obtained from all subjects/patients. The current study was deemed exempt by the Boston University Institutional Review Board.
Keywords
- Diet
- Nutrition policy
- Overweight and obesity
- School nutrition
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Nutrition and Dietetics
- Public Health, Environmental and Occupational Health
