Enhancing nutritional environments through access to fruit and vegetables in schools and homes among children and youth: a systematic review.
Enhancing nutritional environments through access to fruit and vegetables in schools and homes among children and youth: a systematic review.
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DOI：
10.1186/1756-0500-7-422
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发表时间：
2014-07-04
影响因子：
1.8
通讯作者：
Wolfenden, Luke
中科院分区：
文献类型：
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作者：
Ganann, Rebecca;Fitzpatrick-Lewis, Donna;Wolfenden, Luke
背景：低水果和蔬菜(FV)摄入是全球十大死亡率风险因素之一，并与癌症、心血管疾病和糖尿病的风险增加有关。许多环境、社会人口和个人因素影响FV消费。这篇综述的目的是检查在家庭、学校和其他营养环境中提供的干预措施的效果，这些干预措施旨在增加5-18岁儿童的FV可获得性。方法：搜索包括：19个电子书目数据库；灰色文献数据库；关键文章的参考文献列表；有针对性的互联网搜索关键组织网站；手工搜索关键期刊和会议记录；咨询专家以获得更多参考。在以下情况下纳入文章：英语、法语和西班牙语；来自高收入、中等收入和低收入国家；交付给任何能够改变5至18岁儿童生殖器感染环境的人；具有随机和非随机研究设计，提供前后比较，有或没有对照组。结果：该搜索策略检索了近23,000条引文，并产生了23项独特的研究。干预措施主要是区域或州一级的政策干预措施、学校和社区团体的一些课程型干预措施以及花园干预措施。大多数研究是在高收入国家进行的。干预措施、人群、结果和结果测量的多样性排除了荟萃分析。改善儿童FV环境的最有希望的战略是通过当地的学校食品服务政策。在评估以学校为基础的政策的六项研究中，有四项成功地改善了获得FV的机会，另外两项研究发现没有效果。针对食品服务提供者和决策者的更广泛的州或联邦授权政策或教育项目产生了或好或小的影响。同样，家庭干预对家庭可及性没有影响或影响很小，对消费的影响较小。结论：这些研究存在较高的偏差风险，但更严格的研究很难在自然主义环境下以及在政策执行和评估中进行。然而，有一些很有希望的战略来改善FV环境，特别是通过学校的食品服务政策。
BACKGROUND: Low fruit and vegetable (FV) consumption is one of the top 10 global risk factors for mortality, and is related to increased risk for cancer, cardiovascular disease and diabetes. Many environmental, sociodemographic and personal factors affect FV consumption. The purpose of this review is to examine the effects of interventions delivered in the home, school and other nutritional environments designed to increase FV availability for five to 18-year olds.METHODS: The search included: 19 electronic bibliographic databases; grey literature databases; reference lists of key articles; targeted Internet searching of key organization websites; hand searching of key journals and conference proceedings; and consultation with experts for additional references. Articles were included if: in English, French and Spanish; from high-, middle-, and low-income countries; delivered to anyone who could bring about change in FV environment for 5 to 18 year olds; with randomized and non-randomized study designs that provided before-after comparisons, with or without a control group. Primary outcomes of interest were measures of FV availability.RESULTS: The search strategy retrieved nearly 23,000 citations and resulted in 23 unique studies. Interventions were primarily policy interventions at the regional or state level, a number of curriculum type interventions in schools and community groups and a garden intervention. The majority of studies were done in high-income countries.The diversity of interventions, populations, outcomes and outcome measurements precluded meta-analysis. The most promising strategies for improving the FV environment for children are through local school food service policies. Access to FV was successfully improved in four of the six studies that evaluated school-based policies, with the other two studies finding no effect. Broader state or federally mandated policies or educational programs for food service providers and decision makers had mixed or small impact. Similarly family interventions had no or small impact on home accessibility, with smaller impact on consumption.CONCLUSIONS: The studies have high risk of bias but more rigorous studies are difficult to impossible to conduct in naturalistic settings and in policy implementation and evaluation. However, there are promising strategies to improve the FV environment, particularly through school food service policies.