Evaluation of health and economic effects of United States school meal standards consistent with the 2020-2025 dietary guidelines for Americans.
Evaluation of health and economic effects of United States school meal standards consistent with the 2020-2025 dietary guidelines for Americans.
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DOI：
10.1016/j.ajcnut.2023.05.031
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发表时间：
2023-09
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影响因子：
--
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中科院分区：
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目前的学校膳食营养标准于 2010 年制定，与 2020-2025 年美国人膳食指南 (DGA) 并不完全一致。这项研究评估了加强学校膳食中添加糖、钠和全谷物的标准以符合现行指南的潜在短期和长期健康和经济效益。我们使用基于全国代表性数据的比较风险评估框架，其中纳入了国家健康和营养检查调查（2013-2018）3个周期中美国5-18岁儿童的当前人口统计数据、饮食习惯和风险因素。为了估计短期影响，该模型纳入了由于潜在的符合 DGA 的新学校膳食营养标准而估计的饮食变化，以及这些变化对儿童体重指数（公斤/平方米）和血压的影响。为了估计长期影响，该模型进一步纳入了有关儿童饮食变化到成年的可持续性的数据，以及美国成年人的人口统计和风险因素、饮食与疾病关联以及特定疾病的全国死亡率的数据。在假设学校完全遵守的最佳情况下，实施符合 DGA 的新营养标准将使小学生的 BMI 平均降低 0.14 (95% UI: 0.08–0.20) kg/m2，收缩压降低 0.13 (95% UI: 0.06–0.19) (95% mm Hg)。在以后的生活中，新标准估计可预防 10,600 [95% 不确定区间 (UI)：4820–16,800) 成年期每年死于心血管疾病 (CVD)、糖尿病和癌症的人数；每年可节省 355,000 (95% UI: 175,000–538,000) 伤残调整生命年以及 19.3 美元 (95% UI: 9.35–30.3) B 的直接和间接医疗费用。考虑到看似合理（不完整）的学校合规性，实施后每年将节省约 9110 例（95% UI：2740–15,100）例死亡、302,000（95% UI：120,000–479,000）例伤残调整生命年，以及每年 15.9 美元（95% UI：4.54–27.2）B 的医疗保健相关费用成年期。根据 2020-2025 年 DGA 建议，针对添加糖、钠和全谷物制定更严格的学校膳食营养标准，可能会改善饮食、儿童健康以及未来成人的 CVD、糖尿病、癌症负担和相关经济成本。
The current school meal nutrition standards, established in 2010, are not fully aligned with the 2020–2025 Dietary Guideline for Americans (DGA). This study evaluates the potential short-term and long-term health and economic benefits of strengthening the school meal standards on added sugars, sodium, and whole grains to be aligned with current guidelines. We used comparative risk assessment frameworks based on nationally representative data incorporating current demographics, dietary habits, and risk factors of United States children aged 5–18 y from 3 cycles of the National Health and Nutrition Examination Survey (2013–2018). To estimate short-term impact, the model incorporated estimated dietary changes owing to potential new DGA-aligned school meal nutrition standards and the effect of these changes on childhood body mass index (in kg/m2) and blood pressure. To estimate long-term impact, the model further incorporated data on the sustainability of childhood dietary changes into adulthood, and on demographics and risk factors of United States adults, diet-disease associations, and disease-specific national mortality. In a best-case scenario assuming full school compliance, implementing new DGA-aligned nutritional standards would lower elementary children’s BMI by an average 0.14 (95% UI: 0.08–0.20) kg/m2 and systolic blood pressure by 0.13 (95% UI: 0.06–0.19) (95% mm Hg. Later in life, the new standards were estimated to prevent 10,600 [95% uncertainty interval (UI): 4820–16,800) annual deaths from cardiovascular disease (CVD), diabetes, and cancer in adulthood; and save 355,000 (95% UI: 175,000–538,000) disability-adjusted life years and $19.3 (95% UI: 9.35–30.3) B in direct and indirect medical costs each year. Accounting for plausible (incomplete) school compliance, implementation would save an estimated 9110 (95% UI: 2740–15,100) deaths, 302,000 (95% UI: 120,000–479,000) disability-adjusted life years, and $15.9 (95% UI: 4.54–27.2) B in healthcare-related costs per year in later adulthood. Stronger school meal nutrition standards on added sugars, sodium, and whole grains aligned with the 2020–2025 DGA recommendations may improve diet, childhood health, and future adult burdens of CVD, diabetes, cancer, and associated economic costs.
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在学校膳食和学龄儿童的饮食中添加糖。
影响因子：
5.9
作者：
Fox MK;Gearan EC;Schwartz C
通讯作者：
Schwartz C
影响因子：
168.9
作者：
Lim, Stephen S.;Vos, Theo;Flaxman, Abraham D.;Danaei, Goodarz;Shibuya, Kenji;Adair-Rohani, Heather;Amann, Markus;Anderson, H. Ross;Andrews, Kathryn G.;Aryee, Martin;Atkinson, Charles;Bacchus, Loraine J.;Bahalim, Adil N.;Balakrishnan, Kalpana;Balmes, John;Barker-Collo, Suzanne;Baxter, Amanda;Bell, Michelle L.;Blore, Jed D.;Blyth, Fiona;Bonner, Carissa;Borges, Guilherme;Bourne, Rupert;Boussinesq, Michel;Brauer, Michael;Brooks, Peter;Bruce, Nigel G.;Brunekreef, Bert;Bryan-Hancock, Claire;Bucello, Chiara;Buchbinder, Rachelle;Bull, Fiona;Burnett, Richard T.;Byers, Tim E.;Calabria, Bianca;Carapetis, Jonathan;Carnahan, Emily;Chafe, Zoe;Charlson, Fiona;Chen, Honglei;Chen, Jian Shen;Cheng, Andrew Tai-Ann;Child, Jennifer Christine;Cohen, Aaron;Colson, K. Ellicott;Cowie, Benjamin C.;Darby, Sarah;Darling, Susan;Davis, Adrian;Degenhardt, Louisa;Dentener, Frank;Des Jarlais, Don C.;Devries, Karen;Dherani, Mukesh;Ding, Eric L.;Dorsey, E. Ray;Driscoll, Tim;Edmond, Karen;Ali, Suad Eltahir;Engell, Rebecca E.;Erwin, Patricia J.;Fahimi, Saman;Falder, Gail;Farzadfar, Farshad;Ferrari, Alize;Finucane, Mariel M.;Flaxman, Seth;Fowkes, Francis Gerry R.;Freedman, Greg;Freeman, Michael K.;Gakidou, Emmanuela;Ghosh, Santu;Giovannucci, Edward;Gmel, Gerhard;Graham, Kathryn;Grainger, Rebecca;Grant, Bridget;Gunnell, David;Gutierrez, Hialy R.;Hall, Wayne;Hoek, Hans W.;Hogan, Anthony;Hosgood, H. Dean, III;Hoy, Damian;Hu, Howard;Hubbell, Bryan J.;Hutchings, Sally J.;Ibeanusi, Sydney E.;Jacklyn, Gemma L.;Jasrasaria, Rashmi;Jonas, Jost B.;Kan, Haidong;Kanis, John A.;Kassebaum, Nicholas;Kawakami, Norito;Khang, Young-Ho;Khatibzadeh, Shahab;Khoo, Jon-Paul;Kok, Cindy;Laden, Francine;Lalloo, Ratilal;Lan, Qing;Lathlean, Tim;Leasher, Janet L.;Leigh, James;Li, Yang;Lin, John Kent;Lipshultz, Steven E.;London, Stephanie;Lozano, Rafael;Lu, Yuan;Mak, Joelle;Malekzadeh, Reza;Mallinger, Leslie;Marcenes, Wagner;March, Lyn;Marks, Robin;Martin, Randall;McGale, Paul;McGrath, John;Mehta, Sumi;Mensah, George A.;Merriman, Tony R.;Micha, Renata;Michaud, Catherine;Mishra, Vinod;Hanafiah, Khayriyyah Mohd;Mokdad, Ali A.;Morawska, Lidia;Mozaffarian, Dariush;Murphy, Tasha;Naghavi, Mohsen;Neal, Bruce;Nelson, Paul K.;Miquel Nolla, Joan;Norman, Rosana;Olives, Casey;Omer, Saad B.;Orchard, Jessica;Osborne, Richard;Ostro, Bart;Page, Andrew;Pandey, Kiran D.;Parry, Charles D. H.;Passmore, Erin;Patra, Jayadeep;Pearce, Neil;Pelizzari, Pamela M.;Petzold, Max;Phillips, Michael R.;Pope, Dan;Pope, C. Arden, III;Powles, John;Rao, Mayuree;Razavi, Homie;Rehfuess, Eva A.;Rehm, Juergen T.;Ritz, Beate;Rivara, Frederick P.;Roberts, Thomas;Robinson, Carolyn;Rodriguez-Portales, Jose A.;Romieu, Isabelle;Room, Robin;Rosenfeld, Lisa C.;Roy, Ananya;Rushton, Lesley;Salomon, Joshua A.;Sampson, Uchechukwu;Sanchez-Riera, Lidia;Sanman, Ella;Sapkota, Amir;Seedat, Soraya;Shi, Peilin;Shield, Kevin;Shivakoti, Rupak;Singh, Gitanjali M.;Sleet, David A.;Smith, Emma;Smith, Kirk R.;Stapelberg, Nicolas J. C.;Steenland, Kyle;Stoeckl, Heidi;Stovner, Lars Jacob;Straif, Kurt;Straney, Lahn;Thurston, George D.;Tran, Jimmy H.;Van Dingenen, Rita;van Donkelaar, Aaron;Veerman, J. Lennert;Vijayakumar, Lakshmi;Weintraub, Robert;Weissman, Myrna M.;White, Richard A.;Whiteford, Harvey;Wiersma, Steven T.;Wilkinson, James D.;Williams, Hywel C.;Williams, Warwick;Wilson, Nicholas;Woolf, Anthony D.;Yip, Paul;Zielinski, Jan M.;Lopez, Alan D.;Murray, Christopher J. L.;Ezzati, Majid
通讯作者：
Ezzati, Majid
影响因子：
120.7
作者：
Kinderknecht, Kelsey;Harris, Cristen;Jones-Smith, Jessica
通讯作者：
Jones-Smith, Jessica
DOI：
10.1177/0260106020928664
发表时间：
2020-09-01
期刊：
Nutrition and Health (Bicester)
影响因子：
--
作者：
Fulgoni, Victor L., III;Brauchla, Mary;Chu, YiFang
通讯作者：
Chu, YiFang
影响因子：
9.7
作者：
Gortmaker, Steven L.;Wang, Y. Claire;Long, Michael W.;Giles, Catherine M.;Ward, Zachary J.;Barrett, Jessica L.;Kenney, Erica L.;Sonneville, Kendrin R.;Afzal, Amna Sadaf;Resch, Stephen C.;Cradock, Angie L.
通讯作者：
Cradock, Angie L.