School nutrition laws in the US: do they influence obesity among youth in a racially/ethnically diverse state?
School nutrition laws in the US: do they influence obesity among youth in a racially/ethnically diverse state?
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DOI：
10.1038/s41366-021-00900-8
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Sánchez BN
中科院分区：
文献类型：
--
作者：
Sanchez-Vaznaugh EV;Matsuzaki M;Braveman P;Acosta ME;Alexovitz K;Sallis JF;Peterson KE;Sánchez BN
关于州和国家营养政策对学校食品和饮料对儿童超重/肥胖（OV/OB）和相关种族/民族差异的单独或综合影响知之甚少。我们调查了加州制定的学校营养政策对儿童OV/OB和种族/民族差异的影响，这些政策独立于美国国家政策“健康无饥饿儿童法案”（HHFKA）。采用中断时间序列设计，收集了加州公立学校5年级和7年级学生的12，363，089份儿童水平记录的数据，以估计三个时期内OV/OB患病率的性别和种族/民族特异性时间趋势：加州营养政策实施前（2002-2004年）;当只有加州政策生效时（2005-2012年）;当它们与HHFKA同时生效时（2013-2016年）。在国家的政策之前，OV/OB患病率在大多数亚组的儿童中每年都在增加。在加州政策生效后，几乎所有组的OV/OB趋势都有所改善，在添加HFFKA后进一步改善。比较有州和联邦政策与没有政策的时期，OV/OB的年度对数比值的总变化范围为-0.08至-0.01，并因年级、性别和种族/民族而异。在每个性别和年级中，非洲裔美国人的变化最大（-0.08到-0.02，所有p < 0.05），其次是拉丁美洲儿童（-0.06到-0.01，所有p < 0.05）。虽然在双重政策时期之后，这些群体与白色儿童之间的差距缩小了，但差距仍然很大。州和国家的学校营养政策可能有助于遏制加州境内儿童肥胖/肥胖的上升趋势以及种族/民族肥胖/肥胖差异。然而，相当大的OV/OB患病率和差异仍然存在。为了结束这一流行病，促进健康体重和提高健康公平性，未来的努力应该加强州和国家政策，以提高学校的食品质量，特别是那些为OV/OB患病率最高的人群服务的学校。
Little is known about the separate or combined effects of state and national nutrition policies regulating food and beverages in schools on child overweight/obesity (OV/OB) and related racial/ethnic disparities. We investigated the influence of school nutrition policies enacted in California, independently and in combination with the United States’ national policy “Healthy Hunger Free Kids Act” (HHFKA) on childhood OV/OB and racial/ethnic disparities. An interrupted time series design was used with data from 12,363,089 child-level records on 5th- and 7th-graders in California public schools to estimate sex- and racial/ethnic-specific time trends in OV/OB prevalence during three periods: before the California nutrition policies (2002–2004); when only California policies were in effect (2005–2012); and when they were in effect simultaneously with HHFKA (2013–2016). Before the state’s policies, OV/OB prevalence increased annually among children in most subgroups. Improvements in OV/OB trends were observed for almost all groups after the California policies were in effect, with further improvements after the addition of HFFKA. The total change in annual log-odds of OV/OB, comparing the periods with both state and federal policies versus no policies, ranged from −0.08 to −0.01 and varied by grade, sex, and race/ethnicity. Within each sex and grade, the greatest changes were among African-American (−0.08 to −0.02, all p < 0.05) followed by Latino children (−0.06 to −0.01, all p < 0.05). Although disparities narrowed among these groups versus White children after the dual policy period, disparities remained large. State and national nutrition policies for schools may have contributed to containing the upward trend in childhood OV/OB and racial/ethnic OV/OB disparities within California. However, sizable OV/OB prevalence and disparities persist. To end the epidemic, promote healthy weight and increase health equity, future efforts should strengthen state and national policies to improve food quality in schools, particularly those serving populations with the highest OV/OB prevalence.
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5.5
作者：
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