Rationale, design and methods of the HEALTHY study nutrition intervention component
Rationale, design and methods of the HEALTHY study nutrition intervention component
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DOI：
10.1038/ijo.2009.114
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发表时间：
2009-08-01
影响因子：
4.9
通讯作者：
McCormick, S.
中科院分区：
文献类型：
--
作者：
Gillis, B.;Mobley, C.;McCormick, S.
HEALTHY研究是一项随机、对照、多中心、以中学为基础的多方面干预研究，旨在减少2型糖尿病发生的危险因素。这项研究随机将42所中学分为干预组和对照组，并对六年级到八年级的学生进行了跟踪调查。在这里，我们描述了设计的健康营养干预组件，开发修改总的学校食品环境，定义为包括以下内容：联邦早餐，午餐，放学后的零食和晚餐计划;点菜场地，包括小吃店和学校商店;自动售货机;筹款;和教室聚会和庆祝活动。研究人员使用核心和工具箱策略实施干预，以实现并维持以下五个干预目标：（1）降低食物的平均脂肪含量，（2）增加水果和蔬菜的供应和种类，（3）限制甜点和零食的份量和能量含量，（4）消除全脂牛奶和2%牛奶以及所有添加糖的饮料，除了低脂或脱脂风味牛奶，并限制100%的果汁，以小份早餐和（5）增加高纤维谷物食品和豆类的可用性。其他营养干预组成部分的内容是口味测试，自助餐厅的改进，自助餐厅线的消息和其他信息的健康饮食，自助餐厅学习实验室（CLL）的活动，每年两次的培训食品服务人员，每周与食品服务经理，奖励食品服务部门，每年两次的地方会议和三个国家首脑会议与地区食品服务主任。干预设计的优势是营养与其他健康干预成分（体育，行为改变和沟通）的整合，以及营养干预研究工作人员与学校和地区各级食品服务人员之间的合作和融洽关系。国际肥胖杂志（2009）33，S29-S36; doi：10.1038/ijo.2009.114
The HEALTHY study was a randomized, controlled, multicenter and middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Here we describe the design of the HEALTHY nutrition intervention component that was developed to modify the total school food environment, defined to include the following: federal breakfast, lunch, after school snack and supper programs; a la carte venues, including snack bars and school stores; vending machines; fundraisers; and classroom parties and celebrations. Study staff implemented the intervention using core and toolbox strategies to achieve and maintain the following five intervention goals: (1) lower the average fat content of foods, (2) increase the availability and variety of fruits and vegetables, (3) limit the portion sizes and energy content of dessert and snack foods, (4) eliminate whole and 2% milk and all added sugar beverages, with the exception of low fat or nonfat flavored milk, and limit 100% fruit juice to breakfast in small portions and (5) increase the availability of higher fiber grain-based foods and legumes. Other nutrition intervention component elements were taste tests, cafeteria enhancements, cafeteria line messages and other messages about healthy eating, cafeteria learning laboratory (CLL) activities, twice-yearly training of food service staff, weekly meetings with food service managers, incentives for food service departments, and twice yearly local meetings and three national summits with district food service directors. Strengths of the intervention design were the integration of nutrition with the other HEALTHY intervention components (physical education, behavior change and communications), and the collaboration and rapport between the nutrition intervention study staff members and food service personnel at both school and district levels. International Journal of Obesity (2009) 33, S29-S36; doi:10.1038/ijo.2009.114