School Food and Beverage Availability and Children's Diet, Purchasing, and Obesity: Evidence From a Natural Experiment.
School Food and Beverage Availability and Children's Diet, Purchasing, and Obesity: Evidence From a Natural Experiment.
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DOI：
10.1016/j.jadohealth.2020.03.004
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Datar A
中科院分区：
文献类型：
--
作者：
Richardson AS;Nicosia N;Ghosh-Dastidar MB;Datar A
关于学校食品环境与儿童在校购买、饮食行为和身体成分之间关系的现有证据基于容易受到居住选择偏差影响的观察性研究。这项研究利用了由于军人父母被分配到设施而导致的自然实验所产生的学校环境的外生变化。我们分析了 2013 年至 2015 年期间收集的军事青少年环境、运动和营养研究中的 1010 项儿童波观察结果。使用多元线性和逻辑回归，我们检查了学校中可供购买的竞争性食品和饮料 (CF&B) 项目的数量（整体和按类型（不健康、健康、中性））是否与校内食品购买、饮食行为和体重指数 (BMI) 结果相关。协变量包括儿童和家庭特征以及家庭食品环境的健康状况。不健康的物品供应与购买任何糖果（AOR：1.30 p<0.01）、零食（AOR：1.23 p<0.01）和含糖饮料（AOR：1.19 p=0.01）呈正相关。然而，与总体食物和饮料摄入量（例如糖果、苏打水）和体重指数结果没有显着关联。家庭食物环境与所有结果显着相关。获得不健康的 CF&B 物品可能会影响校内购买，但似乎不会影响整体饮食行为和 BMI 结果。校内和校外不同地点的热量摄入替代可能有助于解释为什么购买与不健康的 CF&B 供应相关，但整体饮食和下游 BMI 却不然。
Existing evidence on relationships between school food environments and children’s in-school purchases, dietary behaviors and body composition is based on observational studies that are vulnerable to residential selection bias. This study leveraged exogenous variation in school environments generated by the natural experiment due to military parents’ assignment to installations. We analyzed 1010 child-wave observations from the Military Teenagers Environments, Exercise, and Nutrition Study collected during 2013–2015. Using multiple linear and logistic regression, we examined whether the number of competitive food and beverage (CF&B) items available for purchase in school, overall and by type (unhealthy, healthy, neutral), was associated with in-school food purchases, dietary behaviors, and body mass index (BMI) outcomes. Covariates included child and family characteristics and the healthiness of the home food environment. Unhealthy item availability was positively associated with purchasing any sweets (AOR: 1.30 p<0.01), snacks (AOR: 1.23 p<0.01), and sugar-sweetened beverages (AOR: 1.19 p=0.01). However, there were no significant associations with overall food and beverage intake (e.g., sweets, soda) nor BMI outcomes. The home food environment was significantly associated with all outcomes. Access to unhealthy CF&B items may influence in-school purchases but does not appear to influence overall dietary behaviors and BMI outcomes. Substitution of caloric intake across locations within versus outside of school may play a role in explaining why purchases were associated with unhealthy CF&B availability but overall diet and downstream BMI were not.
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影响因子：
12.7
作者：
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通讯作者：
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影响因子：
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作者：
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DOI：
10.1016/s0002-8223(00)00204-2
发表时间：
2000-06-01
影响因子：
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作者：
Harnack, L;Snyder, P;Neumark-Sztainer, D
通讯作者：
Neumark-Sztainer, D