The Impact of Salad Bars on Dietary Consumption Patterns in Elementary School Students

沙拉吧对小学生饮食消费模式的影响

基本信息

批准号：
10319968
负责人：
Melanie K Bean
金额：
$ 53.82万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-03-21 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10319968
关键词：
Beverages Calories Child Chronic Disease Consumption County Data Diet Dietary intake Eating Empirical Research Energy Intake Evaluation Food Fostering Fruit Goals Healthy Eating Human Resources Hunger Imagery Information Systems Intake Intervention Investigation Investments Link Low income Methodology Methods Modeling Nutrition Policy Obesity Pattern Policies Policy Analysis Procedures Program Evaluation Proxy Random Allocation Randomized, Controlled Trials Recommendation Research Resource Allocation Risk Reduction Role Sales Schools Socioeconomic Status Source Students Time Vegetables Virginia Waiting Lists Weight maintenance regimen Work cost efficient design dietary digital elementary school ethnic minority fruits and vegetables good diet healthy weight implementation determinants implementation evaluation improved indexing lower income families meetings minority children minority student nutrition obesity in children obesity risk primary outcome process evaluation programs prospective racial minority resource guides response school district school environment sixth grade sociodemographic factors sound systems research wasting

项目摘要

PROJECT SUMMARY Despite the importance of fruits and vegetables (FVs) as essential components of a healthy diet, most children do not consume the recommended number of servings of these foods. School meals account for a significant portion of children's overall dietary intake. Changing the school environment is a cost-efficient and effective method for improving dietary intake and can significantly impact the pernicious problem of pediatric obesity. The 2010 Healthy Hunger-Free Kids Act (HHFKA) mandated enhanced focus on FVs in the National School Lunch Program (NSLP), and specifically requires children to take a fruit and/or vegetable at meals (the “serve” model). However, there are significant concerns over increased FV plate waste under this mandate. Simultaneously, there is great national support for school salad bars as a means to increase FV intake within the NSLP. Salad bars might be a particularly effective approach within the “serve” model, as they foster choice, which is linked to increased FV consumption in children. However, little empirical research has investigated the impact of salad bars on FV intake in schools. Further, although FV consumption can facilitate healthy weight management if these foods replace items high in calories, there is a great need to better understand how increasing FV intake, and salad bars, relates to children's diet quality and energy intake at lunch within the NSLP. This is particularly important to investigate in low income and racial/ethnic minority children, who face disproportionate obesity risks and are most likely to be impacted by school obesity policies, such as the HHFKA, given their reliance on school meals. This time-sensitive application will use validated methods, informed by our extensive formative work, to conduct a comprehensive evaluation of salad bars in a northern Virginia school district. This district is installing salad bars into 141 elementary schools over 5-years, facilitating the conduct of a waitlist control, cluster randomized controlled trial. Specifically, 12 pairs of matched schools will be randomly selected: half receiving a salad bar (Intervention) and half serving pre-portioned FVs only, standard under the NSLP (Control). Thus groups will have different FV presentation methods; however all schools will be operating under a policy requiring students to take at least one FV serving. Schools will be matched on Title I status (a proxy for socioeconomic status) and percent of racial/ethnic minority students based on higher obesity risk. Dietary intake will be objectively assessed at lunch in each pair of schools, prior to (baseline), and 4-6 weeks after salad bars are installed (post), resulting in ~14,160 lunch observations throughout the study duration. We will also obtain cafeteria sales and NSLP participation data to examine how salad bars impact these critical revenue sources. Finally, we will assess implementation factors and cafeteria personnel's perspectives, to identify barriers and facilitators to salad bars and inform sustainability efforts. No prior RCTs have prospectively examined the effects of salad bars on FV and energy intake. As such, this study has great potential to inform school nutrition policies and programs designed to enhance dietary intake and reduce obesity.

项目摘要尽管水果和蔬菜（FVS）是健康饮食的重要组成部分，但大多数儿童请勿食用这些食物的建议份量。学校用餐有重要的儿童整体饮食摄入的一部分。改变学校环境是一种成本效益和有效的改善饮食摄入量的方法，可以显着影响小儿肥胖症的有害问题。这 2010年健康饥饿儿童法（HHFKA）在国立学校午餐中要求增强对FVS的关注计划（NSLP），特别要求儿童在用餐时取出水果和/或蔬菜（“服务”型号）。但是，在此任务下，FV板浪费增加存在重大关注点。同时地，国家对学校沙拉棒的支持是增加NSLP中FV摄入量的一种手段。沙拉酒吧可能是“服务”模型中的一种特别有效的方法，因为它们培养了与之相关的选择儿童的FV消费量增加。但是，很少的实证研究研究了盐的影响学校的FV摄入量。尽管FV消耗可以促进健康的体重管理这些食物取代了高卡路里的食品，非常需要更好地了解FV摄入量的增加，和沙拉棒，与NSLP午餐时儿童饮食质量和能量摄入有关。尤其是重要的是要在低收入和种族/族裔少数民族儿童中进行调查，他们面临不成比例的肥胖风险鉴于他们对学校的依赖，最有可能受到学校肥胖政策的影响餐。这个时间敏感的应用程序将使用经过验证的方法，这是我们广泛的形成性工作所告知的对北弗吉尼亚学区的沙拉吧进行全面评估。该地区正在安装在5年内进入141所小学的沙拉吧，支持候补控制，集群的行为随机对照试验。具体来说，将随机选择12对匹配学校：一半接受在NSLP（对照）下，仅标准标准的沙拉棒（干预）和一半提供预分配的FVS。那组将具有不同的FV呈现方法；但是，所有学校都将根据需要的政策运作学生至少要服用一份FV服务。学校将与标题I状态相匹配（社会经济的代理状态）和种族/族裔少数民族学生的百分比是基于较高的肥胖风险。饮食摄入将是在（基线）之前，在每对学校的午餐中进行客观评估，盐棒后4-6周安装（邮政），在整个研究期限内进行约14,160个午餐观察。我们还将获得自助餐厅销售和NSLP参与数据，以研究沙拉棒如何影响这些关键收入来源。最后，我们将评估实施因素和自助餐厅人员的观点，以确定障碍和促进沙拉吧并为可持续性工作提供促进者。先前的RCT没有前瞻性检查效果在FV和能量摄入上的沙拉棒。因此，这项研究具有通知学校营养政策的巨大潜力以及旨在增强饮食摄入量并减少对象性的计划。