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

• 批准号: 9753434
• 负责人: Melanie K Bean
• 金额: $ 69.66万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-21 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9753434
• 关键词: Beverages; Calories; Child; Chronic Disease; Consumption; County; Data; Diet; Dietary intake; Eating; Empirical Research; Energy Intake; Environment; Evaluation; Face; Food; Fostering; Fruit or Vegetable; Goals; Healthy Eating; Human Resources; Hunger; Imagery; Information Systems; Intake; Intervention; Investigation; Investments; Link; Low income; Methodology; Methods; Modeling; Nutrition Policy; Obesity; Pattern; Policies; Procedures; Process; Program Evaluation; Proxy; Randomized Controlled Trials; Research; Resource Allocation; Risk; Role; Sales; Schools; Socioeconomic Status; Source; Students; Time; Virginia; Waiting Lists; Weight maintenance regimen; Work; base; cost efficient; design; digital; elementary school; fruits and vegetables; good diet; healthy weight; improved; indexing; lower income families; meetings; minority children; minority student; nutrition; obesity in children; obesity risk; primary outcome; programs; prospective; racial and ethnic; resource guides; response; school district; sixth grade; sociodemographics; sound; systems research; wasting

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.

项目概要 尽管水果和蔬菜 (FV) 作为健康饮食的重要组成部分很重要，但大多数儿童 不要食用这些食物的建议份量。学校供餐占很大比例 儿童总膳食摄入量的一部分。改变学校环境是一种经济有效的方法 改善饮食摄入的方法，可以显着影响儿童肥胖的有害问题。这 2010 年《健康无饥饿儿童法案》(HHFKA) 要求在全国学校午餐中加强对食品食品的关注 计划（NSLP），特别要求儿童在膳食中摄入水果和/或蔬菜（“服务”模式）。 然而，在此授权下，人们对 FV 印版浪费增加表示严重担忧。同时地， 学校沙拉吧作为增加 NSLP 内 FV 摄入量的一种手段，得到了全国的大力支持。沙拉 酒吧可能是“服务”模式中特别有效的方法，因为它们促进选择，这与 儿童的 FV 消耗量增加。然而，很少有实证研究调查沙拉的影响 学校 FV 摄入量的限制。此外，虽然 FV 消耗可以促进健康的体重管理，如果 这些食物取代了高热量的食物，非常需要更好地了解如何增加 FV 摄入量， 和沙拉吧，与 NSLP 内儿童午餐的饮食质量和能量摄入有关。这一点特别 对面临不成比例的肥胖风险的低收入和种族/族裔儿童进行调查很重要 考虑到他们对学校的依赖，他们最有可能受到 HHFKA 等学校肥胖政策的影响 膳食。这个时间敏感的应用程序将使用经过验证的方法，根据我们广泛的形成工作的信息， 对弗吉尼亚州北部学区的沙拉吧进行全面评估。本小区正在安装 五年内将沙拉吧纳入 141 所小学，促进候补名单控制、集群的实施 随机对照试验。具体来说，将随机选择 12 对匹配学校：一半获得 仅沙拉吧（干预）和半份预分份 FV，NSLP（对照）下的标准配置。因此 各组会有不同的 FV 呈现方式；然而，所有学校都将根据一项政策运营，要求 学生至少服用一份 FV 服务。学校将根据 Title I 地位（社会经济的代表）进行匹配 状况）以及基于较高肥胖风险的种族/族裔学生百分比。膳食摄入量将是 在沙拉吧之前（基线）和之后 4-6 周，在每对学校的午餐时进行客观评估 安装（后），在整个研究期间产生约 14,160 次午餐观察。我们还将获得 自助餐厅销售和 NSLP 参与数据来研究沙拉吧如何影响这些关键收入来源。 最后，我们将评估实施因素和食堂人员的观点，以确定障碍和 沙拉吧的推动者并为可持续发展工作提供信息。之前没有随机对照试验前瞻性地检验过其效果 沙拉吧对 FV 和能量摄入的影响。因此，这项研究具有为学校营养政策提供信息的巨大潜力 以及旨在增加饮食摄入量和减少肥胖的计划。