Do state-level school nutrition requirements promote healthy eating and weight

州级学校营养要求是否促进健康饮食和体重

• 批准号: 7896049
• 负责人: Solveig Argeseanu Cunningham
• 金额: $ 8.42万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7896049
• 关键词: 11 year old; Address; Administrator; Adult; Affect; Age; American; Area; Attention; Behavior; Behavioral; Beverages; Body Weight; Body Weight Changes; Body mass index; Characteristics; Child; Child health care; Childhood; Chronic Disease; Consumption; Data; Data Set; Disease; Eating; Eating Behavior; Effectiveness; Ensure; Environment; Environmental Risk Factor; Ethnic Origin; Evaluation; Exclusion; Family; Food; Future; Goals; Guidelines; Health; Height; Home environment; Institute of Medicine (U.S.); Intake; Intervention; Knowledge; Laws; Lead; Least-Squares Analysis; Life; Literature; Logistic Regressions; Longitudinal Studies; Low Prevalence; Low income; Measures; Mental Depression; Mental Health; Minority; Modeling; Neighborhoods; Non-Insulin-Dependent Diabetes Mellitus; Nutrition Policy; Nutritional; Obesity; Outcome; Parents; Pathway interactions; Pattern; Performance; Physical assessment; Policies; Poverty; Prevalence; Race; Reliance; Reporting; Research; Research Design; Restaurants; Risk; Sales; Sampling; Schools; Statutes and Laws; Students; Surveys; Testing; Time; Training; Weight; Weights and Measures; cohort; consumption measures; design; drinking; early childhood; early onset; expectation; food quality; improved; kindergarten; middle school; nutrition; obesity in children; obesity risk; preference; programs; public health relevance; research study; residence; respiratory; social; sweetened beverage

DESCRIPTION (provided by applicant): The prevalence of obesity among American children is at an all-time high, with over 15% of children currently obese. Child obesity is associated with poorer physical/mental health and social wellbeing as well as increased future risk of obesity and cardiometabolic disease. OBJECTIVES: We will evaluate the potential of state policies that address school breakfast and sweetened beverage availability to improve healthy eating and body weight in elementary and middle school children. We test three hypotheses: 1) State level school breakfast requirements increase availability and consumption of school breakfast and increase intake of nutritious foods; 2) State restrictions on sales of sweetened beverages at school lead to lower availability of such beverages at schools, lower total intake of these items, and lower prevalence of obesity among children; 3) State-level school policies requiring breakfast and restricting sweetened beverage sales have greater impact on low income and minority children. DESIGN: Our analytic strategy replicates an experimental study design by following children who were and were not exposed to policy changes, depending on their state of residence. Comparing children's weight and consumption in states that implemented a policy during the study with those that did not allows us to assess the effect of the policies. We will use the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K), which follows a nationally representative cohort of children from kindergarten into 8th grade. ECLS-K includes substantial numbers of minority and impoverished children. We examine 2 sets of outcomes: children's weight (BMI z-score and obesity) and nutrition (breakfast and sweetened beverage consumption). A significant advantage of the ECLSK is that height and weight are measured by trained assessors. We estimate ordinary least squares regressions, logistic regressions, and fixed effects models, using survey weights to ensure representativeness. Our key explanatory variables are state-level policies, which will be compiled into a comprehensive dataset and merged with the ECLS-K data. We include controls for child, home, neighborhood, and school characteristics. We estimate models by race/ethnicity and poverty status. SIGNIFICANCE: State laws requiring better school nutrition potentially offer a simple, inexpensive strategy for improving nutrition and weight among school-children. Yet the effectiveness of these policies has not been explored. This research contributes to knowledge about weight changes during childhood, progression to obesity, and behavioral and environmental factors that affect these, assessing: 1) The responsiveness of schools to state policy changes; 2) The influence of state policies on child weight and nutrition; and 3) Whether students displace their consumption of unhealthy goods to out-of school settings. We will provide empirical evidence on these issues from the largest national longitudinal study measuring weight and height in children. Public Health Relevance: Previous research shows that breakfast and soda consumption are both independently associated with children's weight outcomes, suggesting that interventions focused on these may have long-term benefits for child health. This study will evaluate state policies with high potential to improve healthy eating and body weight among children, measuring the effects of state policies that require schools to offer breakfast and that restrict sales of sweetened beverages at school. This policy evaluation will assist policymakers in making informed decisions about whether more widespread legislation in these areas would promote children's health.

描述(申请人提供)：美国儿童肥胖率创历史新高，目前超过15%的儿童患有肥胖症。儿童肥胖与较差的身心健康和社会福利以及未来肥胖和心脏代谢性疾病的风险增加有关。目标：我们将评估解决学校早餐和含糖饮料供应的州政策改善中小学生健康饮食和体重的潜力。我们检验了三个假设：1)州一级学校早餐要求增加学校早餐的供应和消费，并增加营养食品的摄入量；2)州一级学校对含糖饮料销售的限制导致此类饮料在学校的可获得性降低，这些物品的总摄入量减少，儿童肥胖率降低；3)州一级学校要求提供早餐并限制含糖饮料销售的政策对低收入和少数族裔儿童有更大的影响。设计：我们的分析策略复制了一项实验研究设计，通过跟踪那些受到和没有受到政策变化影响的儿童，取决于他们的居住状态。比较在研究期间实施了一项政策的州和没有实施政策的州的儿童体重和消耗量，使我们能够评估这些政策的效果。我们将使用幼儿纵向研究，1998-99幼儿园班(ECLS-K)，它跟踪了从幼儿园到8年级的全国代表性儿童队列。ECLS-K包括相当数量的少数民族儿童和贫困儿童。我们考察了两组结果：儿童体重(BMI、z-Score和肥胖)和营养(早餐和含糖饮料消费)。ECLSK的一个显著优势是由训练有素的评估员测量身高和体重。我们使用调查权重来估计普通的最小二乘回归、逻辑回归和固定效应模型，以确保代表性。我们的关键解释变量是州一级的政策，这些政策将被汇编成一个全面的数据集，并与ECLS-K数据合并。我们包括对儿童、家庭、邻居和学校特征的控制。我们根据种族/民族和贫困状况来评估模型。意义：要求更好的学校营养的州法律可能会为改善学龄儿童的营养和体重提供一个简单、廉价的策略。然而，这些政策的有效性还没有得到探索。这项研究有助于了解儿童时期的体重变化、肥胖进展以及影响这些变化的行为和环境因素，评估：1)学校对国家政策变化的反应；2)国家政策对儿童体重和营养的影响；3)学生是否将不健康的商品消费转移到校外环境。我们将从测量儿童体重和身高的最大全国性纵向研究中提供关于这些问题的经验证据。 公共卫生相关性：先前的研究表明，早餐和汽水的摄入量都与儿童的体重结果独立相关，这表明专注于这些方面的干预措施可能对儿童健康有长期好处。这项研究将评估有很大潜力改善儿童健康饮食和体重的州政策，衡量要求学校提供早餐和限制在学校销售含糖饮料的州政策的效果。这项政策评估将协助政策制定者就这些领域更广泛的立法是否将促进儿童健康作出明智的决定。