Assessing the Impact of the New NSLP Nutrition Standards on Child BMI

描述（由申请人提供）：在生命早期解决肥胖问题是一个重要的公共卫生机会。这项研究将是同类研究中第一个评估营养政策的大规模变化可以改善儿童体重结果的程度。这项研究的结果将有助于告知政策制定者投资改善儿童饮食质量的潜在好处。 学校的饮食环境可能会影响儿童的饮食习惯，从而影响肥胖的风险。国家学校午餐计划（NSLP）是学校食品环境的重要组成部分，每天为3100多万儿童提供午餐。根据2010年《健康无饥饿儿童法》的指示，农业部制定了新的《国家营养计划》学童午餐营养标准。这些标准将在2012-2013学年实施，旨在改善膳食质量和与营养有关的儿童成果。该标准的关键组成部分包括：增加水果、蔬菜和全谷物的供应，消除高脂肪乳制品，限制卡路里、钠和饱和脂肪。本研究将针对两个具体目标：1）检查新的学校营养标准是否影响了小学生的体重指数（BMI）和肥胖风险; 2）在两个具体情况下，检查学校营养标准是否按预期执行，并记录学校在执行新的学校营养标准时面临的障碍。 本研究将采用混合方法策略来评估新的NSLP膳食标准对儿童体重结果的影响。采用二级数据和三重差异模型的非实验设计将用于估计新的NSLP营养标准对儿童BMI和体重状况的影响。由半结构化的关键信息提供者访谈和学校午餐观察组成的两级定性研究将提供关于各学区营养标准执行情况的描述性证据，以及营养标准可能影响儿童体重的可能途径。

DESCRIPTION (provided by applicant): Addressing obesity early in life is a significant public health opportunity. This study will be the first of its kind to assess the extent to which large-scle changes in nutrition policy could improve weight outcomes for children. Results from this study will help inform policymakers of the potential benefits of investing in improved diet quality for children. The school food environment may influence the dietary habits of children, and therefore, the risk of obesity. The National School Lunch Program (NSLP) is a key component of the school food environment, serving over 31 million children lunches daily. As directed by the Healthy, Hunger-Free Kids Act of 2010, the Department of Agriculture instituted new NSLP nutrition standards for lunches served to school children. The standards, implemented in the 2012-2013 school year, are designed to lead to improvements in meal quality and nutrition-related child outcomes. Key components of the standards include: increasing fruits and vegetables and whole grains offered, eliminating high fat dairy products, and limiting calories, sodium, and saturated fat. This research will address two specific aims: 1) To examine whether the new school nutrition standards have affected elementary school children's body mass index (BMI) and risk of obesity; and 2) To examine, in two specific contexts, whether or not school nutrition standards being implemented as intended and to document the obstacles schools faced in implementing the new school nutrition standards. This study will employ a mixed methods strategy to assess the impact of the new NSLP meal standards on child weight outcomes. A non-experimental design using secondary data and triple difference models will be used to estimate the impact of the new NSLP nutrition standards on child BMI and weight status. A two-level qualitative study composed of semi-structured key informant interviews and school lunch observation will provide descriptive evidence on the implementation of nutrition standards across school districts and on possible pathways through which nutritional standards may impact child weight.