Dataset Information

Healthier Food and Beverage Interventions in Schools: Four Community Guide Systematic Reviews.

ABSTRACT:

Context

Healthy eating during childhood is important for optimal growth and helps reduce the risk of obesity, which has potentially serious health consequences. Changing the school food environment may offer one way to improve students' dietary intake. This manuscript reports 4 Community Guide systematic reviews examining the effectiveness of interventions in schools promoting healthy eating and weight.

Evidence acquisition

School obesity prevention programs aiming to improve diet were identified from a 2013 Agency for Health Care Research and Quality systematic review and an updated search (August 2012-January 4, 2017). In 2017-2018, Community Guide systematic review methods were used to assess effectiveness as determined by dietary behavior and weight changes.

Evidence synthesis

Interventions improving school meals or offering fruits and vegetables (n=27 studies) are considered effective. Evidence is insufficient to determine the effectiveness of interventions supporting healthier snack foods and beverages outside of school meal programs given inconsistent findings (n=13 studies). Multicomponent interventions to increase availability of healthier foods and beverages are considered effective. These interventions must include 1 component from school meals or fruit and vegetable programs and interventions supporting healthier snack foods and beverages (n=12 studies). There is insufficient evidence to determine the effectiveness of interventions to increase water access because only 2 studies met inclusion criteria.

Conclusions

A total of 2 school-based dietary interventions have favorable effects for improving dietary habits and modest effects for improving or maintaining weight. More evidence is needed regarding interventions with insufficient findings. These reviews may inform researchers and school administrators about healthy eating and obesity prevention interventions.

SUBMITTER: Wethington HR

PROVIDER: S-EPMC9366443 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Publications

Healthier Food and Beverage Interventions in Schools: Four Community Guide Systematic Reviews.

Wethington Holly R HR Finnie Ramona K C RKC Buchanan Leigh Ramsey LR Okasako-Schmucker Devon L DL Mercer Shawna L SL Merlo Caitlin C Wang Youfa Y Pratt Charlotte A CA Ochiai Emmeline E Glanz Karen K

American journal of preventive medicine 20200701 1

<h4>Context</h4>Healthy eating during childhood is important for optimal growth and helps reduce the risk of obesity, which has potentially serious health consequences. Changing the school food environment may offer one way to improve students' dietary intake. This manuscript reports 4 Community Guide systematic reviews examining the effectiveness of interventions in schools promoting healthy eating and weight.<h4>Evidence acquisition</h4>School obesity prevention programs aiming to improve diet ...[more]

PMID: 32564807

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Project description:BackgroundPoint-of-sale is a potentially important opportunity to promote healthy eating through nutrition education and environment modification. The aim of this review was to describe and review the evidence of effectiveness of various types of interventions that have been used at point-of-sale to encourage purchase and/or eating of healthier food and to improve health outcomes, and the extent to which effectiveness was related to intensity, duration and intervention setting.MethodsRecords from searches in databases were screened and assessed against inclusion criteria. Included studies had risk of bias assessed. Intervention effectiveness was assessed for two outcomes: i) purchase and/or intake of healthier food options and/or nutrient intake; and ii) mediating factors that might effect the primary outcome.ResultsThe search identified 5635 references. Thirty-two papers met the inclusion criteria. Twelve studies had low risk of bias and were classified as strong, nine were moderate and 11 were weak. Six intervention types and a range of different outcome measures were described in these papers: i) nutrition education and promotion alone through supermarkets/stores; ii) nutrition education plus enhanced availability of healthy food; iii) monetary incentive alone; iv) nutrition education plus monetary incentives; v) nutrition intervention through vending machines; and vi) nutrition intervention through shopping online. The evidence of this review indicates that monetary incentives offered to customers for a short-term look promising in increasing purchase of healthier food options when the intervention is applied by itself in stores or supermarkets. There was a lack of good quality studies addressing all other types of relevant point-of-sale interventions examining change in purchase and/or intake of healthier food options. There were few studies that examined mediating factors that might mediate the effect on the primary outcomes of relevant interventions.ConclusionsA range of intervention types have been used at point-of-sale to encourage healthy purchasing and/or intake of healthier food options and to improve health outcomes. There is a need for more well designed studies on the effectiveness of a range of point-of-sale interventions to encourage healthier eating and improve health outcomes, and of the mediating factors that might impact these interventions.

Project description:Despite growing interest from government agencies, non-governmental organizations and school boards in restricting or regulating unhealthy food and beverage marketing to children, limited research has examined the emerging knowledge base regarding school-based food and beverage marketing in high-income countries. This review examined current approaches for measuring school food and beverage marketing practices, and evidence regarding the extent of exposure and hypothesized associations with children's diet-related outcomes. Five databases (MEDLINE, Web of Science, CINAHL, Embase, and PsycINFO) and six grey literature sources were searched for papers that explicitly examined school-based food and beverage marketing policies or practices. Twenty-seven papers, across four high-income countries including Canada (n = 2), Ireland (n = 1), Poland (n = 1) and United States (n = 23) were identified and reviewed. Results showed that three main methodological approaches have been used: direct observation, self-report surveys, and in-person/telephone interviews, but few studies reported on the validity or reliability of measures. Findings suggest that students in the U.S. are commonly exposed to a broad array of food and beverage marketing approaches including direct and indirect advertising, although the extent of exposure varies widely across studies. More pervasive marketing exposure was found among secondary or high schools compared with elementary/middle schools and among schools with lower compared with higher socio-economic status. Three of five studies examining diet-related outcomes found that exposure to school-based food and beverage marketing was associated with food purchasing or consumption, particularly for minimally nutritious items. There remains a need for a core set of standard and universal measures that are sufficiently rigorous and comprehensive to assess the totality of school food and beverage marketing practices that can be used to compare exposure between study contexts and over time. Future research should examine the validity of school food and beverage marketing assessments and the impacts of exposure (and emerging policies that reduce exposure) on children's purchasing and diet-related knowledge, attitudes and behaviors in school settings.

Dataset Information

Healthier Food and Beverage Interventions in Schools: Four Community Guide Systematic Reviews.

Context

Evidence acquisition

Evidence synthesis

Conclusions

Publications

Healthier Food and Beverage Interventions in Schools: Four Community Guide Systematic Reviews.

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