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

基本信息

批准号：
8049602
负责人：
Solveig Argeseanu Cunningham
金额：
$ 8.1万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-04-01 至 2013-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8049602
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 drinking early childhood early onset elementary school expectation food quality improved kindergarten middle school nutrition obesity in children obesity risk physical conditioning preference programs public health relevance research study residence respiratory social sweetened beverage

项目摘要

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（由申请人提供）：美国儿童的肥胖患病率处于历史最高水平，目前超过 15% 的儿童肥胖。儿童肥胖与较差的身体/心理健康和社会福祉以及未来肥胖和心脏代谢疾病的风险增加有关。目标：我们将评估解决学校早餐和甜饮料供应问题的国家政策对于改善中小学生健康饮食和体重的潜力。我们测试了三个假设：1）州级学校早餐要求增加了学校早餐的供应和消费，并增加了营养食品的摄入量； 2) 国家对学校销售甜饮料的限制导致学校此类饮料的供应量减少，这些物品的总摄入量减少，儿童肥胖患病率降低； 3）国家级学校要求早餐和限制含糖饮料销售的政策对低收入和少数民族儿童影响更大。设计：我们的分析策略复制了一项实验研究设计，根据居住地的不同，跟踪那些曾或未曾经历过政策变化的儿童。通过比较研究期间实施政策的州和未实施政策的州的儿童体重和消费，我们可以评估政策的效果。我们将使用 1998-99 学前班幼儿纵向研究 (ECLS-K)，该研究跟踪具有全国代表性的从幼儿园到八年级的儿童队列。 ECLS-K 包括大量少数民族和贫困儿童。我们检查两组结果：儿童体重（BMI z 得分和肥胖）和营养（早餐和加糖饮料消耗量）。 ECLSK 的一个显着优势是身高和体重由经过培训的评估员测量。我们使用调查权重来估计普通最小二乘回归、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国家级政策，它将被编译成一个综合数据集并与 ECLS-K 数据合并。我们包括针对儿童、家庭、社区和学校特征的控制。我们根据种族/民族和贫困状况来估计模型。意义：要求改善学校营养的州法律可能为改善学童的营养和体重提供一种简单、廉价的策略。然而这些政策的有效性尚未得到探讨。这项研究有助于了解儿童时期的体重变化、肥胖的进展以及影响这些变化的行为和环境因素，并评估：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) 学生是否将不健康商品的消费转移到校外环境。我们将通过测量儿童体重和身高的最大的全国纵向研究来提供有关这些问题的经验证据。公共健康相关性：先前的研究表明，早餐和苏打水的摄入量都与儿童的体重结果独立相关，这表明针对这些的干预措施可能对儿童健康产生长期益处。这项研究将评估那些在改善儿童健康饮食和体重方面具有巨大潜力的国家政策，衡量要求学校提供早餐和限制在学校销售甜味饮料的国家政策的效果。这项政策评估将帮助政策制定者就这些领域更广泛的立法是否会促进儿童健康做出明智的决定。