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）：美国儿童肥胖症的患病率是历史最高的，目前有15％的儿童肥胖。儿童肥胖与身体/心理健康和社会福祉较差以及肥胖和心脏代谢疾病的未来风险增加有关。目标：我们将评估有关学校早餐和甜味饮料可用性的国家政策的潜力，以改善小学和中学生的健康饮食和体重。我们检验了三个假设：1）国家一级的学校早餐需求增加了学校早餐的可用性和消费，并增加了营养食品的摄入量； 2）国家对学校甜味饮料销售的限制导致学校饮料的可用性降低，这些物品的总摄入量较低，儿童肥胖症患病率较低； 3）需要早餐和限制甜味饮料销售的州一级学校政策对低收入和少数民族儿童的影响更大。设计：我们的分析策略通过以下儿童根据其居住状态来复制实验研究设计。比较在研究期间实施政策的国家的儿童体重和消费与不允许我们评估政策效果的国家的体重和消费。我们将使用1998 - 99年的幼儿园纵向研究（ECLS-K），该研究遵循从幼儿园到八年级的全国代表性儿童的群体。 ECLS-K包括大量少数族裔和贫困儿童。我们检查了两组结果：儿童体重（BMI Z分数和肥胖症）和营养（早餐和甜味饮料消费）。 ECLSK的一个重要优点是，身高和体重是由训练有素的评估者衡量的。我们使用调查权重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。我们的主要解释变量是州级策略，该策略将汇编为综合数据集并与ECLS-K数据合并。我们包括对儿童，家庭，社区和学校特征的控件。我们根据种族/种族和贫困状况估算模型。意义：需要更好的学校营养的州法律潜在地提供了一种简单，廉价的策略，以改善学生的营养和体重。然而，尚未探讨这些政策的有效性。这项研究有助于了解童年期间体重变化，肥胖进展以及影响这些影响的行为和环境因素，评估：1）学校对国家政策变化的响应能力； 2）国家政策对儿童体重和营养的影响； 3）学生是否将对不健康商品的消费取代到校外环境中。我们将提供有关这些问题的经验证据，从最大的国家纵向研究测量儿童的体重和身高。公共卫生相关性：先前的研究表明，早餐和苏打消费都与儿童的体重成果独立相关，这表明专注于这些的干预措施可能对儿童健康有长期的益处。这项研究将评估具有改善儿童健康饮食和体重的高潜力的国家政策，衡量需要学校提供早餐并限制学校饮料销售的国家政策的影响。这项政策评估将有助于决策者做出明智的决定，了解这些领域的广泛立法是否会促进儿童的健康。