The Impact of School Water Access on Child Food and Beverage Intake and Obesity

学校供水对儿童食品和饮料摄入量以及肥胖的影响

• 批准号: 9323551
• 负责人: Anisha Indravadan Patel
• 金额: $ 7.3万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9323551
• 关键词: Adult; Affect; American; Area; Behavior; Beverages; Calories; Centers for Disease Control and Prevention (U.S.); Child; Chronic Disease; Cluster randomized trial; Communities; Comorbidity; Consumption; Development; Dietary Practices; Eating; Energy Intake; Family; Food; Fresh Water; Fruit; Health; Health education; Hour; Hunger; Institute of Medicine (U.S.); Intake; Intervention; Juice; Knowledge; Lead; Low income; Measurement; Measures; Milk; Modeling; Obesity; Outcome; Overweight; Physical activity; Play; Policies; Prevalence; Prevention strategy; Randomized Controlled Trials; Regulation; Research; Rewards; Risk; San Francisco; Schools; Source; Students; Testing; Time; Water; Water consumption; authority; base; cost; diaries; disorder prevention; drinking; drinking water; elementary school; evidence base; food consumption; healthy weight; improved; nutrition; obesity in children; obesity prevention; obesity risk; prevent; programs; public health relevance; social cognitive theory; soft drink; sugar; sweetened beverage; tool; water quality

 DESCRIPTION (provided by applicant): Maintaining a healthy weight is important for young children because childhood obesity is predictive of adult obesity and related chronic illness. Intake of sugar-sweetened beverages (SSBs: sodas, flavored milks, fruit-flavored drinks, and other drinks with added sugar) is a major contributor to obesity. This is particularly true for low income children who are more likely to drink SSBs and to be obese. Children spend substantial time in schools where they consume up to 50% of daily calories, including those from SSBs. Consequently, many obesity prevention efforts have targeted reductions in SSB intake in schools. Recently, scientific authorities have also recommended that schools improve the availability of potable and free drinking water - a healthy alternative to SSBs - as a low-cost and feasible obesity prevention strategy. Emerging policies also mandate water access in schools; but implementation is poor. Although the 2010 Healthy, Hunger-Free Kids Act requires schools participating in federal meal programs to provide free potable water where meals are served, 25% of US schools still fail to do so. And even in schools that offer free water, drinking fountains may be avoided due to concerns about cleanliness or sub-standard water quality. While promotion of drinking water intake in schools is a plausible obesity prevention strategy, no large studies have systematically examined how this tactic can change children's overall dietary patterns and obesity rates in schools that offer SSBs and juices. Our central hypothesis is that in elementary schools, increased access to fresh water and rigorous promotion of its consumption will reduce student intake of caloric beverages, thereby leading to lower rates of obesity. To test this hypothesis, we will conduct a cluster-randomized trial in 26 low-income elementary schools in the San Francisco Bay Area, in which 13 schools will receive a water promotion intervention and 13 schools will serve as controls. The intervention, based on Social Cognitive Theory and the PRECEDE-PROCEED Model and cultivated in prior developmental studies by our team, promotes water consumption by: 1) installing lead-free water stations in cafeterias, physical activity spaces and high-traffic common areas, 2) providing cups and reusable water bottles for students, and 3) conducting a 6-month health education campaign that includes a kick-off play, class lessons, family homework activities, signage, and rewards. From baseline to 9 and 15 months after the start of the intervention, we will measure differences in: 1) water intake (observations and measurements of water taken from water sources) 2) total caloric intake from foods and beverages (24-hour food and beverage diaries) and 3) overweight/obesity prevalence between students in intervention and control schools. If the proposed school water intervention is effective, we can provide school officials with a feasible and low-cost obesity prevention tool. US schools will soon be federally mandated to reevaluate their wellness policies in order to implement new food and beverage regulations. This study presents a timely opportunity to provide leaders with an evidence-based strategy for improving student nutrition and health.

 描述（由申请人证明）：保持健康的体重很重要，因为儿童肥胖症可以预测糖和慢性疾病的摄入量。添加的糖是肥胖的主要贡献者。 可能是IE的收入儿童，包括来自SSB的人。 SSB-作为一种低成本和可行的肥胖症预防策略，尽管2010年健康，无饥饿的儿童法案都要求提供免费的饮料水，但实施也很差餐点是餐的25％，即使在提供自由水的学校，也可以避免使用饮酒，这是由于对不合标准的水质而促进饮用水。一个合理的肥胖策略。学生摄入饮料的摄入量，从而导致较低的比率测试这一假设。认知理论和在我们团队的先前发展研究中培养的模型，通过以下方式促进水消耗量：1）在Cafeter中安装铅冻水站。学生的水瓶和3个月的健康状况为6个月。日记）和3）学生在干预和控制学校中的超重/肥胖症患病率是有效的。 Y新食品和饮料法规。