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（由适用提供）：保持健康体重对幼儿很重要，因为儿童肥胖症可以预测成人肥胖和相关慢性病。摄入糖甜的品种（SSB：苏打水，调味奶，水果味的饮料和其他添加糖的饮料）是肥胖症的主要因素。低点尤其如此 收入的孩子更有可能喝SSB并肥胖。儿童在学校中度过了次要的时间，在那里他们消耗了每日卡路里的50％，包括来自SSB的卡路里。因此，许多预防肥胖症的工作已针对学校的SSB摄入量的减少。最近，科学当局还建议学校改善饮用水和免费饮用水的可用性 - 一种健康的SSB替代品 - 作为一种低成本且可行的预防策略。新兴政策还要求学校的水通道；但是实施很差。尽管《 2010年健康，无饥饿的儿童法》要求参加联邦用餐计划的学校提供​​免费的饮用水，但在提供餐点的地方，但美国25％的学校仍然没有这样做。即使在提供免费水的学校，由于担心清洁度或不合格的水质，也可以避免饮用喷泉。尽管在学校促进饮用水摄入量是一种合理的预防策略，但没有大型研究系统地研究了这种策略如何改变儿童的整体饮食模式和提供SSB和果汁的学校的肥胖率。我们的中心假设是，在小学中，增加获得淡水的机会并严格促进其消费将减少学生对热量饮料的摄入，从而导致肥胖率降低。为了检验这一假设，我们将在旧金山湾区的26所低收入小学中进行集群随机试验，其中13所学校将接受促进供水干预，13所学校将作为控制。 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奖励。从基线到干预开始后的9到15个月，我们将测量以下方面的差异：1）饮水（从水源中获得的水的观察和测量）2）从食物和卧室（24小时的食物和卧室日记）和学生对干预和控制学校之间的超重/肥胖症的总热量摄入（24小时食物和卧室日记）和卧室的总热量摄入量。如果拟议的学校水干预有效，我们可以为学校官员提供可行且低成本的预防工具。美国学校将很快受到联邦政府的要求，以重新评估其健康政策，以实施新的食品和卧室法规。这项研究提供了及时的机会，可以为领导者提供改善学生营养和健康的循证策略。