School Nutrition Policies and Practices on an American Indian Reservation: Research and Policy Considerations

Navajo (Diné) and other American Indian children are more affected by overweight and obesity than their U.S. counterparts. In this descriptive study, the authors combined a socioecological and Navajo cultural framework to analyze the various factors that influence food choices available to children in schools. The Healthy Hunger-Free Kids Act of 2010 updated nutrition standards for school meals and all other foods and beverages sold in schools. Some studies have shown that improved nutrition standards were not favorably received by students and school food programs. To better understand these broader trends in a Navajo context, the researcher administered in-person surveys to 6 principals and 14 food service workers from a sample of 6 schools and performed on-site observations of two schools. Data were analyzed using a combination of descriptive statistics, matrix analysis, and thematic analysis techniques. Results showed that schools were offering more healthy food options in school lunches and that some schools were still serving unhealthy foods, such as pizza, tater tots, and French fries. Classroom and fundraising events provided other sources for low-nutrient foods and beverages. Participants had mixed responses about the updated nutrition standards, and food waste of healthy foods was a major concern. This study proposes opportunities for nurses to engage in research and advance stronger policies that increase healthy food options and limit access to less healthy foods.

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Changes to dietary and health outcomes following implementation of the 2012 updated US Department of Agriculture school nutrition standards: analysis using National Health and Nutrition Examination Survey, 2005–2016

Public Health Nutrition ◽

10.1017/s1368980020001986 ◽

2020 ◽

Vol 23 (16) ◽

pp. 3016-3024 ◽

Cited By ~ 2

Author(s):

Jenny Jia ◽

Lynn L Moore ◽

Howard Cabral ◽

Amresh Hanchate ◽

Marc R LaRochelle

Keyword(s):

Health Outcomes ◽

Vegetable Intake ◽

School Lunch ◽

School Nutrition ◽

Overweight And Obesity ◽

Fruit And Vegetable Intake ◽

Nutrition Examination Survey ◽

Obesity Prevalence ◽

Health And Nutrition ◽

Nutrition Standards

AbstractObjective:In 2012, the US government overhauled school nutrition standards, but few studies have evaluated the effects of these standards at the national level. The current study examines the impact of the updated school nutrition standards on dietary and health outcomes of schoolchildren in a nationally representative data set.Design:Difference-in-differences. We compared weekday fruit and vegetable intake between students with daily school lunch participation and students without school lunch participation before and after implementation of updated school nutrition standards using a multivariable linear regression model. Secondary outcomes included weekday solid fat and added sugar (SoFAS) intake and overweight and obesity prevalence. We adjusted analyses for demographic and family socio-economic factors.Setting:USA.Participants:K-12 students, aged 6–20 years (n 9172), from the National Health and Nutrition Examination Survey, 2005–2016.Results:Implementation of updated school nutrition standards was not associated with a change in weekday fruit and vegetable intake (β = 0·02 cups, 95 % CI −0·23, 0·26) for students with daily school lunch participation. However, implementation of the policy was associated with a 1·5 percentage point (95 % CI −3·0, −0·1) decline in weekday SoFAS intake and a 6·1 percentage point (95 % CI −12·1, −0·1) decline in overweight and obesity prevalence.Conclusions:Changes to US school nutrition standards were associated with reductions in the consumption of SoFAS as well as a decrease in overweight and obesity in children who eat school lunch. However, we did not detect a change in weekday intake of fruits and vegetables associated with the policy change.

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Incidental exposure to hedonic and healthy food features affects food preferences one day later

Cognitive Research Principles and Implications ◽

10.1186/s41235-021-00338-6 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Léo Dutriaux ◽

Esther K. Papies ◽

Jennifer Fallon ◽

Leonel Garcia-Marques ◽

Lawrence W. Barsalou

Keyword(s):

Incidental Learning ◽

Food Preferences ◽

Overweight And Obesity ◽

Healthy Food ◽

General Effect ◽

Healthy Foods ◽

Unhealthy Eating ◽

Affective Processes ◽

Incidental Exposure ◽

High Bmi

AbstractMemories acquired incidentally from exposure to food information in the environment may often become active to later affect food preferences. Because conscious use of these memories is not requested or required, these incidental learning effects constitute a form of indirect memory. In an experiment using a novel food preference paradigm (n = 617), we found that brief incidental exposure to hedonic versus healthy food features indirectly affected food preferences a day later, explaining approximately 10% of the variance in preferences for tasty versus healthy foods. It follows that brief incidental exposure to food information can affect food preferences indirectly for at least a day. When hedonic and health exposure were each compared to a no-exposure baseline, a general effect of hedonic exposure emerged across individuals, whereas health exposure only affected food preferences for high-BMI individuals. This pattern suggests that focusing attention on hedonic food features engages common affective processes across the general population, whereas focusing attention on healthy food features engages eating restraint goals associated with high BMI. Additionally, incidental exposure to food features primarily changed preferences for infrequently consumed foods, having less impact on habitually consumed foods. These findings offer insight into how hedonic information in the obesogenic food environment contributes to unhealthy eating behavior that leads to overweight and obesity. These findings further motivate the development of interventions that counteract the effects of exposure to hedonic food information and that broaden the effects of exposure to healthy food information.

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Correlates of Overweight and Obesity in American Indian Children

Journal of Pediatric Psychology ◽

10.1093/jpepsy/jsn047 ◽

2008 ◽

Vol 34 (3) ◽

pp. 245-253 ◽

Cited By ~ 16

Author(s):

T. Jollie-Trottier ◽

J. E. Holm ◽

J. D. McDonald

Keyword(s):

American Indian ◽

Overweight And Obesity ◽

Indian Children

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Increasing Prevalences of Overweight and Obesity in Northern Plains American Indian Children

Archives of Pediatrics and Adolescent Medicine ◽

10.1001/archpedi.160.1.34 ◽

2006 ◽

Vol 160 (1) ◽

pp. 34 ◽

Cited By ~ 55

Author(s):

Elenora Zephier ◽

John H. Himes ◽

Mary Story ◽

Xia Zhou

Keyword(s):

American Indian ◽

Overweight And Obesity ◽

Northern Plains ◽

Indian Children

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Macho Nachos

Social Psychology ◽

10.1027/1864-9335/a000226 ◽

2015 ◽

Vol 46 (4) ◽

pp. 182-196 ◽

Cited By ~ 12

Author(s):

Luke (Lei) Zhu ◽

Victoria L. Brescoll ◽

George E. Newman ◽

Eric Luis Uhlmann

Keyword(s):

Gender Stereotypes ◽

Food Packaging ◽

Food Preferences ◽

Healthy Food ◽

Psychological Reactance ◽

Unhealthy Food ◽

Healthy Foods ◽

Gender Schema ◽

Male And Female ◽

Schema Congruity

Abstract. The present studies examine how culturally held stereotypes about gender (that women eat more healthfully than men) implicitly influence food preferences. In Study 1, priming masculinity led both male and female participants to prefer unhealthy foods, while priming femininity led both male and female participants to prefer healthy foods. Study 2 extended these effects to gendered food packaging. When the packaging and healthiness of the food were gender schema congruent (i.e., feminine packaging for a healthy food, masculine packaging for an unhealthy food) both male and female participants rated the product as more attractive, said that they would be more likely to purchase it, and even rated it as tasting better compared to when the product was stereotype incongruent. In Study 3, packaging that explicitly appealed to gender stereotypes (“The muffin for real men”) reversed the schema congruity effect, but only among participants who scored high in psychological reactance.

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Alexander First Nations Parents’ Perceptions of a School Nutrition Policy

Canadian Journal of Dietetic Practice and Research ◽

10.3148/cjdpr-2019-026 ◽

2020 ◽

Vol 81 (2) ◽

pp. 66-71 ◽

Cited By ~ 1

Author(s):

Christina Gillies ◽

Anna Farmer ◽

Katerina Maximova ◽

Noreen D. Willows ◽

Keyword(s):

Policy Implementation ◽

First Nations ◽

Structured Interview ◽

Nutrition Policy ◽

School Nutrition ◽

Healthy Foods ◽

Promotion Strategy ◽

Food Programs ◽

Health Promotion Strategy ◽

Survey Responses

Purpose: A school nutrition policy (SNP) is one promising school-based health promotion strategy to improve the food environments of First Nations children. The aim of this study was to explore First Nations parents’ perceptions of a SNP. Methods: A process evaluation of policy implementation was conducted using a mixed-methods design. Parents (n = 83) completed a 19-question survey to capture their perceptions of the policy. Survey responses informed questions in an 11-question semi-structured interview guide. Transcripts from interviews with parents (n = 10) were analyzed using content analysis to identify barriers and facilitators to policy implementation. Results: Parents were supportive of the SNP and the school’s food programs, which they perceived as helping to address community concerns related to nutrition. However, some parents opposed the restriction of unhealthy foods at school celebrations and fundraisers. In addition, despite being aware of the SNP, parents were unable to demonstrate an understanding of the SNP content. Finally, parents struggled to provide their children with healthy foods to bring to school due to lack of affordable and accessible food in the community. Conclusions: Although SNPs may be well-received in First Nations communities, their implementation must be supported by parent involvement and consideration of wider socioeconomic conditions.

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Influence of Parental Health Literacy on Change over Time in the Oral Health of American Indian Children

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115633 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5633

Author(s):

Angela G. Brega ◽

Rachel L. Johnson ◽

Luohua Jiang ◽

Anne R. Wilson ◽

Sarah J. Schmiege ◽

...

Keyword(s):

Oral Health ◽

Health Literacy ◽

American Indian ◽

Health Knowledge ◽

Indian Children ◽

Change Over Time ◽

Oral Health Knowledge ◽

Pediatric Oral Health ◽

Children’S Oral Health ◽

Over Time

In cross-sectional studies, parental health literacy (HL) is associated with children’s oral health. It is unclear, however, whether HL influences pediatric outcomes. We examined the relationship of HL with change over time in parental oral health knowledge, beliefs, and behaviors, as well as pediatric oral health outcomes. We used longitudinal data from a study designed to reduce dental decay in American Indian children (N = 579). At baseline and annually for three years, parents answered questions assessing HL; oral health knowledge, beliefs, and behaviors; and pediatric oral health status. The number of decayed, missing, and filled tooth surfaces (dmfs) was computed based on annual dental evaluations. Linear mixed models showed that HL was significantly associated with all constructs, except dmfs, at their reference time points and persistently across the three-year study period. HL predicted change over time in only one variable, parents’ belief that children’s oral health is determined by chance or luck. HL is strongly associated with oral health knowledge, beliefs, behaviors, and status prospectively but is not a key driver of change over time in these oral health constructs.

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