Association between Nutrition Policies and Student Body Mass Index

In response to concerns about childhood obesity, many US states have implemented policies to limit the sale of unhealthy foods and beverages (e.g., snacks, desserts, and sugary drinks) sold in competition with school meal programs (i.e., competitive foods) in order to improve the nutritional environment of schools and support student health. This study measured state-level competitive food and beverage policies that require foods and beverages sold in à la carte lines, vending machines, and school stores to meet strong nutrition standards and tested the hypothesis that students living in states with stronger laws would have lower body mass index (BMI)-for-age percentiles. BMI data from a national sample of 1625 students attending 284 schools from the School Nutrition and Meal Cost Study were linked to state laws coded as part of the National Wellness Policy Study. A survey-adjusted linear regression model accounting for student and school-level characteristics showed that stronger state nutrition policies were associated with lower student BMI scores (coefficient: −0.06, 95% CI: −0.12, −0.00). Additional models indicated that stronger state policies were significantly associated with fewer unhealthy foods and beverages available in schools. These findings suggest that strong regulations on competitive foods and beverages may lead to improvements in the nutritional quality of the school environment and student BMI. Thus, current federal standards regulating snacks in US schools (i.e., Smart Snacks) are an important element of a comprehensive strategy to improve the school nutrition environment and reduce rates of childhood obesity.

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WHO European Childhood Obesity Surveillance Initiative: School Nutrition Environment and Body Mass Index in Primary Schools

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph111111261 ◽

2014 ◽

Vol 11 (11) ◽

pp. 11261-11285 ◽

Cited By ~ 21

Author(s):

Trudy Wijnhoven ◽

Joop van Raaij ◽

Agneta Sjöberg ◽

Nazih Eldin ◽

Agneta Yngve ◽

...

Keyword(s):

Body Mass Index ◽

Childhood Obesity ◽

Body Mass ◽

Primary Schools ◽

School Nutrition ◽

Nutrition Environment

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Prevalence and correlates of overweight and obesity among primary school children in Kilimanjaro, Tanzania

PLoS ONE ◽

10.1371/journal.pone.0249595 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249595

Author(s):

Mary Vincent Mosha ◽

Sia E. Msuya ◽

Elizabeth Kasagama ◽

Philip Ayieko ◽

Jim Todd ◽

...

Keyword(s):

Body Mass Index ◽

Primary School ◽

Body Mass ◽

Private Schools ◽

School Children ◽

Overweight And Obesity ◽

School Level ◽

Primary School Children ◽

Adjusted Relative Risk ◽

Sugary Drinks

Background Prevalence of childhood overweight and obesity in low- and middle-income countries is on the rise. We focused on multiple factors which could influence body mass index. Methods A cross sectional school-based study was conducted in Moshi, Tanzania. Primary school children aged 9–11 years were recruited from 20 schools through a multistage sampling technique. Questionnaires were used to collect information on physical activity and diet by food frequency questionnaire. Height and weight measurements were taken and body mass index z scores for age and sex (BMIZ) calculated using the WHO AnthroPlus. Children were considered thin if BMIZ was <-2 standard deviations and overweight or obese if BMIZ was >1 SD. Information on school policies and environment was obtained from headteachers. Correlates of overweight and obesity were examined using a multinomial multilevel logistic regression. Results A total of 1170 primary school children, of whom 636 (54%) were girls, were recruited from 20 schools. The prevalence of overweight and obesity was 15% overall (overweight 9% and obesity 6%) and most prevalent in urban areas (23%) and in private schools (24%). Moreover, thinness was found to be (10%) overall, most prevalent in rural areas (13%) and in government schools (14%). At school level, residing in urban (adjusted relative risk ratio [aRRR] 3.76; 95% confidence interval [CI] 2.49,5.68) and being in private school (aRRR 4.08; 95% CI 2.66,6.25) were associated with a higher risk of overweight and obesity while availability of playgrounds in schools (aRRR 0.68; 95% CI 0.47, 0.97) was associated with a lower risk of overweight and obesity. At home level, availability of sugary drinks (aRRR 1.52; 95% CI 1.01,2.28) was associated with a higher risk of overweight and obesity. Conclusion Overweight and obesity are common in private schools and in urban settings. Efforts should be taken to ensure availability of playgrounds in schools and encouraging children to engage in physical activities.

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Meal Quality of Entrées That Can Be Sold as Competitive Foods in Schools and Potential Impact of the Proposed USDA Rollbacks

Nutrients ◽

10.3390/nu12103003 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3003

Author(s):

Juliana F.W. Cohen ◽

Marlene B. Schwartz ◽

Julien Leider ◽

Lindsey Turner ◽

Jamie F. Chriqui

Keyword(s):

Saturated Fat ◽

National Sample ◽

School Nutrition ◽

Healthy Eating Index ◽

School Level ◽

Linear Regression Models ◽

School Lunches ◽

Cost Study ◽

Food Standards ◽

Competitive Foods

The Healthy, Hunger-Free Kids Act strengthened competitive food standards (i.e., Smart Snacks), but an exemption allows reimbursable meal entrées that do not meet Smart Snack standards to be sold as “competitive entrées” on the same day they are served in the reimbursable meal, and the following day. Proposed rollbacks would enable these competitive entrées to continue to be sold on a third day, increasing the availability of competitive foods exempt from Smart Snacks standards. This study compared the Healthy Eating Index (HEI) scores of potential competitive entrées alone versus full reimbursable school lunches, and examined the nutritional characteristics of potential competitive entrées. Data were from a national sample of 1108 schools from the School Nutrition and Meal Cost Study. Linear regression models, accounting for school-level and state and district policy characteristics, found that HEI scores of competitive entrées were an average of 30 points lower than HEI scores of reimbursable lunches, with greater differences in small and rural schools. Less than 1% of common potential competitive entrees met Smart Snack standards, primarily due to higher sodium and saturated fat levels. The proposed rollbacks are estimated to potentially add approximately 662 mg of sodium and 3 g of saturated fat over three days (1103 mg sodium and 5 g saturated fat over a week) on average relative to Smart Snacks limits. Instead of increasing opportunities to sell competitive entrées, their sales should be further limited.

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School-Level Body Mass Index Shapes Children's Weight Trajectories

Journal of School Health ◽

10.1111/josh.12701 ◽

2018 ◽

Vol 88 (12) ◽

pp. 917-927

Author(s):

Ashley W. Kranjac

Keyword(s):

Body Mass Index ◽

Body Mass ◽

School Level ◽

Weight Trajectories

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Orthopedic Problems in Overweight and Obese Children

Integrative Pediatrics and Child Care ◽

10.18314/ipcc.v1i1.1102 ◽

2018 ◽

Vol 1 (1) ◽

pp. 05-07

Author(s):

GL Di Gennaro

Keyword(s):

United States ◽

Coronary Artery Disease ◽

Body Mass Index ◽

Childhood Obesity ◽

Body Mass ◽

The United States ◽

Obese Children ◽

The World ◽

Prevalence Of Obesity ◽

Artery Disease

According to the data published by Haslam and James, about 10% of the world populations aged up to 18 areoverweight or obese [1]. In Europe, there are about 20% children with excessive body mass, 5% of whom sufferfrom obesity [2,3]. Childhood obesity is an ongoing epidemic in the United States [4,5]. The most recent data fromthe US indicate that 16.9% of children and adolescents are obese, defined as a body mass index (BMI) for age >95thpercentile [6,7] and there is evidence that the prevalence of obesity among children will reach 30% by 2030 [8].Childhood obesity is a risk factor for greater morbidity later in life, including diabetes, coronary artery disease andincreased mortality [4,5,9,10].

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Comparison of body mass index, the bioimpedance electric and waist circumference in childhood obesity classification

Advances in Obesity Weight Management & Control ◽

10.15406/aowmc.2019.09.00289 ◽

2019 ◽

Vol 9 (5) ◽

pp. 144-147

Author(s):

Ana Paula Carvalho Moreira Alves ◽

Liliana Filipa Oliveira Carola ◽

Emilia Manuela Oliveira Barros ◽

Ceomara Palmira Tavares de Pna

Keyword(s):

Body Mass Index ◽

Childhood Obesity ◽

Waist Circumference ◽

Body Mass

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Abstract 17944: Effects of School-Based Interventions on Body Mass Index in Children and Adolescents: a Systematic Overview and Meta-analysis

Circulation ◽

10.1161/circ.130.suppl_2.17944 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Jiyoon J Park ◽

Randa Bakhet ◽

Danica Karl ◽

Fei Yuan ◽

Eva Lonn

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Childhood Obesity ◽

Body Mass ◽

Meta Analysis ◽

Control Groups ◽

School Based ◽

School Based Interventions ◽

The Difference ◽

Dietary Modifications

Background: Childhood obesity is a major public health threat. Various school-based interventions (SBIs) to prevent obesity through physical activity and/or dietary modifications were implemented. However, the effectiveness of such SBIs remains unproven. Therefore, we conducted a meta-analysis of randomized controlled trials (RCTs) of SBIs. Methods: We searched for RCTs of SBIs published since 1990. To be eligible studies had to have an RCT design, to include children aged 6-18 years and SBIs were defined as non-pharmacological and non-surgical interventions carried out in a school setting with a minimum duration of 12 weeks. The primary outcome was change in body mass index (BMI. For each study the difference in the mean change in BMI between the intervention and the control groups was computed. The summary estimate for the difference in mean change in BMI and the 95% confidence interval (CI) was computed using a weighted inverse variance approach and a random- effects model. The I 2 statistic was used to test for heterogeneity. Results: Of 504 studies identified, 41 involving 42 430 participants met the inclusion criteria. SBIs varied greatly between studies by type, duration and delivery. In 10 RCTs the SBI focused on physical activity, in 6 on dietary modifications and in 25 on both physical activity and dietary modifications. SBIs duration ranged from 12 weeks to 4 years. There was no significant difference in mean BMI change between the intervention and the control groups (mean difference = -0.281kg/m 2 ; 95% CI -0.584 to 0.022), although there was significant heterogeneity between the RCTs’ findings (Figure). We found also no consistent impact on other measures of adiposity, physical activity patterns, dietary intakes and psychosocial health and wellbeing. Conclusions: SBIs had no substantial impact on BMI in children aged 6-18 years. Further research is needed to identify effective interventions to prevent childhood obesity.

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Addressing the Public Health Epidemic of Childhood Obesity Using Public Schools as Health Education Learning Laboratories

International Journal of Public and Private Perspectives on Healthcare Culture and the Environment ◽

10.4018/ijppphce.2020070102 ◽

2020 ◽

Vol 4 (2) ◽

pp. 12-24

Author(s):

Darrell Norman Burrell ◽

Jorja B. Wright ◽

Clishia Taylor ◽

Tiffiny Shockley ◽

April Reaves ◽

...

Keyword(s):

Body Mass Index ◽

Public Schools ◽

Childhood Obesity ◽

Nutrition Education ◽

Body Mass ◽

Body Fat ◽

School Food ◽

Index Reduction ◽

Keywords And Phrases ◽

Food Gardens

In our society, childhood obesity has become a pressing health issue. Childhood obesity occurs when children are considerably overweight for their age and height. Body mass index (BMI) is used to measure the percentage of body fat; therefore, the higher the BMI, the more body fat an individual has accompanied by the likelihood that the individual is obese. This research aims to address the factors that cause childhood obesity. A total of 116 journal articles were used for the development of this paper; the articles were analyzed and selected based on the occurrence of the following keywords and phrases: (1) childhood obesity, (2) social cognition theory, (3) telemedicine, and (4) nutrition education. The literature review showed a relationship between childhood obesity and body mass index (reduction, the use of telemedicine, and school food gardens). Using telemedicine video conferencing software and adding food gardens to public school curricula may be a strategy educators and policymakers can use to reduce the rate of childhood obesity.

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