Nutrient Intakes among Children and Adolescents Eating Usual Pizza Products in School Lunch Compared with Pizza Meeting HealthierUS School Challenge Criteria

Pizza is a popular food that can contribute to high intakes of saturated fat and sodium among children and adolescents. The objective of this study was to compare daily nutrient intakes when a pizza product meeting the US Department of Agriculture's criteria for competitive food entrées under the HealthierUS School Challenge (HUSSC) was substituted for usual pizza products consumed during foodservice-prepared school lunch. The study used National Health and Nutrition Examination Survey (2005-2008) dietary recall data from a cross-sectional sample of US children and adolescents (age 5 to 18 years, n=337) who ate pizza during school lunch on 1 day of dietary recall. Daily nutrient intakes based on the consumption of usual pizza products for school lunch (pre-modeled) were compared with intakes modeled by substituting nutrient values from an HUSSC whole-grain pizza product (post-modeled). Paired t tests were used to make the comparison. Post-modeled intakes were lower in daily energy, carbohydrate, total fat, saturated fat, cholesterol, and sodium compared with pre-modeled intakes among children and adolescents (P<0.01). Protein, dietary fiber, vitamin A, and potassium intakes were higher in the post-modeled intake condition compared with the pre-modeled condition (P<0.01). Substituting the healthier pizza product for usual pizza products may significantly improve dietary quality of children and adolescents eating pizza for school lunch, indicating that it could be an effective approach to improve the nutritional quality of school lunch programs.     

Food Waste in a School Nutrition Program After Implementation of New Lunch Program Guidelines

ObjectiveTo assess the amount of food waste by meal components according to the new National School Lunch Program guidelines among pre-kindergarten and kindergarten students.MethodsFor 5 consecutive school days in 1 elementary school, the research team collected school lunch trays and separated meal components into bins relative to each food or beverage appearing on the school's daily menu. Bins were weighed in grams and converted to ounces and cups at the end of each lunch period.ResultsThe researchers examined 304 meals from 1 pre-kindergarten class and 5 kindergarten classes. Of 4,988 oz of food and beverages served, 2,261 oz (45.3%) were wasted during 1 full school week, totaling 141 lb. The greatest amount of food waste was generated from vegetables, the main entree, and milk, respectively.Conclusions and ImplicationsStrategies to reduce food waste in school lunch should be researched and implemented.     

A Mixed-Methods Evaluation of a School Wellness Initiative: An Examination of Longer Lunch Periods and More Physical Activity Opportunities

BackgroundThere are currently no national standards for lunch period lengths or physical activity in schools. Research is needed to better understand the impact of school initiatives that improve policies related to lunch and movement opportunities on student outcomes. Additionally, best practices are necessary to support schools that are considering initiatives that address these factors.ObjectiveThis study examined the impact of implementing longer lunch periods, recess, and other movement opportunities on student outcomes and best practices for implementation.DesignA mixed-methods study including surveys and semistructured interviews and focus groups conducted during the 2019-2020 school year.Participants/settingSurveys (n = 5107) from students in grades 3 and 4 attending 19 pilot and 11 matched control elementary schools and interviews/focus groups among principals, cafeteria managers, teachers, and parents in a representative subsample (n = 6) of pilot schools in Anchorage Alaska.Main outcome measuresStudents’ self-reported hunger levels and mood and perceptions and supportive strategies from school principals, cafeteria staff, teachers, and parents were examined.Statistical analyses performedMixed-model analysis of variance accounting for student demographics with students as a random effect (students nested within schools) were used to examine differences in hunger and mood. For interviews/focus groups, responses were analyzed qualitatively using principles of content analysis.ResultsLonger lunch periods were associated with significantly reduced hunger at the end of lunch period and significantly increased self-reported happiness in the cafeteria. Based on interviews/focus groups with school staff and parents, the initiative was generally perceived positively with reported benefits including reductions in disciplinary issues and improvements in student focus, social and emotional learning, and overall student happiness and well-being. Several supportive strategies were identified.ConclusionsInitiatives that increase lunch period lengths and physical activity opportunities have the potential to reduce students’ hunger levels and improve focus and behaviors in the classroom. Schools should consider similar initiatives that incorporate the suggested strategies to potentially improve outcomes among students.     

Nasal Symptoms Are Associated with School Performance in Adolescents

Children with asthma and allergy have higher school absence rates than others, but little is known about their school performance. In a study of 9538 adolescents, nasal symptoms severe enough to affect daily activity were associated with low-grade sum, particularly in adolescents using anti-allergy medication.     

Dietary Intake and Lifestyle Habits of Children Aged 10–12 Years Enrolled in the School Lunch Program in Greece: A Cross Sectional Analysis

School Lunch programs are a common strategy to address social inequalities in food access among children, especially food insecurity. The aim of this study was to evaluate the dietary intake and lifestyle habits of children aged 10–12 years enrolled in the School Lunch Program in Greece. A cross-sectional survey of fifth and sixth grade students, School Lunch recipients (n = 609) and control subjects (n = 736), collected data on sociodemographic, nutritional and lifestyle habits via self-reported questionnaires during May–October 2019. Despite enrollment in the School Lunch Program children in this group reported consuming less meals during the day (3.47 ± 1.38 vs. 3.65 ± 1.35, p = 0.002). No differences were seen in intakes of energy and macronutrients, however School Lunch recipients reported lower intakes of cereals/potatoes and legumes but higher fruit intake (2.32 ± 1.59 vs. 1.97 ± 1.72, p < 0.05). School Lunch recipients reported 42min/d and 28min/d higher screen-time during weekdays and weekends, respectively. Linear regression highlighted that dietary quality was not associated with School Lunch enrollment but rather sleep duration and screen time had a stronger influence on dietary habits. Enrollment in a School Lunch Program was linked to sustained differences in sedentary lifestyle habits but less so in dietary habits.     

Differences in Diet Quality between School Lunch Participants and Nonparticipants in the United States by Income and Race

Prior research has shown that participation in the United States’ National School Lunch Program (NSLP) is associated with consuming higher-quality lunches and diets overall, but little is known about differences by income and race/ethnicity. This analysis used 24 h dietary recall data from the School Nutrition and Meal Cost Study to examine how NSLP participation affects the diet quality of students in different income and racial/ethnic subgroups. Diet quality at lunch and over 24 h was assessed using the Healthy Eating Index (HEI)-2010, where higher scores indicate higher-quality intakes. HEI-2010 scores for NSLP participants and nonparticipants in each subgroup were estimated, and two-tailed t-tests were conducted to determine whether participant–nonparticipant differences in scores within each subgroup were statistically significant. NSLP participants’ lunches received significantly higher total HEI-2010 scores than those of nonparticipants for lower-income, higher-income, non-Hispanic White, and non-Hispanic Black students, suggesting that participating in the NSLP helps most students consume healthier lunches. These significantly higher total scores for participants’ lunch intakes persisted over 24 h for higher-income students and non-Hispanic White students but not for lower-income students or students of other races/ethnicities. For NSLP participants in all subgroups, the nutritional quality of their 24 h intakes was much lower than at lunch, suggesting that the positive influence of the NSLP on their overall diet quality was negatively influenced by foods consumed the rest of the day (outside of lunch).     

Estimates of the Nutritional Impact of Non-Participation in the National School Lunch Program during COVID-19 School Closures

The COVID-19 pandemic resulted in widespread school closures, reducing access to school meals for millions of students previously participating in the US Department of Agriculture (USDA) National School Lunch Program (NSLP). School-prepared meals are, on average, more nutritious than home-prepared meals. In the absence of recent data measuring changes in children’s diets during the pandemic, this article aims to provide conservative, back-of-the-envelope estimates of the nutritional impacts of the pandemic for school-aged children in the United States. We used administrative data from the USDA on the number of NSLP lunches served in 2019 and 2020 and nationally representative data from the USDA School Nutrition and Meal Cost Study on the quality of school-prepared and home-prepared lunches. We estimate changes in lunchtime calories and nutrients consumed by NSLP participants from March to November 2020, compared to the same months in 2019. We estimate that an NSLP participant receiving no school meals would increase their caloric consumption by 640 calories per week and reduce their consumption of nutrients such as calcium and vitamin D. Because 27 to 78 million fewer lunches were served per week in March–November 2020 compared to the previous year, nationally, students may have consumed 3 to 10 billion additional calories per week. As students return to school, it is vital to increase school meal participation and update nutrition policies to address potentially widening nutrition disparities.     

深圳市以肥胖控制为切入点发展健康促进学校项目中期效果评价

目的　通过以肥胖控制为切入点发展健康促进学校模式 ,逐步摸索出适合中国国情的预防和控制儿童肥胖的途径和方法。方法　按照健康促进学校的六大方面要求 ,在项目学校中进行创建活动和并重点进行肥胖干预 ,于干预前后对学生进行问卷和肥胖率调查。结果　与对照学校相比 ,项目学校学生在知识、态度和行为水平上均有显著提高 ;一年来项目学校学生肥胖率维持在 1 4 4% ,而对照学校学生肥胖率从 9 6%上升到 1 3 4% ,增长了 3 8% (P <0 0 5 )。结论　创建活动和肥胖干预工作对学生产生了良好的教育和引导作用 ,同时控制了学生肥胖率的进一步发展。对学生的肥胖干预是一项长期而艰巨的工程 ,而来自政府、社会、学校、社区、家庭、个人等多方面的支持必不可少。以肥胖控制为切入点发展健康促进学校模式非常值得作为一项可持续发展的工作继续推行。     

Serving Breakfast Free to All Students and Type of Breakfast Serving Model Are Associated with Participation in the School Breakfast Program

BackgroundMany students experience challenges participating in the School Breakfast Program (SBP) when breakfast is served before school in the cafeteria. Serving breakfast free to all students or offering innovative breakfast serving models, such as breakfast in the classroom (BIC), grab n’ go, or second chance breakfast, may encourage higher SBP participation rates.ObjectiveTo examine the association between offering breakfast free to all students as well as breakfast serving model with student participation in the SBP in October 2017 among public schools in North Carolina.DesignCross-sectional study using data from the North Carolina Department of Public Instruction.Participants/settingThis study included data from 2,285 North Carolina public schools who served breakfast in October 2017 with 1,445,287 students.Main outcome measuresThe main outcome measures are the odds of a student participating in the SBP among students overall, students eligible for free or reduced-price (FRP) meals, and students not eligible for FRP meals.Statistical analyses performedMultiple logistic regression assessed the association between offering breakfast free to all students and breakfast serving model with the probability of participating in the SBP (number of students participating out of number of students enrolled) for students overall, eligible for FRP meals, and not eligible for FRP meals. Statistical models were stratified by school type (elementary, middle, and high schools).ResultsBreakfast serving models positively associated with SBP participation were BIC and BIC plus grab n’ go for elementary and high school students and grab n’ go and second chance for middle and high school students (P<0.05). Serving breakfast free to all students was positively associated with SBP participation alone and in combination with BIC, second chance, and BIC plus grab n’ go (P<0.05).ConclusionsServing breakfast free to all students and breakfast serving model were associated with SBP participation, and different relationships existed for different school levels.     

Nutrient Density and the Cost of Vegetables from Elementary School Lunches

Vegetables are the major source of the dietary fiber, magnesium, potassium, and vitamins A and C that are crucial in the diets of children. This study assessed the nutrient content of vegetables offered through the National School Lunch Program and examined the relation between the overall nutrient density of vegetable subgroups and the costs of nutrients offered and wasted before and after the changes in school meal standards. Using data collected from 3 elementary schools before and after the changes in school meal standards, we found that vegetable plate waste increased from 52% to 58%. Plate waste for starchy vegetables, exclusive of potatoes, was relatively high compared with other subgroups; however, plate waste for white potatoes was the lowest among any type of vegetable. Energy density; cost per 100 g, per serving, and per 100 kcal; and percentage daily value were calculated and used to estimate nutrient density value and nutrient density per dollar. Cost per 100 kcal was highest for red/orange vegetables followed by dark green vegetables; however, nutrient density for red/orange vegetables was the highest in the group and provided the most nutrients per dollar compared with other subgroups. Given that many vegetables are less energy dense, measuring vegetable costs per 100 g and per serving by accounting for nutrient density perhaps is a better way of calculating the cost of vegetables in school meals.     

Duration of WIC Participation and Early Feeding Practices Are Associated With Meeting the Added Sugars Recommendation at Age 3 Years

ObjectiveTo examine whether duration of participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and early feeding practices are associated with the likelihood of meeting the Dietary Guidelines for Americans (DGA) recommendation for added sugars (AS) at age 3 years.MethodsUsing data from the WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2), logistic regression assessed associations between WIC participation patterns, early feeding practices, and whether 3-year-olds met the AS recommendation.ResultsChildren introduced to sugar-sweetened beverages (SSBs) in their first year were about half (adjusted odds ratio, 0.65; P < 0.01) as likely to meet the recommendation as those not exposed in their first 2 years. First-year-only WIC participation (adjusted odds ratio, 0.61; P < 0.04) also increased the risk of excessive consumption compared with children who participated in their third year.Conclusions and ImplicationsDuration of WIC participation is inversely associated with young children's AS intakes. Public health efforts to reduce WIC attrition and enhance education efforts focused on delaying sugar-sweetened beverage introduction are supported.     

地震灾后绵阳市学校卫生工作的做法与效果

目的 通过对地震灾后绵阳市学校卫生工作做法与效果的分析与讨论,为进一步做好地震灾区学校卫生工作提供经验.方法 对"5·12"地震灾后绵阳市学校卫生工作的做法进行总结和分析,并将春秋季(地震前后)开学时学校卫生情况进行对比分析.结果 从健全制度、明确责任、部门联动、强化措施、督查督办等方面人手,使地震灾后秋季开学时的学校食品卫生、生活饮用水卫生、传染病防控和健康教育等工作基本达到地震前春季开学时水平,确保了灾后开学复课期间的师生卫生安全.结论 地震灾后绵阳市学校卫生工作成效显著,其做法可为其他地震灾区和其它突发公共事件后的学校卫生工作提供参考.     

Validation of a Questionnaire to Measure Fruits and Vegetables Selected and Consumed at School Lunch among Second- and Third-Grade Students

Background

Interventions designed to encourage fruit and vegetable (F/V) consumption within schools are increasingly common. Thus, there is a need for valid, practical dietary assessment instruments to evaluate their effectiveness.

Eating School Meals Daily Is Associated with Healthier Dietary Intakes: The Healthy Communities Study

Background

Research on the association between school meal consumption and overall dietary intake post-Healthy Hunger-Free Kids Act implementation is limited.