Andrea S Richardson1, Nancy Nicosia2, Madhumita B Ghosh-Dastidar3, Ashlesha Datar4. 1. Social and Economic Well-being, RAND Corporation, Pittsburgh, Pennsylvania. Electronic address: arichard@rand.org. 2. Economics, Sociology & Statistics, RAND Corporation, Boston, Massachusetts. 3. Economics, Sociology & Statistics, RAND Corporation, San Francisco, California. 4. Center for Economic and Social Research, University of Southern California, Los Angeles, California.
Abstract
PURPOSE: Existing evidence on relationships between school food environments and children's in-school purchases, dietary behaviors, and body composition is based on observational studies that are vulnerable to residential selection bias. METHODS: This study leveraged exogenous variation in school environments generated by the natural experiment due to military parents' assignment to installations. We analyzed 1,010 child-wave observations from the Military Teenagers Environments, Exercise, and Nutrition Study collected during 2013-2015. Using multiple linear and logistic regression, we examined whether the number of competitive food and beverage (CF&B) items available for purchase in school, overall and by type (unhealthy, healthy, neutral), was associated with in-school food purchases, dietary behaviors, and body mass index (BMI) outcomes. Covariates included child and family characteristics and the healthiness of the home food environment. RESULTS: Unhealthy item availability was positively associated with purchasing any sweets (adjusted odds ratio [AOR], 1.30; p < .01), snacks (AOR, 1.23; p < .01), and sugar-sweetened beverages (AOR, 1.19; p = .01). However, there were no significant associations with overall food and beverage intake (e.g., sweets, soda) nor BMI outcomes. The home food environment was significantly associated with all outcomes. CONCLUSIONS: Access to unhealthy CF&B items may influence in-school purchases but does not appear to influence overall dietary behaviors and BMI outcomes. Substitution of caloric intake across locations within versus outside of school may play a role in explaining why purchases were associated with unhealthy CF&B availability but overall diet and downstream BMI were not.
PURPOSE: Existing evidence on relationships between school food environments and children's in-school purchases, dietary behaviors, and body composition is based on observational studies that are vulnerable to residential selection bias. METHODS: This study leveraged exogenous variation in school environments generated by the natural experiment due to military parents' assignment to installations. We analyzed 1,010 child-wave observations from the Military Teenagers Environments, Exercise, and Nutrition Study collected during 2013-2015. Using multiple linear and logistic regression, we examined whether the number of competitive food and beverage (CF&B) items available for purchase in school, overall and by type (unhealthy, healthy, neutral), was associated with in-school food purchases, dietary behaviors, and body mass index (BMI) outcomes. Covariates included child and family characteristics and the healthiness of the home food environment. RESULTS: Unhealthy item availability was positively associated with purchasing any sweets (adjusted odds ratio [AOR], 1.30; p < .01), snacks (AOR, 1.23; p < .01), and sugar-sweetened beverages (AOR, 1.19; p = .01). However, there were no significant associations with overall food and beverage intake (e.g., sweets, soda) nor BMI outcomes. The home food environment was significantly associated with all outcomes. CONCLUSIONS: Access to unhealthy CF&B items may influence in-school purchases but does not appear to influence overall dietary behaviors and BMI outcomes. Substitution of caloric intake across locations within versus outside of school may play a role in explaining why purchases were associated with unhealthy CF&B availability but overall diet and downstream BMI were not.
Authors: Cynthia L Ogden; Margaret D Carroll; Tala H Fakhouri; Craig M Hales; Cheryl D Fryar; Xianfen Li; David S Freedman Journal: MMWR Morb Mortal Wkly Rep Date: 2018-02-16 Impact factor: 17.586
Authors: Hazreen Abdul Majid; Ai Kah Ng; Maznah Dahlui; Shooka Mohammadi; Mohd Nahar Azmi Bin Mohamed; Tin Tin Su; Muhammad Yazid Jalaludin Journal: Nutrients Date: 2022-06-30 Impact factor: 6.706