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1.
J Nutr Educ Behav ; 56(4): 230-241, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38583880

RESUMO

OBJECTIVE: To evaluate if parent perceptions of school meals influence student participation. DESIGN: In May 2022, an online survey was used to evaluate parents' perceptions of school meals and their children's participation. PARTICIPANTS: A total of 1,110 California parents of kindergarten through 12th-grade students. MAIN OUTCOME MEASURES: Student participation in school lunch and breakfast. ANALYSIS: Principal component analysis and Poisson regression models. RESULTS: Three groups of parental perceptions were identified: (1) positive perceptions (eg, liking school meals and thinking that they are tasty and healthy), (2) perceived benefits to families (eg, school meals save families money, time, and stress), and (3) negative (eg, concerns about the amount of sugar in school meals and stigma). More positive parental perceptions about school meals and their benefits to families were associated with greater student meal participation. In contrast, more negative parental perceptions were associated with reduced student participation in school meals (P < 0.05). CONCLUSION AND IMPLICATIONS: Parent perceptions of school meals may affect student participation in school meal programs. Working to ensure parents are familiar with the healthfulness and quality of school meals and the efforts schools are making to provide high-quality, appealing meals may be critical for increasing school meal participation rates.


Assuntos
Serviços de Alimentação , Criança , Humanos , Refeições , Desjejum , Almoço , Estudantes , Pais
2.
J Adolesc Health ; 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38597842

RESUMO

PURPOSE: This study aimed to implement and evaluate integrated, school-based nutrition intervention packages for adolescents in Dodoma, Tanzania. METHODS: A cluster randomized controlled trial was conducted among six secondary schools in Dodoma, Tanzania. Two schools received the full-intervention package of school meals, nutrition education, school gardens, and community workshops. Two schools received the partial-intervention package without the school meals component. Two schools served as the controls and did not receive any intervention. The intervention was implemented over one academic year. The analytical sample included 534 adolescents aged 14 to 17 at baseline and 286 parents. Outcomes included nutrition knowledge, food preferences, diet quality, food insecurity, physical activity, growth, and anemia. Linear models were used to estimate mean differences, and logistic regression models were used to estimate odds ratios (ORs). RESULTS: Compared to the control, both the partial (OR: 0.59; 95% confidence interval [CI]: 0.35, 1.00) and full (OR: 0.49; 95% CI: 0.40, 0.59) interventions were associated with lower odds of poor diet quality among adolescents. Among the parents, both the partial (OR: 0.28; 95% CI: 0.20, 0.40) and full (OR: 0.28; 95% CI: 0.13, 0.58) interventions were associated with lower odds of poor diet quality. The partial (OR: 0.29; 95% CI: 0.18, 0.47) and full (OR: 0.47; 95% CI: 0.30, 0.72) interventions were associated with lower odds of adolescent overweight or obesity. DISCUSSION: School-based nutritional intervention packages incorporating multiple actions may improve the diet quality of adolescents and their household members and reduce the double burden of adolescent malnutrition.

3.
Health Econ ; 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38478556

RESUMO

The China Student Nutrition Improvement Plan (SNIP) covers 40.6 million students in the compulsory education stage, accounting for 42% of all students enrolled in rural compulsory education in 2021. This paper utilizes the county-by-county rollout of the SNIP and estimates the effect of this nutritional intervention on students' cognitive outcomes. We find that SNIP increases math test scores but has a statistically insignificant effect on verbal achievement. The effect is greater for middle school students and children from disadvantaged families. The SNIP affects the cognitive performance of students by improving their health status, increasing school attendance, fostering good study habits, raising educational expectations, and improving the human capital of peers.

4.
Ann Agric Environ Med ; 31(1): 57-64, 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38549477

RESUMO

INTRODUCTION AND OBJECTIVE: Provision of healthy and high-quality school meals is an important solution to improve children's health and well-being. Moreover, the meals provided at schools should not only meet dietary guidelines but also questions of sustainability. The aim of the study was to develop a new index to assess the quality of school meal menus, specifically their accordance with actual regulations, dietary guidelines and some sustainability goals. MATERIAL AND METHODS: The School Meal Index-Lunch Evaluation (SMI-LE) is an originally created index to evaluate the quality of 5-day school menus. The general idea is to reflect the healthy and sustainability issues that should be present in school canteens according to WHO and EU recommendations. The index was tested in a real-life situation and fifty 5-day school menus available online from primary schools located in different regions of Poland, in rural and urban areas, were assessed with SMI-LE. RESULTS: The median value of SMI-LE equaled 52 /140 points. Most of the analyzed menus (72%) were classified as 'Medium' quality according to SMI-LE. The menus classified as 'Low' were characterized by the lowest energy value, the lowest content of calcium, magnesium, iron, potassium, and folates, while the highest of sodium. Menus from the 'Good' category had the highest nutritional value, as well as the lowest sodium content. CONCLUSIONS: A novel tool to has been provided for measuring the quality of school meals that addresses health and sustainability issues. It responds to the need for new indices that would consider changes in dietary guidelines and increasing knowledge about the impact of food systems on the environment.


Assuntos
Serviços de Alimentação , Almoço , Criança , Humanos , Refeições , Instituições Acadêmicas , Sódio
5.
Healthcare (Basel) ; 12(4)2024 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-38391828

RESUMO

A healthy and balanced diet is crucial for children's well-being and aids in preventing diet-related illnesses. Furthermore, unhealthy dietary habits indirectly impact children's health, as the food industry stands as one of the primary drivers of climate change. Evidence shows the Mediterranean diet is sustainable for both children's and the planet's health. The aim of this cross-sectional study was to evaluate the eating habits of children aged between 6 months and 3 years, in the province of Modena and Reggio Emilia, in Italy, along with their adherence to the guidelines for a healthy diet, and examine the role of pediatricians in promoting knowledge about nutrition and sustainability. In our sample (218 children), most children exceeded the recommended meat and cheese intake, while consuming insufficient amounts of vegetables, fruit, and legumes. Vegetable and fruit consumption declined with the increase in age category while eating sweets, soft drinks, and processed food increased. Incorporating school meals' data into this analysis, we observed a modification in dietary compliance, characterized by an increase in meat and cheese consumption, alongside improvements in the intake of vegetables, fruits, fish, eggs, and legumes. This study suggests that supporting an integrated approach that combines social and educational initiatives is crucial. Future research should prioritize fostering sustainable eating habits within communities to facilitate dietary habits' transformation and encourage healthier lifestyles.

6.
Public Health Nutr ; 27(1): e25, 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38164650

RESUMO

OBJECTIVE: Implementation of school meal guidelines is often inadequate, and evidence for effective implementation strategies for school-based nutrition interventions is limited. The aim of the present study was to examine the implementation and effectiveness of a multi-strategy implementation intervention to increase adherence to the Norwegian national school meal guideline. DESIGN: The study was a school-based hybrid implementation effectiveness trial with a pre-post non-equivalent control group design, testing three implementation strategies: internal facilitation, training and an educational meeting. SETTING: Primary schools and after-school services in two counties in south-east Norway. PARTICIPANTS: School principals, after-school leaders and class teachers from thirty-three schools in the intervention county and principals and after-school leaders from thirty-four schools in a comparison county. RESULTS: There was a significant difference of 4 percentage points in change scores between the intervention and the comparison groups at follow-up, after adjusting for baseline adherence (B = 0·04, seB = 0·01, t = 3·10, P = 0·003). The intervention effect was not associated with the school's socio-economic profile. School-level fidelity was the implementation dimension that was most strongly correlated (r s = 0·48) with the change scores in the intervention group, indicating that principals' support is important for gaining the largest intervention effects. CONCLUSIONS: A school-based intervention with low intensity, based on trained teachers as internal facilitators, can increase adherence to the national school meal guideline among Norwegian primary schools, irrespective of local socio-economic conditions. Implementation fidelity, at an organisational level, may be a useful predictor for intervention outcomes in schools.


Assuntos
Refeições , Instituições Acadêmicas , Humanos , Promoção da Saúde , Noruega , Serviços de Saúde Escolar
7.
Nutrients ; 16(2)2024 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-38257106

RESUMO

To support families during the COVID-19 pandemic, the USDA allowed all US schools to offer meals at no cost regardless of family income, a policy referred to as Universal Free Meals or Healthy School Meals for All (HSM4A). Despite the recognized benefits and popularity of HSM4A during the pandemic, the policy expired in June 2022. The goal of this study was to gather perceptions of parents in Arizona about school meals, the HSM4A program, and the discontinuation of HSM4A. In collaboration with a local anti-hunger group, using an online survey distributed in September and October 2022, we collected data from a diverse sample of over 2000 parents living in Arizona. Parents unequivocally supported HSM4A during the pandemic (97%) and expressed support for continuing to offer HSM4A (95%). High levels of support were seen across all groups in the study, including from individuals who identified as politically conservative. We also analyzed 750 responses to an open-ended question asking respondents to share their thoughts about offering meals to all Arizona students regardless of family income. The majority of emergent themes related to perceived benefits of HSM4A, including reducing financial burden and stress for families. Our findings will be useful for advocates and policy makers considering HSM4A legislation.


Assuntos
COVID-19 , Pandemias , Humanos , Arizona , Refeições , Pais
8.
Nutrients ; 16(2)2024 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-38257169

RESUMO

Snacks and beverages are often sold in addition to meals in U.S. schools ("competitive foods"), but their current nutritional quality and compliance with national Smart Snacks standards are unknown. This study assessed competitive foods in a national sample of 90 middle and high schools. Differences in compliance by school characteristics were measured using mixed methods analysis of variance. Overall, 80% of the schools in the sample sold competitive foods; but they were less commonly available in schools with universal free school meal (UFSM) policies. A total of 840 unique products were documented and, on average, 75% were compliant with Smart Snacks standards. A total of 56% aligned with recommended added sugar limits (<10% of calories); and 340 unique products (40%) aligned with both sugar and Smart Snacks standards. Approximately one-fifth of competitive foods contained synthetic dyes, and 31% of beverages contained artificial sweeteners. Smart Snacks standards compliance was greater when competitive foods were overseen by food service departments, in comparison with others (e.g., principals, student organizations, or outside vendors [77% vs. 59% compliance; p = 0.003]). Therefore, district wellness policies should consider requiring food service departments to oversee competitive foods. Federal and state policies should limit added sugars, artificial sweeteners, and synthetic dyes. This appears to be highly feasible, given the substantial number of products that meet these criteria. UFSM policies should also be considered to support healthier school meal environments more broadly.


Assuntos
Corantes , Lanches , Humanos , Valor Nutritivo , Política de Saúde , Açúcares , Edulcorantes
9.
J Acad Nutr Diet ; 124(3): 346-357.e2, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37858673

RESUMO

BACKGROUND: Despite federal regulations limiting saturated fat and sodium levels on a weekly average basis, daily nutrient content of school meals in the United States is not regulated, leading to potential large fluctuations and intake well in excess of dietary recommendations. OBJECTIVE: To assess the daily prevalence of potential public elementary school meal combinations that were high in saturated fat and sodium (using cutoffs based on the US Department of Agriculture weekly average reimbursable meal thresholds), and to identify saturated fat and sodium thresholds for entrées to limit full meals exceeding those cutoffs. DESIGN: Cross-sectional. PARTICIPANTS AND SETTING: Four weeks of publicly available public elementary school (kindergarten through grade five) breakfast and lunch menus with associated nutrition data were collected from a national stratified random sample of 128 school districts during fall 2019. MAIN OUTCOME MEASURES: Percent of meal combinations exceeding the saturated fat and Target 1 sodium thresholds were calculated, as well as thresholds for saturated fat and sodium levels in breakfast and lunch entrées. STATISTICAL ANALYSES: Descriptive statistics and logistic regression were used to examine the odds of alignment with sodium and saturated fat US Department of Agriculture thresholds. RESULTS: The prevalence of elementary breakfast and lunch meal combinations that were high in sodium was on average 11% and 12.4%, respectively, and for saturated fat was 10.6% and 34%, respectively. Entrées above certain thresholds (≥400 and ≥1,000 mg sodium and ≥4.5 and ≥6 g saturated fat for breakfast and lunch, respectively) had a higher odds of producing a reimbursable meal that was high in sodium and saturated fat. CONCLUSIONS: There is widespread availability of high-saturated fat and sodium elementary school meal combinations on a daily basis. Daily thresholds, in addition to weekly nutrient thresholds, as well as limits on sodium and saturated fat for entrées, may therefore be needed to prevent daily excess intake of saturated fat and sodium among elementary students.


Assuntos
Serviços de Alimentação , Estados Unidos , Humanos , Criança , Sódio , Estudos Transversais , Dieta , Refeições , Almoço
10.
Appetite ; 193: 107134, 2024 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-38008191

RESUMO

The school meal system could contribute to the transition towards more sustainable food system by promoting plant-based meals. Knowing whether parents want more vegetarian school meals for their children is a prerequisite for a successful implementation. The present study aimed to estimate the proportion of parents who would opt for more vegetarian school meals for their children and to study associations of willingness with family characteristics and food choice motives. An online survey was sent to parents whose children are registered for school canteen in Dijon (France). We collected child-level information, data on family sociodemographic characteristics, and data on dietary habits and food choice motives of the family. We examined family characteristics associated with the willingness to increase the frequency of vegetarian school meals from one meal per week to two or daily. Generalized linear models were performed. In total, 49% of parents were willing to opt for a second weekly vegetarian meal and 26% for a daily vegetarian meal for their children (n = 1261). Parents willing to opt for more vegetarian meal were more likely to have higher education, be flexitarian or vegetarian and to currently opt for pork-free meals for their children, and their children attended the school canteen less frequently. Environmental motives were positively associated with the willing to opt for a second weekly vegetarian meal; familiarity and sensory appeal motives were negatively associated. Health and animal welfare motives were positively associated with the willing to opt for a daily vegetarian meal and sensory appeal was negatively associated. Increasing the frequency of vegetarian school meals would satisfy a demand expressed by parents but must be accompanied by interventions enhancing pleasure of eating vegetarian meals.


Assuntos
Dieta , Preferências Alimentares , Humanos , Pais , Características da Família , Comportamento Alimentar , Refeições
11.
Econ Hum Biol ; 52: 101335, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38070227

RESUMO

This study examines the impacts of childhood exposure to the Nutrition Improvement Program (NIP), which provides free school meals to eligible students in rural China, on adult labor market outcomes. Using data from the China Family Panel Studies, we employ a cohort difference-in-differences (DID) design to identify the NIP's long-term effects. The results show that early-life exposure to the NIP has increased adulthood employment probability by 6.5 percentage points. Childhood exposure to the NIP has also resulted in an average increase of 12.4% in adult hourly wages and 10.3% in annual income. These findings remain robust to a battery of validity checks. Our heterogeneous analysis demonstrates that these effects are more pronounced among those who are females and from households with low socioeconomic status. Further, we find that exposure to the NIP yields lasting beneficial effects on adult education attainment, cognitive and non-cognitive skills, as well as health and health behaviors. This suggests that improvements in human capital accumulation and health behaviors are potential mechanisms contributing to the long-term labor market consequences of the NIP. Our study sheds light on the enduring impacts of school-based nutrition intervention on individuals' economic well-being in developing countries.


Assuntos
Cognição , Renda , Adulto , Feminino , Humanos , Masculino , Fatores Socioeconômicos , Escolaridade , China/epidemiologia , Economia
12.
Nutrients ; 15(21)2023 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-37960149

RESUMO

Vegetables are an essential component of a healthy dietary pattern in children; however, their consumption is often insufficient due to lack of preference. To address this, the influence of combining vegetables (mixed peas and carrots-MPACs) with potatoes, a generally liked food, on overall vegetable consumption among children aged 7-13 years was explored. The research involved a cross-over study design with 65 participants who completed five lunchtime meal conditions, each with different combinations of MPACs and potatoes versus a control (MPACs with a wheat roll). The meals were provided in a cafeteria setting, and plate waste was used to measure vegetable consumption. Anthropometric data and other variables were also measured. Notably, self-reported hunger did not significantly differ between conditions. Meal condition was a significant predictor of MPACs (F = 5.20; p = 0.0005), with MPAC consumption highest when combined with shaped potato faces in the same bowl (+8.77 g compared to serving MPACs and shaped potato faces in separate bowls) and lowest when combined with diced potatoes in the same bowl (-2.85 g compared to serving MPACs and diced potatoes in separate bowls). The overall model for MPAC consumption was influenced by age, height z-score, body fat percentage z-score, and condition (likelihood ratio = 49.1; p < 0.0001). Age had the strongest correlation with vegetable consumption (r = 0.38), followed by male gender, height z-score (r = 0.30), and body fat z-score (r = -0.15). The results highlight the positive impact of combining potatoes with vegetables in school meals, particularly when using shaped potato faces. These findings emphasize the potential of potatoes as a valuable vegetable option in promoting healthier eating habits among children. Additionally, future research could explore the impact of different potato combinations and investigate other factors influencing meal consumption in school settings.


Assuntos
Solanum tuberosum , Verduras , Criança , Humanos , Masculino , Estudos Cross-Over , Dieta , Comportamento Alimentar , Frutas , Feminino , Adolescente
13.
J Sch Health ; 2023 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-37994552

RESUMO

BACKGROUND: The National School Lunch and School Breakfast programs reduce food insecurity and improve dietary intake. During the COVID-19 pandemic, school meals were provided to all children at no cost, regardless of income. This policy is known as Healthy School Meals For All (HSMFA). The purpose of the study was to examine the feasibility of a HSMFA policy in Utah. METHODS: A mixed-methods approach was used, including qualitative interviews for policymakers, surveys for school foodservice directors, and financial modeling of Utah Child Nutrition Programs data. Analysis included a phenomenological analytic approach for qualitative data, descriptive statistics for surveys, and development of a cost model with 6 scenarios. RESULTS: Qualitative data revealed themes of (1) awareness; (2) responsibility; (3) perspectives on school meals; and (4) new opportunities. Most (81%) foodservice directors believed HSMFA should continue post-pandemic. HSMFA would cost $51,341,436 to $82,358,375 per year. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: HSMFA would result in the equitable treatment of all children regarding access to healthy school meals. CONCLUSIONS: Given the support of foodservice directors but the lack of political consensus, considering stepwise implementation and providing cost estimates may increase feasibility of a HSMFA policy in Utah.

14.
Br J Nutr ; : 1-5, 2023 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-38012852

RESUMO

The link between school feeding programmes (SFP) and the promotion of healthy eating and health is being explored in studies performed in different countries. The coronavirus disease-19 pandemic has revealed flaws and weaknesses in contemporary food systems, with many school-age children experiencing food insecurity and hunger. There is intense debate among policymakers regarding whether government SFP should be universal or targeted. Countries such as Brazil and India, which have two of the most comprehensive universal free-of-charge programmes, have shown the benefits of SFP, including improved nutritional status, support for more sustainable food systems, attendance and academic performance. Evidence shows and supports actions advocating that it is time to offer healthy and free school meals for all students.

15.
J Acad Nutr Diet ; 2023 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-37935347

RESUMO

BACKGROUND: The coronavirus disease 2019 pandemic triggered nationwide school closures in March 2020, putting millions of children in the United States who were reliant on subsidized school meals at risk of experiencing hunger. In response, the US Department of Agriculture mobilized the Summer Food Service Program and Seamless Summer Option program to provide emergency free school meals. There is a need to investigate the effectiveness of these programs in covering underresourced communities during the pandemic. OBJECTIVE: This study assessed associations between meal distribution and census tract demographics (ie, poverty level, race/ethnicity, and deprivation level based on social deprivation index score). DESIGN: An observational study using longitudinal meal distribution data collected over an 18-month period following school closures (March 2020 to August 2021). PARTICIPANTS AND SETTING: Monthly meal distribution data were collected for community sites serving 142 census tracts within 4 urban New Jersey cities predominantly populated by people with low incomes and from racial and ethnic minority groups. MAIN OUTCOME MEASURES: Main outcome measures were the number of meals served monthly by Summer Food Service Program and Seamless Summer Option meal sites. STATISTICAL ANALYSES PERFORMED: A 2-part multivariable regression approach was used to analyze the data. RESULTS: In the first step, logistic regression models showed that high-deprivation tracts were more likely to serve meals during the observed period (odds ratio 3.43, 95% CI 1.001 to 11.77; P = 0.0499). In the second step, among tracts that served any meals during the observed period, mixed effects negative binomial regression models showed that high-poverty and high-deprivation tracts served comparatively more meals (incidence rate ratio [IRR] 2.83, 95% CI 2.29 to 3.51; P < 0.001 and IRR 1.94, 95% CI 1.65 to 2.28; P < 0.001, respectively). CONCLUSIONS: Findings show that meal distribution during the pandemic was higher within census tracts with higher poverty and deprivation levels, indicating that underresourced communities with higher need had more free meals available during this unprecedented public health emergency.

16.
BMC Public Health ; 23(1): 2102, 2023 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-37880618

RESUMO

BACKGROUND: One of the reasons for the more prominent resistance of canteen managers to implementing healthy canteens is based on the belief in the economic infeasibility of these models. The research aimed to verify the economic and financial viability of traditional and healthy models of school canteens in a Brazilian metropolis. METHODS: The case study was carried out with 36 companies in the school canteen sector in a Brazilian metropolis. The classification of items sold in canteens considered the extent and purpose of food processing according to the NOVA Classification. The characterization and definition of traditional canteens and healthy canteens were proposed considering the amount of in natura or minimally processed foods and culinary preparations without the presence of ultra-processed foods; the percentage of ultra-processed foods or processed foods or culinary preparations with the presence of ultra-processed foods; and the existence of prohibited foods. The economic and financial analysis was carried out mainly through the evaluation of profitability. Data were collected through an electronic self-administered questionnaire sent to canteen managers. The Mann-Whitney test was used to compare medians and the Chi-Square/Fisher's Exact Test to compare proportions. RESULTS: The study included six companies, responsible for 36 canteen units in private schools, 30 classified in the traditional model (83.3%), and six in the healthy model (16.7%). The median percentage of natural, minimally processed foods and commercialized culinary preparations was higher among the healthy model canteens (87.9% vs. 60.0%, p < 0.001). While the median percentage of ultra-processed, processed, or preparations with the presence of ultra-processed (40.0% vs. 12.1%, p < 0.001) and prohibited foods (10.0% vs. 0%, p < 0.001) sold was higher in the traditional model canteens. The results indicated that the profitability in the healthy canteens was higher (p < 0.001) than in the traditional ones. CONCLUSIONS: Healthy school canteens showed better financial and economic results compared to traditional canteens with emphasis on greater profitability and a shorter recovery time of the initial investment.


Assuntos
Serviços de Alimentação , Humanos , Promoção da Saúde/métodos , Alimentos , Alimento Processado , Instituições Acadêmicas , Dieta
17.
Nutrients ; 15(17)2023 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-37686770

RESUMO

The emergency school meals program provided free meals to children in the United States (US) during COVID-19-related school closures. This scoping review aims to synthesize the existing qualitative empirical evidence published between March 2020 and January 2023 on the operations and utilization of emergency school meal programs during the pandemic. Qualitative, US-based peer-reviewed literature was collected from three sources: (1) parent review of all federal nutrition assistance programs; (2) systematic search of four databases; and (3) manual search of grey literature. Identified scientific articles and grey literature reports (n = 183) were uploaded into Covidence and screened for duplicates and inclusion/exclusion criteria. Our final sample included 21 articles/reports, including 14 mixed methods and seven qualitative-only projects. Articles spanned all U.S. states. Articles had similar research questions to understand school meals and/or general food access during COVID-19, with an emphasis on long-term policy implications. Hybrid deductive/inductive analytic coding was used to analyze data, utilizing domains from the Getting to Equity Framework (GTE). GTE considers multi-level factors that influence nutrition behavior while centering more equitable pathways to improve nutrition security and reduce adverse health. Findings were sorted into two categories: operational challenges during the pandemic and solutions to address inequities in school meal distribution during and after the pandemic, particularly during school closures such as summers or future emergencies. Key challenges related to supply chain issues, safety, and balancing families' needs with limited staff capacity. Programs addressed equity by (a) reducing deterrents through federally issued waivers and increased communications which allowed the serving of meals by programs to families who previously did not have access, (b) building community capacity through collaborations and partnerships which allowed for increased distribution, and (c) preparing and distributing healthy options unless barriers in supply chain superseded the effort. This review highlights the importance of emergency school meal programs and provides insights into addressing challenges and promoting equity in future out-of-school times. These insights could be applied to policy and practice change to optimize program budgets, increase reach equitably, and improve access to nutritious meals among populations at highest risk for nutrition insecurity.


Assuntos
COVID-19 , Criança , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Orçamentos , Movimento Celular , Comunicação , Refeições
18.
J Sch Health ; 93(9): 762-777, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37670594

RESUMO

BACKGROUND: Changes to policies at the federal, state, and local levels over the last decade have influenced the school nutrition environment and services. METHODS: This systematic review includes an analysis of individual research articles and government reports published from 2010 to 2021 that examine interventions to improve the school nutrition environment and services and increase the availability, selection, and consumption of healthier foods and beverages in K-12 schools in the United States. RESULTS: Nutrition standards for school meals and food outside of meals improved access to healthier options in school. Providing school nutrition professionals with professional development, improving the palatability of school meals, offering taste tests, pre-slicing fruit, providing recess before lunch, offering incentives for trying healthier options, and providing access to drinking water resulted in increased selection and consumption of healthier items. There were inconclusive or mixed findings for some intervention strategies including adequate seat time for meals. CONCLUSIONS: Despite demonstrated improvements to school meal programs and competitive foods, more work is needed to change the selection and consumption of healthier options among K-12 students. Schools can use multiple interventions to improve the school nutrition environment and services and help students adopt food and beverage choices that support health.


Assuntos
Dieta Saudável , Estado Nutricional , Humanos , Políticas , Refeições , Estudantes
19.
Arch Pediatr ; 30(7): 471-476, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37704525

RESUMO

BACKGROUND: A poor nutritional status in children results in reduced physical and mental health and poor academic performance. The National Homegrown School Feeding Program (NHSFP) was introduced in Nigeria in 2016 to ameliorate short-term hunger and improve the nutritional status of school-aged children (SAC). At least 33% of the recommended nutrient intake (RNI) for the enrolled students should be met by the school meals. However, to our knowledge, the contribution of school meals served through the NHSFP to the RNI of SAC in Zaria, Nigeria, remains to be explored. METHODS: We conducted a school-based cross-sectional study among 276 eligible SAC recruited from public primary schools in the Zaria Local Government Area. Portion sizes of the meals served through the NHSFP were determined using an electronic scale, meal samples were collected for nutrient analysis, and the average daily nutrient intake of the participants from the meals was calculated. The average daily intake of nutrients and energy of the participants was compared with the age- and sex-specific RNI to estimate the percentage contribution of the meals. RESULTS: The portion sizes recorded were 199.3 ± 20.6 g, 263.9 ± 11.5 g, 242.1 ± 16.8 g, 311 ± 17.3 g, and 160.3 ± 1.9 mL, respectively, for moi-moi, jollof rice and beans, bean porridge, jollof rice and boiled egg, and yoghurt. In addition, the meals contained moisture (30.13-66.11%), ash (0.73-7.08%), crude fat (9-32.61%), crude protein (7.25-24.5%), crude fiber (0-2.45%), and total carbohydrate (2.19-29.74%) with an energy content ranging from 183.6 to 330.57 kcal. Similarly, the meals contained calcium (82.58-711 mg), potassium (133-797 mg), sodium (340-1720 mg), iron (0.078-8.60 mg), zinc (1.84-13.4 mg), vitamin A (2.38-100.56 RAE), and vitamin C (0.04-1.57 mg) per 100 g of the school meals. The meals contributed 18.2-19.1%, 102.8-183.7%, 13.04-13.6%, and 26.1%-35.8% of the RNI for carbohydrates, proteins, fiber, and energy, respectively. Furthermore, they contributed 137-175%, 314.3-502.2%, 87.6-142.1%, 21.5-25.1%, 279.2-348.5%, 3.3-5.9%, 24.7-48.8%, and 3.3-5.9% of the RNI for iron, zinc, calcium, potassium, sodium, vitamin A, and vitamin C, respectively. CONCLUSION: The meals served through the NHSFP contributed at least 33% of the RNI for energy, protein, iron, calcium, sodium, vitamin A, and zinc. However, they could not meet the 33% of the RNI for carbohydrates, fiber, potassium, and vitamin C. Increasing the portion sizes and the diversity of the meals can address the suboptimal contribution of the meals to the RNI for carbohydrates, fiber, potassium, and vitamin C.


Assuntos
Dieta , Vitamina A , Masculino , Feminino , Humanos , Criança , Cálcio , Estudos Transversais , Nigéria , Valor Nutritivo , Ingestão de Energia , Instituições Acadêmicas , Vitaminas , Refeições , Carboidratos da Dieta , Ácido Ascórbico , Sódio , Ferro , Zinco , Potássio
20.
J Public Health Res ; 12(3): 22799036231193071, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37622100

RESUMO

Background: The COVID-19 pandemic brought changes to primary school lunches leading to concerns over nutritional quality and uptake of lunches by vulnerable children. Regional data from Tayside, Scotland, showed that only 55% of children who were eligible for free school meals took these (normal uptake pre-pandemic was 66%). The current work aimed to identify teachers' perceptions of meal provisioning in primary schools during the first year of the COVID-19 pandemic. Design and methods: A cross-sectional online survey was carried out among primary school teachers across Tayside, Scotland. Using an online survey (21 questions combining multiple choice formats and open text) and interviews, primary school teachers shared their views on food quality, quantity, meal choices and factors influencing uptake of primary school lunches. Interviews were recorded, transcribed and thematically analysed with respect to factors influencing consumption. Results: The survey was completed by 41 teachers and 8 participated in a follow up interview. Around one-third (29%) of primary school teachers believed the quality of lunches had decreased and cited poor appearance of food, use of takeaway containers and food wastage. The lunch format was viewed negatively principally relating to the substitution of hot lunches with cold sandwiches, portion sizes, choice and perceived value for money. Concerns were expressed about acceptability and how far the meals contributed to food security. Conclusions: Further work on food provisioning is needed in order to identify ways to provide a nutritional safety net for vulnerable children.

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