美国学校午餐计划实施法案对改善儿童膳食质量的影响 作者： 发布时间：/7/29 22:21:00 美国华盛顿大学公共卫生学院Jessica Jones-Smith团队分析了在美国学校午餐计划中实施《健康、无饥饿儿童法案》对儿童膳食质量的影响。7月28日，该研究发表在《美国医学会杂志》上。
在全国范围内实施的《健康、无饥饿儿童法案》旨在改善国家学校午餐计划（NSLP）提供膳食的营养质量。
为了评估《健康、无饥饿儿童法案》与参加NSLP的学生午餐膳食质量之间是否存在关联，研究组进行了一项连续横断面研究，使用-、-、-和-的国家健康与营养检查调查（NHANES）数据，对在NHANES中接受调查，并参加NSLP的学生进行分析。这些学生的年龄为5-18岁，幼儿园至级，学校提供午餐，且每周膳食表准确可靠。主要结局是通过健康饮食指数-（HEI-）衡量的午餐膳食质量，0-100分，分数越高，越符合《 美国饮食指南》的标准。
6389名参与调查学生的平均年龄为11.7岁，50%为女生，56%为非西班牙裔白人，32%为低收入人群，12%为中低收入人群，56%为中高收入人群。共有2472名学生（39%）参与NSLP。低收入学生中，NSLP参与者校正后的政策实施前HEI-得分为42.7分，政策实施后为54.6分；非NSLP参与者政策实施前后分别为34.8分和34.1分。
中低收入学生中，NSLP参与者校正后的政策实施前HEI-得分为40.4分，政策实施后为54.8分；非NSLP参与者政策实施前后分别为34.2分和36.1分。中高收入学生中，NSLP参与者校正后的政策实施前HEI-得分为42.7分，政策实施后为55.5分；非NSLP参与者政策实施前后分别为38.9分和43.6分。
总之，对于参与NSLP的低收入、中低收入和中高收入学生群体，实施《健康、无饥饿儿童法案》后，午餐膳食质量显著改善。
附：英文原文
Title: Association of the Healthy, Hunger-Free Kids Act With Dietary Quality Among Children in the US National School Lunch Program
Author: Kelsey Kinderknecht, Cristen Harris, Jessica Jones-Smith
Issue Volume: /07/28
Abstract: Importance The Healthy, Hunger-Free Kids Act of , implemented nationwide in , was intended to improve the nutritional quality of meals served in the National School Lunch Program (NSLP).
Objective To assess whether there was an association between the Healthy, Hunger-Free Kids Act of and dietary quality of lunch for students participating in the NSLP, stratified by income.
Design, Setting, Participants Serial cross-sectional study design, using National Health and Nutrition Examination Survey (NHANES) data from -, -, -, and -, of students who were surveyed in the NHANES and were attending schools participating in the NSLP. Individuals who were aged 5 to 18 years, in kindergarten through 12th grade, enrolled in a school that served school lunch, and had a reliable weekday dietary recall were included.
Exposures The Healthy, Hunger-Free Kids Act of (prepolicy period: -; postpolicy period: -), with participation in the NSLP estimated based on an algorithm.
Main Outcomes and Measures The primary outcome was dietary quality of intake for lunch, measured by the Healthy Eating Index- (HEI-) score (range, 0-100; 0 indicates a diet with no adherence to the Dietary Guidelines for Americans and 100 indicates a diet with complete adherence to the guidelines).
Results Among 6389 students included in the surveys (mean age, 11.7 [95% CI, 11.6-11.9] years; 3145 [50%] female students; 1880 [56%] were non-Hispanic white), 32% were low-income, 12% were low-middle income, and 56% were middle-high income students. A total of 2472 (39%) were participants in the NSLP. Among low-income students, the adjusted mean prepolicy HEI- score was 42.7 and the postpolicy score was 54.6 among NSLP participants and the adjusted mean prepolicy score was 34.8 and postpolicy score was 34.1 among NSLP nonparticipants (difference in differences, 12.6 [95% CI, 8.9-16.3]). Among low-middle income students, the adjusted mean prepolicy HEI- score was 40.4 and postpolicy score was 54.8 among NSLP participants and the adjusted mean prepolicy score was 34.2 and postpolicy score was 36.1 among NSLP nonparticipants (difference in differences, 12.4 [95% CI, 4.9-19.9]). Among middle-high income students, the adjusted mean HEI- prepolicy score was 42.7 and postpolicy score 55.5 for NSLP participants and the adjusted mean prepolicy score was 38.9 and prepolicy score was 43.6 for NSLP nonparticipants (difference in differences, 8.1 [95% CI, 4.2-12.0]).
Conclusions and Relevance In a serial cross-sectional study of students, the Healthy, Hunger-Free Kids Act of was associated with better changes in dietary quality for lunch among presumed low-income, low-middle income, and middle-high income participants in the NSLP compared with nonparticipants.
DOI: 10.1001/jama..9517
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期刊信息
JAMA-Journal of The American Medical Association：《美国医学会杂志》，创刊于1883年。隶属于美国医学协会，最新IF：51.273
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