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Impact of Competitive Foods in Public Schools on Child Nutrition: Effects on Adolescent Obesity in The United States An Integrative Systematic Literature Review

Sildén, Kirsten LU (2017) MPHN40 20171
Social Medicine and Global Health
Abstract
Abstract

Objective: To identify and analyse literature on the effects of competitive foods in public schools on adolescent weight (BMI), and possible impacts they may have on adolescent obesity in the United States.

Methods: An integrative systematic review of literature was conducted. The literature was collected in CINAHL, Medline and EMBASE databases. Refined keyword search is further detailed in the report. Year restrictions were 2006-2017 from peer reviewed journals and published in English, with age parameters of adolescents 13-18 years in middle or high schools in the United States. Criteria for inclusion targeted at least one of 1) sugar-sweetened beverages (SSB), 2) competitive foods, 3) commercial foods, 4) vending... (More)
Abstract

Objective: To identify and analyse literature on the effects of competitive foods in public schools on adolescent weight (BMI), and possible impacts they may have on adolescent obesity in the United States.

Methods: An integrative systematic review of literature was conducted. The literature was collected in CINAHL, Medline and EMBASE databases. Refined keyword search is further detailed in the report. Year restrictions were 2006-2017 from peer reviewed journals and published in English, with age parameters of adolescents 13-18 years in middle or high schools in the United States. Criteria for inclusion targeted at least one of 1) sugar-sweetened beverages (SSB), 2) competitive foods, 3) commercial foods, 4) vending machines, 5) al a carte venues, and 6) school stores, examining their associations with weight/Body Mass Index (BMI), using either BMI measurements or caloric intake analysis.

Results: The total of 164 articles were detected with 89 full abstracts examined and assessed, for a final analysis of 34 full text articles based on the inclusion criteria for this literature review. Twenty-six articles met the inclusion criteria. Many of the articles addressed multiple areas of interest within their study. Aspects of interest most commonly found involved BMI/Obesity/Weight in 19 (73%) articles, 15 (58%) articles examined Calorie (Kcal) density or consumption, 20 (77%) articles discussed the Availability of competitive foods in schools, 14 (54%) articles included analysis of competitive food and beverage and nutrition policies, and 18 (69%) addressed Other effects (socio-economic status (SES), race, ethnicity, and sex).

Conclusion: This systematic literature review found that although there is substantial evidence that competitive foods (foods sold to students which are not part of the regular school lunch programs) are highly available in middle, and especially high schools, there is still a lack of strong evidence that it is causal in increasing BMI/weight in adolescents. However, there is enough corroboration in the research which shows that higher caloric intake, as well as SES, race, ethnicity and sex are factors worthy of studying further and more in depth to determine how to better combat adolescent obesity in the United States. Additional longitudinal and higher quality research still needs to be done in this regard. (Less)
Popular Abstract
Popular Science Summary



‘Weigh in’ on Competitive Foods in Schools

Currently in the United States (U.S.), more than one third of adolescents, children between the ages of 13 and 18, weigh in as either being overweight or obese. It is now projected that as our population grows older, we will see both public health as well as economic burdens increase substantially. The Center for Disease Control and Prevention (CDC) has reported recently that adolescent obesity is a cause for great health concerns, considering the risks associated with obesity are plentiful, including: stroke, coronary heart disease, sleep apnea and respiratory issues, osteoarthritis, hypertension, Type 2 diabetes, and some cancers, just to name a few. It is due... (More)
Popular Science Summary



‘Weigh in’ on Competitive Foods in Schools

Currently in the United States (U.S.), more than one third of adolescents, children between the ages of 13 and 18, weigh in as either being overweight or obese. It is now projected that as our population grows older, we will see both public health as well as economic burdens increase substantially. The Center for Disease Control and Prevention (CDC) has reported recently that adolescent obesity is a cause for great health concerns, considering the risks associated with obesity are plentiful, including: stroke, coronary heart disease, sleep apnea and respiratory issues, osteoarthritis, hypertension, Type 2 diabetes, and some cancers, just to name a few. It is due to these grave health concerns that we must look at potential causes to why our adolescents are suffering so much from this epidemic.

Consider for a moment the amount of time our young people are spending in school environments. It is assumed that a typical adolescent is in school around six or more hours per day and approximately 180 days out of each year. Therefore, we might assume that the school environment might hold a unique amount of influence upon the diets and eating behaviors of U.S. schoolchildren. Examining this theory, it is important to consider the eating environments within the schools in the U.S., and whether competitive foods, which according to the United States Department of Agriculture (USDA) are defined as being foods that are available for purchase at school which are not part of the regular school lunch programs, are responsible for the increase in obesity in our adolescents.

After extensively reviewing the most current literature on this theory, it is reasonable to say that although there are some results which support the association between competitive foods and weight gain, they are small and lacking in solid research. Interestingly, I noticed in most of the findings in my search, that other factors, such as those with a genetic susceptibility to weight, socio economic factors (SES), race, ethnicity, age, and gender seemed to be affected the strongest by availability of competitive foods in schools. It was surprising that there was less robust research to prove what seems to me to be obvious; if there is junk food available, more kids will purchase it, and therefore, more kids will be eating a higher intake of calories and thus, gaining more weight. However, what the research has showed so far, is that without further longitudinal and more involved research, instilling stricter food and beverage policies in school settings will be challenging.

Essentially, the bottom line was this: it is critical that we look at all aspects in the lives of our children, from their home situations and environments, economic resources and spending habits, schools, community, availability and consumer influence on purchasing less nutritious foods and beverages, to gender, ethnicity and racial complexities. The task is enormous, yet it is critical that we come to a better understanding of how to attack and conquer this pandemic which is spreading rapidly through our nations youth. (Less)
Please use this url to cite or link to this publication:
@misc{8923187,
  abstract     = {Abstract

Objective: To identify and analyse literature on the effects of competitive foods in public schools on adolescent weight (BMI), and possible impacts they may have on adolescent obesity in the United States.

Methods: An integrative systematic review of literature was conducted. The literature was collected in CINAHL, Medline and EMBASE databases. Refined keyword search is further detailed in the report. Year restrictions were 2006-2017 from peer reviewed journals and published in English, with age parameters of adolescents 13-18 years in middle or high schools in the United States. Criteria for inclusion targeted at least one of 1) sugar-sweetened beverages (SSB), 2) competitive foods, 3) commercial foods, 4) vending machines, 5) al a carte venues, and 6) school stores, examining their associations with weight/Body Mass Index (BMI), using either BMI measurements or caloric intake analysis.

Results: The total of 164 articles were detected with 89 full abstracts examined and assessed, for a final analysis of 34 full text articles based on the inclusion criteria for this literature review. Twenty-six articles met the inclusion criteria. Many of the articles addressed multiple areas of interest within their study. Aspects of interest most commonly found involved BMI/Obesity/Weight in 19 (73%) articles, 15 (58%) articles examined Calorie (Kcal) density or consumption, 20 (77%) articles discussed the Availability of competitive foods in schools, 14 (54%) articles included analysis of competitive food and beverage and nutrition policies, and 18 (69%) addressed Other effects (socio-economic status (SES), race, ethnicity, and sex).

Conclusion: This systematic literature review found that although there is substantial evidence that competitive foods (foods sold to students which are not part of the regular school lunch programs) are highly available in middle, and especially high schools, there is still a lack of strong evidence that it is causal in increasing BMI/weight in adolescents. However, there is enough corroboration in the research which shows that higher caloric intake, as well as SES, race, ethnicity and sex are factors worthy of studying further and more in depth to determine how to better combat adolescent obesity in the United States. Additional longitudinal and higher quality research still needs to be done in this regard.},
  author       = {Sildén, Kirsten},
  keyword      = {school OR schools united states OR U.S. OR US OR united states of America 'food' OR 'food preferences' OR 'food habits' OR 'health behavior' OR 'feeding behavior' OR 'child nutrition' 'weight gain' OR 'overweight' OR 'BMI' OR 'Body Mass Index' OR 'Body Composition' OR 'Obesity' OR 'Adolescent Obesity' OR 'Pediatric Obesity' OR 'body weight' 'nutrition policy' OR 'health promotion' OR 'health policy' OR 'school health policy' 'food services' OR 'competitive food' OR 'competitive foods' OR 'commercial food' OR 'beverages' OR 'carbonated beverages' OR 'sugar-sweetened beverages' OR 'vending machines' OR 'food dispensers' OR 'food dispensers,automatic' OR 'foods of minimal nutritional value' OR 'FMNV'},
  language     = {eng},
  note         = {Student Paper},
  title        = {Impact of Competitive Foods in Public Schools on Child Nutrition: Effects on Adolescent Obesity in The United States An Integrative Systematic Literature Review},
  year         = {2017},
}