Effect of nutrition changes on foods selected by students in a middle school-based diabetes prevention intervention program: The HEALTHY experience
Open accessAbstract
BACKGROUND: The HEALTHY primary prevention trial developed an integrated multicomponent intervention program to moderate risk factors for type 2 diabetes in middle schools. The nutrition component aimed to improve the quality of foods and beverages served to students. Changes in the School Breakfast Program (SBP), National School Lunch Program (NSLP), and à la carte venues are compared to the experience of control schools. METHODS: The intervention was implemented in 21 middle schools from winter 2007 through spring 2009 (following a cohort of students from sixth through eighth grades); 21 schools acted as observed controls. The nutrition component targeted school food service environmental change. Data identifying foods and nutrients served (selected by students for consumption) were collected over a 20-day period at baseline and end of study. Analysis compared end of study values for intervention versus control schools. RESULTS: Intervention schools more successfully limited dessert and snack food portion size in NSLP and à la carte and lowered fat content of foods served. Servings of high-fiber grain-based foods and/or legumes were improved in SBP but not NSLP. Intervention and control schools eliminated >1% fat milk and added-sugar beverages in SBP, but intervention schools were more successful in NSLP and à la carte. CONCLUSION: The HEALTHY program demonstrated significant changes in the nutritional quality of foods and beverages served in the SBP, NSLP, and à la carte venues, as part of an effort to decrease childhood obesity and support beneficial effects in some secondary HEALTHY study outcomes.
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Among 10 studies reporting the proportion of schools implementing a targeted policy, practice, or program versus a minimal or usual practice control, the median unadjusted effect size was 16.2%, ranging from -0.2% to 66.6%.
“For example, among 10 studies reporting the proportion of schools implementing a targeted policy, practice, or program versus a minimal or usual practice control, the median unadjusted effect size was 16.2%, ranging from –0.2% to 66.6%.”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [51]
Thirteen studies, including four RCTs, were assessed as unclear risk of selection bias as methods of sequence generation and allocation were not reported.
“Thirteen studies, including four RCTs were assessed as unclear risk of selection bias as methods of sequence generation and allocation were not reported [44, 46, 47, 50, 51, 54–56, 58, 64, 66, 67].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [51]
Seven studies were assessed as low risk of detection bias.
“Seventeen of the included studies were assessed as high risk [26, 28, 37, 41, 43, 44, 46–49, 52, 54–56, 58, 66, 67] and seven studies were assessed as low risk of detection bias [27, 42, 51, 53, 60, 62, 63].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [51]
Ten studies were assessed as low risk of selective reporting as a trial registration or a published protocol paper was identified and all a priori determined outcomes were reported.
“Ten studies were assessed as low risk of selective reporting as a trial registration or a published protocol paper was identified and all a priori determined outcomes were reported [26, 44, 51, 53, 54, 60, 62–64, 67].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [51]
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- Authors
- The HEALTHY Study Group, Mobley, C. C., Stadler, D. D., Staten, M. A., El ghormli, L., Gillis, B., Hartstein, J., Siega‐Riz, A. M., & Virus, A.
- Affiliations
- University of Nevada, Las Vegas (US)
- National Institutes of Health (US)
- University of California, Irvine (US)
- University of North Carolina at Chapel Hill (US)
- Temple University (US)
- Corresponding author
- Mobley, Connie C.
- Venue
- Journal of School Health
- Publisher
- Wiley
- Published
- 2012-01-12
- Volume
- 82
- Issue
- 2
- Pages
- 82-90
- ISSN
- 0022-4391 (ISSN-L)
- 1746-1561
- PMC
- PMC3261591
- OpenAlex
- W2000642155
- Cited by
- 46
- References
- 24
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 5 · 2022: 2 · 2021: 6 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 2 · 2015: 4 · 2014: 4 · 2013: 6 · 2012: 3
- FWCI
- 5.25
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of School Health (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Scholarship - UNLV (University of Nevada Reno) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (2r24hd050924-06)
- National Institute of Diabetes and Digestive and Kidney Diseases (U01‐DK61230, U01DK061223, U01 DK61249, U01- DK61231, U01DK061230, U01-DK61223, U01DK061249, U01DK061231)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24 HD-050924)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- type 2 diabetes prevention, school meals, School Breakfast Program, National School Lunch Program, portion size, fat content, Fabaceae, childhood obesity, junior high school students, multicomponent intervention
- MeSH terms
- Adolescent, Energy Intake, Diabetes Mellitus, Type 2, Feeding Behavior, Female, Food Preferences, Food Services, Health Promotion, Humans, Male, Nutrition Surveys, Nutritive Value, Obesity, School Health Services, Schools, Students, United States, Program Evaluation, Adolescent Nutritional Physiological Phenomena
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