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Influence of school competitive food and beverage policies on obesity, consumption, and availability: a systematic review.

Publication ,  Journal Article
Chriqui, JF; Pickel, M; Story, M
Published in: JAMA Pediatr
March 2014

IMPORTANCE: The US Department of Agriculture recently issued an interim final rule governing the sale of foods and beverages sold outside of the school meal programs ("competitive foods and beverages" [CF&Bs]). OBJECTIVE: To examine the potential influence that the federal rule may have based on peer-reviewed published studies examining the relationship between state laws and/or school district policies and student body mass index (BMI) and weight outcomes, consumption, and availability of CF&Bs. EVIDENCE REVIEW: Keyword searches of peer-reviewed literature published between January 2005 and March 2013 were conducted using multiple databases. Titles and abstracts for 1160 nonduplicate articles were reviewed, with a full review conducted on 64 of those articles to determine their relevancy. Qualitative studies, studies of self-reported policies, or studies examining broad policies without a specific CF&B element were excluded. FINDINGS: Twenty-four studies were selected for inclusion. Studies focused on state laws (n = 14), district policies (n = 8), or both (n = 2), with the majority of studies (n = 18) examining foods and beverages (as opposed to food-only or beverage-only policies). Sixteen studies examined prepolicy/postpolicy changes, and 8 studies examined postpolicy changes. Study designs were cross-sectional (n = 20), longitudinal (n = 3), or a combination (n = 1). Outcomes examined included change in BMI, weight, probability of overweight or obesity (n = 4), consumption (n = 10), and availability (n = 13); 3 studies examined more than 1 outcome. The majority of studies primarily reported results in the expected direction (n = 15), with the remaining studies (n = 9) reporting primarily mixed or nonsignificant results. CONCLUSIONS AND RELEVANCE: In most cases, CF&B policies are associated with changes in consumption and/or availability in the expected direction; however, caution should be exercised, given that nearly all were cross-sectional. The influence of such policies on overall student consumption and BMI and weight outcomes was mixed. The findings hold promise for the likely influence of federal CF&B regulations on changes in student in-school consumption and in-school competitive food availability. Further research is needed to truly understand the association between these policies and overall consumption and weight outcomes.

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Published In

JAMA Pediatr

DOI

EISSN

2168-6211

Publication Date

March 2014

Volume

168

Issue

3

Start / End Page

279 / 286

Location

United States

Related Subject Headings

  • United States
  • Students
  • Schools
  • Pediatrics
  • Overweight
  • Obesity
  • Nutrition Policy
  • Male
  • Humans
  • Food Services
 

Citation

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Chriqui, J. F., Pickel, M., & Story, M. (2014). Influence of school competitive food and beverage policies on obesity, consumption, and availability: a systematic review. JAMA Pediatr, 168(3), 279–286. https://doi.org/10.1001/jamapediatrics.2013.4457
Chriqui, Jamie F., Margaret Pickel, and Mary Story. “Influence of school competitive food and beverage policies on obesity, consumption, and availability: a systematic review.JAMA Pediatr 168, no. 3 (March 2014): 279–86. https://doi.org/10.1001/jamapediatrics.2013.4457.
Chriqui, Jamie F., et al. “Influence of school competitive food and beverage policies on obesity, consumption, and availability: a systematic review.JAMA Pediatr, vol. 168, no. 3, Mar. 2014, pp. 279–86. Pubmed, doi:10.1001/jamapediatrics.2013.4457.

Published In

JAMA Pediatr

DOI

EISSN

2168-6211

Publication Date

March 2014

Volume

168

Issue

3

Start / End Page

279 / 286

Location

United States

Related Subject Headings

  • United States
  • Students
  • Schools
  • Pediatrics
  • Overweight
  • Obesity
  • Nutrition Policy
  • Male
  • Humans
  • Food Services