Gorski Mary T, Cohen Juliana F W, Hoffman Jessica A, Rosenfeld Lindsay, Chaffee Ruth, Smith Lauren, Rimm Eric B
Mary T. Gorski is with the Interfaculty Initiative in Health Policy, Harvard Graduate School of Arts and Sciences, Harvard University, Cambridge, MA. Juliana F. W. Cohen is with the Department of Health Sciences, Merrimack College, North Andover, MA. Jessica A. Hoffman and Ruth Chaffee are with the Department of Applied Psychology, Bouvé College of Health Sciences, Northeastern University, Boston. Lindsay Rosenfeld is with the Institute for Child, Youth, and Family Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA. At the time of the study Lauren Smith was with the Department of Public Health, Commonwealth of Massachusetts, Boston. Eric B. Rimm is with the departments of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston.
Am J Public Health. 2016 Jun;106(6):1101-8. doi: 10.2105/AJPH.2016.303139. Epub 2016 Apr 14.
To examine changes in competitive foods (items sold in à la carte lines, vending machines, and school stores that "compete" with school meals) in Massachusetts middle and high schools before and after implementation of a statewide nutrition law in 2012.
We photographed n = 10 782 competitive foods and beverages in 36 Massachusetts school districts and 7 control state districts to determine availability and compliance with the law at baseline (2012), 1 year (2013), and 2 years (2014) after the policy (overall enrollment: 71 202 students). We examined availability and compliance trends over time.
By 2014, 60% of competitive foods and 79% of competitive beverages were compliant. Multilevel models showed an absolute 46.2% increase for foods (95% confidence interval = 36.2, 56.3) and 46.8% increase for beverages (95% confidence interval = 39.2, 54.4) in schools' alignment with updated standards from 2012 to 2014.
The law's implementation resulted in major improvements in the availability and nutritional quality of competitive foods and beverages, but schools did not reach 100% compliance. This law closely mirrors US Department of Agriculture Smart Snacks in School standards, suggesting that complying with strict nutrition standards is feasible, and schools may experience challenges and improvements over time.
研究2012年马萨诸塞州一项全州营养法实施前后，该州初中和高中的竞争性食品（在点菜窗口、自动售货机和校内商店出售的与学校膳食“竞争”的食品）的变化情况。
我们拍摄了马萨诸塞州36个学区和7个对照州学区的n = 10782种竞争性食品和饮料，以确定在政策实施前（2012年）、1年后（2013年）和2年后（2014年）的可获得性及是否符合法律规定（总入学人数：71202名学生）。我们研究了随时间推移的可获得性和合规趋势。
到2014年，60%的竞争性食品和79%的竞争性饮料符合规定。多层次模型显示，从2012年到2014年，学校在符合更新标准方面，食品的绝对增幅为46.2%（95%置信区间 = 36.2, 56.3），饮料的绝对增幅为46.8%（95%置信区间 = 39.2, 54.4）。
该法律的实施使竞争性食品和饮料的可获得性及营养质量有了重大改善，但学校并未达到100%的合规率。这项法律与美国农业部的《学校智能零食》标准非常相似，表明遵守严格的营养标准是可行的，并且学校可能会随着时间的推移面临挑战并取得改进。
