Sliwa Sarah A, Miller Gabrielle F, Brener Nancy D, Park Sohyun, Merlo Caitlin L
Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia; Division of Analysis, Research, and Practice Integration, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia.
J Adolesc Health. 2017 May;60(5):577-583. doi: 10.1016/j.jadohealth.2016.11.021. Epub 2017 Jan 7.
Researchers previously examined the relationship between school beverage policies and sugar-sweetened beverage (SSB) consumption. This study addressed a research gap by examining cross-sectional associations between district-level policies and practices and U.S. high school students' consumption of milk and 100% fruit juice.
Data from the 2012 School Health Policies and Practices Study and 2013 Youth Risk Behavior Surveillance System were linked for 12 large urban school districts. Outcome variables were daily milk consumption (≥1 glass/day) and 100% fruit juice consumption (≥1 time/day). Exposure variables were five district policies (i.e., restrict SSB sales, maintain closed campuses, offer/sell healthful alternatives, restrict promotional products, and require nutrition education). Logistic regression models estimated the odds of consuming milk or 100% fruit juice daily, conditional on the policies and adjusting for sex, race/ethnicity, grade level, weight status, and district free/reduced-price lunch eligibility (n = 23,173).
Students in districts that required/recommended restricting the times of SSB sales had 55% higher (adjusted odds ratio [AOR], 1.55; 95% confidence interval [CI], 1.28-1.87) odds of consuming ≥1 glass/day of milk than students in districts without this policy. Closed campus policies were associated with lower odds of consuming milk (AOR, .72; 95% CI, .63-.82) and higher odds of consuming juice (AOR, 1.27; 95% CI, 1.07-1.50). Policies requiring/recommending that districts offer/sell healthful alternatives were associated with lower odds of consuming 100% fruit juice daily.
Results suggest that restricting SSB sales may support adolescents' milk consumption. Future studies should assess whether the implementation of federal standards that further restrict SSB sales in school leads to increased milk consumption.
研究人员此前研究了学校饮料政策与含糖饮料（SSB）消费之间的关系。本研究通过考察地区层面的政策与实践与美国高中生牛奶和100%果汁消费之间的横断面关联，填补了一项研究空白。
将2012年学校健康政策与实践研究以及2013年青少年风险行为监测系统的数据与12个大型城市学区的数据相链接。结果变量为每日牛奶消费量（≥1杯/天）和100%果汁消费量（≥1次/天）。暴露变量为五项地区政策（即限制含糖饮料销售、维持封闭校园、提供/销售健康替代品、限制促销产品以及要求进行营养教育）。逻辑回归模型估计了在这些政策条件下每日饮用牛奶或100%果汁的几率，并对性别、种族/族裔、年级水平、体重状况以及学区免费/减价午餐资格进行了调整（n = 23,173）。
要求/建议限制含糖饮料销售时间的学区的学生，每日饮用≥1杯牛奶的几率比没有这项政策的学区的学生高55%（调整后的优势比[AOR]，1.55；95%置信区间[CI]，1.28 - 1.87）。封闭校园政策与饮用牛奶的几率较低（AOR，0.72；95% CI，0.63 - 0.82）以及饮用果汁的几率较高（AOR，1.27；95% CI，1.07 - 1.50）相关。要求/建议学区提供/销售健康替代品的政策与每日饮用100%果汁的几率较低相关。
结果表明，限制含糖饮料销售可能有助于青少年饮用牛奶。未来的研究应评估进一步限制学校含糖饮料销售的联邦标准的实施是否会导致牛奶消费量增加。
