Davis Melinda M, Spurlock Margaret, Ramsey Katrina, Smith Jamie, Beamer Beth Ann, Aromaa Susan, McGinnis Paul B
1 Department of Family Medicine, OHSU-PSU School of Public Health, Oregon Rural Practice-Based Research Network, Oregon Health & Science University, Portland, OR, USA.
2 School-Based Health Center, Multnomah County, Portland, OR, USA.
J Sch Nurs. 2017 Aug;33(4):285-298. doi: 10.1177/1059840517703744. Epub 2017 Apr 13.
Providing flavored milk in school lunches is controversial, with conflicting evidence on its impact on nutritional intake versus added sugar consumption and excess weight gain. Nonindustry-sponsored studies using individual-level analyses are needed. Therefore, we conducted this mixed-methods study of flavored milk removal at a rural primary school between May and June 2012. We measured beverage selection/consumption pre- and post-chocolate milk removal and collected observation field notes. We used linear and logistic mixed models to assess beverage waste and identified themes in staff and student reactions. Our analysis of data from 315 unique students and 1,820 beverages choices indicated that average added sugar intake decreased by 2.8 g postremoval, while average reductions in calcium and protein consumption were negligible (12.2 mg and 0.3 g, respectively). Five thematic findings emerged, including concerns expressed by adult staff about student rebellion following removal, which did not come to fruition. Removing flavored milk from school-provided lunches may lower students' daily added sugar consumption without considerably decreasing calcium and protein intake and may promote healthy weight.
在学校午餐中提供调味牛奶存在争议，关于其对营养摄入、添加糖消费和体重过度增加的影响，证据相互矛盾。需要进行非行业资助的个体水平分析研究。因此，我们在2012年5月至6月期间对一所农村小学取消调味牛奶一事进行了这项混合方法研究。我们在取消巧克力牛奶前后测量了饮料选择/消费情况，并收集了实地观察记录。我们使用线性和逻辑混合模型来评估饮料浪费情况，并确定了教职工和学生反应中的主题。我们对315名学生的数据分析以及1820次饮料选择表明，取消调味牛奶后，平均添加糖摄入量减少了2.8克，而钙和蛋白质的平均摄入量减少可忽略不计（分别为12.2毫克和0.3克）。出现了五个主题性发现，包括成年教职工担心取消调味牛奶后学生会叛逆，但这种情况并未出现。从学校提供的午餐中取消调味牛奶可能会降低学生每日的添加糖消费量，而不会大幅减少钙和蛋白质的摄入量，并且可能有助于促进健康体重。
