Mansfield Jennifer L, Savaiano Dennis A
Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA. North Central Nutrition Education Center of Excellence, Purdue University, West Lafayette, Indiana, USA.
Nutr Rev. 2017 Jul 1;75(7):533-552. doi: 10.1093/nutrit/nux020.
Federal regulation mandates that the US National School Lunch Program nutrition standards align with the Dietary Guidelines for Americans. As students consume a substantial proportion of their nutrition during school lunch, increasing access to healthy foods is proposed to improve student dietary outcomes. The purpose of this review is to assess whether policy changes impacted food-consumption behaviors of students during periods when (1) school wellness policies were implemented (2006-2007); (2) the Healthy, Hunger-Free Kids Act was passed (2010-2012); and (3) the Healthy, Hunger-Free Kids Act was implemented (2012-present). PubMed, Web of Science, and Science Direct were searched for primary research studies. Policy evaluations and interventions implemented from 2006 to 2016 were included. A total of 31 studies evaluating plate waste, dietary intake, food selection, and/or purchasing patterns were identified and reviewed. Fourteen of 19 intervention and longitudinal observation studies reported improved food-consumption behaviors (increased selection, intake, and sales of healthy foods, and decreased plate waste). Only 2 of 12 one-time observation studies reported food-consumption behaviors meeting target nutrition standards. The majority of studies indicated that increasing access to healthy foods during school lunch improved students' dietary intakes. Challenges related to study design, adaptation period, quality of foods, and policy implementation likely affect a school lunch program's ability to impact students' food-consumption behaviors. Ongoing evaluation of these programs is warranted.
联邦法规规定，美国国家学校午餐计划的营养标准应与《美国人膳食指南》保持一致。由于学生在校午餐期间摄入了很大一部分营养，因此有人提议增加健康食品的供应，以改善学生的饮食状况。本综述的目的是评估在以下几个时期政策变化是否影响了学生的食物消费行为：（1）实施学校健康政策期间（2006 - 2007年）；（2）《健康、无饥饿儿童法案》通过期间（2010 - 2012年）；以及（3）《健康、无饥饿儿童法案》实施期间（2012年至今）。通过检索PubMed、科学网和科学Direct数据库查找相关的初步研究。纳入了2006年至2016年实施的政策评估和干预措施。共识别并审查了31项评估餐盘浪费、饮食摄入量、食物选择和/或购买模式的研究。19项干预和纵向观察研究中有14项报告称食物消费行为有所改善（健康食品的选择、摄入量和销售量增加，餐盘浪费减少）。12项一次性观察研究中只有2项报告食物消费行为符合目标营养标准。大多数研究表明，增加在校午餐期间健康食品的供应改善了学生的饮食摄入量。与研究设计、适应期、食品质量和政策实施相关的挑战可能会影响学校午餐计划对学生食物消费行为的影响能力。有必要对这些计划进行持续评估。
