国民健康服务体系（NHS）场所内的食品和饮料零售商是否遵守了英国国家卫生与临床优化研究所（NICE）关于儿童肥胖的质量标准94指南？一项针对英格兰两家大型二级医疗NHS医院的横断面研究。
Are food and drink retailers within NHS venues adhering to NICE Quality standard 94 guidance on childhood obesity? A cross-sectional study of two large secondary care NHS hospitals in England.
作者信息
James Alice, Birch Laura, Fletcher Peter, Pearson Sally, Boyce Catherine, Ness Andy R, Hamilton-Shield Julian P, Lithander Fiona E
机构信息
Faculty of Health Sciences, University of Bristol, Bristol, UK.
NIHR Bristol Biomedical Research Centre (Nutrition Theme), University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
出版信息
BMJ Open. 2017 Nov 16;7(11):e018214. doi: 10.1136/bmjopen-2017-018214.
OBJECTIVE
To assess whether the food and drink retail outlets in two major National Health Service (NHS) district general hospitals in England adhere to quality statements 1-3 of the UK National Institute for Health and Care Excellence (NICE) quality standard 94.
DESIGN
Cross-sectional, descriptive study to assess the food and drink options available in vending machines, restaurants, cafes and shops in two secondary care hospitals.
MAIN OUTCOME MEASURES
Adherence to quality statement 1 whereby the food and drink items available in the vending machines were classified as either healthy or less healthy using the Nutrient Profiling Model (NPM). Compliance with quality statements 2 and 3 was assessed through the measurement of how clearly the shops, cafes and restaurants displayed nutrition information on menus, and the availability and prominent display of healthy food and drink options in retail outlets, respectively.
RESULTS
Adherence to quality statement 1 was poor. Of the 18 vending machines assessed, only 7 (39%) served both a healthy food and a healthy drink option. Neither hospital was compliant with quality statement 2 wherein nutritional information was not available on menus of food providers in either hospital. There was inconsistent compliance with quality standard 3 whereby healthy food and drink options were prominently displayed in the two main hospital restaurants, but all shops and cafes prioritised the display of unhealthy items.
CONCLUSIONS
Neither hospital was consistently compliant with quality statements 1-3 of the NICE quality standard 94. Improving the availability of healthy foods and drinks while reducing the display and accessibility to less healthy options in NHS venues may improve family awareness of healthy alternatives. Making it easier for parents to direct their children to healthier choices is an ostensibly central component of our healthcare system.
目的
评估英国两家主要的国民保健服务（NHS）区级综合医院的食品和饮料零售点是否符合英国国家卫生与临床优化研究所（NICE）质量标准94的质量声明1 - 3。
设计
横断面描述性研究，以评估两家二级医疗机构医院自动售货机、餐厅、咖啡馆和商店提供的食品和饮料选择。
主要观察指标
遵守质量声明1，即使用营养成分分析模型（NPM）将自动售货机中提供的食品和饮料项目分类为健康或不太健康。通过测量商店、咖啡馆和餐厅在菜单上展示营养信息的清晰程度，以及零售点中健康食品和饮料选择的可用性和显著展示情况，分别评估对质量声明2和3的遵守情况。
结果
对质量声明1的遵守情况较差。在评估的18台自动售货机中，只有7台（39%）同时提供健康食品和健康饮料选择。两家医院均未遵守质量声明2，即两家医院的食品供应商菜单上均未提供营养信息。对质量标准3的遵守情况不一致，两家主要医院餐厅显著展示了健康食品和饮料选择，但所有商店和咖啡馆都优先展示不健康食品。
结论
两家医院均未始终遵守NICE质量标准94的质量声明1 - 3。在NHS场所增加健康食品和饮料的供应，同时减少展示和提供不太健康的选择，可能会提高家庭对健康替代品的认识。让家长更容易引导孩子做出更健康的选择显然是我们医疗保健系统的核心组成部分。
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