Sildén Kirsten E
a Department of Public Health , Lund University , Ängelholm , Sweden.
Glob Health Action. 2018;11(1):1477492. doi: 10.1080/16549716.2018.1477492.
The United States (US) is currently facing a public health crisis due to the percentage of obesity in adolescents. The Center for Disease Control (CDC) stated the risks for children due to obesity are many. Adolescents obtain a large portion of their daily caloric intake at school; therefore, what foods/drinks they are consuming is so serious.
To identify and analyze literature on the effects of competitive foods in public schools on adolescent weight, or Body Mass Index (BMI), and possible impacts they may have on adolescent obesity in the United States.
An integrative systematic review of literature was conducted. The literature was collected in CINAHL, MEDLINE and EMBASE databases. Refined keyword search is further detailed in the report. Year restrictions were 2006-2017 from peer-reviewed journals and published in English, including adolescents 13-18 years old in the US. Criteria for inclusion targeted at least one of (1) sugar-sweetened beverages (SSB), (2) competitive foods, (3) commercial foods, (4) vending machines, (5) al a carte venues, and (6) school stores, examining their associations with weight measurements, using either weight or BMI, or caloric intake analysis.
A total of 164 articles were detected and assessed, for a final analysis of 34 full text articles. Twenty-six articles met the inclusion criteria. Common aspects of interest involved BMI/Obesity/Weight (73%), (58%) examined Calorie density or consumption, (77%) discussed the Availability of competitive foods in schools, (54%) included Analysis of competitive food, beverage and nutrition policies, and (69%) addressed Other effects.
This review discovered substantial evidence that competitive foods are highly available in schools, however, lacking in robust evidence proving causality in increasing BMI or weight. There is strong corroboration in the research revealing that Other effects are factors worthy of studying further. Additional longitudinal and higher-quality research needs to be performed.
由于青少年肥胖率问题，美国目前正面临一场公共卫生危机。疾病控制中心（CDC）指出，肥胖给儿童带来诸多风险。青少年日常热量摄入的很大一部分来自学校；因此，他们在校食用何种食物/饮料至关重要。
识别并分析关于公立学校的竞争性食品对青少年体重或身体质量指数（BMI）的影响，以及它们对美国青少年肥胖可能产生的影响的文献。
进行了文献的综合系统综述。文献收集于CINAHL、MEDLINE和EMBASE数据库。报告中进一步详细说明了精确的关键词搜索。年份限制为2006 - 2017年，来自同行评审期刊且以英文发表，涵盖美国13 - 18岁的青少年。纳入标准针对以下至少一项：（1）含糖饮料（SSB），（2）竞争性食品，（3）商业食品，（4）自动售货机，（5）单点餐厅，以及（6）学校商店，使用体重或BMI或热量摄入分析来研究它们与体重测量的关联。
共检测并评估了164篇文章，最终对34篇全文进行分析。26篇文章符合纳入标准。共同关注的方面包括BMI/肥胖/体重（73%），（58%）研究了热量密度或摄入量，（77%）讨论了学校竞争性食品的可获取性，（54%）纳入了竞争性食品、饮料和营养政策分析，以及（69%）涉及其他影响。
本综述发现大量证据表明学校中竞争性食品随处可得，然而，缺乏确凿证据证明其与BMI增加或体重增加存在因果关系。研究中有强有力的佐证表明其他影响是值得进一步研究的因素。需要开展更多纵向和高质量的研究。
