Mohammadi Shooka, Su Tin Tin, Jalaludin Muhammad Yazid, Dahlui Maznah, Azmi Mohamed Mohd Nahar, Papadaki Angeliki, Jago Russell, Toumpakari Zoi, Majid Hazreen A
Department of Social and Preventive Medicine, Faculty of Medicine, Centre of Population Health, University of Malaya, Kuala Lumpur, Malaysia.
South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia.
Front Public Health. 2020 Sep 22;8:549637. doi: 10.3389/fpubh.2020.549637. eCollection 2020.
School environments can influence students' dietary habits. Hence, implementing a healthy canteen intervention programme in schools is a recommended strategy to improve students' dietary intake. This study will evaluate the feasibility of providing healthier food and beverage options in selected secondary schools in Malaysia by working with canteen vendors. It also will assess the changes in food choices before and after the intervention. A feasibility cluster randomised controlled study will be conducted in six secondary schools (intervention, = 4; control, = 2) comprising of rural and urban schools located in Selangor and Perak states in Malaysia. Four weeks of intervention will be conducted among Malaysian adolescents aged 15 years old. Two interventions are proposed that will focus on providing healthier food options in the canteen and convenience shops in the selected schools. Interventions 1 and 2 will entail training the canteen and school convenience shop operators. Intervention 2 will be applied to subsidise the cost of low energy-dense (traditional cake), vegetables, and fruits. The control group will continue to sell the usual food. Trained dietitians will audit the canteen menu and food items sold by the school canteen and convenience shops in all schools. Anthropometric measurements, blood pressure and dietary assessment will be collected at baseline and at the end of 4-week intervention. Focus group discussions with students and in-depth interviews with headmasters, teachers, and school canteen operators will be conducted post-intervention to explore intervention acceptability. Under this Healthy School Canteen programme, school canteens will be prohibited from selling "red flag" foods. This refers to foods which are energy-dense and not nutritious, such as confectionery and deep-fried foods. They will also be prohibited from selling soft drinks, which are sugar-rich. Instead, the canteens will be encouraged to sell "green flag" food and drinks, such as fruits and vegetables. It is anticipated that this feasibility study can provide a framework for the conception and implementation of nutritional interventions in a future definitive trial at the school canteens in Malaysia.
学校环境会影响学生的饮食习惯。因此,在学校实施健康食堂干预计划是提高学生饮食摄入量的一项推荐策略。本研究将通过与食堂供应商合作,评估在马来西亚选定的中学提供更健康的食品和饮料选择的可行性。它还将评估干预前后食物选择的变化。将在马来西亚雪兰莪州和霹雳州的六所中学(干预组 = 4所;对照组 = 2所)开展一项可行性整群随机对照研究,这些学校包括农村和城市学校。将对15岁的马来西亚青少年进行为期四周的干预。提出了两项干预措施,重点是在选定学校的食堂和便利店提供更健康的食物选择。干预措施1和2将包括培训食堂和学校便利店经营者。干预措施2将用于补贴低能量密度食品(传统蛋糕)、蔬菜和水果的成本。对照组将继续销售常规食品。经过培训的营养师将审核所有学校食堂和便利店出售的食堂菜单和食品。将在基线和四周干预结束时收集人体测量数据、血压和饮食评估。干预后将与学生进行焦点小组讨论,并与校长、教师和学校食堂经营者进行深入访谈,以探讨干预措施的可接受性。在这项健康学校食堂计划下,学校食堂将被禁止出售“红旗”食品。这指的是能量密度高且无营养的食品,如糖果和油炸食品。它们还将被禁止出售富含糖分的软饮料。相反,食堂将被鼓励出售“绿旗”食品和饮料,如水果和蔬菜。预计这项可行性研究可为未来在马来西亚学校食堂进行的确定性试验中的营养干预措施的构思和实施提供一个框架。