College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Ave, Fayetteville, AR 72701. Email:
Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas.
Prev Chronic Dis. 2022 Sep 1;19:E55. doi: 10.5888/pcd19.220051.
The Centers for Disease Control and Prevention's Sodium Reduction in Communities Program aims to reduce dietary sodium intake through policy, systems, and environmental approaches. The objective of our study was to evaluate changes in sodium levels over 5 years (2016-2021) in food served in school lunches as an outcome of a Sodium Reduction in Communities program in Arkansas's largest school district.
We collaborated with Springdale Public Schools (SPS) to reduce dietary sodium intake in school lunches through increased implementation of 1) food service guidelines, 2) procurement practices, 3) food preparation practices, and 4) environmental strategies. These activities were maintained from year 1 through year 5. Implementation priorities were informed each year by evaluation findings from the preceding year.
We collected lunch service records and information on nutritional content of menu items for the 30 schools under the direction of SPS's Child Nutrition Department. We used a pretest-posttest quantitative evaluation design to analyze annual changes in the sodium content of meals, from baseline through year 5.
From baseline through year 1, SPS reduced sodium served per diner, per entrée offered, and per entrée served. These reductions were maintained from baseline through 5 years of follow-up. Mean sodium per 1,000 kcal per diner served was 1,740 mg at baseline and was lower in each of the 5 follow-up years: 1,488 mg (14% decrease) in year 1; 1,495 mg (14% decrease) in year 2; 1,612 mg (7% decrease) in year 3; 1,560 mg (10% decrease) in year 4; and 1,532 mg (12% decrease) in year 5. Energy served per diner remained stable.
Our study provides evidence for sustained sodium reduction strategies in a large ethnically and socioeconomically diverse school district, pointing to the potential benefit of implementing similar strategies in other school districts. The study also shows how program evaluation can be used to support sustainability.
疾病控制与预防中心的社区减钠计划旨在通过政策、系统和环境方法减少饮食中的钠摄入量。我们研究的目的是评估阿肯色州最大学区社区减钠计划实施 5 年来（2016-2021 年）学校午餐中钠含量的变化。
我们与斯普林代尔公立学校（SPS）合作，通过增加实施以下措施来降低学校午餐中的饮食钠摄入量：1）食品服务指南，2）采购实践，3）食品准备实践，以及 4）环境策略。这些活动从第 1 年持续到第 5 年。每年根据前一年的评估结果确定实施重点。
我们根据 SPS 儿童营养部门的指导收集了 30 所学校的午餐服务记录和菜单项目营养含量信息。我们使用预测试后定量评估设计来分析从基线到第 5 年期间膳食中钠含量的年度变化。
从基线到第 1 年，SPS 减少了每位用餐者、每份提供的主菜和每份主菜的钠含量。这些减少从基线持续到 5 年的随访。每位用餐者提供的 1000 卡路里热量中钠的平均含量为 1740 毫克，在接下来的 5 年随访中逐渐降低：第 1 年为 1488 毫克（减少 14%）；第 2 年为 1495 毫克（减少 14%）；第 3 年为 1612 毫克（减少 7%）；第 4 年为 1560 毫克（减少 10%）；第 5 年为 1532 毫克（减少 12%）。每位用餐者提供的能量保持稳定。
我们的研究为一个大型种族和社会经济多样化的学区提供了持续的减钠策略的证据，表明在其他学区实施类似策略可能具有潜在的益处。该研究还展示了如何使用计划评估来支持可持续性。
