Sang Iii Charlie J, de Visser Rosa, Krallman Rachel, Pai Chih-Wen, Montgomery Daniel, Moser Cydni A, Kline-Rogers Eva, DuRussel-Weston Jean, Eagle Kim A, Chinapaw Mai, Jackson Elizabeth A
Division of Cardiology (CJ Sang III), Department of Medicine, University of North Carolina at Chapel Hill.
Michigan Clinical Outcomes Research and Reporting Program (R de Visser, R Krallman, C-W Pai, D Montgomery, E Kline-Rogers, and EA Jackson), Michigan Medicine, Ann Arbor, Mich; Amsterdam UMC (M Chinapaw), Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Health Behavior and Chronic Diseases and Methodology, Amsterdam, the Netherlands.
Acad Pediatr. 2023 Nov-Dec;23(8):1605-1613. doi: 10.1016/j.acap.2023.07.018. Epub 2023 Aug 3.
Childhood obesity remains a major public health issue. This study assessed the association between school-sourced lunches and cardiometabolic risk factors in middle-school students.
Data from health behavior surveys and physiologic screenings in a Michigan middle-school wellness program between 2005 and 2019 were used to analyze the association of school lunch consumption with cardiometabolic risk factors (overweight/obesity, non-fasting lipids/glucose, blood pressure) and dietary behaviors (fruit/vegetable consumption, intake of sugar-sweetened beverages/foods). Students were divided into three groups based on their responses to the survey item if they 1) always, 2) sometimes, or 3) never consumed school-sourced lunches. Groups were compared using descriptive statistics and chi-squared tests.
Students consuming school-sourced lunches were more likely to have overweight or obesity, without significant differences in total, HDL, or LDL cholesterol. There was no difference in non-fasting glucose levels, blood pressure, or resting heart rate. Students consuming school sourced lunch were more likely to have increased sugary and fatty food or beverage consumption. Students consuming school sourced lunch were more likely to attend school in a low or middle socioeconomic status region.
In this large cohort of middle-school children, consuming school-sourced lunches was associated with a greater prevalence of overweight and obesity and consumption of fatty foods and sugary beverages. School-based interventions should target methods to reduce consumption of sugary beverages and unhealthy snacks and promote consumption of fruits and vegetables, particularly among high-risk individuals.
儿童肥胖仍然是一个主要的公共卫生问题。本研究评估了学校提供的午餐与中学生心血管代谢危险因素之间的关联。
利用2005年至2019年密歇根州一项中学健康项目中的健康行为调查和生理筛查数据，分析学校午餐消费与心血管代谢危险因素（超重/肥胖、非空腹血脂/血糖、血压）和饮食行为（水果/蔬菜消费、含糖饮料/食物摄入量）之间的关联。根据学生对调查项目的回答，将他们分为三组：1）总是，2）有时，或3）从不食用学校提供的午餐。使用描述性统计和卡方检验对各组进行比较。
食用学校提供午餐的学生超重或肥胖的可能性更大，总胆固醇、高密度脂蛋白胆固醇或低密度脂蛋白胆固醇无显著差异。非空腹血糖水平、血压或静息心率无差异。食用学校提供午餐的学生更有可能增加含糖和高脂肪食物或饮料的消费。食用学校提供午餐的学生更有可能在社会经济地位低或中等的地区上学。
在这个庞大的中学生队列中，食用学校提供的午餐与超重和肥胖的患病率更高以及高脂肪食物和含糖饮料的消费有关。基于学校的干预措施应针对减少含糖饮料和不健康零食的消费，并促进水果和蔬菜的消费，特别是在高危个体中。
