Associations between the school food environment, student consumption and body mass index of Canadian adolescents

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RESEARCH

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Associations between the school food environment, student consumption and body mass index of Canadian adolescents Louise C Mâsse1,4*, Judith Evelyn de Niet-Fitzgerald1, Allison W Watts1, Patti-Jean Naylor2 and Elizabeth M Saewyc3

Abstract Background: Increasing attention has been paid to the school food environment as a strategy to reduce childhood obesity. The purpose of this study was to examine associations between the school food environment, students’ dietary intake, and obesity in British Columbia (BC), Canada. Methods: In 2007/08, principal responses about the school environment (N = 174) were linked to grades 7-12 students (N = 11,385) from corresponding schools, who participated in the BC Adolescent Health Survey. Hierarchical mixed-effect regression analyses examined the association between the school food environment and student’s intake of sugar-sweetened beverages (SSBs), food consumption, and body mass index. Analyses controlled for school setting, neighborhood education level and student’s age and sex. Results: School availability of SSBs was positively associated with moderate (Odds Ratio (OR) = 1.15, 95% Confidence Interval (CI) = 1.02-1.30) and high (OR = 1.43, 95% CI = 1.13-1.80) SSB intake as were less healthful school nutrition guidelines for moderate SSB consumers only (OR = 0.65, 95% CI = 0.48-0.88). Availability of SSBs at school and its consumption were positively associated with student obesity (OR = 1.50, 95% CI = 1.12-2.01 and OR = 1.66, 95% CI = 1.19-2.34, respectively) but not with overweight. In contrast, consumption of less healthful food was positively associated with overweight (OR = 1.03, 95% CI = 1.01-1.06). Conclusions: The results of this study provide further evidence to support the important role of schools in shaping adolescents’ dietary habits. Availability and consumption of SSBs, but not less healthful foods, at school were associated with higher adolescent obesity highlighting that other environments also contribute to adolescent obesity. Keywords: School food environment, Diet, Body mass index, School policy, Sugar-sweetened beverages, Adolescents

Background Similar to other developed countries, the prevalence of measured overweight and obesity among Canadian youth aged 6 to 17 years in 2010 was 19.5% and 11.6%, respectively [1]. Over consumption of empty calories, defined as calories originating from solid fat and added sugar, is seen as an important contributor to childhood obesity [2]. The consumption of empty calories accounts for about 40% of the total calories consumed by US children (2-18 year) of which 22% are from sugar-sweetened beverages (SSBs) [3]. * Correspondence: [email protected] 1 School of Population and Public Health, University of British Columbia, F508-4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada 4 Department of Pediatrics/School of Population and Public Health, University of British Columbia, F508-4480 Oak Street, Vancouver, BC V6H 3V4, Canada Full list of author information is available at the end of the ar