Changes in Body Mass Index Among School-Aged Youths Following Implementation of the Healthy, Hunger-Free Kids Act of 2010-Reference-Cited by-同舟云学术

Changes in Body Mass Index Among School-Aged Youths Following Implementation of the Healthy, Hunger-Free Kids Act of 2010

Published:2023-04-01 Issue:4 Volume:177 Page:401
ISSN:2168-6203
Container-title:JAMA Pediatrics
language:en
Short-container-title:JAMA Pediatr

Author:

Chandran Aruna¹,Burjak Mohamad¹,Petimar Joshua²,Hamra Ghassan¹,Melough Melissa M.³,Dunlop Anne L.⁴,Snyder Brittney M.⁵,Litonjua Augusto A.⁶,Hartert Tina⁷,Gern James⁸⁹,Alshawabkeh Akram N.¹⁰,Aschner Judy¹¹¹²,Camargo Carlos A.¹³,Dabelea Dana¹⁴,Duarte Cristiane S.¹⁵,Ferrara Assiamira¹⁶,Ganiban Jody M.¹⁷,Gilliland Frank¹⁸,Gold Diane R.¹⁹²⁰,Hedderson Monique¹⁶,Herbstman Julie B.²¹,Hockett Christine²²²³,Karagas Margaret R.²⁴,Kerver Jean M.²⁵²⁶,Lee-Sarwar Kathleen A.¹⁹²⁷,Lester Barry²⁸,McEvoy Cindy T.²⁹,Niu Zhongzheng¹⁸,Stanford Joseph B.³⁰³¹,Wright Rosalind³²,Zimmerman Emily³³,Farzan Shohreh¹⁹,Zhang Zhumin³⁴,Knapp Emily¹

Affiliation:

1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

2. Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts

3. Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle Children’s Hospital, Seattle, Washington

4. Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia

5. Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee

6. Division of Pediatric Pulmonology, Golisano Children’s Hospital, University of Rochester Medical Center, Rochester, New York

7. Vanderbilt University Medical Center, Nashville, Tennessee

8. Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin–Madison

9. Department of Medicine, School of Medicine and Public Health, University of Wisconsin–Madison

10. College of Engineering, Northeastern University, Boston, Massachusetts

11. Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, New Jersey

12. Albert Einstein College of Medicine, Bronx, New York

13. Massachusetts General Hospital, Harvard Medical School, Boston

14. Lifecourse Epidemiology of Adiposity & Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado

15. Department of Psychiatry, New York State Psychiatric Institute and Columbia University, New York

16. Division of Research, Kaiser Permanente Northern California, Oakland

17. Department of Psychological & Brain Sciences, The George Washington University, Washington, DC

18. Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles

19. Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts

20. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

21. Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York

22. Avera Research Institute, Sioux Falls, South Dakota

23. University of South Dakota, Sioux Falls

24. Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire

25. Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing

26. Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing

27. Channing Division of Network Medicine and Division of Allergy and Clinical Immunology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts

28. The Warren Alpert Medical School, Brown University, Providence, Rhode Island

29. Oregon Health & Science University, Portland

30. Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City

31. Department of Pediatrics, University of Utah School of Medicine, Salt Lake City

32. Icahn School of Medicine at Mount Sinai, New York, New York

33. Department of Communication Sciences and Disorders, Northeastern University, Boston, Massachusetts

34. Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison

Abstract

ImportanceThe prevalence of obesity among youths 2 to 19 years of age in the US from 2017 to 2018 was 19.3%; previous studies suggested that school lunch consumption was associated with increased obesity. The Healthy, Hunger-Free Kids Act of 2010 (HHFKA) strengthened nutritional standards of school-based meals.ObjectiveTo evaluate the association between the HHFKA and youth body mass index (BMI).Design, Setting, and ParticipantsThis cohort study was conducted using data from the Environmental Influences on Child Health Outcomes program, a nationwide consortium of child cohort studies, between January 2005 and March 2020. Cohorts in the US of youths aged 5 to 18 years with reported height and weight measurements were included.ExposuresFull implementation of the HHFKA.Main Outcomes and MeasuresThe main outcome was annual BMI z-score (BMIz) trends before (January 2005 to August 2016) and after (September 2016 to March 2020) implementation of the HHFKA, adjusted for self-reported race, ethnicity, maternal education, and cohort group. An interrupted time-series analysis design was used to fit generalized estimating equation regression models.ResultsA total of 14 121 school-aged youths (7237 [51.3%] male; mean [SD] age at first measurement, 8.8 [3.6] years) contributing 26 205 BMI measurements were included in the study. Overall, a significant decrease was observed in the annual BMIz in the period following implementation of the HHFKA compared with prior to implementation (−0.041; 95% CI, −0.066 to −0.016). In interaction models to evaluate subgroup associations, similar trends were observed among youths 12 to 18 years of age (−0.045; 95% CI, −0.071 to −0.018) and among youths living in households with a lower annual income (−0.038; 95% CI, −0.063 to −0.013).Conclusions and RelevanceIn this cohort study, HHFKA implementation was associated with a significant decrease in BMIz among school-aged youths in the US. The findings suggest that school meal programs represent a key opportunity for interventions to combat the childhood obesity epidemic given the high rates of program participation and the proportion of total calories consumed through school-based meals.

Publisher

American Medical Association (AMA)

Subject

Pediatrics, Perinatology and Child Health

Link

https://jamanetwork.com/journals/jamapediatrics/articlepdf/2801450/jamapediatrics_chandran_2023_oi_220094_1680182442.5504.pdf

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