Effect of changes to the school food environment on eating behaviours and/or body weight in children: a systematic review

Abstract

Previous school obesity-prevention reviews have included multi-component interventions. Here, we aimed to review the evidence for the effect of isolated food environment interventions on both eating behaviours (including food purchasing) and/or body weight. Five electronic databases were searched (last updated 30 November 2013). Of the 1,002 unique papers identified, 55 reported on school food environment changes, based on a review of titles and abstracts. Thirty-seven further papers were excluded, for not meeting the inclusion criteria. The final selection consisted of 18 papers (14 United States, 4 United Kingdom). Two studies had a body mass index (BMI) outcome, 14 assessed purchasing or eating behaviours and two studies assessed both weight and behaviour. Seventeen of 18 papers reported a positive outcome on either BMI (or change in BMI) or the healthfulness of food sold or consumed. Two studies were rated as strong quality and 11 as weak. Only three studies included a control group. A school environment supportive of healthy eating is essential to combat heavy marketing of unhealthy food. Modification of the school food environment (including high-level policy changes at state or national level) can have a positive impact on eating behaviours. A need exists, however, for further high-quality studies.

Support for healthy eating at schools according to the comprehensive school health framework: evaluation during the early years of the Ontario School Food and Beverage Policy implementation

“…[1][2][3] As the high prevalence of childhood obesity continues, schools have been encouraged to adopt policies that formally promote healthy eating behaviours among students. [4][5][6] Internationally, school nutrition policies have played a critical role in supporting the healthy eating behaviours of children.…”

The price of healthy and unhealthy foods in Australian primary school canteens

“…3,4 To date, public health policy targeting the school food environment has largely focused on reducing the availability of unhealthy foods from school food outlets. 5,6 Alternative strategies to promote healthy food purchasing by and for students have received little attention from policy makers. Price is a key determinant of purchase choice in schools; 7 it is easily amenable to intervention, 8 and relative pricing approaches are recommended by the World Health Organization.…”

Soutien en faveur de l’alimentation saine dans les écoles conformément à l’approche globale de la santé en milieu scolaire : évaluation au cours des premières années de la mise en oeuvre de la Politique de l’Ontario concernant les aliments et les boissons dans les écoles

“…Le fait de disposer de soutien au sein des quatre piliers de la santé en milieu scolaire au cours de la mise en oeuvre de la Politique s'est révélé efficace pour favoriser des comportements sains de la part des élèves 2,29 . Notre étude a mis en lumière dif férents niveaux de soutien envers les piliers de la santé en milieu scolaire au cours de la mise en oeuvre de la N P/P 150 au sein des écoles lors des deux périodes.…”