Implementation of Competitive Food and Beverage Standards in a Sample of Massachusetts Schools: The NOURISH Study (Nutrition Opportunities to Understand Reforms Involving Student Health)

Abstract

Background During 2012, Massachusetts adopted comprehensive school competitive food and beverage standards that closely align with Institute of Medicine recommendations and Smart Snacks in School national standards. Objective We examined the extent to which a sample of Massachusetts middle schools and high schools sold foods and beverages that were compliant with the state competitive food and beverage standards after the first year of implementation, and complied with four additional aspects of the regulations. Design Observational cohort study with data collected before implementation (Spring 2012) and 1 year after implementation (Spring 2013). Participants/setting School districts (N=37) with at least one middle school and one high school participated. Main outcome measures Percent of competitive foods and beverages that were compliant with Massachusetts standards and compliance with four additional aspects of the regulations. Data were collected via school site visits and a foodservice director questionnaire. Statistical analyses performed Multilevel models were used to examine change in food and beverage compliance over time. Results More products were available in high schools than middle schools at both time points. The number of competitive beverages and several categories of competitive food products sold in the sample of Massachusetts schools decreased following the implementation of the standards. Multilevel models demonstrated a 47-percentage-point increase in food and 46-percentage-point increase in beverage compliance in Massachusetts schools from 2012 to 2013. Overall, total compliance was higher for beverages than foods. Conclusions This study of a group of Massachusetts schools demonstrated the feasibility of schools making substantial changes in response to requirements for healthier competitive foods, even in the first year of implementation.

Limited School Drinking Water Access for Youth

“…However, there are several limitations to this study. A majority of school districts that were initially approached declined to participate in the full NOURISH evaluation due to a lack of interest or time, 25 and schools that participated had a larger proportion of white and higher income students. It is unclear whether these schools might have drinking water access that is substantially different than schools that were not sampled, and thus these findings may not be generalizable to all secondary schools in Massachusetts.…”

“…School districts with both middle and high schools in Massachusetts were eligible to participate in the study; 113 districts were invited to participate, with a middle and high school randomly sampled within each district. 25 Of these, 31 districts (31%) agreed to participate in the water access assessment, with the primary reason for nonparticipation given being a lack of time on the part of the district food service directors, resulting in a final sample size of 59 school buildings for water access analysis (in two districts, the middle and high school shared the same building, while in a third district only a high school was visited). Each participating school was visited by research assistants on one day to complete a direct observation of drinking water availability at the school.…”

How do we actually put smarter snacks in schools? NOURISH (Nutrition Opportunities to Understand Reforms Involving Student Health) conversations with food-service directors

“…Changes were not easy, but they did result in the availability of healthier competitive food and beverage options in the school environment (17,18) . We uncovered seven main messages from interviews with FSD, which suggest strategies for complying with comprehensive school competitive food and beverage policies.…”

The nutritional preferences in the college students and the risk of gaining excessive weight

“…В то же время наблю- дается дефицит пищевых волокон, витаминов, ми-кроэлементов [11][12][13]. Ряд авторов указывают на скудность недельного рациона студентов [14,15]. В рационе студентов обнаруживается большое количество готовых продуктов: крекеров, чипсов.…”