Reducao do uso de acucar em escolas publicas: ensaio randomizado por conglomerados

Abstract

OBJECTIVE:To test the effi cacy of nutritional guidelines for school lunch cooks aiming to reduce added sugar in school meals and their own sugar intake. METHODS:A controlled randomized cluster trial was carried out in twenty public schools in the municipality of Niteroi in Rio de Janeiro, Southeastern Brazil, from March to December 2007. A nutrition educational program was implemented in the schools in question through messages, activities and printed educational materials encouraging reduced levels of added sugar in school meals and in the school lunch cooks' own intake. The reduced availability of added sugar in schools was evaluated using spreadsheets including data on the monthly use of food item supplies. The cooks' individual food intake was evaluated by a Food Frequency Questionnaire. Anthropometric measurements were taken according to standardized techniques and variation in weight was measured throughout the duration of the study. RESULTS:There was a more marked reduction in the intervention schools compared to the control schools (-6.0 kg versus 0.34 kg), but no statistically signifi cant difference (p = 0.21), although the study power was low. Both groups of school lunch cooks showed a reduction in the consumption of sweets and sweetened beverages, but the difference in sugar intake was not statistically signifi cant. Weight loss and a reduction in total energy consumption occurred in both groups, but the difference between them was not statistically signifi cant, and there was no alteration in the percentages of adequacy of macronutrients in relation to energy consumption. CONCLUSIONS:The strategy of reducing the use and consumption of sugar by school lunch cooks from public schools could not be proved to be effective. Obesity is viewed as a global epidemic. It refl ects the complex interaction of genetic, metabolic, cultural, environmental, socio-economic and behavioral factors, although it's most basic explanation lies in energy intake. 19 Consumption of carbohydrates, principally in the form of simple sugars, has increased over the last 20 years, as have rates of obesity and being overweight. 9

Interventions to Promote Healthy Meals in Full-Service Restaurants and Canteens: A Systematic Review and Meta-Analysis

“…The 41 included interventions were analyzed for one or more of the three outcomes identified and mentioned above: (1) 22 interventions (17 RCTs and 5 non-RCTs) aimed to improve customers' dietary intake regarding the consumed food and beverage items and the nutritional composition of food in terms of micro-and macronutrients [27,29,43,44,[49][50][51][52][53][54][55][56][57][58][59][63][64][65][66][67][68][69];…”

“…(2) 14 interventions (13 RCTs and 1 non-RCT) aimed to increase healthy food offerings on menus [37][38][39][40][41][42][43][44][45][46][47][48]62,72]; and (3) 16 interventions (14 RCTs and 2 non-RCTs) aimed to increase the population's healthy food purchases [25][26][27][28][29]40,45,46,56,60,61,65,66,[69][70][71] (Table 2).…”

“…The included interventions were set in 12 different countries. Most of them were performed in the United States (n = 20) [26][27][28]37,38,40,48,51,52,55,56,60,61,63,[65][66][67][68][69][70] and Australia (n = 11) [25,39,41,43,[45][46][47]58,59,62,71], while the other studies were conducted in Lebanon [29], Brazil [44], Denmark [50], Malaysia [42], Scotland [53], Belgium [49], Mexico [72], Ecuador [54], Ireland [64], and the UK [57].…”

“…The included studies took place in different settings. Twenty-four RCT and 5 non-RCT studies were applied in school settings, specifically in primary and secondary schools [25,27,29,38,41,42,44,[46][47][48][49][53][54][55]57,60,63,65,66,68,69,71] or in a childcare service center [39,43,58,59,62,67,72]. Then, 8 RCTs were conducted in community settings, including 1 intervention in sporting clubs [45]; 2 interventions in restaurants [26] and/or food stores [40]; 4 interventions in after-school programs in churches, communities and schools [37,51,52,70]; and 1 intervention in recreation centers, including corner stores, wholesalers and carry-out restaurants [56].…”

PAAPPAS community trial protocol: a randomized study of obesity prevention for adolescents combining school with household intervention

“…In the first initiative, the main intervention focused on the reduction of sodas [ 7 ]. The second study was conducted among school cooks [ 8 , 9 ] with the main aim of reducing use of sugar at school and also to reduce sugar intake and increase physical exercise among the school cooks. The third study, focused on positive messages to increase the intake of water, fruit, and beans and to reduce intake of cookies, sugar-sweetened beverages, and savory snacks [ 10 ].…”