State School Nutrition and Physical Activity Policy Environments and Youth Obesity

Abstract

Background With the epidemic of childhood obesity, there is national interest in state-level school policies related to nutrition and physical activity, policies adopted by states, and relationships to youth obesity. Purpose This study develops a comprehensive state-level approach to characterize the overall obesity prevention policy environment for schools and links the policy environments to youth obesity for each state. Methods Using 2006 School Health Policies and Programs Study (SHPPS) state data, qualitative and quantitative methods were used (2008–2009) to construct domains of state-level school obesity prevention policies and practices, establish the validity and reliability of the domain scales, and examine their associations with state-level obesity prevalence among youth aged 10–17 years from the 2003 National Survey of Children’s Health. Results Nearly 250 state-level obesity prevention–policy questions were identified from the SHPPS. Three broad policy topic areas containing 100 food service and nutrition (FSN) questionnaire items; 146 physical activity and education (PAE) items; and two weight assessment (WA) items were selected. Principal components analysis and content validity assessment were used to further categorize the items into six FSN, ten PAE, and one WA domain. Using a proportional scaled score to summarize the number of policies adopted by states, it was found that on average states adopted about half of the FSN (49%), 38% of the PAE, and 17% of the WA policies examined. After adjusting for state-level measures of ethnicity and income, the average proportion of FSN policies adopted by states was correlated with the prevalence of youth obesity at r =0.35 (p=0.01). However, no correlation was found between either PAE or WA policies and youth obesity (PAE policies at r=0.02 [p=0.53] and WA policies at r =0.16 [p=0.40]). Conclusions States appear to be doing a better job adopting FSN policies than PA or WA policies, and adoption of policies is correlated with youth obesity. Continued monitoring of these policies seems to be warranted.

Impact of competitive foods in public schools on child nutrition: effects on adolescent obesity in the United States an integrative systematic literature review

“…Nanney et al [47] found that Food Service and Nutrition (FSN) policy groupings with the strongest associations to youth obesity are policies which pertained to competitive foods and food service standards. After adjusting for factors, nutrition policies addressing competitive foods in other venues, food service director qualifications, and BMI screening remained positively and significantly related to the odds of obesity in children, as revealed by Riis et al [52].…”

“…Some studies included ages 6–12, and data were then extrapolated which focused on the age of inclusion for this review. The size of sample varied anywhere between 186 students involved in a high school intervention [45], to US student population age 10–17 across 50 states in the US [47]. …”

“…Fox et al [58] discussed reductions in daily Kcalories from consumption of energy-dense foods and beverages in school with possible associations to weight of adolescents. Nanney et al [47] details the varying levels of obesity across the country in various states and regions and any relevance it has on nutrition, physical activity, and education policies within schools. Fletcher et al [59] examined the effects of soft drink taxes on weight among children, change in BMI, obesity prevalence, or soft drink calorie consumption.…”

“…Snelling et al [46], sought to compare the NSLP with competitive food offerings and the impact availability and type of competitive foods had on adolescent consumption and purchasing behaviors. Nanney et al [47], examined cross-sectional associations to discover if youth obesity prevalence and comprehensive school-based obesity prevention policies were linked. Smith & Holloman [45], analyzed the purchasing patterns of SSB consumption when restrictions on availability were implemented in school settings.…”

“…Evaluating different competitive food and beverage policies within schools around the country and their association with adolescent obesity were also examined [47,62] and, Nanney et al [47], and Riis et al [52], add analysis on physical education policies in addition to school nutrition policies. Taber et al [54], analyzed state school meal laws and their associations with weight status in adolescents.…”