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Policy Options to Support Healthy Eating in Schools

Politiques visant à favoriser une saine alimentation dans les écoles

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ABSTRACT

Objectives: School nutrition policies offer a promising avenue by which to promote healthy eating and reduce the risk of chronic disease. This article reviews policy components that could support healthy eating, examines their evidence base and suggests directions for future research.

Method: Information was drawn from research and other literature written in English between 1994 and 2008. Guided by recommendations from the World Health Organization, evidence pertaining to five potential components of policies was identified and reviewed: foods available, the food environment, health education, health services and counselling, and family and community outreach.

Results: A limited number of evaluations have examined the impact of school nutrition standards and have shown a positive impact on food availability and student nutrient intake. Results have shown that behaviourally focused nutrition education, especially when combined with food services and other initiatives, may affect students’ eating habits positively but may not decrease obesity levels. Evidence pertaining to other potential policy subcomponents, such as limiting food marketing in schools, coordinating all food services and providing nutrition-related health services, is limited or lacking.

Conclusion: Conceptually, comprehensive school nutrition policies comprising all five policy components offer an integrated and holistic approach to school nutrition. They could provide an umbrella to guide all school actions pertaining to nutrition and serve as a framework for accountability. Does conceptualization match reality? Further research is needed to determine how policy components affect implementation and outcomes.

Résumé

Objectifs: Les politiques de nutrition en milieu scolaire sont une stratégie prometteuse en matière de promotion de la saine alimentation et de réduction du risque de maladies chroniques. Le présent article examine les composantes de ces politiques qui peuvent favoriser une saine alimentation. Après avoir examiné leurs fondements scientifiques, il propose des orientations en vue de recherches ultérieures.

Méthodologie: Les informations présentées dans cet article proviennent de recherches ou d’autres documents publiés en anglais entre 1994 et 2008. En nous inspirant des recommandations de l’Organisation mondiale de la Santé, nous avons identifié et examiné certains éléments d’information entourant cinq composantes potentielles des politiques de nutrition, à savoir: aliments disponibles, environnement alimentaire, éducation en santé, services de santé et de consultation, et sensibilisation des familles et de la collectivité. Nous avons évalué certaines initiatives d’éducation en nutrition en tant qu’interventions dans le cadre de certains programmes, mais non en tant qu’éléments de ces politiques.

Résultats: Le nombre limité d’études qui ont évalué l’impact des normes nutritionnelles en vigueur dans les écoles ont révélé l’impact positif de celles-ci sur la disponibilité des aliments et l’apport nutritionnel des élèves. Les résultats démontrent que l’éducation en nutrition axée sur le comportement, surtout lorsqu’elle est combinée à des services alimentaires et à d’autres initiatives, peut avoir un impact positif sur les habitudes alimentaires des élèves, sans nécessairement réduire le taux d’obésité. On dispose de peu ou pas de données probantes quant aux autres sous-composantes potentielles des politiques de nutrition, notamment la restriction du marketing alimentaire dans les écoles, la coordination de tous les services alimentaires et l’offre de services de santé en matière de nutrition.

Conclusion: En théorie, les politiques globales de nutrition en milieu scolaire qui incluent les cinq composantes stratégiques déjà mentionnées s’inscrivent dans le cadre d’une approche intégrée et holistique de la nutrition dans les écoles. Ces politiques pourraient orienter l’ensemble des mesures entreprises dans les écoles en matière de nutrition et servir en même temps de cadre de responsabilisation. Peut-on affirmer que la théorie correspond à la réalité ? De nouvelles recherches s’imposent pour vérifier l’impact de chacune des composantes de ces politiques sur leur mise en œuvre et leurs résultats.

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Références

  1. St. Leger, L., «Protocols and guidelines for health promoting schools», Pro-mot Educ, 12(3–4), 2005, p. 145–147.

    Google Scholar 

  2. Story, M., K.M. Kaphingst, R. Robinson-O’Brien et K. Glanz, «Creating healthy food and eating environments: Policy and environmental approaches», Annu Rev Public Health, 29, 2008, p. 253–272.

    PubMed  Google Scholar 

  3. Foster, G.D., S. Sherman, K.E. Borradaile, K.M. Grundy, S.S. Vander Veur, J. Nachmani and coll., «A policy-based school intervention to prevent overweight and obesity», Pediatrics, 121(4), 2008, p. e794–e802. Sur Internet: https://doi.org/http://pediatrics.aappublications.org/cgi/content/full/121/4/e794 (consulté le 5 août 2008).

    PubMed  Google Scholar 

  4. Organisation mondiale de la Santé, «What is a Health Promoting School?», Genève, OMS, 2006. Sur Internet: https://doi.org/http://www.who.int/school_youth_health/gshi/hps/en/print.html (consulté le 20 juin 2008).

  5. Agence de la santé publique du Canada, «L’Approche globale de la santé en milieu scolaire», Ottawa, Ontario, ASPC, 2008. Sur Internet: https://doi.org/http://www.phac-aspc.gc.ca/dca-dea/7-18yrs-ans/sante_globale-fra.php (consulté le 9 décembre 2008).

    Google Scholar 

  6. Organisation mondiale de la Santé, «Stratégie mondiale pour l’alimentation, l’exercice physique and la santé», 2004. Sur Internet: https://doi.org/http://apps.who.int/gb/ebwha/pdf_files/WHA57/A57_R17-fr.pdf (consulté le 20 juin 2008).

    Google Scholar 

  7. Institute of Medicine, Preventing Childhood Obesity: Health in the Balance, Washington, District fédéral de Columbia, National Academies Press, 2005.

    Google Scholar 

  8. Institute of Medicine, Nutrition Standards for Foods in Schools: Leading the Way toward Healthier Youth, Washington, District fédéral de Columbia, National Academies Press, 2007.

    Google Scholar 

  9. Vereecken, C.A., K. Bobelijn et L. Maes, «School food policy at primary and secondary schools in Belgium-Flanders: Does it influence young people’s food habits?», Eur J Clin Nutr, 59, 2005, p. 271–277.

    CAS  PubMed  Google Scholar 

  10. Wojcicki, J.M. et M.B. Heyman, «Healthier choices and increased participation in a middle school lunch program: Effects of nutrition policy changes in San Francisco», Am J Public Health, 96(9), 2006, p. 1542–1547.

    PubMed  PubMed Central  Google Scholar 

  11. Story, M., M.P. Snyder, J. Anliker, J.L. Weber, L. Cunningham-Sabo, E.J. Stone and coll., «Changes in the nutrient content of school lunches: Results from the Pathways study», Prev Med, 37(Suppl. 1), 2003, p. S35–S45.

    PubMed  Google Scholar 

  12. Aldinger, C.E. et J.T. Jones, «Healthy Nutrition: An Essential Element of a Health-promoting School», Série d’information de l’OMS sur la santé à l’école, document 4, Genève, OMS, 1998.

    Google Scholar 

  13. Harper, C., L. Wood et C. Mitchell, «The Provision of School Food in 18 Countries. School Food Trust», 2008. Sur Internet: https://doi.org/http://www.school-foodtrust.org.uk/UploadDocs/Library/Documents/school_food_in18coun-tries.pdf (consulté le 7 mai 2009).

    Google Scholar 

  14. Ministère de l’Agriculture des États-Unis, «School Nutrition Dietary Assessment Study-III», vol. I: School Foodservice, School Food Environment, and Meals Offered and Served, 2007. Sur Internet: https://doi.org/http://www.fns.usda.gov/oane/MENU/Published/CNP/FILES/SNDAIII-Vol1ExecSum.pdf (consulté le 7 juillet 2008).

    Google Scholar 

  15. Bere, E., M.B. Veierød, S. Øivind, K.I. Klepp, «Free school fruit–sustained effect three years later», Int J Behav Nutr Phys Act, 19(4), 2007, p. 5. Sur Internet: https://doi.org/http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1804281 (consulté le 18 juillet 2008).

    Google Scholar 

  16. Perry, C.L., D.B. Bishop, G.L. Taylor, M. Davis, M. Story et C. Gray, «A randomized school trial of environmental strategies to encourage fruit and vegetable consumption among children», Health Educ Behav, 31(1), 2004, p. 65–76.

    PubMed  Google Scholar 

  17. Ransome, K., J. Rusk, M.A. Yurkiw et C.J. Field, «A school milk promotion program increases milk consumption and improves the calcium and vitamin D intakes of elementary school students», Can J Diet Pract Res, 59(4), 1998, p. 70–75.

    PubMed  Google Scholar 

  18. Caiger, J., «Nutrient composition of children’s lunches: The association between the school food environment, dietary intake and weight status of elementary school children [thèse]», Charlottetown, Île-du-Prince-Édouard, Université de l’Île-du-Prince-Édouard, 2009.

    Google Scholar 

  19. Hay, D.I., «School food programs: A good choice for children?», Perception, 23(4), 2000. Sur Internet: https://doi.org/http://www.ccsd.ca/perception/234/sf.htm (consulté le 15 février 2010).

    Google Scholar 

  20. Story, M., K.M. Kaphingst et S. French, «The role of schools in obesity prevention», Future of Children, 16(1), 2006, p. 109–142.

    Google Scholar 

  21. Vallianatos, M., R. Gottlieb et M.A. Haase, «Farm-to-school: trategies for urban health, combating sprawl, and establishing a community food systems approach», J Planning Ed Res, 23, 2004, p. 414–423.

    Google Scholar 

  22. Vartanian, L.R., M.B. Schwartz et K.D. Brownell, «Effects of soft drink consumption on nutrition and health: A systematic review and meta-analy-sis», Am J Public Health, 97(4), 2007, p. 667–675.

    PubMed  PubMed Central  Google Scholar 

  23. Grimm, G.C., L. Harnack et M. Story, «Factors associated with soft drink consumption in school-aged children», J Am Diet Assoc, 104(8), 2004, p. 1244–1249.

    PubMed  Google Scholar 

  24. Alliance for a Healthier Generation, «Competitive Beverage Guidelines». Sur Internet: https://doi.org/http://www.healthiergeneration.org/beverages/ (consulté le 4 août 2008).

  25. American Beverage Association, «School Beverage Guidelines Progress Report 2007–2008», 2008. Sur Internet: https://doi.org/http://www.schoolbeverages.com/down-load.aspx?id=111 (consulté le 4 août 2009).

  26. Boissons rafraîchissantes, «Lignes directrices de l’industrie sur la vente des boissons dans les écoles», 2007. Sur Internet: https://doi.org/http://www.refreshments.ca/pdf/School%20guidelines%20RefCda%20website%20reload%20200705.pdf (consulté le 4 août 2009).

    Google Scholar 

  27. National Alliance for Nutrition and Activity, «Model Local School Wellness Policies on Physical Activity and Nutrition», 2005. Sur Internet: https://doi.org/http://www.opi.state.mt.us/pdf/schoolfood/NANAModel.pdf (consulté le 4 août 2008).

    Google Scholar 

  28. Swinburn, B., G. Sacks, T. Lobstein, N. Rigby, L.A. Baur, K.D. Brownell and coll., «The ‘Sydney Principles’ for reducing the commercial promotion of foods and beverages to children», Public Health Nutr, 11(9), 2008, p. 881–886.

    PubMed  Google Scholar 

  29. Institute of Medicine, Food Marketing to Children and Youth: Threat or Opportunity? Washington, District fédéral de Columbia, National Academies Press, 2006.

    Google Scholar 

  30. French, S.A., M. Story, J.A. Fulkerson et P. Hannan, «An environmental intervention to promote lower-fat food choices in secondary schools: Outcomes of the TACOS study», Am J Public Health, 94(9), 2004, p. 1507–1512.

    PubMed  PubMed Central  Google Scholar 

  31. Kipke, M.D., E. Iverson, D. Moore, C. Booker, V. Ruelas, A.L. Peters and coll., «Food and park environments: Neighborhood-level risks for childhood obesity in east Los Angeles», J Adolesc Health, 40(4), 2007, p. 325–333.

    PubMed  Google Scholar 

  32. Fox, S., A. Meinen, M. Pesik, M. Landis et P.L. Remington, «Competitive food initiatives in schools and overweight in children: A review of the evidence», WMJ, 104(5), 2005, p. 38–43.

    PubMed  Google Scholar 

  33. Kubik, M.Y., L.A. Lytle et M. Story, «Schoolwide food practices are associated with body mass index in middle school students», Arch Pediatr Adolesc Med, 159(12), 2005, p. 1111–1114.

    PubMed  Google Scholar 

  34. Turner, S., B. Mayall et M. Mauthner, «One big rush: Dinner-time at school», Health Educ J, 54, 1995, p. 18–27.

    Google Scholar 

  35. Ministère de la Santé du Royaume-Uni, «National Healthy Schools Program». Sur Internet: https://doi.org/http://www.healthyschools.gov.uk/Themes/Default.aspx?theme=2 (consulté le 20 août 2008).

    Google Scholar 

  36. General Accounting Office, «School Meal Programs: Competitive Foods are Widely Available and Generate Substantial Revenues for Schools», 2005. Sur Internet: https://doi.org/http://www.gao.gov/new.items/d05563.pdf (consulté le 4 août 2008).

    Google Scholar 

  37. Kann, L, S.K. Telljohann et S.F. Wooley, «Health education: Results from the School Health Policies and Programs Study 2006», J Sch Health, 77(8), 2007, p. 408–434.

    PubMed  Google Scholar 

  38. Himes, J.H., K. Ring, J. Gittelsohn, L. Cunningham-Sabo, J. Weber, J. Thompson and coll., «Impact of the Pathways intervention on dietary intakes of American Indian schoolchildren», Prev Med, 37, 2003, p. S55–S61.

    PubMed  Google Scholar 

  39. Summerbell, C.D., E. Waters, L.D. Edmunds, S. Kelly, T. Brown, K.J. Campbell., «Interventions for preventing obesity in children», Cochrane Database Syst Rev, 20(3), 2005, CD001871.

  40. Hoelscher, D.M., A. Evans, G.S. Parcel et S.H. Kelder, «Designing effective nutrition interventions for adolescents», J Am Diet Assoc, 102(3 Suppl.), 2002, p. S52–S63.

    PubMed  Google Scholar 

  41. Rossiter, M., T. Glanville, J. Taylor et I. Blum, «School food practices of prospective teachers», J Sch Health, 77(10), 2007, p. 694–700.

    PubMed  Google Scholar 

  42. Caballero, B., T. Clay, S.M. Davis, B. Ethelbah, B. Holy Rock, T. Lohman and coll., «Pathways: A school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren», Am J Clin Nutr, 78(5), 2003, p. 1030–1038.

    CAS  PubMed  PubMed Central  Google Scholar 

  43. Hoelscher, D.M., H.A. Feldman, C.C. Johnson, L.A. Lytle, S.K. Osganian, G.S. Parcel and coll., «School-based health education programs can be maintained over time: Results from the CATCH Institutionalization study», Prev Med, 38, 2004, p. 594–606.

    PubMed  Google Scholar 

  44. O’Toole, T.P., S. Anderson, C. Miller et J. Guthrie, «Nutrition services and foods and beverages available at school: Results from the School Health Policies and Programs Study 2006», J Sch Health, 77(8), 2007, p. 500–521.

    PubMed  Google Scholar 

  45. Wainwright, P., J. Thomas et M. Jones, «Health promotion and the role of the school nurse: A systematic review», J Adv Nurs, 32(5), 2000, p. 1083–1091.

    CAS  PubMed  Google Scholar 

  46. Justus, M.B., K.W. Ryan, J. Rockenbach, C. Katterapalli et P. Card-Higginson, «Lessons learned while implementing a legislated school policy: Body mass index assessments among Arkansas’s public school students», J Sch Health, 77(10), 2007, p. 706–713.

    PubMed  Google Scholar 

  47. Nihiser, A.J., S.M. Lee, H. Wechsler, M. McKenna, E. Odom, C. Reinold and coll., «Body mass index measurement in schools», J Sch Health, 77(10), 2007, p. 651–671.

    PubMed  Google Scholar 

  48. American Dietetic Association, «Position of the American Dietetic Association: Individual-, family-, school-, and community-based interventions for pediatric overweight», J Am Diet Assoc, 106(6), 2006, p. 925–945.

    Google Scholar 

  49. Organisation mondiale de la Santé, «Nutrition Friendly Schools Initiative: Part I, NFSI Framework», Genève, Organisation mondiale de la Santé, 2007.

    Google Scholar 

  50. An overview of school nutrition policies in Canada. Dietitians of Canada, 2008 (sept.), p. 1–3. Sur Internet: https://doi.org/http://www.bitsandbytes.ca/resources/school_nutrition_policies_Sept_08.pdf (consulté le 15 février 2010).

    Google Scholar 

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Authors and Affiliations

  1. Department of Kinesiology, University of New Brunswick, PO Box 4400, Fredericton, NB, E3B 5A3, Canada

    Mary L. McKenna Ph.D., RD (Professor)

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  1. Mary L. McKenna Ph.D., RD
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Correspondence to Mary L. McKenna Ph.D., RD.

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McKenna, M.L. Policy Options to Support Healthy Eating in Schools. Can J Public Health 101 (Suppl 2), S14–S18 (2010). https://doi.org/10.1007/BF03405619

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