Abstract
Background
Increasing consumption of highly processed foods has been associated with adverse
health outcomes among children. In the US, children consume up to half of their daily
energy intake at school.
Objectives
We sought to characterize foods that children bring from home to school according
to processing level and to evaluate the effectiveness of a school-based intervention,
Great Taste Less Waste (GTLW), in reducing the proportion of energy brought from highly
processed foods from home compared with control.
Design
Secondary data analysis of a 7-month school-based, cluster-randomized trial.
Participants/setting
Third- and fourth-grade students (n = 502, mean age: 9.0 ± 0.62 years) at 10 public
elementary schools in Eastern Massachusetts (school year 2012-2013).
Intervention
GTLW included a 22-lesson classroom curriculum, homework activities, monthly parent
newsletters, a food shopping and packing guide for parents, food demonstrations, school-wide
announcements, and a poster contest.
Main outcome measures
The energy content of foods brought to school was estimated from digital photographs,
and foods were assigned to 1 of 3 processing levels (less processed or unprocessed,
moderately processed, or highly processed) based on an established classification
system.
Statistical analyses performed
The percentage of energy brought from foods categorized into each processing level
was calculated and compared pre- and postintervention using hierarchical linear models.
Results
Most of the food brought from home to school was highly processed (70% of food energy
brought). Foods categorized as snack foods and desserts contributed the greatest percentage
of total energy to the highly processed category at baseline and follow-up (72% and
69%, respectively). Energy from foods brought for snack tended to be more highly processed
than those brought for lunch. No significant differences were observed from pre- to
postintervention in the GTLW group compared with control for the percentage of energy
brought from highly processed foods in adjusted models (β: −1.1, standard error: 2.2,
P = .6) or any other processing level.
Conclusions
Highly processed foods were prevalent in home-packed lunches and snacks, and these
patterns persisted after a targeted intervention. Further research is needed to identify
strategies to improve the healthfulness of foods brought from home to school.
Keywords
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Biography
S. A. Blondin is a postdoctoral fellow, Harvard T.H. Chan School of Public Health, Boston, MA.
Biography
RF. AlSukait is an assistant professor, Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
Biography
R. Bleiweiss-Sande is postdoctoral fellow, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Biography
C. D. Economos is a professor, Tufts University Friedman School of Nutrition Science and Policy, Boston, MA.
Biography
J. P. Goldberg is a professor, Tufts University Friedman School of Nutrition Science and Policy, Boston, MA.
Biography
L. Tanskey is a postdoctoral teaching scholar in the Department of Food, Bioprocessing, & Nutrition Sciences at North Carolina State University.
Article info
Publication history
Published online: October 03, 2020
Accepted:
July 16,
2020
Received:
March 18,
2020
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This project was supported by Award Number R01HD065888 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development and by the Boston Nutrition Obesity Research Center (BNORC) (DK046200). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development, the National Institutes of Health, or BNORC. ChildObesity180 supported analysis of these data.
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© 2021 by the Academy of Nutrition and Dietetics.
