Intervention Leads to Improvements in the Nutrient Profile of Snacks Served in Afterschool Programs: a Group Randomized Controlled Trial

Overview

Journal Transl Behav Med

Publisher Oxford University Press

Specialties General Medicine
Public Health
Social Sciences

Date 2016 Aug 17

PMID 27528522

Citations 12

Authors

Michael W Beets

Brie Turner-McGrievy

R Glenn Weaver

Jennifer Huberty

Justin B Moore

Dianne S Ward

Darcy A Freedman

Affiliations

Soon will be listed here.

Abstract

Widely adopted nutrition policies for afterschool programs (ASPs) focus on serving a fruit/vegetable daily and eliminating sugar-sweetened foods/beverages. The impact of these policies on the nutrient profile of snacks served is unclear. Evaluate changes in macro/micronutrient content of snacks served in ASPs. A 1-year group randomized controlled trial was conducted in 20 ASPs serving over 1700 elementary-age children. Intervention ASPs received a multistep adaptive framework intervention. Direct observation of snack served was collected and nutrient information determined using the USDA Nutrient Database, standardized to nutrients/100 kcal. By post-assessment, intervention ASPs reduced total kcal/snack served by 66 kcal (95CI -114 to -19 kcal) compared to control ASPs. Total fiber (+1.7 g/100 kcal), protein (+1.4 g/100 kcal), polyunsaturated fat (+1.2 g/100 kcal), phosphorous (+49.0 mg/100 kcal), potassium (+201.8 mg/100 kcal), and vitamin K (+21.5 μg/100 kcal) increased in intervention ASPs, while added sugars decreased (-5.0 g/100 kcal). Nutrition policies can lead to modest daily caloric reductions and improve select macro/micronutrients in snacks served. Long-term, these nutritional changes may contribute to healthy dietary habits.

Citing Articles

Opportunities in the Extended Day: Approaches for Promoting Physical Activity and Healthy Eating During Out-of-School Time.

Sliwa S, Chang Chusan Y, Dahlstrom C J Sch Health. 2023; 93(9):813-827.

PMID: 37670603 PMC: 11181343. DOI: 10.1111/josh.13370.

Interventions in outside-school hours childcare settings for promoting physical activity amongst schoolchildren aged 4 to 12 years.

Virgara R, Phillips A, Lewis L, Baldock K, Wolfenden L, Ferguson T Cochrane Database Syst Rev. 2021; 9:CD013380.

PMID: 34694005 PMC: 8543676. DOI: 10.1002/14651858.CD013380.pub2.

Interventions for increasing fruit and vegetable consumption in children aged five years and under.

Hodder R, OBrien K, Tzelepis F, Wyse R, Wolfenden L Cochrane Database Syst Rev. 2020; 5:CD008552.

PMID: 32449203 PMC: 7273132. DOI: 10.1002/14651858.CD008552.pub7.

Club Fit: Development of a Physical Activity and Healthy Eating Intervention at a Boys & Girls Club After School Program.

Wieland M, Biggs B, Brockman T, Johnson A, Meiers S, Sim L J Prim Prev. 2020; 41(2):153-170.

PMID: 32096111 DOI: 10.1007/s10935-020-00582-4.

Interventions for increasing fruit and vegetable consumption in children aged five years and under.

Hodder R, OBrien K, Stacey F, Tzelepis F, Wyse R, Bartlem K Cochrane Database Syst Rev. 2019; 2019(11).

PMID: 31697869 PMC: 6837849. DOI: 10.1002/14651858.CD008552.pub6.

References

Hawe P, Shiell A, Riley T . Complex interventions: how "out of control" can a randomised controlled trial be?. BMJ. 2004; 328(7455):1561-3. PMC: 437159. DOI: 10.1136/bmj.328.7455.1561. View

Darmon N, Darmon M, Maillot M, Drewnowski A . A nutrient density standard for vegetables and fruits: nutrients per calorie and nutrients per unit cost. J Am Diet Assoc. 2005; 105(12):1881-7. DOI: 10.1016/j.jada.2005.09.005. View

Cassady D, Vogt R, Oto-Kent D, Mosley R, Lincoln R . The power of policy: a case study of healthy eating among children. Am J Public Health. 2006; 96(9):1570-1. PMC: 1551941. DOI: 10.2105/AJPH.2005.072124. View

Bontrager Yoder A, Schoeller D . Fruits and vegetables displace, but do not decrease, total energy in school lunches. Child Obes. 2014; 10(4):357-64. PMC: 4121049. DOI: 10.1089/chi.2014.0017. View

Israel B, Schulz A, Parker E, Becker A . Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998; 19:173-202. DOI: 10.1146/annurev.publhealth.19.1.173. View

Parikh S, Pollock N, Bhagatwala J, Guo D, Gutin B, Zhu H . Adolescent fiber consumption is associated with visceral fat and inflammatory markers. J Clin Endocrinol Metab. 2012; 97(8):E1451-7. PMC: 3410273. DOI: 10.1210/jc.2012-1784. View

Ajja R, Beets M, Huberty J, Kaczynski A, Ward D . The healthy afterschool activity and nutrition documentation instrument. Am J Prev Med. 2012; 43(3):263-71. PMC: 3432570. DOI: 10.1016/j.amepre.2012.05.020. View

Wandersman A, Duffy J, Flaspohler P, Noonan R, Lubell K, Stillman L . Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation. Am J Community Psychol. 2008; 41(3-4):171-81. DOI: 10.1007/s10464-008-9174-z. View

Weaver R, Beets M, Webster C, Beighle A, Huberty J . A conceptual model for training after-school program staffers to promote physical activity and nutrition. J Sch Health. 2012; 82(4):186-95. DOI: 10.1111/j.1746-1561.2011.00685.x. View

10.

Beets M, Weaver R, Turner-Mcgrievy G, Huberty J, Ward D, Freedman D . Making Healthy Eating Policy Practice: A Group Randomized Controlled Trial on Changes in Snack Quality, Costs, and Consumption in After-School Programs. Am J Health Promot. 2015; 30(7):521-31. PMC: 5594564. DOI: 10.4278/ajhp.141001-QUAN-486. View

11.

Beets M, Tilley F, Turner-Mcgrievy G, Weaver R, Jones S . Community partnership to address snack quality and cost in after-school programs. J Sch Health. 2014; 84(8):543-8. PMC: 4109654. DOI: 10.1111/josh.12175. View

12.

Beets M, Tilley F, Kyryliuk R, Weaver R, Moore J, Turner-Mcgrievy G . Children select unhealthy choices when given a choice among snack offerings. J Acad Nutr Diet. 2014; 114(9):1440-6. PMC: 4149844. DOI: 10.1016/j.jand.2014.04.022. View

13.

Mozaffarian R, Wiecha J, Roth B, Nelson T, Lee R, Gortmaker S . Impact of an organizational intervention designed to improve snack and beverage quality in YMCA after-school programs. Am J Public Health. 2009; 100(5):925-32. PMC: 2853616. DOI: 10.2105/AJPH.2008.158907. View

14.

Astrup A . The satiating power of protein--a key to obesity prevention?. Am J Clin Nutr. 2005; 82(1):1-2. DOI: 10.1093/ajcn.82.1.1. View

15.

Fulton S, McKinley M, Young I, Cardwell C, Woodside J . The Effect of Increasing Fruit and Vegetable Consumption on Overall Diet: A Systematic Review and Meta-analysis. Crit Rev Food Sci Nutr. 2014; 56(5):802-16. DOI: 10.1080/10408398.2012.727917. View

16.

Keenan M, Zhou J, McCutcheon K, Raggio A, Bateman H, Todd E . Effects of resistant starch, a non-digestible fermentable fiber, on reducing body fat. Obesity (Silver Spring). 2006; 14(9):1523-34. DOI: 10.1038/oby.2006.176. View

17.

Beets M, Tilley F, Kim Y, Webster C . Nutritional policies and standards for snacks served in after-school programmes: a review. Public Health Nutr. 2011; 14(10):1882-90. DOI: 10.1017/S1368980011001145. View

18.

Beets M, Weaver R, Tilley F, Turner-Mcgrievy G, Huberty J, Ward D . Salty or sweet? Nutritional quality, consumption, and cost of snacks served in afterschool programs. J Sch Health. 2015; 85(2):118-24. PMC: 4432474. DOI: 10.1111/josh.12224. View

19.

Beets M, Huberty J, Beighle A . Systematic observation of physical activity in afterschool programs: preliminary findings from Movin' Afterschool intervention. J Phys Act Health. 2012; 10(7):974-81. DOI: 10.1123/jpah.10.7.974. View

20.

Wiecha J, Hall G, Gannett E, Roth B . Development of healthy eating and physical activity quality standards for out-of-school time programs. Child Obes. 2012; 8(6):572-6. DOI: 10.1089/chi.2012.0030. View