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标题：The Impact of the Texas Public School Nutrition Policy on Student Food Selection and Sales in Texas
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作者：Karen W. Cullen ; Kathleen B. Watson
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2009
卷号：99
期号：4
页码：706-712
DOI：10.2105/AJPH.2007.129387
语种：English
出版社：American Public Health Association
摘要：Objectives. We assessed the statewide impact of the 2004 Texas Public School Nutrition Policy on foods and beverages served or sold in schools. Methods. We collected lunch food production records from 47 schools in 11 Texas school districts for the school years before (2003–2004) and after (2004–2005) policy implementation. Cafeteria servings of fruit, vegetables (regular and fried), and milk served each day were calculated. Twenty-three schools from 5 districts provided records of à la carte sales of candy, chips, desserts, drinks, ice cream, and water. We examined aggregated school-level differences in total items served or sold per day per student between study years. Results. School demographics were similar to state data. Regardless of district and school size, cafeterias served significantly fewer high-fat vegetable items per student postpolicy ( P < .001). Postpolicy snack bar sales of large bags of chips were significantly reduced ( P = .006), and baked chips sales significantly increased ( P = .048). Conclusions. School food policy changes have improved foods served or sold to students. It is not known whether improved lunch choices influence consumption for the whole day. School food policies have become a component of public health efforts to reduce the increasing rates of childhood obesity.^{1 , 2} The focus on nutrition guidelines for foods is because there are no federal rules for competitive foods sold outside the National School Lunch Program meal, such as in snack bars and vending machines, except for foods of minimal nutritional value (e.g., soda).³ Although states, school districts, and individual schools have enacted policies regarding foods or beverages available in school food environments,⁴ such policies are controversial. Barriers to improving school food environments include the loss of revenue generated from vending machine, snack bar, and à la carte sales⁵ as well as school staff, student, and parent attitudes toward the types of foods expected in schools.⁶ There are also concerns that limiting access to these foods at school will not improve overall student dietary intake and that if these items are not available in schools, students will compensate by increasing consumption of desired foods in out-of-school environments.⁷ However, school wellness policies do affect the school food environment and dietary behavior. The Texas Public School Nutrition Policy, an unfunded mandate to promote a healthful school environment for Texas students, was implemented statewide in fall 2004. The Texas Department of Agriculture notified districts about the policy. Implementation is monitored during periodic school food service reviews. The guidelines apply to all school food environments, including vending.⁸ The Texas policy restricts the portion sizes of high-fat and sugar snacks to fewer than 200 kilocalories per serving package and sweetened beverages to 12 ounces or less, limits the fat content of milk offered to 1% or less, provides guidelines for the fat content of foods served, and sets limits on the frequency of serving high-fat vegetables such as french fries.⁸ A recent study found positive changes 2 years after the Texas Public School Nutrition Policy was implemented.⁹ During the 2005–2006 school year, middle-school student lunch consumption of milk, fruit, and vegetables significantly increased, whereas consumption of sweetened beverages, candy, chips, and dessert foods decreased⁹ compared with consumption in 2001–2002. During 2004–2005, we conducted a statewide evaluation of the Texas policy to assess food service–level policy adherence. We assessed whether there were changes in the foods served and sold to students in the first year after implementation. Although we did not directly evaluate changes in student consumption, we did evaluate changes in food availability, which influences student consumption.⁹ The primary hypotheses were that sales or selection of fruit, regular or nonfried vegetables, and milk would be higher and sales or selections of sweetened beverages and high-fat or sugar foods per student would be lower in 2004–2005 after the policy implementation than they were in 2003–2004 before policy implementation.