Intervention leads to improvements in the nutrient profile of snacks served in afterschool programs: a group randomized controlled trial

Beets, Michael W.; Turner‐McGrievy, Brie; Weaver, R. Glenn; Huberty, Jennifer; Moore, Justin B.; Ward, Dianne S.; Freedman, Darcy A.

doi:10.1007/s13142-015-0342-z

Cited by 16 publications

(15 citation statements)

References 37 publications

(48 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This approach was used in order to help identify easily interpretable, actionable changes to menu planning that camps could make, as this is an approach that has been shown to be effective in other out-of-school settings. 5,23 …”

Section: Methodsmentioning

confidence: 99%

What Do Children Eat in the Summer? A Direct Observation of Summer Day Camps That Serve Meals

Kenney¹,

Lee²,

Brooks³

et al. 2017

Journal of the Academy of Nutrition and Dietetics

View full text Add to dashboard Cite

What do children eat in the summer? A direct observation of summer day camps that serve meals Background Over 14 million children in the United States attend summer camp annually, yet little is known about the food environment in day camps. Objectives Describe the nutritional quality of meals served to, brought by, and consumed by children attending summer day camps serving meals and snacks; describe camp water access. Design Cross-sectional study. Participants/settings One hundred forty-nine children attending five summer camps in Boston, Massachusetts in 2013. Main outcome measures Foods and beverages served were observed for five consecutive days. For two days, children’s dietary intake was directly observed using a validated protocol. Outcome measures included total energy (kcals) and servings of different types of foods and beverages served and consumed during breakfast, lunch, and snack. Statistical analyses performed Mean total energy, trans fats, sodium, sugar, and fiber served per meal were calculated across the camps, as were average weekly frequencies of serving fruits, vegetables, meat/meat alternates, grains, milk, 100% juice, sugar-sweetened beverages, whole grains, red/highly processed meats, grain-based desserts, and salty snacks. Mean consumption was calculated per camper per day. Results On average, camps served 647.7 (SD: 134.3) kcals for lunch, 401.8 kcals (149.6) for breakfast, and 266.4 (SD: 150.8) kcals for snack. Most camps served red/highly processed meats, salty snacks, and grain-based desserts frequently, and rarely served vegetables or water. Children consumed little (for example, at lunch, 36.5% of fruit portions, 35.0% of meat/meat alternative portions, and 37.6% of milk portions served), except for salty snacks (66.9% of portions) and grain-based desserts (64.1% of portions). Sugar-sweetened beverages and salty snacks were frequently brought to camp. A quarter of campers drank nothing throughout the entire camp day. Conclusions The nutritional quality of foods and beverages served at summer day camps could be improved. Future studies should assess barriers to consumption of healthy foods and beverages in these settings.

show abstract

Section: Methodsmentioning

confidence: 99%

What Do Children Eat in the Summer? A Direct Observation of Summer Day Camps That Serve Meals

Kenney¹,

Lee²,

Brooks³

et al. 2017

Journal of the Academy of Nutrition and Dietetics

View full text Add to dashboard Cite

show abstract

“…This contradicts findings in other afterschool program studies. For example, Beets et al found that the adoption of healthy eating standards improved the snack type served at their sites. By design, the HEPA standards and best practices are not prescriptive, rather afterschool programs are encouraged to identify and select standards that work for their site.…”

Section: Discussionmentioning

confidence: 99%

“…A team of 2 observers performed snack observations at each site; one observer recorded for 5 random boys, and the other for 5 random girls to ensure sex equality in our samples. However, we did not look for differences by sex in the resulting data as other research in the field did not stratify by sex . The observers did not interfere with normal snack time routine while collecting data.…”

Section: Methodsmentioning

confidence: 99%

“…A handful of studies have evaluated the effectiveness of the HEPA standards in afterschool programs but only 2 have focused on healthy eating standards and nutrition outcomes . One study found that the adoption of healthy eating standards improved weekly fruit and vegetable consumption, and another found that fruit intake increased, but not vegetable intake . Importantly, both studies focused on menu items served and not actual consumption.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The Adoption of the Healthy Eating Standards in Local Afterschool Programs Does Not Improve Quality of Snacks

Helmick

Esmond²,

Hedrick³

et al. 2019

Journal of School Health

View full text Add to dashboard Cite

OBJECTIVES:In 2011, the National Afterschool Association adopted the Healthy Eating and Physical Activity (HEPA) standards to address snack quality and physical activity in afterschool programs. Although research has indicated promise in the adoption of these policies by national organizations, less is known about local adoption, implementation, and effectiveness. In this study, we aimed to compare the quality of snacks served at program sites pre-and post-adoption and to determine the quality of non-program snacks compared to program snacks. METHODS:An interrupted time series design was used to measure snack quality and consumption at 3 policy adopting sites and 2 non-policy adopting sites that served as a comparison control. Trained research staff collected snack type, brand, and amount consumed using a modified quarter-waste method. Analysis on nutrient content of snacks was completed using Nutrition Data System for Research software. RESULTS:Adoption of the HEPA standards among policy adopting sites did not result in significantly better snack quality.Across all sites, program snacks were healthier than non-program snacks. CONCLUSION:Pursuing additional components of the HEPA standards related to implementation may be necessary to significantly improve snack quality. Environmental supports such as limiting the amount of non-program snacks available onsite may improve snack quality.of positive energy balance, or a greater number of calories consumed compared to calories expended. 7-10 The drivers of positive energy balance in children are lack of physical activity and caloric overconsumption often characterized by poor diet quality. 7 It is estimated that children consume an extra 110-165 kcal per day, contributing to energy imbalance and overall weight

show abstract

“…16–18 ASPs, defined as child care programs operating immediately after the school day, every day of the school year for a minimum of 2 hours, serving a minimum of 30 children of elementary age (6–12 years), operated in a school, community, or faith setting, served a snack, and were located within a 1.5-hour drive from the university of the first author, were eligible to participate. Programs were identified from a registry of ASPs operating in the state and randomly selected for invitation to participate in the study.…”

Section: Methodsmentioning

confidence: 99%

Two-Year Healthy Eating Outcomes: An RCT in Afterschool Programs

Beets

Weaver

Turner‐McGrievy

et al. 2017

American Journal of Preventive Medicine

Self Cite

View full text Add to dashboard Cite

Introduction Across the U.S., afterschool programs (ASPs, 3:00PM–6:00PM) are trying to achieve nationally endorsed nutrition standards (Healthy Eating Standards) calling for fruits/vegetables and water to be served every day, while eliminating sugar-sweetened beverages and foods. The purpose of this study was to evaluate the 2-year changes in the types of foods and beverages served during a community-based intervention designed to achieve the Healthy Eating Standards. Study design Randomized delayed treatment trial with an immediate (1-year baseline and 2-year intervention) or delayed (2-year baseline and 1-year intervention) groups. Setting/participants Twenty ASPs serving 1,700 children (aged 5–12 years) were recruited, with baseline occurring spring 2013, and outcome assessment occurring spring 2014 and 2015. Intervention The multistep intervention, Strategies To Enhance Practice for Healthy Eating, assisted ASP leaders/staff to serve foods/beverages that meet the nutrition standards. Main outcome measures The foods and beverages served for snack were observed directly. Results Compared with non-intervention years, both the immediate and delayed groups increased the number of days/week that fruits/vegetables (0.6 vs 1.7 days/week and 0.6 vs 4.4 days/week, OR=3.80, 95% CI=1.45, 9.95) and water (2.3 vs 3.7 days/week and 2.7 vs 4.8 days/week, OR=4.65, 95% CI=1.69, 12.79) were served. Sugar-sweetened beverages were almost eliminated by post-assessment (1.2 vs 0.2 days/week and 3.2 vs 0.0 days/week, OR=0.05, 95% CI=0.02, 0.13). Only the immediate group decreased the number of days/week desserts were served (2.9 vs 0.6 days/week, OR=0.10, 95% CI=0.03, 0.33). Implementation barriers for the delayed group included once/month delivery schedules for fruits/vegetables and limited storage space for foods meeting the Healthy Eating Standards. Conclusions Improvements in the foods/beverages served in ASPs can be made, yet were hindered by structural barriers related to procurement and storage of perishable foods. Additional efforts are needed to support ASPs as they work toward fully achieving the Healthy Eating Standards.

show abstract

Intervention leads to improvements in the nutrient profile of snacks served in afterschool programs: a group randomized controlled trial

Abstract: Widely adopted nutrition policies for afterschool programs (ASPs) focus on serving a fruit/vegetable daily and eliminating sugar-sweetened foods/beverages.

Cited by 16 publications

References 37 publications

What Do Children Eat in the Summer? A Direct Observation of Summer Day Camps That Serve Meals

What Do Children Eat in the Summer? A Direct Observation of Summer Day Camps That Serve Meals

The Adoption of the Healthy Eating Standards in Local Afterschool Programs Does Not Improve Quality of Snacks

Two-Year Healthy Eating Outcomes: An RCT in Afterschool Programs

Contact Info

Product

Resources

About