The Environmental Component: Changing School Food Service to Promote Cardiovascular Health

Abstract

An environmental program directed at the food service departments of two boarding high schools has been tested in a concurrently controlled longitudinal investigation in which the intervention was applied to each school in alternate years. It has been demonstrated that changes in food purchasing and preparation practices can markedly decrease sodium and modify the fat composition of foods, and that such practices result in significant changes in the nutrient intake of students. Even without an educational component for students, who maintained their usual dietary practices, the changes by food service workers led to 15-20% less sodium intake, 20% less saturated fat intake, and an increase in the P/S ratio from 0.46 to 0.84 among students. The change in sodium intake over a school year resulted in lower blood pressure among students receiving the intervention. Adjusting for sex and baseline blood pressure, the estimated effect of the intervention on systolic pressure was -1.7 mmHg (95% C.I. -0.6, -2.9; p = 0.003); for diastolic pressure, it was -1.5 mmHg (95% C.I. -0.6, -2.5; p = 0.002). Such modifications by school food service workers are well accepted and produce very palatable foods. The widespread dissemination of such practices could favorably affect cardiovascular risk factors of students everywhere.

Behavioral Science Research in Diabetes: Lifestyle changes related to obesity, eating behavior, and physical activity

“…Signs advocating the use of stairs for cardiovascular health or for weight control increased Caucasians' but not African-Americans' use of stairs. Of particular note are the studies by Ellison et al (27,28) showing that changes in the food supply in boarding schools are well tolerated and can lead to improvements in physiological risk factors.…”

“…Signs advocating the use of stairs for cardiovascular health or for weight control increased Caucasians' but not African-Americans' use of stairs. Of particular note are the studies by Ellison et al (27,28) showing that changes in the food supply in boarding schools are well tolerated and can lead to improvements in physiological risk factors.Whereas these studies investigating specific manipulations of the environment have tended to show positive effects, there are several large community interventions and school-based approaches that relied mainly on educational programming, which had much more limited effects on eating behavior, eating activity, or obesity (29-31). Thus, actually changing the environment may be far more effective than trying to educate the public to deal with an unhealthful environment.…”

Health Promotion as a Public Health Strategy for the 1990s

“…Worksite health promotion will expand with notable provisions for institutional supports for employee participation (8,21,22,99). Schools will place increasing emphasis on social and organi zational factors in programs for the modification or development of diet and prevention of substance abuse (10,17,23,73,88). In most communities, new emphasis will be placed on concerns with the environment and with housing and other conditions of living that shape the health-related lifestyle of the individuals and families in the community.…”

Senate Bill 934

“…[6][7][8][9] Even after a short period of implementation, such regulations have resulted in positive health outcomes and reduced rates of increase in overweight and obesity. In 2004 in Los Angeles and 2007 in all of California, policies that restricted the sugar and fat content of foods sold outside school meal programs were put into effect.…”