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Title: Changes in association between school foods and child and adolescent dietary quality during implementation of the Healthy, Hunger-Free Kids Act of 2010

Citation Type: Journal Article

Publication Year: 2020

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DOI: 10.1101/19005579

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Abstract: Purpose. To estimate the effect of Healthy, Hunger-Free Kids Act of 2010 (HHFKA) implementation on dietary quality of all US school-aged children and adolescents, and examine whether those effects differed by demographic group. Methods. We used survey regression on 2007-2016 National Health and Nutrition Examination Survey (NHANES) data to estimate the proportion of energy intake from school foods and the association between school food intake and dietary quality, before and after HHFKA passage/implementation. To account for demographic changes in the US population over time, inverse probability weighting was employed. The product of the proportion of energy from school foods and the association between school food intake and dietary quality estimated the effect of HHFKA implementation on dietary quality. Results. School food intake quantity remained stable during the study period. HHFKA implementation improved students' dietary quality by 4.3 Healthy Eating Index-2010 (HEI) points (95% CI: 2.5, 6.1) on days when school foods were eaten, and by 1.3 HEI points (95% CI: 0.73, 1.8) averaged over all days annually. Conclusions. HHFKA implementation improved the total dietary quality of US school students. US students would benefit from eating school meals in the post-HHFKA era, and HHFKA regulations should not be relaxed.

Url: https://doi.org/10.1101/19005579

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Authors: Berger, Aaron T.; Widome, Rachel; Erickson, Darin J; Laska, Melissa Nelson; Harnack, Lisa J

Periodical (Full): medRxiv

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