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Randomized Controlled Trial
. 2018 Nov;42(11):1845-1852.
doi: 10.1038/s41366-018-0214-y. Epub 2018 Sep 25.

Efficacy of a school-based obesity prevention intervention at reducing added sugar and sodium in children's school lunches: the LA Health randomized controlled trial

Keely R Hawkins  1 , Jeffrey H Burton  1 , John W Apolzan  1 , Jessi L Thomson  2 , Donald A Williamson  1 , Corby K Martin  3
Affiliations
Randomized Controlled Trial

Efficacy of a school-based obesity prevention intervention at reducing added sugar and sodium in children's school lunches: the LA Health randomized controlled trial

Keely R Hawkins et al. Int J Obes (Lond). 2018 Nov.

Abstract

Background: Decreasing selection and consumption of sodium and added sugars in the school cafeteria setting is important to provide optimal nutrition to children.

Objective: The ofjective of this study is to determine whether Louisiana (LA) Health, a school-based obesity prevention intervention, could successfully reduce children's selection and consumption of sodium and added sugars during school lunches vs. the control group.

Design: Food selection, consumption, and plate waste from student lunches (3 consecutive days) in 33 public schools in rural Louisiana were collected and analyzed using the digital photography of foods method at baseline and after a 28-month obesity prevention intervention (LA Health) beginning in 4th-6th grade (87% of children received free or reduced cost lunch). Selection and consumption of energy, added sugar, and sodium was objectively measured using digital photography of foods. Mixed models, including Race and BMI, were used to determine whether change in selection and consumption differed by group.

Results: Sodium decreased for selection (- 233.1 ± 89.4 mg/lunch, p = 0.04) and consumption (- 206.3 ± 65.9, mg/lunch) in the intervention (vs. control) by month 18, and in consumption by month 28 (- 153.5 ± 66.9 mg/lunch, p = 0.03). Change in added sugar consumption decreased in the intervention (vs. control) at month 18 (- 3.7 ± 1.6, p = 0.05) and at month 28 (- 3.5 ± 1.6 tsp/lunch, p = 0.05).

Conclusions: LA Health decreased the amount of added sugar and sodium selected and consumed, but not plate waste, by month 28. Results highlight the importance of long-term interventions and policies targeting provision and selection to improve dietary patterns in children, with less focus on plate waste.

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Conflict of interest statement

Conflict Of Interest: Authors have no potential conflicts of interest.

Figures

Figure 1.
Figure 1.. Change in energy A) selection, B) consumption, and C) plate waste for control and intervention from baseline (BL) to 18 and 28 months.
No significant between group changes were shown by month 18 for selection (p=0.51), consumption (p=0.42), and plate waste (p=0.99). By month 28, change in consumption (p=0.02) was significantly difference between groups, but not for selection (p=0.08) or plate waste (p=0.99).
Figure 2.
Figure 2.. Change in sodium A) selection, B) consumption, and C) plate waste for control and intervention from baseline (BL) to 18 and 28 months.
At month 18, change in sodium was significantly lower for the intervention (vs. control) for selection (p=0.04) and consumption (p=0.01), but not plate waste (p=0.77). By month 28, change in sodium consumption (p=0.03) was significantly lower for the intervention (vs. control), while no differences were shown for selection (p=0.07) or plate waste (p=0.77).
Figure 3.
Figure 3.. Change in added sugar A) selection, B) consumption, and C) plate waste for control and intervention from baseline (BL) to 18 and 28 months.
By month 18, change in added sugar consumption (p=0.02) was significantly lower for the intervention (vs. control), but no differences were shown for selection (p=0.08) or plate waste (p=0.74). By month 28, change in added sugar consumption (p=0.05) was significantly lower in the intervention (vs. control), while no differences were shown for change in consumption (p=0.08) or plate waste (p=0.74).
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