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Pediatrics

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

International Journal of Obesity volume 42, pages 1845–1852 (2018)Cite this article

Subjects

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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Acknowledgements

The LA Health project was supported by the National Institutes of Health grant R01 HD048483 and the US Department of Agriculture grant 58-6435-4-90. This work was also partially supported by the NORC center grant #1P30 DK072476 entitled “Nutritional Programming: Environmental and Molecular Interactions” sponsored by the NIDDK. KRH is supported by NIH grant T32 DK064584. JHB was funded in part 1 U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds the Louisiana Clinical and Translational Science Center.

Author’s contributions

DAW conceptualized and designed the study, conducted the research, reviewed and revised the manuscript, and approved the final manuscript as written. KRH analyzed the data, wrote the paper, and had primary responsibility for final content. JHB carried out all analysis, reviewed and revised the manuscript, and approved the final manuscript as written. CKM conducted the research, reviewed and revised the manuscript, had primary responsibility for final content, and approved the final manuscript as written. JWA and JLT reviewed and revised the manuscript, and approved the final manuscript as written.

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Authors and Affiliations

  1. Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA, 70808, USA

    Keely R. Hawkins, Jeffrey H. Burton, John W. Apolzan, Donald A. Williamson & Corby K. Martin

  2. USDA Agricultural Research Service, 141 Experiment Station Road, Stoneville, MS, 38776, USA

    Jessi L. Thomson

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  1. Keely R. Hawkins
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  2. Jeffrey H. Burton
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Correspondence to Corby K. Martin.

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Hawkins, K.R., Burton, J.H., Apolzan, J.W. et al. 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. Int J Obes 42, 1845–1852 (2018). https://doi.org/10.1038/s41366-018-0214-y

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