Effect of changes to the school food environment on eating behaviours and/or body weight in children: a systematic review.

Driessen CE(1), Cameron AJ, Thornton LE, Lai SK, Barnett LM.

Author information: 
(1)School of Health and Social Development, Deakin University, Burwood,

Previous school obesity-prevention reviews have included multi-component
interventions. Here, we aimed to review the evidence for the effect of isolated
food environment interventions on both eating behaviours (including food
purchasing) and/or body weight. Five electronic databases were searched (last
updated 30 November 2013). Of the 1,002 unique papers identified, 55 reported on 
school food environment changes, based on a review of titles and abstracts.
Thirty-seven further papers were excluded, for not meeting the inclusion
criteria. The final selection consisted of 18 papers (14 United States, 4 United 
Kingdom). Two studies had a body mass index (BMI) outcome, 14 assessed purchasing
or eating behaviours and two studies assessed both weight and behaviour.
Seventeen of 18 papers reported a positive outcome on either BMI (or change in
BMI) or the healthfulness of food sold or consumed. Two studies were rated as
strong quality and 11 as weak. Only three studies included a control group. A
school environment supportive of healthy eating is essential to combat heavy
marketing of unhealthy food. Modification of the school food environment
(including high-level policy changes at state or national level) can have a
positive impact on eating behaviours. A need exists, however, for further
high-quality studies.

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