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Abstract/Details

Association of the Healthy, Hunger-Free Kids Act with Dietary Quality Among Children in the US National School Lunch Program

Kinderknecht, Kelsey.  University of Washington. ProQuest Dissertations Publishing, 2020. 28087842.

Abstract (summary)

Importance: The Healthy, Hunger-Free Kids Act of 2010, implemented nationwide in 2012, was intended to improve the nutritional quality of meals served in the National School Lunch Program (NSLP).

Objective: To assess whether there was an association between the Healthy, Hunger-Free Kids Act of 2010 and dietary quality of lunch for students participating in the NSLP, stratified by income.

Design, Setting, Participants: Serial cross-sectional study design, using National Health and Nutrition Examination Survey (NHANES) data 2007-2008, 2009-2010, 2013-2014, and 2015-2016, of students surveyed in NHANES and attending schools participating in the NSLP. Individuals who were aged 5 to 18 years, in kindergarten through 12th grade, enrolled in a school that served school lunch, and had a reliable weekday dietary recall were included.

Exposure: The Healthy, Hunger-Free Kids Act of 2010 (pre-policy period: 2007-2010; post-policy period: 2013-2016), with participation in the NSLP estimated based on an algorithm.

Main Outcome and Measure: The primary outcome was dietary quality of intake for lunch, measured by Healthy Eating Index-2010 (HEI-2010) score (range 0-100; 0 indicates a diet with no adherence to the 2010 Dietary Guidelines for Americans and 100 indicates a diet with complete adherence to the guidelines).

Results: Among 6389 students included in the surveys (mean age, 11.7 [95%CI, 11.6-11.9] years; 3145 [50%] female students; 1880 [56%] were non-Hispanic white), 32%were low-income, 12% were low-middle–income, and 56% were middle-high–income students.A total of 2472 (39%) were participants in the NSLP. Among low-income students, the adjusted mean prepolicy HEI-2010 score was 42.7 and the postpolicy score was 54.6 among NSLP participants and the adjusted mean prepolicy score was 34.8 and postpolicy score was 34.1 among NSLP nonparticipants (difference in differences, 12.6 [95%CI, 8.9-16.3]). Among low-middle–income students, the adjusted mean prepolicy HEI-2010 score was 40.4 and postpolicy score was 54.8 among NSLP participants and the adjusted mean prepolicy score was 34.2 and postpolicy score was 36.1 among NSLP nonparticipants (difference in differences, 12.4 [95%CI, 4.9-19.9]). Among middle-high–income students, the adjusted mean HEI-2010 prepolicy score was 42.7 and postpolicy score 55.5 for NSLP participants and the adjusted mean prepolicy score was 38.9 and prepolicy score was 43.6 for NSLP nonparticipants (difference in differences, 8.1 [95%CI, 4.2-12.0]).

Conclusions and Relevance: In a serial cross-sectional study of students, the Healthy, Hunger-Free Kids Act of 2010 was associated with better changes in dietary quality for lunch among presumed low income, low-middle income, and middle-high income participants in the National School Lunch Program compared with non-participants.

Indexing (details)


Subject
Public health;
Nutrition
Classification
0573: Public health
0570: Nutrition
Identifier / keyword
Diet quality; Nutrition; Pediatrics; School food
Title
Association of the Healthy, Hunger-Free Kids Act with Dietary Quality Among Children in the US National School Lunch Program
Author
Kinderknecht, Kelsey
Number of pages
15
Degree date
2020
School code
0250
Source
MAI 82/4(E), Masters Abstracts International
Place of publication
Ann Arbor
Country of publication
United States
ISBN
9798684659348
Advisor
Jones-Smith, Jessica
Committee member
Harris, Cristen
University/institution
University of Washington
Department
Nutritional Sciences
University location
United States -- Washington
Degree
Master's
Source type
Dissertation or Thesis
Language
English
Document type
Dissertation/Thesis
Dissertation/thesis number
28087842
ProQuest document ID
2465806866
Copyright
Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works.
Document URL
https://www.proquest.com/pqdtglobal/docview/2465806866/abstract/