In 2005, the state of California introduced the "Competitive Foods and Beverages Program," a set of regulations regarding what foods could be sold on school campuses from vending machines, student-run stores, and in the cafeteria. Rather than the previous free-for-all, all foods now had to meet certain nutritional requirements regarding caloric and sugar content. The hope was that if students didn't have easy access to junk foods, rates of childhood obesity would decrease.
Now, ten years later, a study in JAMA Pediatrics examined how effective these policies have been. And the results have been pretty mixed, to say the least.
The study was massive, looking at 2,700,880 fifth-grade students across 5,362 public schools. And while obesity rates have actually risen -- from 43.5% in 2001 to 45.8% in 2010 -- the trends have changed in a downward direction after the institution of the 2005 regulations. So, that's good. (There has also been a slight gender gap, as the annual decline in obesity was a few tenths of a percentage greater in females than in males.) But there is one big problem that the study highlights.
From the official conclusion from the study:
Our study found population-level improvements in the prevalence of childhood overweight/obesity that coincided with the period following implementation of statewide CF&B policies (2005-2010). However, these improvements were greatest at schools in the most advantaged neighborhoods.
In other words: While a decrease in childhood obesity occurred across all levels of the state (hooray!), the drops didn't occur nearly as much in schools that were located in poor neighborhoods (boo). In fact, students living in the lowest-income neighborhoods of the state saw a "zero or near zero" change in obesity rates over the past ten years.
Why would these changes occur more in affluent communities but not poor ones? I spoke to one of the study's authors, Emma V. Sanchez-Suet from San Francisco State University, about what went wrong and how to fix it.
In what ways did the new standards succeed at what they hoped to accomplish?
Emma V. Sanchez-Suet: The ultimate goal of the standards was to influence children's body weight, and this was because there was a great concern about childhood obesity during that time, in the early 2000s. So, that was done directly by transforming the food environment inside of the schools. By making healthy food choices the easy choice for all students, we would eventually influence body weight in a way that kids would no longer become overweight or obese. We were pleasantly surprised that body weight improved for all students regardless of their socioeconomic level of their school neighborhood.
Why did students in disadvantaged areas benefit less than students in affluent areas?
Sanchez-Suet: The reason for that we were not able to study. Our findings suggest that the California policy may be a crucial tool to prevent childhood obesity, but that we may be able to accelerate progress by also paying attention to the socioeconomic environment in the school neighborhoods. We know that to prevent obesity, it requires multiple approaches in any sector of society. That includes the home environment, and also the school environment, as well as the neighborhoods where those schools are located.
So, how do we fix this discrepancy?
Sanchez-Suet: In addition to these policies we need to look at other places where we can influence. We know from other research that children in disadvantaged neighborhoods are more likely to be exposed to environmental factors that make them more susceptible to obesity. So, for example, they may be exposed to unhealthy foods with fast food elements and convenience stores that sell high density foods and sugar beverages. We also know that children in these neighborhoods may not have as much opportunity for physical activity, if their neighborhoods have fewer parks and heavier traffic. So, we need other strategies that are not only focused on school. Our study suggests that the policy is very important but we also need to pay attention to things that are happening outside of the school, specifically focusing on school neighborhoods. We know that some neighborhoods don't have these resources, or less of them than others.
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