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JAMA Study: Giving School Lunches a Fighting Chance Helps Curb Obesity, But Neighborhood Wealth Matters


California's policies to limit what kinds of foods and beverages can be sold alongside meals regulated by the National School Lunch Program are among the strictest in the nation. The rules appear to have helped stabilize and, in some areas, reverse childhood obesity trends.

Policies to keep junk food from competing with school meal plans appeared to curb childhood obesity, but students who lived in wealthier neighborhoods showed more progress than those from poor areas, according to a study released today.

Writing for JAMA Pediatrics, Emma V. Sanchez-Vaznaugh, ScD, MPH, of San Francisco State University and her coauthors analyzed the effects of California’s strict policies to regulate “competitive foods and beverages,” which are sold alongside the meals governed by the National School Lunch Program. While all schools that receive federal funds for school meals must have limits on the availability of foods that compete with them, California’s rules are among the strictest in the nation, the authors note.

The study looks at obesity trends among California public elementary school students in the 4 years before California’s rules took effect, 2001-2005, and the 4 years after, 2006-2010. Data covered more than 2.7 million fifth-graders from 5326 schools.

The prevalence of fifth-graders who were overweight or obese increasingly slightly each year from 2001 to 2005, from 43.5% to 46.6%. Then, this rate stabilized from 2006 to 2010, starting at 46.2% and declining slightly to 45.8%.

Where a student lived mattered in determining his or her chances of being overweight or obese. Fifth-graders were mostly likely to be overweight or obese were if they attended a school in a low-income neighborhood, and least likely to be overweight if they lived a wealthy neighborhood. By 2010, the prevalence of students who were overweight or obese was 52.8% in the lowest-income area, compared with 36.2% in the highest-income neighborhood.

Researchers found that that while obesity trends leveled off in low-income areas in the years after California enacted its policies, prevalence of obesity actually declined in areas with the highest income and education levels. The authors write that while nutrition policies for schools are important, more work must be done to address a student’s overall environment.

“To reduce disparities and prevent childhood obesity among all children, school policies and environmental interventions must address relevant contextual factors in neighborhoods surrounding schools,” the study says.

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