A systematic review of the effectiveness of school lunch program for reducing childhood obesity

• Main Authors: Hung, Li-tung, Tony, 幸利東
• Language: English
• Published: The University of Hong Kong (Pokfulam, Hong Kong) 2014
• Subjects: Obesity in children; Luncheons
• Online Access: http://hdl.handle.net/10722/206912

Objective: The purpose of this systematic review is to investigate the effectiveness of school lunch programs for reducing childhood obesity by examining changes to the Body Mass Index (BMI) as an outcome measure to compare and assess the effectiveness of different school lunch interventions. Background: Childhood obesity has a high likelihood of leading to obesity in adulthood and this negative effect is well documented. School lunches have been widely implemented in this decade for tackling childhood obesity. Many countries are following this trend to align school lunches with national or standard nutrition guidelines as part of the school policy. Since many schools have only recently started to provide school lunches, the impact of these programs in terms of reducing childhood obesity has yet to be fully explored. Methods: Published literature about school lunch and body mass index from 2008 to 2014 was collected through PubMed and ScienceDirect. Relevant studies, including cohort studies, cross-sectional studies, case control studies, and observational studies, were included if they involved interventions that measured BMI as an independent outcome. Results: Nine studies from USA and one from Norway were included in this systematic review. For measuring school lunch participation, 4 were associated with increased BMI after intervention, 1 was associated with decreased BMI and 3 were not statistically significant with BMI. For studies that included consumption or observed energy intake, 3 were associated with lower BMI and 1 study showed that higher consumption lowered initial BMI but increased BMI over time. Overall, the results were inconsistent, and this may be attributed to confounding factors such as different food environments, meal quality, and availability of school snacks. Conclusion: The implications for school lunch programs as a key factor in lowering childhood obesity are complicated. No solid conclusions can be inferred for the effectiveness of school lunch program for lowering childhood obesity, as certain studies show positive relationships and others show no association. Future research with primary data and longitudinal cohort with years follow up may be considered for studying the relationship of between the school lunch program and the trend of BMI of children change at each level of school. Research on extending observed energy intake should also be applied in order to provide guidance for policy change on the meal quality, food options, competitive foods availability as well as nutrition guidelines. === published_or_final_version === Public Health === Master === Master of Public Health