Summary of studies in comparisons 1 (n = 8) and 2 (n = 1): nutrition standards
| Study ID (study design/risk of bias) . | Setting (country) . | Intervention (duration) . |
|---|---|---|
| Comparison 1: Nutrition standards to increase availability of healthy food and beverages at school vs no intervention | ||
| Bartholomew 200633 (cluster RCT/unclear) | Primary schools (USA) | Low/moderate fat entrée offered (total fat ≤35% TE, saturated fat <10% TE, added sugar ≤35% by weight; limiting serving sizes) (4 mo) |
| Kocken 201234 (cluster RCT/high) | Secondary schools (Netherland) | Increase low-calorie products in vending machines (75% products favorable [<100 kcal] or moderately favorable (100–170 kcal) (1.5 mo) |
| Pre–primary schools (Chile) | Three studies assessing the reduction of the energy content of school meals by 10% through decreasing discretionary energy from nonessential fats (30% to 25%) + increasing nutrient-dense foods (ie, FV) (2.8 to 4.8 y) |
| Johnson 201637 (uITS/unclear) | Middle and secondary schools (USA) | Revised nutrition standards for NSLP/NSBP; increased the availability of whole grains, FV; weekly requirements for beans/peas, dark-green, red/orange, starchy, and other vegetables. Increased portion sizes of FV; students to select at least 1 serving of FV (15 mo). |
| Secondary schools (USA) | Remove snack chips, candy, sweet desserts, and sweetened beverages from snack bars; remove vending machines from cafeterias (1 y) |
| Secondary schools (USA) | Nutrition guidelines for foods sold at school: reducing total fat to ≤35% of calories, saturated fat to <10% of calories, added sugar to ≤35% by weight, and limiting serving sizes (1 y) |
| Comparison 2: Nutrition standards regarding availability of healthy beverages at school vs no intervention | ||
| Secondary schools (USA) | Eliminating/reducing the availability of SSBs and diet soda in food avenues (a la carte and vending programs) (9 mo) |
| Study ID (study design/risk of bias) . | Setting (country) . | Intervention (duration) . |
|---|---|---|
| Comparison 1: Nutrition standards to increase availability of healthy food and beverages at school vs no intervention | ||
| Bartholomew 200633 (cluster RCT/unclear) | Primary schools (USA) | Low/moderate fat entrée offered (total fat ≤35% TE, saturated fat <10% TE, added sugar ≤35% by weight; limiting serving sizes) (4 mo) |
| Kocken 201234 (cluster RCT/high) | Secondary schools (Netherland) | Increase low-calorie products in vending machines (75% products favorable [<100 kcal] or moderately favorable (100–170 kcal) (1.5 mo) |
| Pre–primary schools (Chile) | Three studies assessing the reduction of the energy content of school meals by 10% through decreasing discretionary energy from nonessential fats (30% to 25%) + increasing nutrient-dense foods (ie, FV) (2.8 to 4.8 y) |
| Johnson 201637 (uITS/unclear) | Middle and secondary schools (USA) | Revised nutrition standards for NSLP/NSBP; increased the availability of whole grains, FV; weekly requirements for beans/peas, dark-green, red/orange, starchy, and other vegetables. Increased portion sizes of FV; students to select at least 1 serving of FV (15 mo). |
| Secondary schools (USA) | Remove snack chips, candy, sweet desserts, and sweetened beverages from snack bars; remove vending machines from cafeterias (1 y) |
| Secondary schools (USA) | Nutrition guidelines for foods sold at school: reducing total fat to ≤35% of calories, saturated fat to <10% of calories, added sugar to ≤35% by weight, and limiting serving sizes (1 y) |
| Comparison 2: Nutrition standards regarding availability of healthy beverages at school vs no intervention | ||
| Secondary schools (USA) | Eliminating/reducing the availability of SSBs and diet soda in food avenues (a la carte and vending programs) (9 mo) |
Abbreviations: FV, fruit and vegetables; NSBP, national school breakfast program; NSLP, national school lunch program; PCS, prospective controlled study; RCT, randomized controlled trial; SSB, sugar-sweetened beverage; TE, total energy; uITS, uncontrolled interrupted time-series study.
Summary of studies in comparisons 1 (n = 8) and 2 (n = 1): nutrition standards
| Study ID (study design/risk of bias) . | Setting (country) . | Intervention (duration) . |
|---|---|---|
| Comparison 1: Nutrition standards to increase availability of healthy food and beverages at school vs no intervention | ||
| Bartholomew 200633 (cluster RCT/unclear) | Primary schools (USA) | Low/moderate fat entrée offered (total fat ≤35% TE, saturated fat <10% TE, added sugar ≤35% by weight; limiting serving sizes) (4 mo) |
| Kocken 201234 (cluster RCT/high) | Secondary schools (Netherland) | Increase low-calorie products in vending machines (75% products favorable [<100 kcal] or moderately favorable (100–170 kcal) (1.5 mo) |
| Pre–primary schools (Chile) | Three studies assessing the reduction of the energy content of school meals by 10% through decreasing discretionary energy from nonessential fats (30% to 25%) + increasing nutrient-dense foods (ie, FV) (2.8 to 4.8 y) |
| Johnson 201637 (uITS/unclear) | Middle and secondary schools (USA) | Revised nutrition standards for NSLP/NSBP; increased the availability of whole grains, FV; weekly requirements for beans/peas, dark-green, red/orange, starchy, and other vegetables. Increased portion sizes of FV; students to select at least 1 serving of FV (15 mo). |
| Secondary schools (USA) | Remove snack chips, candy, sweet desserts, and sweetened beverages from snack bars; remove vending machines from cafeterias (1 y) |
| Secondary schools (USA) | Nutrition guidelines for foods sold at school: reducing total fat to ≤35% of calories, saturated fat to <10% of calories, added sugar to ≤35% by weight, and limiting serving sizes (1 y) |
| Comparison 2: Nutrition standards regarding availability of healthy beverages at school vs no intervention | ||
| Secondary schools (USA) | Eliminating/reducing the availability of SSBs and diet soda in food avenues (a la carte and vending programs) (9 mo) |
| Study ID (study design/risk of bias) . | Setting (country) . | Intervention (duration) . |
|---|---|---|
| Comparison 1: Nutrition standards to increase availability of healthy food and beverages at school vs no intervention | ||
| Bartholomew 200633 (cluster RCT/unclear) | Primary schools (USA) | Low/moderate fat entrée offered (total fat ≤35% TE, saturated fat <10% TE, added sugar ≤35% by weight; limiting serving sizes) (4 mo) |
| Kocken 201234 (cluster RCT/high) | Secondary schools (Netherland) | Increase low-calorie products in vending machines (75% products favorable [<100 kcal] or moderately favorable (100–170 kcal) (1.5 mo) |
| Pre–primary schools (Chile) | Three studies assessing the reduction of the energy content of school meals by 10% through decreasing discretionary energy from nonessential fats (30% to 25%) + increasing nutrient-dense foods (ie, FV) (2.8 to 4.8 y) |
| Johnson 201637 (uITS/unclear) | Middle and secondary schools (USA) | Revised nutrition standards for NSLP/NSBP; increased the availability of whole grains, FV; weekly requirements for beans/peas, dark-green, red/orange, starchy, and other vegetables. Increased portion sizes of FV; students to select at least 1 serving of FV (15 mo). |
| Secondary schools (USA) | Remove snack chips, candy, sweet desserts, and sweetened beverages from snack bars; remove vending machines from cafeterias (1 y) |
| Secondary schools (USA) | Nutrition guidelines for foods sold at school: reducing total fat to ≤35% of calories, saturated fat to <10% of calories, added sugar to ≤35% by weight, and limiting serving sizes (1 y) |
| Comparison 2: Nutrition standards regarding availability of healthy beverages at school vs no intervention | ||
| Secondary schools (USA) | Eliminating/reducing the availability of SSBs and diet soda in food avenues (a la carte and vending programs) (9 mo) |
Abbreviations: FV, fruit and vegetables; NSBP, national school breakfast program; NSLP, national school lunch program; PCS, prospective controlled study; RCT, randomized controlled trial; SSB, sugar-sweetened beverage; TE, total energy; uITS, uncontrolled interrupted time-series study.
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