| Question: Nutrition standards/rules increasing the availability of healthy beverages in school compared with no intervention for health and other outcomes Setting: Secondary schools in the USA . | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Certainty assessment . | Effect . | Certainty . | Importance . | ||||||
| No. of studies . | Study design . | Risk of bias . | Inconsistency . | Indirectness . | Imprecision . | Other considerations . | |||
| Consumption of healthy FNABs—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Consumption of discretionary FNABs (follow-up: 1 y; assessed with: mean servings/d of sugar-sweetened beverages) | |||||||||
| 1 | Observational studies | Not seriousa | Not serious | Not seriousb | Not serious | None | One study (Whatley Blum 2008)39 reported no difference in effect both for boys (MD –0.01, 95% CI: –0.30 to 0.28, n = 183) and girls (MD –0.01, 95% CI: –0.20 to 0.18, n = 273) |
| CRITICAL |
| Diet: energy intake—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Purchasing behavior/sales data—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Nutrient and calorie content of available foods—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Exposure to marketing of FNABs—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Anthropometry: overweight/obesity—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | IMPORTANT |
| Question: Nutrition standards/rules increasing the availability of healthy beverages in school compared with no intervention for health and other outcomes Setting: Secondary schools in the USA . | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Certainty assessment . | Effect . | Certainty . | Importance . | ||||||
| No. of studies . | Study design . | Risk of bias . | Inconsistency . | Indirectness . | Imprecision . | Other considerations . | |||
| Consumption of healthy FNABs—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Consumption of discretionary FNABs (follow-up: 1 y; assessed with: mean servings/d of sugar-sweetened beverages) | |||||||||
| 1 | Observational studies | Not seriousa | Not serious | Not seriousb | Not serious | None | One study (Whatley Blum 2008)39 reported no difference in effect both for boys (MD –0.01, 95% CI: –0.30 to 0.28, n = 183) and girls (MD –0.01, 95% CI: –0.20 to 0.18, n = 273) |
| CRITICAL |
| Diet: energy intake—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Purchasing behavior/sales data—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Nutrient and calorie content of available foods—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Exposure to marketing of FNABs—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Anthropometry: overweight/obesity—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | IMPORTANT |
Abbreviations: FNAB, food and nonalcoholic beverage; GRADE, Grading of Recommendations Assessment, Development and Evaluation; MD, mean difference.
Not downgraded for risk of bias as the study design already starts at low certainty.
Not downgraded due to indirectness: Although the evidence is from only 1 study from a high-income country, which may not be representative of all settings, the guideline development group decided not to downgrade for indirectness.
| Question: Nutrition standards/rules increasing the availability of healthy beverages in school compared with no intervention for health and other outcomes Setting: Secondary schools in the USA . | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Certainty assessment . | Effect . | Certainty . | Importance . | ||||||
| No. of studies . | Study design . | Risk of bias . | Inconsistency . | Indirectness . | Imprecision . | Other considerations . | |||
| Consumption of healthy FNABs—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Consumption of discretionary FNABs (follow-up: 1 y; assessed with: mean servings/d of sugar-sweetened beverages) | |||||||||
| 1 | Observational studies | Not seriousa | Not serious | Not seriousb | Not serious | None | One study (Whatley Blum 2008)39 reported no difference in effect both for boys (MD –0.01, 95% CI: –0.30 to 0.28, n = 183) and girls (MD –0.01, 95% CI: –0.20 to 0.18, n = 273) |
| CRITICAL |
| Diet: energy intake—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Purchasing behavior/sales data—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Nutrient and calorie content of available foods—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Exposure to marketing of FNABs—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Anthropometry: overweight/obesity—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | IMPORTANT |
| Question: Nutrition standards/rules increasing the availability of healthy beverages in school compared with no intervention for health and other outcomes Setting: Secondary schools in the USA . | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Certainty assessment . | Effect . | Certainty . | Importance . | ||||||
| No. of studies . | Study design . | Risk of bias . | Inconsistency . | Indirectness . | Imprecision . | Other considerations . | |||
| Consumption of healthy FNABs—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Consumption of discretionary FNABs (follow-up: 1 y; assessed with: mean servings/d of sugar-sweetened beverages) | |||||||||
| 1 | Observational studies | Not seriousa | Not serious | Not seriousb | Not serious | None | One study (Whatley Blum 2008)39 reported no difference in effect both for boys (MD –0.01, 95% CI: –0.30 to 0.28, n = 183) and girls (MD –0.01, 95% CI: –0.20 to 0.18, n = 273) |
| CRITICAL |
| Diet: energy intake—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Purchasing behavior/sales data—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Nutrient and calorie content of available foods—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Exposure to marketing of FNABs—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | CRITICAL |
| Anthropometry: overweight/obesity—not reported | |||||||||
| — | — | — | — | — | — | — | — | — | IMPORTANT |
Abbreviations: FNAB, food and nonalcoholic beverage; GRADE, Grading of Recommendations Assessment, Development and Evaluation; MD, mean difference.
Not downgraded for risk of bias as the study design already starts at low certainty.
Not downgraded due to indirectness: Although the evidence is from only 1 study from a high-income country, which may not be representative of all settings, the guideline development group decided not to downgrade for indirectness.
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