School Food Environmental Factors Related to Eating Behaviors and Nutritional Status among School-aged Children in Primary Schools
Keywords:
สิ่งแวดล้อมด้านอาหารของโรงเรียน, พฤติกรรมบริโภคอาหาร, ภาวะโภชนาการAbstract
Abstract
The prevalence of malnutrition in school-aged children, particularly overweight and obesity, has been steadily increasing, adversely affecting development and raising the risk of non-communicable diseases. Improving the school food environment is therefore a crucial strategy to promote healthy eating behaviors and address nutritional problems.
This study aimed to examine the relationships between school food environmental factors related to eating behaviors and nutritional status among school-aged children in primary schools. A cross-sectional study was conducted among 958 students in grades 5–6 and 30 teachers responsible for school lunch programs from 30 primary schools under the Office of the Basic Education Commission (OBEC). Data were collected from June to August 2023 using questionnaires, interviews, and surveys. The analysis was carried out using descriptive statistics and multiple logistic regression.
The result revealed that the policy-related food environment factors, including schools with comprehensive food policies aligned with OBEC’s 2021 guidelines on the sale of health-promoting food and beverages, were associated with consumption of processed meats and soft drinks (OR 0.457, 95% CI 0.224–0.935; OR 0.514, 95% CI 0.250–1.057, respectively). Schools with in-school measures to control the provision or sale of unhealthy foods were associated with vegetable consumption (OR 6.500, 95% CI 1.542–27.398), and schools that restricted sales around school were associated with normal nutritional status and overweight (OR 0.590, 95% CI 0.386–0.902; OR 2.348, 95% CI 1.169–4.717, respectively). In terms of economic factors, adequate lunch budgets in schools were associated with processed meat consumption (OR 2.951, 95% CI 1.091–7.982) and undernutrition (OR 13.708, 95% CI 2.083–90.202). Regarding the physical environment, limiting food and beverage sales to the canteen area was associated with the consumption of sugary snacks (OR 0.352, 95% CI 0.145–0.856), while the absence of food sales around the school and the availability of high-quality school lunch meals were associated with obesity (OR 0.069, 95% CI 0.008–0.600) and undernutrition (OR 0.066, 95% CI 0.007-0.602), respectively, and the provision of high-quality school lunches was associated with undernutrition (OR 0.066, 95% CI 0.007–0.602). For sociocultural factors, schools with activities promoting food and nutrition knowledge and skills were also associated with consumption of soft drinks (OR 0.546, 95% CI 0.302–0.985), and having meal planners who had nutrition training was associated with consumption of high-fat foods (OR 16.437, 95% CI 1.226–220.302) and obesity (OR 0.002, 95% CI 0.000–0.745).
In conclusion, the findings highlight that the school food environment plays a critical role in promoting healthy eating behaviors and nutritional status. Therefore, relevant agencies should strengthen and enforce food and beverage control measures in schools, provide adequate funding, develop personnel capacity, and continuously promote nutrition education for students.
References
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