Impact of an organizational intervention designed to improve snack and beverage quality in YMCA after-school programs.

OBJECTIVES We evaluated the quality of snacks and beverages served at YMCA after-school programs before and after the programs' participation in a YMCA Learning Collaborative. METHODS We collected data on the types and brands of snacks and beverages (including fresh fruits and vegetables, whole grains, foods with trans fats, water, and sugar-sweetened beverages) served daily during 3 different time periods spanning 14 months in total, and the components of the healthy eating standards. We compared snack and beverage quality before and after the intervention. RESULTS Weekly servings of fresh fruits and vegetables (1.3 vs 3.9; P = .02) and weekly servings of fruits and vegetables as a whole (1.9 vs 5.2; P = .009) increased from baseline to postintervention; weekly servings of desserts (1.3 vs 0.5; P = .049), foods with added sugars (3.9 vs 2.4; P = .03), and foods containing trans fats (2.6 vs 0.7; P = .01) decreased. After the intervention, all YMCAs offered water daily, and none served sugar-sweetened beverages. The percentage of calories from fruits and vegetables significantly increased after the intervention, whereas the percentage of calories from foods containing trans fats and added sugars decreased. CONCLUSIONS A learning collaborative can disseminate healthy eating standards among participating organizations and facilitate improvements in the quality of after-school snacks and beverages.

[1]  S B Roberts,et al.  Dietary fiber and weight regulation. , 2009, Nutrition reviews.

[2]  H. Gibson‐Moore,et al.  Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth , 2009, European Journal of Clinical Nutrition.

[3]  D. Dzewaltowski,et al.  Physical activity and healthy eating in the after-school environment. , 2008, The Journal of school health.

[4]  S. Gortmaker,et al.  Increasing Caloric Contribution From Sugar-Sweetened Beverages and 100% Fruit Juices Among US Children and Adolescents, 1988–2004 , 2008, Pediatrics.

[5]  Katherine M Flegal,et al.  High body mass index for age among US children and adolescents, 2003-2006. , 2008, JAMA.

[6]  S. Barlow,et al.  Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. , 2007, Pediatrics.

[7]  J. Brug,et al.  Tracking of fruit and vegetable consumption from adolescence into adulthood and its longitudinal association with overweight , 2007, British Journal of Nutrition.

[8]  Karen M. Kuntz,et al.  Estimating the Energy Gap Among US Children: A Counterfactual Approach , 2006, Pediatrics.

[9]  K. Dodd,et al.  Most Americans eat much less than recommended amounts of fruits and vegetables. , 2006, Journal of the American Dietetic Association.

[10]  F. Hu,et al.  Intake of sugar-sweetened beverages and weight gain: a systematic review. , 2006, The American journal of clinical nutrition.

[11]  D. Cassady,et al.  The power of policy: a case study of healthy eating among children. , 2006, American journal of public health.

[12]  John C. Hanes,et al.  An environmental approach to obesity prevention in children: Medical College of Georgia FitKid Project year 1 results. , 2005, Obesity research.

[13]  S. Kelder,et al.  The CATCH Kids Club: a pilot after-school study for improving elementary students’ nutrition and physical activity , 2005, Public Health Nutrition.

[14]  Heather Patrick,et al.  A Review of Family and Social Determinants of Children’s Eating Patterns and Diet Quality , 2005, Journal of the American College of Nutrition.

[15]  B. Popkin,et al.  Changes in beverage intake between 1977 and 2001. , 2004, American journal of preventive medicine.

[16]  G. Colditz,et al.  Sugar-added beverages and adolescent weight change. , 2004, Obesity research.

[17]  L. Andersen,et al.  High intake of added sugar among Norwegian children and adolescents , 2004, Public Health Nutrition.

[18]  K. Patrick,et al.  Diet, physical activity, and sedentary behaviors as risk factors for overweight in adolescence. , 2004, Archives of pediatrics & adolescent medicine.

[19]  L. Bandini,et al.  Energy-dense snack food intake in adolescence: longitudinal relationship to weight and fatness. , 2004, Obesity research.

[20]  P. Petersen,et al.  Diet, nutrition and the prevention of dental diseases , 2004, Public Health Nutrition.

[21]  B. Popkin,et al.  Why do some overweight children remain overweight, whereas others do not?† , 2003, Public Health Nutrition.

[22]  A. Kant.  Reported consumption of low-nutrient-density foods by American children and adolescents: nutritional and health correlates, NHANES III, 1988 to 1994. , 2003, Archives of pediatrics & adolescent medicine.

[23]  Su-Jau Yang,et al.  Eating patterns and obesity in children. The Bogalusa Heart Study. , 2003, American journal of preventive medicine.

[24]  N. Lien,et al.  Stability in consumption of fruit, vegetables, and sugary foods in a cohort from age 14 to age 21. , 2001, Preventive medicine.

[25]  G. Colditz,et al.  Cross-sectional measurement of nutrient intake among adolescents in 1996. , 2001, Preventive medicine.

[26]  B. Popkin,et al.  The increasing prevalence of snacking among US children from 1977 to 1996. , 2001, The Journal of pediatrics.

[27]  L. Epstein,et al.  Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. , 2001, Obesity research.

[28]  Steven L Gortmaker,et al.  Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis , 2001, The Lancet.

[29]  M. Goran,et al.  Comparison of children's dietary intake patterns with US dietary guidelines. , 2000, The British journal of nutrition.

[30]  R. Pérez‐Escamilla,et al.  Biobehavioral factors are associated with obesity in Puerto Rican children. , 2000, The Journal of nutrition.

[31]  J Gittelsohn,et al.  Overweight among children and adolescents in a Native Canadian community: prevalence and associated factors. , 2000, The American journal of clinical nutrition.

[32]  L. Lytle,et al.  How Do Children's Eating Patterns and Food Choices Change over Time? Results from a Cohort Study , 2000, American journal of health promotion : AJHP.

[33]  Mark A Pereira,et al.  Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. , 1999, JAMA.

[34]  W. Willett,et al.  Trans fatty acids and coronary heart disease. , 1999, The New England journal of medicine.

[35]  D. Allison,et al.  Estimated intakes of trans fatty and other fatty acids in the US population. , 1999, Journal of the American Dietetic Association.

[36]  M. Barker,et al.  Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial , 1997, BMJ.

[37]  R. Ballard-Barbash,et al.  Food intakes of US children and adolescents compared with recommendations. , 1997, Pediatrics.

[38]  D. Neumark-Sztainer,et al.  Correlates of inadequate fruit and vegetable consumption among adolescents. , 1996, Preventive medicine.

[39]  S. Kelder,et al.  Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors. , 1994, American journal of public health.

[40]  P. Cleaton-jones,et al.  Sugar intake and dental caries , 1992, British Dental Journal.

[41]  G Block,et al.  Food group intake patterns and associated nutrient profiles of the US population. , 1991, Journal of the American Dietetic Association.

[42]  G Block,et al.  Dietary diversity in the US population, NHANES II, 1976-1980. , 1991, Journal of the American Dietetic Association.

[43]  J. Fleiss,et al.  Intraclass correlations: uses in assessing rater reliability. , 1979, Psychological bulletin.

[44]  J. Stockman.  High Body Mass Index for Age Among US Children and Adolescents, 2003-2006 , 2010 .

[45]  Mary Hagedorn,et al.  National Household Education Surveys Program of 2007 , 2009 .

[46]  D. Jacobs,et al.  An after-school obesity prevention program for African-American girls: the Minnesota GEMS pilot study. , 2003, Ethnicity & disease.

[47]  Darrell M. Wilson,et al.  Dance and reducing television viewing to prevent weight gain in African-American girls: the Stanford GEMS pilot study. , 2003, Ethnicity & disease.

[48]  B. Lin,et al.  Higher Fruit Consumption Linked With Lower Body Mass Index , 2002 .

[49]  Anson,et al.  DIET , LIFESTYLE , AND THE RISK OF TYPE 2 DIABETES MELLITUS IN WOMEN , 2001 .

[50]  J. F. Morton,et al.  Food sources of added sweeteners in the diets of Americans. , 2000, Journal of the American Dietetic Association.

[51]  D. Jacobs,et al.  Whole-grain consumption and chronic disease: protective mechanisms. , 1997, Nutrition and cancer.

[52]  E. Krenning,et al.  Bone mineral density in children and adolescents: relation to puberty, calcium intake, and physical activity. , 1997, The Journal of clinical endocrinology and metabolism.

[53]  B. G. Bibby.  The cariogenicity of snack foods and confections. , 1975, Journal of the American Dental Association.