The impact of a water promotion and access intervention on elementary school students in the presence of food insecurity
Abstract Objective: School-based interventions encouraging children to replace sugar-sweetened beverages with water show promise for reducing child overweight. However, students with child food insecurity (CFI) may not respond to nutrition interventions like children who are food-secure. Design:...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Public Health Nutrition |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S1368980024002283/type/journal_article |
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| _version_ | 1841526456589484032 |
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| author | Leslie Gerstenfeld Lauren Blacker Charles E McCulloch Lorrene D Ritchie Valeria M Ordonez Laura Schmidt Anisha I Patel |
| author_facet | Leslie Gerstenfeld Lauren Blacker Charles E McCulloch Lorrene D Ritchie Valeria M Ordonez Laura Schmidt Anisha I Patel |
| author_sort | Leslie Gerstenfeld |
| collection | DOAJ |
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Abstract
Objective:
School-based interventions encouraging children to replace sugar-sweetened beverages with water show promise for reducing child overweight. However, students with child food insecurity (CFI) may not respond to nutrition interventions like children who are food-secure.
Design:
The Water First cluster-randomised trial found that school water access and promotion prevented child overweight and increased water intake. This secondary analysis used mixed-effects regression to evaluate the interaction between the Water First intervention and food insecurity, measured using the Child Food Security Assessment, on child weight status (anthropometric measurements) and dietary intake (student 24-h recalls, beverage intake surveys).
Setting:
Eighteen elementary schools (serving ≥ 50 % children from low-income households), in which drinking water had not been previously promoted, in the San Francisco Bay Area.
Participants:
Students in fourth-grade classes (n 1056).
Results:
Food insecurity interacted with the intervention. Among students with no CFI, the intervention group had a lower prevalence of obesity from baseline to 7 months (–0·04, CI –0·08, 0·01) compared with no CFI controls (0·01, CI –0·01, 0·04) (P = 0·04). Among students with high CFI, the intervention group had a pronounced increase in the volume of water consumed between baseline and 7 months (86·2 %, CI 21·7, 185·0 %) compared with high CFI controls (–13·6 %, CI –45·3, 36·6 %) (P = 0·02).
Conclusions:
Addressing food insecurity in the design of water promotion interventions may enhance the benefit to children, reducing the prevalence of obesity.
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| format | Article |
| id | doaj-art-c9df73feff5345758e109a16f7a031be |
| institution | Kabale University |
| issn | 1368-9800 1475-2727 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Public Health Nutrition |
| spelling | doaj-art-c9df73feff5345758e109a16f7a031be2025-01-16T21:49:02ZengCambridge University PressPublic Health Nutrition1368-98001475-27272025-01-012810.1017/S1368980024002283The impact of a water promotion and access intervention on elementary school students in the presence of food insecurityLeslie Gerstenfeld0Lauren Blacker1Charles E McCulloch2Lorrene D Ritchie3https://orcid.org/0000-0002-8038-1821Valeria M Ordonez4Laura Schmidt5Anisha I Patel6Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USARUSH University Medical College, Chicago, IL, USADepartment of Epidemiology and Biostatistics, University of California, San Francisco School of Medicine, San Francisco, CA, USANutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, Oakland, CA, USAStanford Department of Pediatrics, Palo Alto, CA, USAPhilip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA Department of Humanities and Social Sciences, University of California, San Francisco, San Francisco, CA, USAStanford Department of Pediatrics, Palo Alto, CA, USA Abstract Objective: School-based interventions encouraging children to replace sugar-sweetened beverages with water show promise for reducing child overweight. However, students with child food insecurity (CFI) may not respond to nutrition interventions like children who are food-secure. Design: The Water First cluster-randomised trial found that school water access and promotion prevented child overweight and increased water intake. This secondary analysis used mixed-effects regression to evaluate the interaction between the Water First intervention and food insecurity, measured using the Child Food Security Assessment, on child weight status (anthropometric measurements) and dietary intake (student 24-h recalls, beverage intake surveys). Setting: Eighteen elementary schools (serving ≥ 50 % children from low-income households), in which drinking water had not been previously promoted, in the San Francisco Bay Area. Participants: Students in fourth-grade classes (n 1056). Results: Food insecurity interacted with the intervention. Among students with no CFI, the intervention group had a lower prevalence of obesity from baseline to 7 months (–0·04, CI –0·08, 0·01) compared with no CFI controls (0·01, CI –0·01, 0·04) (P = 0·04). Among students with high CFI, the intervention group had a pronounced increase in the volume of water consumed between baseline and 7 months (86·2 %, CI 21·7, 185·0 %) compared with high CFI controls (–13·6 %, CI –45·3, 36·6 %) (P = 0·02). Conclusions: Addressing food insecurity in the design of water promotion interventions may enhance the benefit to children, reducing the prevalence of obesity. https://www.cambridge.org/core/product/identifier/S1368980024002283/type/journal_articleFood insecurityDrinking waterObesityDiet |
| spellingShingle | Leslie Gerstenfeld Lauren Blacker Charles E McCulloch Lorrene D Ritchie Valeria M Ordonez Laura Schmidt Anisha I Patel The impact of a water promotion and access intervention on elementary school students in the presence of food insecurity Public Health Nutrition Food insecurity Drinking water Obesity Diet |
| title | The impact of a water promotion and access intervention on elementary school students in the presence of food insecurity |
| title_full | The impact of a water promotion and access intervention on elementary school students in the presence of food insecurity |
| title_fullStr | The impact of a water promotion and access intervention on elementary school students in the presence of food insecurity |
| title_full_unstemmed | The impact of a water promotion and access intervention on elementary school students in the presence of food insecurity |
| title_short | The impact of a water promotion and access intervention on elementary school students in the presence of food insecurity |
| title_sort | impact of a water promotion and access intervention on elementary school students in the presence of food insecurity |
| topic | Food insecurity Drinking water Obesity Diet |
| url | https://www.cambridge.org/core/product/identifier/S1368980024002283/type/journal_article |
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