The association between the introduction of a province-wide school nutrition policy and food consumption in elementary school children on Prince Edward Island

Although the majority of Canadian provinces have now adopted province-wide school nutrition policies in an effort to improve children's eating habits and reduce childhood overweight, there has been little evaluation of healthy eating policies across the country. Nutrition policies for elementary schools in Prince Edward Island were adopted by all three school districts in 2005-2006, referred to as the PEI School Nutrition Policy in this thesis. This purpose of this study was to describe food consumption of those grade five and six students participating in the Eating Behaviour Survey in 2007 and to examine the association between any changes in food consumption and the implementation of the school nutrition policy (2001/02 vs. 2007). An in-class survey was used to describe food intakes according to grade and gender for all grade 5 and 6 children in PEI in 2007 (n=2026). A quasi-experimental, pre-test--post-test design was then used to compare food consumption data from a subset of 11 schools which were included in both a pre-policy (2001/02) survey and the post-implementation survey (2007) (n=1533). Study hypotheses were that (1) daily intakes of Milk and Alternatives (MA) and Vegetables and Fruit (VF) will be higher and intakes of low nutrient density foods (LNDF) will be lower following implementation of the PEI School Nutrition Policy compared to pre-implementation; (2) students will be more likely to consume adequate amounts of MA, VF following policy implementation compared to pre-implementation and (3) students will be less likely to consume three or more servings of LNDF following policy implementation compared to pre-implementation. Hierarchical linear modelling was then used to assess changes in food consumption between 2001/02 and 2007, with survey year as a fixed effect and gender, grade and the difference in students' total daily number of food servings between the two time periods as covariates.;Study results provide support for our hypotheses in that the introduction of the PEI School Nutrition Policy has been associated with a significant reduction in the consumption of low-nutrient density foods and a modest increase in the consumption of healthier choices from the Vegetables and Fruit and Milk and Alternatives food groups. The results thus underscore the importance of school nutrition policies, which modify the school food environment through the restriction of 'poor choices', in improving children's diet quality and their overall health. Findings are also consistent with a growing number of studies demonstrating the impact of changes to the school food environment on student food and nutrient intakes. While reducing unhealthy foods is a positive change to the school food environment, the lack of improvement in healthy choices may suggest that a more comprehensive intervention is needed where healthy choices are made readily available to students.;Results indicated that students in 2007 were more than twice as likely to report consuming less than 3 servings of LNDF compared to those in 2001/02 (OR=2.14 [95% CI 1.63, 2.83]). Survey year was also a significant predictor of whether or not students met CFG recommendations for Milk and Alternatives and Vegetables and Fruit. Students who were surveyed in 2007 were 1.3 times more likely to consume the recommended servings of Milk and Alternatives (p<0.05) and 1.5 times more likely to consume the recommended servings of Vegetables and Fruit than students in 2001/02.