uninterested; considering little passion or eagerness, assignment help

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Writing

Description

The Literature Reviews should not include any class readings, as reviews must be from sources that you have discovered yourself. They should be written as bullet points, and should be about two pages in length.


For each source read, you should write a Literature Review which includes the following sections:

  • Provide full citation in MLA format
  • Identify the key concepts of the piece
  • Give some information on the author(s)
  • Define unfamiliar vocabulary if any exists
  • Give three pertinent quotations, correctly cited, AND explain the significance of each quotation
  • Explicitly explain how this material helps you to answer the research questions posed
  • Explicitly state how this reading connects to previous readings that you have done in this course, and trace areas of agreement and disagreement about particular topics.
  • Identify new questions so as to delve even more deeply into the research


These Literature Reviews should be of immense use not only in contributing to your body of knowledge about the topic under investigation, but also because sections of your reviews might be able to be imported directly into your research paper.


Example literature review

Source

Sandel, Michael J. "2. The Greatest Happiness Principle/ Utilitarianism." Justice: What's the Right Thing to Do? New York: Farrar, Straus and Giroux, 2009. 31 57.

Summary

Michael Sandel explores utilitarianism applied by Jeremy Benthan and John Stuart Mill. Benthan’s utilitarianism says that the standard of right and wrong is determined by plain and pleasure. This expert also showed that utilitarianism can fail to respect individual rights. John Stuart Mill had a classic denfense of individual freedom. He wanted to maximize utilty in the long run and not just by a case-by-case basis like Benthan believed.

Author Information

Michael Sandel is a professor at Harvard University. He teaches a course in Justice. He is a political philosopher most famous for his critique of John Rawl’s Theory of Justice.

Unfamiliar Vocab

  • Tepid: uninterested; considering little passion or eagerness
  • Utility: whatever produces pleasure or happiness, and whatever prevents pain or suffering

Quotes and meaning

  • “The first approach says that morality of an action depends solely on the consequences it brings about; the right thing to do is whatever will produce the best state of affairs, all things considered. The second approach says that consequences are not all we should care about, morally speaking; certain duties and rights should command our respect, for reasons independent of the social consequences” (Sandel 33).

The first approach would be in favor of favoring big interest groups and the second would be in favor of considering all groups equally no matter what the social consequence would be; in the case of Congress, the social component of getting re-elected.

  • Jeremy Benthan’s philosophy “exerts a powerful hold on the thinking of policy-makers, economists, business executives, and ordinary citizens to this day” (Sandel 34).

Since Benthan’s philosophy is already considered in the field it will strengthen my ethical argument. Objection to Bentham: This is against big interest groups financial and social influence over Congress. It isn’t ethical to impose the big interest groups view in legislation because it interferes with individual liberty in order for the individual (member of congress) to get re-elected.

  • “Allowing the majority to silence dissenters or censor-free-thinkers might maximize utility today, but it will make society worse off—less happy—in the long run” (Sandel 60).

Along with actions and consequenseces, character also matters when considering morality. Politicians who favor big interest groups or wealthy interest groups for the sole reason to have a better chance of getting re-elected and not because he believes in the matter has no character, and is therefore not acting in an ethical manner.

How the material helps

This material will help because it made me think of another view of utilitarianism. It also gave important quotes that proved that government thinks of these ethical principles; whether they apply them to their actions is questionable. It also gave me important information about rights in regard to ethics. Although legality doesn’t mean ethicality this material connected the two in a way that makes constitutional values necessary when considering ethics.

Connections with other readings (mention authors and titles)

This connects with Kwame Anthony Appiah, Experiments in Ethics, as both authors consider Utilitarianism .

Newly identified questsion

  • Even though legality doesn’t mean ethicality, do we need to consider constitutional rights when considering ethics


I have 2 articles, so there will 2 reviews that I will need.

First one


期刊全文

Changes in a Middle School Food Environment Affect Food Behavior and Food Choices RSS 下载PDF

Journal of the Academy of Nutrition and Dietetics, 2012-01-01, 卷号 112, 期 1, 页 137-141, Copyright © 2012 Academy of Nutrition and Dietetics

Abstract

Increasing rates of obesity among children ages 12 to 19 years have led to recommendations to alter the school food environment. The purpose of this study was to determine whether there are associations between an altered school food environment and food choices of middle school students both in and outside of school. In a midsized western city, two of six middle schools allowed only bottled water in vending machines, only milk and fruit on à la carte menus, and offered a seasonal fruit and vegetable bar. Three years after the intervention was initiated, seventh- and eighth-grade students attending the two intervention schools and four control middle schools were surveyed about their food choices. A total of 2,292 surveys were completed. Self-reported frequency of consumption for nine food groups in the survey was low; consumption was higher outside than in school. Boys consumed more milk than girls although girls consumed more fruits and vegetables. Significant socioeconomic differences existed. Compared with students who paid the full lunch fee, students qualifying for free and reduced-price meals consumed more milk and juice in schools but less outside school; more candy and energy drinks in school; and more sweet drinks, candy, pastries, and energy drinks outside school. Students in intervention schools were 24% more likely to consume milk outside school, 27% less likely to consume juice in school, and 56% less likely to consume sweet pastries in school. There were no differences in fruit and vegetable consumption reported by children in control and intervention schools. Overall, there was a positive association between a modified school food environment and student food behavior in and outside school. Policies related to the school food environment are an important strategy to address the obesity epidemic in our country.

During the past 20 years the rate of overweight among 12- to 19-year-olds has more than tripled ( ), and nearly one in three children in the United States is now overweight or obese ( ). Overweight in adolescence is a greater predictor of risk for hyperlipidemia, hypertension, diabetes, and osteoporosis than overweight in adulthood, making adolescence a crucial time to encourage healthy food and physical activity habits ( ). Because of their continuous and intensive contact with children during the first 2 decades of their lives, schools provide an ideal setting for obesity-related interventions ( ). Most schools offer US Department of Agriculture (USDA) School Lunch and Breakfast Programs ( ) and some form of competitive à la carte food options (ie, food sold outside the purview of a USDA meal program). Competitive foods tend to be high in energy from fat and/or sugar and low in nutrients ( ) and their availability has a negative influence on nutrient consumption ( ), particularly among students from low-income families. Availability of these foods is associated with reduced participation in USDA meal programs ( ).

The school food environment, which for this study included all foods available to students in school during the school day, was targeted as a place in which to reduce adolescent obesity. Several studies have reported that restricting less-healthy foods in cafeterias and vending machines reduced consumption of low nutrient, high-energy foods ( ). However the duration and effect of changes has been studied for a relatively short period of time, often <1 year ( ).

The purpose of this research was to examine the relationships between changes in the school food environment and food choices made by early adolescents. This study extends beyond others in that the intervention reduced vending machine beverages to water only, limited à la carte offerings, extended changes in the school food environment to 3 years, and assessed adolescent food consumption both in school and outside of school.

Methods

Participants

The study population was 4,113 students (grades seven and eight) enrolled in six middle schools in a midsized western city. Two schools served as intervention schools (total enrollment 1,406); one had a large proportion of students receiving free and reduced-price meals (71.3%), whereas the other had a smaller proportion receiving free and reduced-priced meals (46.2%). Four schools served as control schools (total enrollment 2,707); two control schools had a large proportion of students receiving free and reduced-price meals (81.1%), and two had a smaller proportion receiving free and reduced-price meals (37.6%). High numbers of students eligible for free and reduced-price meal status determined the study variable for low-income status.

In the two intervention schools, modification of the school food environment was initiated during fall of the 2007-2008 school year and continued through the 2008-2009 and 2009-2010 school years. A food behavior survey was administered to middle-school students in seventh and eighth grades in intervention and control schools during the 2009-2010 school year during fitness and health classes.

More than 90% of students in this school district are white. To protect the identity of nonwhite students, race was not included in the analysis. Personal identifiers were removed and a unique study-specific identification number was assigned to each participant by the school district. Approval for the project was granted by the school district Assessment Review Committee and the Washington State University Institutional Review Board. Dichotomous classification of a student's socioeconomic status was determined by qualification for free or reduced-price meals as a part of the USDA school meal program.

Modifications to School Food Environment

Three school years before this study, the school district implemented a wellness policy in all schools that eliminated sugared beverages and only allowed 100% juice products and flavored nonenergy-providing water to be sold during the school day. Competitive à la carte items were limited to 250 kcal and 9 g fat.

The intervention reported here further modified the school food environment in two middle schools by removing juice products and allowing only nonflavored bottled water in vending machines, restricting à la carte items to only milk and fruit and removing all other items, and making a seasonal fruit and vegetable bar available to all students. The research hypothesis was that when compared to middle school students in control schools, the middle school students in the intervention schools with altered school food environments would report healthier food choices.

Measures of Food Behaviors

A revised beverage and snack questionnaire developed by Neuhouser and colleagues ( ) was used to assess the previous week's food choices of students in school and outside of school. The food frequency questionnaire was originally developed to assess the food behavior of middle school students in Washington State and to evaluate the effectiveness of school district wellness policies. The previously established validity coefficients for the individual food items ranged from 0.56 to 0.87. The original 19 food items were reduced to a total of nine food categories that focused on items commonly found in the school environment. The revised survey instrument was selected and modified to ensure completion within 5 to 7 minutes and to identify food frequency differences between intervention and control schools. The nine food categories included on the revised instrument were juice, milk, sweet-drink, energy drinks, chips, candy, pastries, vegetables, and fruits. In the modified version of the survey used in this study, reliability was confirmed with Cronbach's α, which ranged from .55 to .79. Food and beverage consumption during the previous week both in school and outside of school were assessed. Students chose among seven consumption frequency options from “zero servings per week” up to “four or more servings per day.” Responses were condensed in the analysis to three categories: high (at least two to three servings per day), medium (five or six servings per week or one serving per day), and low (at most four servings per week) consumption, to avoid low cell counts while preserving the monotonicity of the responses.

Statistical Analyses

Wilcoxon matched-pairs signed rank test was used to evaluate whether there were differences in frequency of consumption of various food and drink products in school and outside school. Kruskal-Wallis equality-of-populations rank test was used to evaluate whether there were sex differences and income differences in frequency of consumption of various food and drink products in school and outside of school. To determine whether consumption of the various food products and drinks, both in and outside of school, varied between intervention and control schools, ordered logistic regression analyses were conducted. Covariates in the regression models included sex and income status of the students. In addition, while conducting the analysis for the consumption patterns in school, the consumption behavior outside school was controlled to capture individuals' overall preference for certain food items. The number of observations in the ordered logistic regression model was 1,975.

Results and Discussion

A total of 2,292 surveys (response rate 55.6%) were returned from seventh- and eighth-grade students in intervention and control schools. Intervention schools represented 26% of respondents, whereas the control schools (four of six middle schools) represented 74%. Response rates for control (87.4%) and intervention (82.4%) schools were similar. Boys (51%) and girls (49%) were equally represented among respondents.

Overall, students self-reported low consumption for all nine categories of food on the food frequency survey and reported higher frequency of food consumption outside school than inside school ( Table 1 ). This is consistent with reports that children in this age group under-report food consumption ( ) and consume more food outside school than in school ( ). The food most frequently consumed was milk; however, only one fourth reported at least two servings of milk per day outside of school; 14% reported consuming at least two servings of milk daily in school. Sweetened drink consumption was lower in this survey than reported in other studies ( ): medium to high frequency of consumption of sweetened beverages was reported by 12% to 18% of students in school and 20% to 30% outside school. More than three fourths of students in this study reported low consumption (less than one serving per day) of chips, candy, pastries, and energy drinks; this may be a reflection of the school wellness policies that the school district implemented before our study.

Table 1

Seventh- and eighth-grade children's differences in food choices in and outside school, by sex and meal status a

Self-reported intake frequencyIn SchoolOutside School
Boys (n=1,176)Girls (n=1,116)Paid meals (n=997)Free/reduced-price meals (n=1,022)Boys (n=1,176)Girls (n=1,116)Paid meals (n=997)Free/reduced-price meals (n=1,022)
%
Milk
Low42.7755.0060.8339.1347.5952.4845.2752.58
Medium40.1233.6628.9044.4427.1126.5127.8726.19
High17.1111.3410.2716.4325.3021.0126.8621.23
Rank test37.10 ⁎⁎87.46 ⁎⁎7.03 ⁎⁎12.55 ⁎⁎
Fruits
Low59.5957.7259.4458.0445.6738.9440.6043.18
Medium27.2030.4330.6227.9433.0535.2535.1834.49
High13.2111.859.9414.0221.2925.8124.4422.33
Rank test0.251.6711.77 ⁎⁎1.63
Vegetables
Low67.9569.9071.6067.2947.2140.2742.7144.46
Medium22.3722.2820.7522.9936.1140.3638.9938.02
High9.687.827.659.7216.6819.3718.3017.52
Rank test1.444.81 10.33 ⁎⁎0.61
Juice
Low71.2076.9880.3068.7361.6064.9062.4763.24
Medium19.1518.0815.3821.6321.6521.1523.0420.85
High9.654.944.329.6416.7513.9514.4915.91
Rank test12.60 ⁎⁎38.14 ⁎⁎3.390.003
Sweet drinks
Low81.2186.4384.7283.2070.5473.7876.4868.78
Medium12.308.8911.869.6318.0916.9416.7818.53
High6.494.683.427.1711.379.286.7412.69
Rank test11.36 ⁎⁎1.553.3518.11 ⁎⁎
Chips
Low85.3685.3584.2185.7478.0778.5879.1277.21
Medium11.2211.7713.4810.8215.7414.9415.7615.76
High3.422.882.313.446.196.485.127.03
Rank test0.0030.690.061.42
Candy
Low88.2489.4091.8486.2182.4679.8484.8278.04
Medium7.647.376.148.6711.2613.5010.3514.05
High4.123.232.025.126.286.664.837.91
Rank test0.8417.04 ⁎⁎2.3515.7 ⁎⁎
Pastries
Low89.7794.3293.7490.7285.9786.1388.9983.70
Medium7.054.064.846.229.449.917.8811.43
High3.181.621.423.064.593.963.134.87
Rank test16.03 ⁎⁎6.62 0.0211.89 ⁎⁎
Energy drinks
Low93.9195.9696.8793.6189.4192.0794.2788.50
Medium3.182.691.523.836.025.593.427.53
High2.911.351.612.554.572.342.313.97
Rank test5.17 11.49 ⁎⁎5.17 20.74 ⁎⁎

a The numbers of observations reported in the second row are approximate because they might vary due to missing data across different food items. Results are from Kruskal-Wallis equality-of-proportions rank tests. Low=0-4 servings/wk (less than 1/d); Medium=5-6 servings/wk (1/d); High=2-3 servings/d.

P <0.05.

⁎⁎ P <0.01.

For the combined control and intervention group clear sex differences in the frequency of self-reported food choices were identified ( Table 1 ). Boys consistently reported more frequent milk consumption in and outside school compared with girls. In school 17.1% of boys consumed two or more daily servings of milk compared with 11.3% of girls, and outside school 25.3% of boys consumed two or more daily servings compared with 21.0% of girls. Girls reported more frequent consumption of fruits and vegetables than boys outside school. Nearly 26% of girls consumed at least two fruits per day outside school compared to 21.3% of boys, and 19.4% of girls consumed at least two vegetables per day outside school compared with 16.7% of boys. Boys consumed more juice, sweet drinks, and pastries at school than girls.

For the combined groups significant income differences were noted for student frequency of consumption of several food items in and outside of school ( Table 1 ). Milk consumption by students receiving free and reduced-price meals was higher than that by students receiving fully-paid meals in school; however, students with fully-paid meals consumed more milk outside of school. Students receiving free and reduced-price meals reported consuming more juice at school than students who paid for their meals; they also consumed more candy and energy drinks in school and more sweet drink, candy, pastries, and energy drinks outside of school. This may support the conclusion drawn by Drewenoski and Darmon ( ) that lower-income families choose foods that provide high energy return for the cost.

Significant differences were identified between intervention and control schools ( Table 2 ). The ordered logistic regression that controlled for sex, meal status, and location of food item consumption showed that students in intervention schools were 56% less likely to consume pastries and 27% less likely to consume juice, which was the only energy-dense vended beverage in control schools. This demonstrates that modifying the school food environment likely has a positive influence on the foods that students consume. Students at intervention schools were 24% more likely to consume milk outside of school. It may be because the limited beverage options at intervention schools created a taste preference for milk at home. It was surprising that fruit and vegetable consumption reported by students at the intervention schools was not significantly better than those students in the control schools because seasonal fruit and vegetable bars were available to all students in intervention schools regardless of whether they purchased a school meal. Fresh fruits and vegetables were available to all students in control schools on the meal line. Van Cauwenberghe and colleagues ( ) also reported that fruit and vegetable intake was not affected by changes in school food environment.

Table 2

Consumption differences by seventh- and eighth-grade children (n=2,000) between intervention and control schools a b

Dependent variable aIn SchoolOutside School
Odds ratioStandard errorP valueOdds ratioStandard errorP value
Milk0.970.100.771.240.130.04
Fruit1.010.120.951.210.130.09
Vegetables1.080.140.560.940.100.58
Juice0.730.100.020.820.100.10
Sweet drinks0.870.150.770.940.130.64
Chips0.870.150.411.170.170.29
Candy0.970.200.880.990.160.96
Pastries0.440.120.001.400.250.06
Energy drinks1.030.350.920.840.200.48

a The numbers of observations reported in the first row are approximate because they might vary due to missing data across different food items. Results are from ordered logistic regressions. The ordered logistic regression analysis was conducted using STATA 10 (2007, Stata Corp, College Station, TX).

b Independent variables in each regression analysis are sex, school meal status, and consumption of the same food item in the complementary location.

The findings of this study present a conundrum for school administrators. Findings demonstrated that healthful modifications in the school food environment are associated with positive food behaviors in early adolescents, but there was a cost associated with those changes. Each intervention school spent 49% more on produce per student than control schools during the 2008-2009 and 2009-2010 school years (spending about $2,500 more per school per year), and annually both schools together lost approximately $24,000 in gross school meal sales due to lost à la carte sales and a $9,000 annual loss in vending sales. The pressures to provide more nutritious, often more costly foods to students in the midst of shrinking budgets and unfunded mandates makes it difficult to eliminate profitable competitive foods.

Conclusions

This study identified a positive association between reported student food choices and a modified food environment. School food polices and the food environment can be part of a long-term solution to the youth obesity problem. Practitioners in school nutrition need to work with key decision makers to offer a healthful school food environment. Especially school meal programs in lower income areas need to be encouraged and promoted because of the key nutrients provided by school meals.

Findings of this study are limited due to lack of ethnic/racial diversity among respondents, the fact that the study relied on self-reported frequency of food choices, and knowledge that it was administered in a health and fitness class. Future research should include more objective measures of food behavior. In addition, longitudinal research is needed to assess food behaviors before and after a school food environment intervention to determine the causal effect of changes in the school food environment on food behaviors among adolescents.

STATEMENT OF POTENTIAL CONFLICT OF INTEREST: No potential conflict of interest was reported by the authors.

FUNDING/SUPPORT: This project was supported by National Research Initiative grant no. 2006-04637 from the US Department of Agriculture's National Institute for Food and Agriculture Teen Eating and Activity Mentoring in Schools program .

ACKNOWLEDGEMENTS: The authors thank Washington State University, especially the team at the College of Nursing, whose commitment to excellence in research and support of partnerships and scholarly work made this article possible.

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RESEARCH ARTICLE Availability of Vending Machines and School Stores in California Schools NAFISSATOU CISSE-EGBUONYE, MPHa SANDY LILES, MPHb KATHARINE E. SCHMITZ, MPHc NADA KASSEM, DrPHd VERONICA L. IRVIN, PhD, MPHe MELBOURNE F. HOVELL, PhD, MPHf ABSTRACT BACKGROUND: This study examined the availability of foods sold in vending machines and school stores in United States public and private schools, and associations of availability with students’ food purchases and consumption. METHODS: Descriptive analyses, chi-square tests, and Spearman product-moment correlations were conducted on data collected from 521 students aged 8 to 15 years recruited from orthodontic offices in California. RESULTS: Vending machines were more common in private schools than in public schools, whereas school stores were common in both private and public schools. The food items most commonly available in both vending machines and school stores in all schools were predominately foods of minimal nutritional value (FMNV). Participant report of availability of food items in vending machines and/or school stores was significantly correlated with (1) participant purchase of each item from those sources, except for energy drinks, milk, fruits, and vegetables; and (2) participants’ friends’ consumption of items at lunch, for 2 categories of FMNV (candy, cookies, or cake; soda or sports drinks). CONCLUSIONS: Despite the Child Nutrition and Women, Infants, and Children (WIC) Reauthorization Act of 2004, FMNV were still available in schools, and may be contributing to unhealthy dietary choices and ultimately to health risks. Keywords: childhood obesity; schools; foods of minimal nutritional value. Citation: Cisse-Egbuonye N, Liles S, Schmitz KE, Kassem N, Irvin VL, Hovell MF. Availability of vending machines and school stores in California schools. J Sch Health. 2016; 86: 48-53. Received on January 17, 2014 Accepted on May 10, 2015 C hildhood obesity is one of the most serious threats to public health both nationally and globally.1 In the United States childhood obesity affects approximately 17% (12.5 million) of children and adolescents.2 This rate indicates the urgency in examining the predictors of childhood obesity, therefore that tailored and effective interventions can be designed and implemented to reduce its incidence. The United States is often described as an ‘‘obesogenic’’ environment due to factors that promote increased energy intake and sedentary behaviors.2 The most commonly studied environments in the United States have been the child’s home and school. This study focused on schools in Orange and San Diego counties, California. The School Environment and Its Role in Childhood Obesity In the 2011-2012 school year approximately 49.5 million students were enrolled in public elementary and secondary schools.3 About 5.3 million were a Graduate Teaching Assistant, (ncisse@neo.tamu.edu), Department of Health & Kinesiology, Texas A&M University, 311 Blocker Hall, College Station, TX 77843. bResearch Associate, (sliles@cbeachsdsu.org), Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 230, San Diego, CA 92123. c Research Associate, (kschmitz@mail.sdsu.edu), Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 230, San Diego, CA 92123. d Research Scientist, (nkassem@cbeachsdsu.org), Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 230, San Diego, CA 92123. e Assistant Professor, (Veronica.irvin@oregonstate.edu), College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, 97331. f Director/Distinguished Professor of Public Health, (mhovell@cbeachsdsu.org), Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA. Address correspondence to: Nafissatou Cisse-Egbuonye, Graduate Teaching Assistant, (ncisse@neo.tamu.edu), Department of Health & Kinesiology, Texas A&M University, 311 Blocker Hall, College Station, TX 77843. This study was funded by the Center for Behavioral Epidemiology and Community Health R01 CA138192-01A2 (Hovell) NIH/NCI Clinician Promotion of Healthy Diet and Activity to Reduce Obesity Among Adolescents. 48 • Journal of School Health • January 2016, Vol. 86, No. 1 • © 2015, American School Health Association enrolled in private schools.4 According to the US Department of Agriculture (USDA), approximately 32 million US school-aged children receive their school meals through the National School Lunch Program (NSLP).5 Schools have significant continuous, intensive contact, and influence on children during their first 2 decades of life.4 Enactment and enforcement of school-based policies and programs to support healthy eating and physical activity are needed to assist with the reversal of obesity rates in children.6 In 2010 the Healthy, Hunger-Free Kids Act (HHFK) set ‘‘nutrition standards for competitive foods and beverages sold outside of the federal reimbursable school meals program during the school day. These standards set limits on calories, salt, sugar, and fat in foods and beverages and promote snack foods that have whole grains, low fat dairy, fruits, vegetables or protein foods as their main ingredients.’’7 ‘‘Competitive foods’’ are defined as foods offered for sale at school, other than meals served through USDA’s school meal programs—school lunch, school breakfast, and afterschool snack programs. Competitive foods are often foods of minimal nutritional value (FMNV), providing less than 5% of the recommended daily allowance per serving for each of 8 specified nutrients: protein, vitamin A, vitamin C, niacin, riboflavin, thiamine, calcium, and iron.5 All minimally nutritious foods and beverages are prohibited from being sold in food service areas during the meal period.8 However, restrictions on FMNV during the meal period have not been effective in addressing childhood obesity, possibly because these foods are made available to students in many schools throughout the remainder of the school day. The Fourth School Nutrition Dietary Assessment Study (SNDA-IV) showed that vending machines were widely available in high schools (85%) and middle schools (67%), more so than in elementary schools (13%). These figures represent a 15% to 19% decrease across elementary, middle, and high schools relative to SNDA-III data.9 In a survey of 116 schools, 106 (91%) had vending machines, and only 18% of beverage items within the vending machines met criteria in the Dietary Guidelines for Americans for calories and type of beverages.10 Another survey found that 83% of 152 schools had vending machines that primarily sold FMNV (soft drinks, chips, and sweets).11 In another study, 18% of 4322 students surveyed had purchased less healthy snacks or beverages from vending machines 2 or more days during the previous 5 school days instead of buying school lunch.12 The presence of beverage vending machines in schools has been associated with the weight status of students.13 The United States has enacted policies to limit children’s access to high-fat foods and sugar sweetened beverages in schools. The Child Nutrition and Women, Infants, and Children (WIC) Reauthorization Act of 2004 required every school district participating in the Journal of School Health • NSLP to establish local school wellness policies by fall 2006.5 However, the requirements, implementation, and enforcement of wellness policies have varied across school districts. According to the 2012 National School Health Policies and Programs Study (SHPPS), although progress has been made between 2006 and 2012 in the types of foods sold during school, there is still need for improvement. The study found that less than half of the school districts required their schools to prohibit the availability of junk foods in vending machines, and less than one-third of districts required schools to prohibit junk foods in school stores, canteens, or snack bars.14 Thus, on June 28, 2013, amendments to the HHFK act set new standards consistent with the 2010 Dietary Guidelines for Americans for all foods sold (1) outside school meal programs, (2) on school campuses, and (3) at any time during the school day.15 These new nutrition standards, which schools must have met by July 1, 2014, take a great stride in addressing consumption of unhealthy foods in schools. It will be important to evaluate the impact of these amendments on the availability and consumption of FMNV in future research. In California, state regulations also govern competitive food and beverage items sold on elementary, middle, and high school grounds.16 Prior to the above new amendments in elementary schools the sale of competitive foods were solely allowed at least one-half hour after school. In middle and high schools, snack items must be less than 250 calories per item and an entrée cannot be more than 400 calories. Snack items can have only 35% of calories from fat and only 10% of calories from saturated fat, and can only be 35% sugar by weight. An entrée must have less than 36% of calories from fat. Schools may sell milk, sweetened or unsweetened, with less than 2% milk fat, beverages that are more than 50% juice with no added sweeteners, and water. Middle and high schools can also sell electrolyte replacement beverages. The prohibition of sales of FMNV was effective only during a meal period and only in a food service area. FMNV sales were permitted in other locations at school or after the meal period.16 In the United States most studies on vending machines and school stores were conducted before the 2006 requirement to implement school wellness policies. Therefore, it is important to examine recent data to determine whether there have been improvements in the nutritive value of foods typically sold at schools that might affect the quality of students’ dietary intake. Theoretical Framework The Behavioral Ecological Model (BEM) was used to conceptualize the influence of the availability of January 2016, Vol. 86, No. 1 • © 2015, American School Health Association • 49 vending machines and school stores on students’ dietary intake. The BEM links behavioral science to basic biological sciences, as foundations for behavior and learning. It emphasizes ecological principles of selection by environmental consequences at the individual and group/cultural level.17 It recognizes the intertwined relationship that exists between the individual and the environment, and assumes that the best predictor of human behavior is the person’s environment. Guided by the BEM, the aims of this study were to (1) identify the types of foods sold in vending machines and school stores in public and private schools in California; (2) determine whether the availability of FMNV in vending machines and school stores was associated with student purchase and consumption of FMNV; and (3) determine whether student purchase was associated with consumption. then asked what food items (yes/no) were available in their school vending machines and school stores, and what items they purchased in the past week. The 14 response options were ice cream or frozen yogurt; cookies or cakes; sports drinks; energy drinks; water; milk; soda; fruit; french fries; chips; yogurt; vegetables; cheese; candy. Children were also asked how many of their friends they thought ate/drank each of the following 6 food categories during school days: yogurt or cheese; chips or french fries; fruits or vegetables; candy, cookies, or cake; soda or sports drinks; milk. Procedure Orthodontic offices were recruited from listings in orthodontist directories, local yellow pages, and electronic search engines. Orthodontic patients were then recruited from participating offices by a letter from the orthodontist describing the study, followed by a telephone call from research staff for consenting families. Upon completion of the baseline surveys, participants were reimbursed for study participation. METHODS Data analyses were conducted using cross-sectional baseline data collected by the Healthy Smiles Program, a 5-year longitudinal research study testing a multicomponent intervention designed to increase physical activity, reduce sedentary practices, and promote healthy diets among youth. The intervention was conducted in orthodontic offices in Orange, Riverside, and San Diego counties. Data Analysis Analyses were performed using SPSS version 19.0 (SPSS, Inc., 2012). Availability of vending machines and school stores, and frequencies of food items in vending machine and school stores were computed separately for private and public schools because USDA and California governmental food policies in regard to FMNV apply to public but not private schools, and the NSLP is only for public schools. Owing to data skew, Mann-Whitney U tests were used to assess differences by type of school, and Spearman rankorder correlations were used to evaluate associations of availability of items in vending machines and school stores with (1) participant purchase of items from those sources, and (2) the number of the participant’s friends who consumed these food items at lunchtime. Participants Participants were 521 preteens and teens 815 years of age receiving orthodontic treatment and their parents, who consented to participation between January 2010 and March 2013. Preteens who participated in organized sports or activities 3 or more days per week for 9 or more months a year, had severe medical conditions that hindered physical activity, required highly specialized diets, had less than 1 year left in treatment, or planned to move within the next 18 months were excluded from participation. Preteens participating in organized sports or activities were excluded because their high level of exercise left little room for improvement. Youth who were home-schooled were also excluded from the current analyses. RESULTS Characteristics of respondents are presented in Table 1. Participants were 55.1% female, ranging in age from 8 to 15 years. Fifty-one percentage identified as white, non-Hispanic; 25.9% identified as Hispanic. The majority (73.3%) of the sample was of normal weight and over half (59.1%) were middle school students. Availability of vending machines and school stores in schools is presented in Table 2. Either school stores or vending machines were reported available by 56.2% of respondents. Although there was a significant difference in the reported availability of vending machines between private (39.4%) and public (27.1%) schools (p < .05), the difference in availability Instruments During home visits both parent and child completed self-administered questionnaires. Parents answered questions about their child’s race, Hispanic ethnicity, sex, and age. Child participants were asked where they could buy food/snacks or drinks at school other than the cafeteria. Response options were vending machine; school store; food/drinks are only sold in the cafeteria; none of these things are at my school. Children were 50 • Journal of School Health • January 2016, Vol. 86, No. 1 • © 2015, American School Health Association Table 1. Characteristics of Respondents (N = 521) Reporting on 339 Schools Characteristics N Sex Male Female Age in years, mean (SD) Hispanic Native American Asian Pacific Islander Black/African American White/Caucasian Multi-racial Not specified Non-Hispanic Native American Asian Pacific Islander Black/African American White/Caucasian Multiracial Not specified Body mass index (BMI)∗ Underweight (≤5th percentile) Normal weight (5th to 85th percentile) Overweight (85th to 95th percentile) Obese (≥95th percentile) School type Public Private School classification Elementary school Middle school High school Percent 234 287 44.9 55.1 12.0 (1.7) 0 1 0 4 55 3 72 0.0 0.7 0.0 3.0 40.7 2.2 53.3 1 33 3 13 266 34 7 0.3 9.2 0.8 3.6 74.5 9.5 2.0 23 382 68 47 4.4 73.3 13.1 9 450 71 86.4 13.6 180 308 33 34.5 59.1 6.3 ∗ Age- and sex-adjusted BMI percentiles are based on the Centers for Disease Control and Prevention 2000 reference standard. Table 2. Student Reported Availability of Vending Machines and School Stores by Public vs. Private School Participants who Participants who reported reported the the availability Participants availability of school (N = 521) vending machines∗ of school stores School type Public Private N N % N % 450 71 122 28 27.1 39.4 213 31 47.3 43.7 ∗ Percentages are significantly different by school type, p = .03. of school stores between private (43.7%) and public (47.3%) schools was not statistically significant. For respondents who reported the presence of vending machines and school stores on campus, Table 3 presents the percentage of those respondents reporting that a specific type of food item was available. The 521 respondents in our sample reported on 339 different schools, therefore in a number of instances Journal of School Health • Table 3. Student Reported Availability of Food Items in Vending Machines and School Stores by Public vs. Private School Schools having vending machines Schools having school stores Public Private Public Private (N = 122) (N = 28) (N = 213) (N = 31) (%) (%) (%) (%) FMNV 1. Ice cream/frozen yogurt 2. Cookies/cake 3. Candy 4. French Fries 5. Chips 6. Soda 7. Sports drink 8. Energy drink Healthy items 1. Water 2. Milk 3. Fruit 4. Yogurt 5. Vegetables 6. Cheese 11 35 37 1 66 20 69 1 7 36 43 0 68 46 82 14 45 66 27 5 75 19 69 5 32 42 52 7 68 26 68 7 80 14 12 3 3 5 89 14 11 4 4 0 80 35 37 14 11 17 71 26 29 19 16 3 more than one respondent reported on a given school. The most prevalent food items in vending machines and school stores in both types of schools were predominately FMNV. The most frequently reported FMNV were sports drinks (range: 68-82%), chips (range: 66-75%), and candy, cookies and cakes (range: 27-66%). Soda was also frequently available in private school vending machines (46%). Of healthy items, a high prevalence of water was reported in vending machines and school stores in both types of schools (range: 71-89%). For schools having either vending machines or a school store, 33.9% of respondents attending public schools, and 35.6% attending private schools, reported purchasing food items from these sources in the last week. Considering both types of schools together, the most frequently purchased item was water. The other 5 healthy food items—yogurt, cheese, fruits, milk, and vegetables—were all purchased less often than any of the 8 FMNV items except for french fries and energy drinks. Participant report of availability of items in vending machines and/or school stores was correlated (p < .01) with participant purchase of items from those sources for 10 of the 14 items. The 4 exceptions were energy drinks, milk, fruits, and vegetables. We also tested associations of the number of one’s friends who consumed items in each of 6 categories of foods at lunchtime—3 categories of FMNV and 3 categories of healthy foods—with the availability of items in a given category in either vending machines or school stores. Only 2 categories of items were significantly correlated—candy, cookies, January 2016, Vol. 86, No. 1 • © 2015, American School Health Association • 51 or cake (p = .017); and soda or sports drinks (p < .001). The chips or french fry category was near-significant (p = .072), as was fruits or vegetables (p = .054). factor to consider is that school stores and vending machines play a fiscal role for schools. There has been a recent trend of school districts negotiating exclusive ‘‘pouring rights’’ contracts with soft drink companies.22 Many of these contracts have provisions to increase the percentage of profits schools receive when sales volume of competitive foods increases. According to the BEM, such contracts are reinforcing social contingencies for increasing sugar-sweetened beverages. Availability of FMNV in school vending machines and/or school stores was associated with participant purchase of the food items from those sources. Also, availability of most FMNV in vending machines and/or school stores correlated with participants’ friends’ consumption of those FMNV during lunch. Previous studies showed that students’ food purchases at school were associated with availability of snack machines,23 and that students who had access to FMNV in vending machines and/or school stores tended to choose those items instead of healthier food choices.19,23 Furthermore, participant purchase of soda or sports drinks and milk from vending machines and school stores was significantly associated with friends’ consumption of these items during lunch time. Although it is uncertain how much reducing the availability of FMNV in schools may impact childhood obesity, our findings support policies that restrict or eliminate FMNV from school vending machines and school stores. DISCUSSION Owing to increasing rates of childhood and adolescent obesity, attention has been paid to the impact of vending machines on students’ health status.18 Our results suggested that California private schools have more vending machines than public schools. This is not surprising, as private schools are exempt from complying with competitive food and beverage regulations. The types of competitive food items most frequently available in vending machines regardless of school type were predominantly FMNV despite legislative attempts to limit FMNV in both private and public school settings. These results are consistent with those of comparable studies.19,20 Although studies have been conducted to examine the role of vending machines in US schools, the role of school stores has largely been neglected. In our study, school stores were reported more frequently than vending machines for both school types, in contrast to data from prior studies.9,21 As with vending machines, the competitive foods available from school stores were primarily FMNV. It is possible that California restrictions on vending machine content have increased the popularity of school stores in comparison to vending machines. In the United States prior to the HHFK Act of 2010, most policies restricting competitive food items in schools applied only to vending machines. For example, on July 1, 2004, California Senate Bill 677 (Chapter 415) banned the sales of carbonated beverages in vending machines in elementary, middle, and junior high schools, and replaced them with milk, water, and juice. The Senate bill also limited accessibility of vending machines in middle and junior high schools from one-half hour before the start of the school day to one-half hour after the end of the school day.15 Even though this bill was established to promote healthy eating among students, it still exempted the sales of certain beverages at specified school events and failed to ban sales of such items in school stores. In the United States, the most frequently available item in school stores and vending machines was water. The availability of sports drinks was also reported frequently. With passage of the new legislation, schools may have replaced carbonated beverages with water and sports drinks. The potential contributions of sports drinks to childhood obesity should be considered in future research. Future legislation banning other FMNV from school venues has the potential to initiate the replacement of FMNV with healthier food items, as may have occurred with the ban of carbonated beverages. In the current US economy, an important 52 • Journal of School Health • January 2016, Vol. 86, No. 1 Limitations Our survey did not ask participants what food items they saw their friends purchase from vending machines and/or school stores. In addition, we did not ask participants if they had access to vending machines or school stores during their mealtime. Therefore, we do not know to what extent participants and their friends actually purchased and ate snacks from these sources. Drawing the conclusion that vending machines/school stores are instrumental in student’s poor dietary intake is premature. The sample was drawn from orthodontist offices; therefore, the youth in this study and the schools they attended may not be representative of the overall population of school children or of schools. Larger samples of students drawn from each of a random sample of schools would provide a more accurate indication of food item prevalence. In addition, it is important to note that data from this research study were collected during ongoing changes in school nutritional policies. Conclusions We found that FMNV were still available in many schools after the Child Nutrition and WIC Reauthorization Act of 2004, and that schoolchildren • © 2015, American School Health Association were more likely to purchase FMNV when they were available in vending machines and school stores. Further research is needed to determine the effect of the HHFK Act of 2010 on US school food services, to understand the impact of school policies on the eating practices of children better. IMPLICATIONS FOR SCHOOL HEALTH Schools play an important role in combatting childhood obesity. The Child Nutrition and WIC Reauthorization Act of 2004 was implemented to address less healthy foods in schools. However, our study indicates that FMNV were still available in vending machines and school stores after its implementation. This access to FMNV increases the likelihood that students purchase and consume food items that promote obesity. The HHFK act of 2010 reauthorized the Child Nutrition programs, and allowed the USDA Secretary to establish regulations based on science-based nutrition standards for all foods sold in schools, to more effectively address the problem of FMNV.7 Prior to this legislation the USDA secretary did not have authority to regulate food requirements for foods sold outside the NSLP and School Breakfast Program. More recent amendments to the HHFK act have set new standards to further limit accessibility to FMNV; however, the policies still exempt afterschool events and fund-raising activities not occurring in food service areas during meal periods.15 To have maximum impact on child health, the ban on unhealthy foods should apply to the entire school environment. It is critical that policy makers and school personnel work together to find sources of revenue other than sales of FMNV at school activities to address the financial needs of schools. Human Subjects Approval Statement This study was reviewed and approved by San Diego State University Institutional Review Board. REFERENCES 1. World Health Organization. Childhood overweight and obesity. Available at: http://www.who.int/dietphysical activity/childhood/en/. Accessed January 20, 2013. 2. Centers for Disease Control and Prevention. Overweight and obesity. Available at: http://www.cdc.gov/obesity/ data/childhood.html. Accessed January 23, 2013. 3. National Center for Educational Statistics. Public school enrollment. Available at: http://nces.ed.gov/programs/ coe/indicator_cga.asp. Accessed on November 1, 2014. 4. National Center for Educational Statistics. Private school enrollment. Available at: http://nces.ed.gov/programs/coe/ indicator_cgc.asp. Accessed on November 1, 2014. 5. United States Department of Agriculture. National School Lunch Program: participation and lunches served. Available at: http://www.fns.usda.gov/cnd/Lunch/AboutLunch/Program History.htm. Accessed February 2, 2013. Journal of School Health • 6. Fox M, Gordon A, Nogales R, Wilson A. Availability and consumption of competitive foods in US public schools. J Am Diet Assoc. 2009;109(suppl. 2):S57-S66. 7. United States Department of Agriculture. Healthy-Hunger Free Kids Act of 2010. Available at: http://www.fns.usda.gov/ cnd/governance/legislation/cnr_2010.htm. Accessed March 30, 2013. 8. Centers for Disease Control and Prevention. Competitive foods and beverages in U.S. schools. Available at: http://www.cdc.gov/healthyyouth/nutrition/pdf/compfoods booklet.pdf. Accessed on February 2, 2013. 9. Johnston LD, O’Malley PM, Terry-McElrath YM, Colabianchi N. School Policies and Practices to Improve Health and Prevent Obesity: National Secondary School Survey Results. Available at: http://www.bridgingthegap research.org/_asset/gqq408/SS_2013_report.pdf. Accessed on November 10, 201. 10. Pasch K, Lytle L, Samuelson A, Farbakhsh K, Kubik M, Patnode C. Are school vending machines loaded with calories and fat: an assessment of 106 middle and high schools. J Sch Health. 2011;81(4):212-218. 11. Rovner A, Nansel T, Wang J, Iannotti R. Food sold in school vending machines is associated with overall student dietary intake. J Adolesc Health. 2011;48(1):13-19. 12. Park S, Sappenfield W, Huang Y, Sherry B, Bensyl D. The impact of the availability of school vending machines on eating behavior during lunch: the Youth Physical Activity and Nutrition Survey. J Am Diet Assoc. 2010;110(10):1532-1536. 13. Minaker L, Storey K, Raine K, et al. Associations between the perceived presence of vending machines and food and beverage logos in schools and adolescents’ diet and weight status. Public Health Nutr. 2011;14(8):1350-1356. 14. Center for Disease Control and Prevention. Results from the School Health Policies and Practices Study 2012. Available at http://www.cdc.gov/healthyyouth/shpps/2012/pdf/shppsresults_2012.pdf. Accessed November 10, 2014. 15. United States Department of Agriculture. Federal Register 2013. Available at: http://www.gpo.gov/fdsys/pkg/FR-201306-28/pdf/2013-15249.pdf. Accessed July 11, 2013. 16. California Department of Education. Competitive food and beverages sales in schools. Available at: http://www.cde.ca.gov/ ls/nu/he/compfoodsreq.asp. Accessed February 2, 2013. 17. Hovell MF, Wahlgren DR, Adams MA. The logical and empirical basis for the behavioral ecological model. In: DiClemente RJ, Crosby R, Kegler M, eds. Emerging Theories and Models in Health Promotion Practice and Research. 2nd ed. San Francisco, CA: Jossey-Bass Publishers; 2009:415-449. 18. Centers for Disease Control and Prevention. Availability of less nutritious snack foods and beverages in secondary schools—selected states, 2002-2008. MMWR Morb Mortal Wkly Rep. 2009;58(39):1102-1104. 19. Caruso M, Klein E, Kaye G. Campus-based snack food vending consumption. J Nutr Educ Behav. 2014;46(5):401-405. 20. Kakarala M, Keast D, Hoerr S. School children’s consumption of competitive foods and beverages, excluding a la carte. J Sch Health. 2010;80(9):429-435. 21. Johnston LD, O’Malley PM, Terry-McElrath YM, Colabianchi N. School policies and practices to improve health and prevent obesity: National Secondary School Survey results. Available at http://www.bridgingthegapresearch.org/_asset/gqq408/SS_ 2013_report.pdf. Accessed November 10, 2014. 22. Robert Wood Johnson Foundation. National Nutrition Standards for Snack and a la Carte Foods and Beverages Sold in Schools. Available at: http://www.pewtrusts.org/ ∼/media/Assets/2012/06/26/REV_HIA_-FULL-FINALWEB090712.pdf. Accessed November 10, 2014. 23. Thompson O, Yaroch A, Moser R, Finney Rutten L, Agurs CT. School vending machine purchasing behavior: results from the 2005 Youth Styles Survey. J Sch Health. 2010;80(5):225-232. January 2016, Vol. 86, No. 1 • © 2015, American School Health Association • 53 Copyright of Journal of School Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
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Surname 1
Name
Prof
Course
Date
Literature Reviews
Source
Raposo, António, et al. "VENDING MACHINE FOODS: EVALUATION OF NUTRITIONAL
COMPOSITION." Italian Journal of Food Science 28.3 (2016).
Summary
The study took into consideration the nutritional composition of foods from vending machines in
relation to Gran Canaria population consumption. The nutritional quality of foods from vending
machines contributes to the increased obesity cases as well as associated diseases. The
sandwiches had lowest energy levels while the croissants were found to contain highest energy
levels. The food stuffs in vending machines contain saturated fat and calories than
recommended.
Authors’ information
Antonio Raposo is a research associate at Center for Interdisciplinary Research in Caparica,
Portugal
Carrascosa, Conrado is a distinguished professor at the Department of Animal Pathology and
production, Bromatology and Food Technology in the University of Las Palmas.

Surname 2
Tavares Ana is a professor at the school of health Sciences and Technologies in the University of
Lusofona, Portugal
Saavedra Pedro is a mathematics professr at the university of Las Palmas
Rafael Millan is a distinguished professor at the Department of Animal Pathology and
production, Bromatology and Food Technology in the University of Las Palmas.

Unfamiliar vocabulary
Cuisine- cooking method
Baguettes- loaf
Quotes and meaning
➢ Vending machines reflect the good availability...


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