Impact of competitive foods in public schools on child nutrition: effects on adolescent obesity in the United States an integrative systematic literature review

Background: The United States (US) is currently facing a public health crisis due to the percentage of obesity in adolescents. The Center for Disease Control (CDC) stated the risks for children due to obesity are many. Adolescents obtain a large portion of their daily caloric intake at school; therefore, what foods/drinks they are consuming is so serious. Objective: To identify and analyze literature on the effects of competitive foods in public schools on adolescent weight, or Body Mass Index (BMI), and possible impacts they may have on adolescent obesity in the United States. Methods: An integrative systematic review of literature was conducted. The literature was collected in CINAHL, MEDLINE and EMBASE databases. Refined keyword search is further detailed in the report. Year restrictions were 2006–2017 from peer-reviewed journals and published in English, including adolescents 13–18 years old in the US. Criteria for inclusion targeted at least one of (1) sugar-sweetened beverages (SSB), (2) competitive foods, (3) commercial foods, (4) vending machines, (5) al a carte venues, and (6) school stores, examining their associations with weight measurements, using either weight or BMI, or caloric intake analysis. Results: A total of 164 articles were detected and assessed, for a final analysis of 34 full text articles. Twenty-six articles met the inclusion criteria. Common aspects of interest involved BMI/Obesity/Weight (73%), (58%) examined Calorie density or consumption, (77%) discussed the Availability of competitive foods in schools, (54%) included Analysis of competitive food, beverage and nutrition policies, and (69%) addressed Other effects. Conclusion: This review discovered substantial evidence that competitive foods are highly available in schools, however, lacking in robust evidence proving causality in increasing BMI or weight. There is strong corroboration in the research revealing that Other effects are factors worthy of studying further. Additional longitudinal and higher-quality research needs to be performed.