[Impact of an intervention improving the food supply (excluding school meals) with educational support in middle and high schools].

Within the Nutrition, Prevention, and Health Program for children and teenagers in Aquitaine, an experimental intervention was implemented in 2007-2008 in the middle and high schools in Aquitaine (southwest France). This intervention aimed to improve the eating habits of adolescents, combining actions to improve the food supply sold during recreational times (remove/limit fat and sugar products sold and promote the sale of fruits and bread) and health education actions to make adolescents aware of the concept of nutritional balance and steer their choice towards recommended products. The aim of this paper was to evaluate the impact of the intervention on the eating behavior of adolescents and the food supply sold during recreational times in middle and high schools in Aquitaine. A survey was conducted before and after the implementation of the intervention in seven middle and high schools that have implemented actions (intervention group) and eight middle and high schools that have not implemented actions (control group). In these schools, 1602 adolescents answered the survey before and 1050 after the intervention (samples were independent because of the anonymity of responses). The impact of the intervention on the dietary behavior of teenagers was modeled using logistic regression adjusted on potential confounding variables (sex, age, and educational status). In multivariate analyses, the intervention was associated with more frequent daily intake of breakfast (OR=2.63; 95% CI [1.89; 3.66]) and lower intake of morning snacks (OR=0.66; 95% CI [0.48; 0.90]), higher consumption of starchy foods (OR=1.77; 95% CI [1.30; 2.42]), bread at breakfast, morning snacks, and a light afternoon meal (OR=1.43; 95% CI [1.07; 1.90]), and the food supply sold at recreational times (OR=1.34 95% CI [1.01; 1.78]). These results show that the "Improving food supply in middle and high schools associated with educational support actions" project led to the sales of recommended foods during recreational times and improved students' eating behavior. These results encourage partners to pursue these actions in all volunteer middle and high schools.