title: Effects of a healthy food supply intervention in a military setting: positive changes in cereal, fat and sugar containing foods.
abstract: BACKGROUND
  In Finland, all men are liable to military service and a clear majority completes service. The increasing prevalence of obesity also among soldiers concerns conscripts' food choices. Conscripts are served nutritionally planned regular main meals but individual choices take place in free-time eating. This study assesses the effects in conscripts' eating habits in an intervention targeting the supply of healthy foods available in the military setting.
  
  
  METHODS
  Participants were 604 18-21-year old male conscripts of whom 242 belonged to Control Group and 362 to Intervention Group. Participants of Control Group were historical controls performing military service one year before Intervention Group. The intervention targeted selection, placement, and attractiveness of healthy foods in garrison refectories and soldier's home cafeterias, the two main food providers in the military. Dietary intake data was collected by self-administered questionnaire at three time points: before/beginning of military service (T0), 8 weeks (T1) and 6 months (T2) of military service. Outcome measures were food consumption frequencies and four dietary indexes (Cereal Index, Fruit and Vegetable Index, Fat Index and Sugar Index) developed to characterize the diet. Changes between study groups in outcome variables and in time were analysed by repeated-measures analysis of covariance.
  
  
  RESULTS
  Significant (p < 0.05) intervention effects and time-intervention interactions mostly in favor of Intervention Group were found. In Intervention Group, Cereal Index was significantly higher at T2 and the overall level of porridges and cereals was higher during follow-up when comparing to Control Group. Also, the overall levels of Fat Index, potato chips, soft drinks and desserts as well as sweet pastries at T1 were significantly lower in Intervention Group. At the same time, Fruit and Vegetable Index and the level of fruit and berries were lower in Intervention Group during follow-up.
  
  
  CONCLUSIONS
  In the military setting, healthier food choices can be promoted by intervening on the main food environments by improving the supply of healthy foods. However, impacting on conscripts' individual selection as fruit and vegetable consumption is more challenging.
authors: Health Behavior and Health Promotion Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, FI-00271, Helsinki, Finland. clarissa.bingham@thl.fi
authors: Clarissa M L
authors: CM
authors: Bingham
authors: Marjaana
authors: M
authors: Lahti-Koski
authors: Pauli
authors: P
authors: Puukka
authors: Marja
authors: M
authors: Kinnunen
authors: Piia
authors: P
authors: Jallinoja
authors: Pilvikki
authors: P
authors: Absetz
mesh_terms: D000293:Adolescent; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage; D019422:Dietary Sucrose / Q000008:administration & dosage; D002523:Edible Grain; D005247:Feeding Behavior / Q000523:psychology; D005387:Finland / Q000453:epidemiology; D005522:Food Services / Q000592:standards*; D005523:Food Supply / Q000592:standards* / Q000706:statistics & numerical data; D005638:Fruit; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D016272:Occupational Health; D011795:Surveys and Questionnaires; D014675:Vegetables; D055815:Young Adult
chemical_list: D004041:Dietary Fats; D019422:Dietary Sucrose