***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Aims : The aim of this pilot study was to investigate the feasibility and effectiveness of placing water coolers on sugar-sweetened beverage sales at secondary schools ( age 12–18 years ) in the city of Zwolle , the Netherl and s. Methods : Six schools , hosting 5,866 pupils , were divided in three intervention and three control schools . In the intervention schools , water coolers were placed in the canteen . Hidden observations were performed in one school to study the intervention ’s feasibility , and school personnel was interviewed . Beverage sales were monitored before and during the intervention . After the intervention period , 366 class 1 and 2 pupils completed a question naire about their drinking habits ( response rate 81 % ) . Results : Placement of water coolers appeared to be a feasible intervention at secondary schools . However , it did not affect sales of sugar-sweetened beverages at schools . Although mean intake of sugar-sweetened beverages at school was high , more than 500 ml/day for boys , and more than 250 ml/day for girls , only a minority of these quantities was purchased at school . Conclusion : We conclude that placing water coolers as a single-issue intervention in secondary school canteens should not be prioritized in the combat against obesity Aims : To estimate the impact of school fruit tuck shops on  children ’s consumption of fruit and sweet and savoury snacks . Design : Cluster r and omised effectiveness trial with school as the unit of r and omisation . Setting : 43 primary schools in deprived areas in south Wales and south-west Engl and with a range of school food policies . Intervention : Schools operated fruit tuck shops throughout one academic year . Control schools did not do so . Measures : Repeated cross-sections of children aged 9–11 years completed a  computerised 24-hour recall question naire  at baseline ( n = 1902 ) and at 1-year follow-up ( n = 1924 ) , when a brief question naire was also completed ( n = 1976 ) . Results : Approximately 70 000 fruits were sold in the 23 intervention schools over the year , equivalent to 0.06 fruits per student per day . Children in intervention schools were more likely to report eating fruit as a snack at school ‘ often ’ ( OR 1.49 , 95 % CI 1.15 to 1.95 ) . There were no significant differences in children ’s intake of fruit or other snacks . There was a significant interaction ( p<0.02 ) between the intervention group and school food policy : where students were only allowed to bring fruit to school , fruit consumption was 0.37 portions per day ( 0.11 to 0.64 ) higher in intervention schools , compared to 0.14 portions ( −0.30 to 0.58 ) where no food was allowed and −0.13 portions ( −0.33 to 0.07 ) where there were no restrictions . Conclusions : In isolation , fruit tuck shops were not effective in changing children ’s snacking behaviour in schools . However , the results suggest that fruit tuck shops had a greater impact when reinforced by school policies restricting the types of foods students were allowed to bring to school OBJECTIVE . The study tested whether a combined environmental and educational intervention solely promoting water consumption was effective in preventing overweight among children in elementary school . METHODS . The participants in this r and omized , controlled cluster trial were second- and third- grade rs from 32 elementary schools in socially deprived areas of 2 German cities .  Water fountains were installed and teachers presented 4 prepared classroom lessons in the intervention group schools ( N = 17 ) to promote water consumption .  Control group schools ( N = 15 ) did not receive any intervention . The prevalence of overweight ( defined according to the International Obesity Task Force criteria ) , BMI SD scores , and beverage consumption ( in glasses per day ; 1 glass was defined as 200 mL ) self-reported in 24-hour recall question naires , were determined before ( baseline ) and after the intervention . In addition , the water flow of the fountains was measured during the intervention period of 1 school year ( August 2006 to June 2007 ) . RESULTS . Data on 2950 children ( intervention group : N = 1641 ; control group : N = 1309 ; age , mean ± SD : 8.3 ± 0.7 years ) were analyzed . After the intervention , the risk of overweight was reduced by 31 % in the intervention group , compared with the control group , with adjustment for baseline prevalence of overweight and clustering according to school . Changes in BMI SD scores did not differ between the intervention group and the control group . Water consumption after the intervention was 1.1 glasses per day greater in the intervention group . No intervention effect on juice and soft drink consumption was found . Daily water flow of the fountains indicated lasting use during the entire intervention period , but to varying extent . CONCLUSION . Our environmental and educational , school-based intervention proved to be effective in the prevention of  overweight among children in elementary school , even in a population from socially deprived areas OBJECTIVE To measure the effect of a  school fruit and vegetable subscription  on  children 's intake of fruit and vegetables after 5 weeks of intervention . SETTING Seven primary schools in Denmark . DESIGN AND METHODS Intervention schools ( n=4 ) were offered a fruit and vegetable subscription comprising one piece per day . Control schools situated in another municipality were not offered the subscription . Intake of fruit and vegetables was measured at baseline and 5 weeks after the start of the subscription . Two methods were used for dietary assessment : a pre-coded 24-hour recall form including total food intake and a food-frequency question naire ( FFQ ) including only fruit and vegetables . SUBJECTS Children aged 6 - 10 years ( n=804 from intervention schools and n=689 from control schools ) . Response rate in the dietary assessment was 31 % . RESULTS At intervention schools 45 % of the children enrolled in the subscription . After 5 weeks of intervention , both subscribers and non-subscribers had increased their intake of fruit by 0.4 ( P=0.019 ) and 0.3 ( P=0.008 ) pieces per school day , respectively , but no change was observed in vegetable intake . Total intake increased only for non-subscribers by 0.4 piece/school day ( P=0.008 ) mainly due to the consistent increase in fruit intake . No change in intake was measured at control schools . Only the 24-hour recall question naire was sensitive enough to pick up the changes of the subscription , whereas the FFQ was not . CONCLUSION Five weeks with the subscription affected both subscribers and non-subscribers to increase intake of fruit . This may indicate that the subscription had an additional effect of stimulating parents of non-subscribers to supply their children with fruit . The results stress the importance of evaluating the effect of this type of programme , and the carefulness needed in design ing the evaluation study Out-of-school-time programs serve snacks to millions of children annually . State and national snack policies endorse serving more-healthful options , such as fruits , yet often allow less-healthful options , such as cookies and chips , to be served simultaneously . To date , no studies have examined the choices children make when provided with disparate snack options in out-of-school-time programs . An experimental study with r and omized exposures was conducted that exposed children ( 5 to 10 years old ) to the following conditions : whole or sliced fruit ; whole/sliced fruit , sugar-sweetened snacks ( eg , cookies ) and flavored salty ( eg , nacho cheese-flavored tortilla chips ) snacks ; and whole/sliced fruit and less-processed/unflavored grain snacks ( eg , pretzels ) , during a 2-week period representing 18 snack occasions ( morning and afternoon ) during summer 2013 . The percentage of children who selected snacks , snack consumption , and percent of serving wasted were calculated and analyzed using repeated- measures analyses of variance with Bonferroni adjustments . A total of 1,053 observations were made . Sliced fruit was selected more than whole fruit across all conditions . Fruit ( sliced or whole ) was seldom selected when served simultaneously with sugar-sweetened ( 6 % vs 58 % ) and flavored salty ( 6 % vs 38 % ) snacks or unflavored grain snacks ( 23 % vs 64 % ) . More children consumed 100 % of the sugar-sweetened ( 89 % ) and flavored salty ( 82 % ) snacks compared with fruit ( 71 % ) ; 100 % consumption was comparable between fruit ( 59 % ) and unflavored grain snacks ( 49 % ) . Approximately 15 % to 47 % of fruit was wasted , compared with 8 % to 38 % of sugar-sweetened , flavored salty , and unflavored grain snacks . Snack policies that encourage out-of-school-time programs to serve fruit require clear language that limits offering less-healthful snack options simultaneously Objective : Two studies examined the hypothesis that making snacks less accessible contributes to the regulation of food intake . Study 1 examined whether decreasing the accessibility of snacks reduces probability and amount of snack intake . The aim of Study 2 was to replicate the results and explore the underlying mechanism in terms of perceived effort to obtain the snack and perceived salience of the snack . Methods : In Study 1 ( N = 77 ) and Study 2 ( N = 54 )  distance to a bowl of snacks was r and omly varied at 20 , 70 or 140 cm in an experimental between-subjects design . Main outcome measures were the number of people who ate any snacks ( probability of snack intake ) , the amount of snacks consumed and risk of compensatory behaviour as measured by food craving . In Study 2 , self-report ratings of salience and effort were examined to explore potential underlying mechanisms . Results : Study 1 showed lower probability and amount of intake in either of more distant conditions ( 70 and 140 cm ) compared to the proximal condition ( 20 cm ) , with no unintended effects in terms of increased craving . Study 2 replicated the results of Study 1 and showed that distance affected perceived effort but not salience . Conclusions : Making snacks less accessible by putting them further away is a potentially effective strategy to decrease snack intake , without risk of compensatory behaviour OBJECTIVE To assess the impact of a school-based nutrition education intervention aim ed at increasing the consumption of fruits and vegetables . DESIGN The intervention programme increased the provision of fruits and vegetables in schools and provided a range of point-of-purchase marketing material s , newsletters for children and parents , and teacher information . Curriculum material s at age 6 - 7 and 10 - 11 years were also developed and utilised . Evaluation was undertaken with groups of younger ( aged 6 - 7 years ) and older ( aged 10 - 11 years ) children . Methods included 3-day dietary records with interview and cognitive and attitudinal measures at baseline , with follow-up at 9 months , in intervention and control schools . SETTING The work was undertaken in primary schools in Dundee , Scotl and . SUBJECTS Subjects comprised 511 children in two intervention schools with a further 464 children from two schools acting as controls . RESULTS Children ( n=64 ) in the intervention schools had an average increase in fruit intake ( 133+/-1.9 to 183+/-17.0 g day(-1 ) ) that was significantly ( P<0.05 ) greater than the increase ( 100+/-11.7 to 107+/-14.2 g day(-1 ) ) estimated in children ( n=65 ) in control schools . No other changes in food or nutrient intake were detected . Increases in scores for variables relating to knowledge about fruits and vegetables and subjective norms were also greater in the intervention than in the control group , although taste preferences for fruits and vegetables were unchanged . CONCLUSIONS It is concluded that a whole school approach to increasing intakes of fruits and vegetables has a modest but significant effect on cognitive and attitudinal variables and on fruit intake BACKGROUND Restricting children 's access to palatable foods may appeal to parents as a straightforward means of promoting moderate intakes of foods high in fat and sugar ; however , restricting access to palatable foods may have unintended effects on children 's eating . The efficacy of restricting children 's access to palatable foods as a means of promoting patterns of moderate intake of those foods is unknown . OBJECTIVE Two experiments were conducted to test the hypothesis that restricting access to a palatable food enhances children 's subsequent behavioral responses to , selection of , and intake of that restricted food . DESIGN Both experiments used a within-subjects design to examine the effects of restricting access to a palatable food on children 's subsequent behavior , food selection , and food intake . The first experiment examined the effects of restriction within and outside the restricted context and the second experiment focused on the effects within the restricted context . RESULTS In both experiments , restricting access to a palatable food increased children 's behavioral response to that food . Experiment 2 showed that restricting access increased children  's subsequent selection and intake of that food within the restricted context . CONCLUSIONS Restricting access focuses children 's attention on restricted foods , while increasing their desire to obtain and consume those foods . Restricting children 's access to palatable foods is not an effective means of promoting moderate intake of palatable foods and may encourage the intake of foods that should be limited in the diet BACKGROUND Secondary school students often do not drink sufficient quantities of water during the school day to prevent dehydration , promote learning and good health . The study aim ed to measure the effect of health promotion and the free provision of cooled filtered water on the consumption of water and soft drinks . It also aim ed to explore students ' views of drinking water provision . METHODS A study was conducted with three secondary schools in North Tyneside . Over a 3 month period one school was given cooled filtered water and 
    Output:
    
Authors ' conclusions The current evidence suggests that changing the number of available food options or altering the positioning of foods could contribute to meaningful changes in behaviour , justifying policy actions to promote such changes within food environments .