Farm to Elementary School Programming Increases Access to Fruits and Vegetables and Increases Their Consumption Among Those With Low Intake

ObjectiveTo assess the effectiveness of Wisconsin Farm to School (F2S) programs in increasing students' fruit and vegetable (FV) intake.DesignQuasi-experimental baseline and follow-up assessments: knowledge and attitudes survey, food frequency questionnaire (FFQ), and lunch tray photo observation.SettingWisconsin elementary schools: 1 urban and 8 rural.ParticipantsChildren, grades 3–5 (n = 1,117; 53% male, 19% non-Caucasian).Intervention(s)Farm to School programming ranging from Harvest of the Month alone to comprehensive, including school garden, locally sourced produce in school meals, and classroom lessons.Main Outcome MeasuresKnowledge, attitudes, exposure, liking, willingness; FFQ-derived (total), and photo-derived school lunch FV intake.Analysist tests and mixed modeling to assess baseline differences and academic-year change.ResultsHigher willingness to try FV (+1%; P < .001) and knowledge of nutrition/agriculture (+1%; P < .001) (n = 888), and lunch FV availability (+6% to 17%; P ≤ .001) (n = 4,451 trays), both with increasing prior F2S program exposure and across the year. There was no effect on overall dietary patterns (FFQ; n = 305) but FV consumption increased among those with the lowest intakes (FFQ, baseline very low fruit intake, +135%, P < .001; photos: percentage of trays with no FV consumption for continuing programs decreased 3% to 10%, P ≤ .05).Conclusions and ImplicationsFarm to School programming improved mediators of FV consumption and decreased the proportion of children with unfavorable FV behaviors at school lunch. Longer-term data are needed to further assess F2S programs.     

The Addition of a Plain or Herb-Flavored Reduced-Fat Dip Is Associated with Improved Preschoolers' Intake of Vegetables

This quasiexperimental study used a within-subjects experimental design to determine whether adding herbs and/or spices to a reduced-fat dip increased children's willingness to taste, liking of, and consumption of vegetables. Participants were preschool children aged 3 to 5 years who attended a child-care center in Central Pennsylvania in late 2008 and early 2009. First, children's familiarity with and liking of six raw vegetables and five dips (reduced-fat plain, herb, garlic, pizza, and ranch) were assessed. In Experiment 1 (n=34), children tasted a vegetable they liked, one they disliked, and one they refused, with a reduced-fat plain dip and their favorite reduced-fat herb-flavored dip. In Experiment 2 (n=26 or n=27), they rated their liking of celery and yellow squash, with and without their favorite reduced-fat herb dip (pizza or ranch), and their intake of those vegetable snacks was measured. In Experiment 1, the herb-flavored dip was preferred over the plain dip (P<0.01), and children were three times more likely to reject the vegetable alone, compared with eating the vegetable paired with an herb dip (P<0.001). In Experiment 2, children ate significantly more of a previously rejected or disliked vegetable (celery and squash) when offered with a preferred reduced-fat herb dip than when the vegetable was served alone (P<0.05). These findings suggest that offering vegetables with reduced-fat dips containing familiar herb and spice flavors can increase tasting and thereby promote liking, acceptance, and consumption of vegetables, including vegetables previously rejected or disliked.     

Nutrient intake and nutritional status indicators of participant and nonparticipant pupils of a parent-supported school lunch program in Kenya

ObjectiveTo compare nutrient intake and indicators of nutritional status of western Kenyan pupil participants and nonparticipants of a parent-supported school lunch program.DesignPupils and their caregivers were interviewed to assess their 24-hour dietary intake and the socioeconomic status of the family. Pupils' weights and heights were measured.SettingEight randomly selected schools with parent-supported school lunch programs in Emuhaya, western Kenya.Participants320 pupils aged between 10 and 12 years in Standard 5 and Standard 6 were disaggregated into school lunch participants (n = 160) and nonparticipants (n = 160).Main Outcome MeasuresPupils' energy and protein intake; nutritional status indicators; household socioeconomic characteristics.AnalysisIndependent t test for comparison of group means; chi-square for socioeconomic characteristics. Level of significance was P = .05.ResultsEnergy and protein consumption of participants was higher than that of the nonparticipants. Severe underweight, severe stunting, and severe wasting were significantly higher among the nonparticipants. Hunger and a higher absenteeism rate from school were more commonly reported among the nonparticipants.Conclusions and ImplicationsThis study demonstrates the interaction of poverty, nutrition status, and education. To improve the nutritional status and academic performance of the students whose parents cannot afford to participate in school lunch programs, funding from external sources is essential.     

Child Involvement in Choosing a Recipe,Purchasing Ingredients,and Cooking at School Increases Willingness to Try New Foods and Reduces Food Neophobia

ObjectiveTo investigate the effect of involving children in their feeding process (choosing a recipe, purchasing the ingredients, and cooking) on their lunch food choice in a school environment.DesignQuasi-experimental.SettingTwo schools in Bilbao, Spain.ParticipantsA total of 202 children (aged 8–9 years) participated in the study (43% girls), with 99 in the nutrition education (NE) group and 103 in the hands-on (HO) group.InterventionThree 1-hour workshops (1 workshop/wk), different for each group: HO, cooking-related activities, and NE, healthy habits promotion through nutrition education activities.Main Outcome MeasuresFood neophobia, diet quality, cooking self-efficacy and attitudes toward cooking, and food intake and selection of the experimental lunches.AnalysisChi-square test of independence, ANCOVA, and t tests were performed.ResultsStudents from the HO group selected and ate more spinach/broccoli (P < 0.001 and P = 0.02, respectively) for the first lunch; and selected more spinach/broccoli (P = 0.04) for the second lunch. After the intervention, improvements were observed for spinach liking and neophobia for the HO group and cooking self-efficacy and KidMed score for both groups.Conclusions and ImplicationsBoth interventions succeeded in improving children's diet quality, but only the HO group reduced food neophobia levels. Therefore, involving children in choosing a recipe, purchasing ingredients, and cooking may promote changing eating behaviors toward healthy habits such as increasing vegetable consumption.     

Repeated exposure in a natural setting: a preschool intervention to increase vegetable consumption

BackgroundLaboratory and home-based research suggest that repeated exposure to vegetables may increase consumption among children. Effectiveness of repeated exposure to vegetables has not been tested in a community-based preschool setting.ObjectiveThis randomized controlled trial tested the hypotheses that children who are served unfamiliar vegetables repeatedly in the preschool lunch setting will increase consumption of them, and that consumption will be influenced by peer eating behaviors and parental feeding behaviors.Subjects/settingData were collected in two private preschools in a small northeastern city in 2007. Ninety-six children (aged 3 to 6 years) participated.DesignSchools were randomly assigned to condition. During the first 6 weeks, Preschool A served three vegetables at lunch on 10 separate occasions (ie, 30 days of exposure), while Preschool B continued routine practice. In the 7th week, schools reversed conditions and Preschool B served the vegetables for the next 6 weeks. Consumption data were collected daily in the intervention school and at baseline and post-intervention meals in the control school.Primary outcomes/statistical analysesAnalysis of variance was used to examine the effect of vegetable exposure on vegetable intake; multilevel models were used to examine the effect of peer eating behaviors and parental feeding practices on vegetable intake.ResultsRepeated exposure did not increase vegetable consumption. Greater consumption by tablemates was a significant predictor of greater vegetable consumption; across the three vegetables, 1 g of peer intake was associated with roughly a 1/5-g intake increase among the subjects. Overall, children demonstrated wide fluctuation in vegetable consumption from day to day, creating as much variability within subjects as between them.ConclusionsFurther research should explore the conditions necessary for repeated exposure to increase vegetable consumption in preschool settings. Creating opportunities for young children to serve as peer models has promise as a strategy to promote vegetable consumption.     

Student Perception of Healthfulness,School Lunch Healthfulness,and Participation in School Lunch: The Healthy Communities Study

ObjectiveTo increase understanding about the healthfulness of school lunch and participation, this study measured 3 school lunch variables, students’ perception of healthfulness, objective healthfulness, and participation, and examined associations between each pair of variables (3 associations).MethodsMultilevel models were used for a secondary analysis of data from the Healthy Communities Study, a 2013–2015 observational study of schools (n = 423) and children (n = 5,106) from 130 US communities.ResultsStudents who reported that school lunches were sometimes, often, or very often healthy ate school lunches more frequently per week (β = .71; P < .001) than did students who responded never or rarely. No associations were found with objective school lunch healthfulness.Conclusions and ImplicationsStudent perception of healthfulness of school lunch is positively associated with participation but not with objective school lunch healthfulness. Understanding how student perception is associated with participation can inform effective communications to students to increase participation in the school lunch program.     

中国10个地区成年人腌制蔬菜摄入情况的流行病学特征分析

目的 描述中国慢性病前瞻性研究（CKB）队列10个地区不同种类腌制蔬菜摄入的地区、时间和人群分布特征。方法 CKB项目分别在2004-2008年、2008年和2013-2014年开展了基线调查、第一次和第二次重复调查。根据10个地区第二次重复调查对象的咸菜和酸泡菜平均摄入频率,将调查地区分为摄入咸菜为主地区、摄入酸泡菜为主地区和几乎不摄入腌制蔬菜地区。然后分别在前两组地区中运用logistic回归描述腌制蔬菜摄入的时间变化趋势和人群分布特征,并分析其他膳食特征的分布情况。结果 摄入咸菜为主地区包括青岛、哈尔滨、苏州、浙江项目点,而摄入酸泡菜为主地区包括甘肃、四川项目点,两类地区分别纳入204 036和105 573名基线调查对象。摄入咸菜为主地区在基线调查、第一次和第二次重复调查腌制蔬菜的平均摄入频率分别为3.1、3.3、1.8 d/周;摄入酸泡菜为主地区相应的频率为2.8、2.7、1.6 d/周,均呈下降趋势（P<0.001）。基线调查时两类地区的已婚、文化程度较低者腌制蔬菜摄入频率均更高;摄入咸菜为主地区年龄较大者腌制蔬菜摄入频率更高,而摄入酸泡菜为主地区相反（P<0.001）。随着腌制蔬菜摄入频率的增加,两类地区经常摄入辣食、口味偏咸等人群比例也呈增加趋势（P<0.05）。结论 CKB项目人群的腌制蔬菜摄入种类和水平存在明显的地区和人群分布差异,摄入频率呈下降趋势,且与其他膳食特征存在相关。     

Lunch,recess and nutrition: Responding to time incentives in the cafeteria

ObjectivesIn this study, we evaluate if moving recess before lunch has an effect on the amount of fruits and vegetables elementary school students eat as part of their school-provided lunch.MethodsParticipants were 1st–6th grade students from three schools that switched recess from after to before lunch and four similar schools that continued to hold recess after lunch. We collected data for an average of 14 days at each school (4 days during spring 2011, May 3 through June 1, 2011 and 9 days during fall 2011, September 19 through November 11, 2011). All of the schools were in Orem, UT. Data was collected for all students receiving a school lunch and was based on observational plate waste data.ResultsWe find that moving recess before lunch increased consumption of fruits and vegetables by 0.16 servings per child (a 54% increase) and increased the fraction of children eating at least one serving of fruits or vegetables by 10 percentage points (a 45% increase). In contrast, the schools in our control group actually experienced a small reduction in fruit and vegetable consumption during the same time period.ConclusionsOur results show the benefits of holding recess before lunch and suggest that if more schools implement this policy, there would be significant increases in fruit and vegetable consumption among students who eat school lunch as part of the National School Lunch Program.     

The CHANGE Study: A Healthy-Lifestyles Intervention to Improve Rural Children's Diet Quality

BackgroundDespite the high rates of overweight and obesity among rural children, there have been limited interventions reported to improve the diet quality of rural, low-income children in the United States.ObjectiveOur aim was to evaluate students' diet quality at baseline and after implementing the CHANGE (Creating Healthy, Active and Nurturing Growing-Up Environments) study, a 2-year (2007-2009) randomized, controlled, community- and school-based intervention to prevent unhealthy weight gain among rural school-aged children.DesignWe used a school and community-based group randomized, controlled design.Participants/settingData were collected in eight rural communities in California, Kentucky, Mississippi, and South Carolina (one elementary school per community). Children in grades 1 to 6 participated in the study (n=432; mean age=8.65 years±1.6 years). Students' diets were assessed at baseline (spring or early fall 2008) and post intervention (spring 2009) using the Block Food Screener for ages 2 to 17 years.Statistical analysesMixed-model analysis of variance was used to examine the effect of the CHANGE study intervention on students' diets. Results were adjusted for corresponding baseline dietary values, sex, age, grade, race/ethnicity, and state, with school included as a random effect nested within condition.ResultsAt the end of 1 year, students enrolled in the CHANGE study intervention schools consumed significantly more vegetables (0.08 cups/1,000 kcal/day; P=0.03) and combined fruits and vegetables (0.22 cups/1,000 kcal/day; P<0.05) compared with students in control schools. Students in the intervention schools also showed a reduction in the average daily dietary glycemic index (GI=−1.22; P<0.05) and a trend toward more fruit consumption (0.15 cups/1,000 kcal/day; P=0.07). There were no significant differences in students' consumption of whole grains, legumes, dairy, potatoes/potato products, saturated fat, added sugars, or dietary fiber consumption.ConclusionsThe CHANGE study enhanced some aspects of rural students' dietary intake. Implementing similar interventions in rural America can be promising to support vegetable consumption.     

A Nitrate-Rich Vegetable Intervention Elevates Plasma Nitrate and Nitrite Concentrations and Reduces Blood Pressure in Healthy Young Adults

BackgroundEmerging evidence suggests that increasing dietary nitrate intake may be an effective approach to reduce blood pressure. Beetroot juice is often used to supplement dietary nitrate, whereas nitrate intake levels from habitual diet are low. An increase in the habitual intake of nitrate-rich vegetables may represent an alternative to nitrate supplementation. However, the effectiveness and acceptability of a nitrate–rich-vegetables diet remain to be established.ObjectiveThe aim was to investigate the effect and feasibility of two different intervention strategies to increase dietary nitrate intake, on plasma nitrate/nitrite concentrations and blood pressure.DesignA randomized, crossover trial was used.ParticipantsParticipants were healthy men and women (both n=15; age: 24±6 years) from the Netherlands.InterventionParticipants were instructed to consume ∼400 mg nitrate at lunch, provided through nitrate-rich vegetables and dietary counseling, or beetroot juice supplementation. Both interventions lasted 1 week, with 1-week washout (January to April 2017).Main outcomePlasma nitrate and nitrite concentrations and resting systolic and diastolic blood pressure were measured in an overnight fasted state (before and after intervention) and ∼2.5 hours after lunch (before and throughout intervention on day 1, 4, and 7).Statistical analysisTwo-factor (time × treatment) repeated-measures analyses of variance were performed.ResultsMean plasma nitrate concentrations increased with both interventions, with a larger increase in beetroot juice vs nitrate-rich vegetables, both in a fasted state and ∼2.5 hours after lunch (day 1, beetroot juice: 2.31±0.56 mg/dL [373±90 μmol/L] vs nitrate-rich vegetables: 1.71±0.83 mg/dL [277±134 μmol/L]; P<0.001). Likewise, mean plasma nitrite concentrations increased with both interventions, but were higher after lunch in beetroot juice than in nitrate-rich vegetables (day 1: 2.58±1.52 μg/dL [560±331 nmol/L] vs 2.15±1.21 μg/dL [468±263 nmol/L]; P=0.020). Fasting mean systolic and diastolic blood pressure did not change, but mean systolic and diastolic blood pressure assessed ∼2.5 hours after lunch were significantly reduced throughout both intervention periods (P<0.05), with no differences between beetroot juice and nitrate-rich vegetables (day 1, systolic blood pressure: –5.1±9.5 mm Hg and diastolic blood pressure: –5.3±8.9 mm Hg).ConclusionShort-term consumption of dietary nitrate in the form of nitrate-rich vegetables represents an effective means to increase plasma nitrate and nitrite concentrations, and reduces blood pressure to the same extent as beetroot juice supplementation.     

A Fresh Fruit and Vegetable Program Improves High School Students' Consumption of Fresh Produce

Low fruit and vegetable intake may be associated with overweight. The United States Department of Agriculture implemented the Fresh Fruit and Vegetable Program in 2006-2007. One Houston-area high school was selected and received funding to provide baskets of fresh fruits and vegetables daily for each classroom during this period. This study assessed the impact of the program on students' fruit and vegetable intake. At program end (May 2007), fruit and vegetable intake surveys were distributed to students at the intervention school as well as at a comparison high school that did not receive the program. Surveys, which were completed anonymously, were received from 34% of intervention and 42% of comparison school students. The students were classified as to whether they met the recommended daily intake of fruit, 100% fruit juice, and vegetables. The probability of meeting the recommendations was assessed with logistic regression analyses, controlling for sex, age, and ethnicity. Compared with the comparison control school students, intervention school students were more likely to report eating fruit and drinking 100% fruit juice at least two times per day (39.3% vs 27.3%; P<0.05) and consuming total fruit, juice, and vegetables (22% vs 18.4%; P<0.05) five or more times per day in the preceding 7 days. More intervention school students (59.1%) than comparison school students (40.9%) reported eating fruit at least one time per day (P<0.05). There were no group differences in vegetable intake. Fresh fruit and vegetable distribution programs provide the opportunity for students to taste a variety of fruits and vegetables, and may improve consumption of these foods by adolescents.     

Oregon Parents’ Perceptions of the Supportiveness of the School Environment for Their Children's Health Behaviors

ObjectiveTo describe Oregon parents’ perceptions of their children's school regarding health behaviors; examine how perceptions vary by parent, child, and community characteristics; and identify recommendations for improving school environments.MethodsOregon parents with an elementary school–aged child completed an electronic survey.ResultsOver 90% of parents (n = 814) described their child's school as supportive of healthy eating and physical activity. Parents who ate ≥5 fruits/vegetables per day more often perceived their children's school as unsupportive of healthy eating (P < 0.001) and physical activity (P < 0.05) relative to others. Parents of children eligible for free/reduced-price lunch more often perceived the school as unsupportive of physical activity (P < 0.05) relative to others. Parental recommendations included improving school meals and providing short physical activity breaks.Conclusions and ImplicationsParents’ suggested school improvements can inform school wellness committees’ and administrators’ quality-improvement efforts and, in turn, better support children's healthy behaviors.     

The association between family meals, TV viewing during meals, and fruit, vegetables, soda, and chips intake among Latino children

ObjectiveExamine the relationship of family meals to children's consumption of fruit and vegetables as well as soda and chips. Additionally, to assess the relationship between viewing TV during family meals and children's diet.DesignCross-sectional study that used a questionnaire completed by parents.SettingThirteen schools in San Diego, California.ParticipantsSeven hundred ninety-four children and their parents.AnalysisOrdinal regression assessed associations between children's intake of fruit, vegetables, soda, and chips with family meal frequency and TV viewing during family meals.ResultsChildren who consumed breakfast, lunch, or dinner with their family at least 4 days per week ate fruit and vegetables 5 or more times a week 84%, 85%, and 80%, respectively. Of those children who ate breakfast, lunch, or dinner with their family at least 4 days per week, 40%, 44%, and 43% consumed soda and chips 5 or more times a week, respectively. Children who ate breakfast with their families at least 4 times a week were more likely to consume fruit and vegetables, and children whose TV was never or rarely on during family meals were less likely to consume soda and chips (P = .04 and P < .001, respectively).ConclusionsInterventions geared at increasing the frequency of eating breakfast as a family and decreasing the amount of TV watched during family meals are needed, especially among acculturating Latino families.     

Agricultural Experiences Are Positively Associated With High School Students' Fruit and Vegetable Perceptions and Consumption

Objective

To examine the relationship between high school students' agricultural experiences and their (1) attitudes about consuming local fruits and vegetables, (2) willingness to try new fruits and vegetables, and (3) fruit and vegetable consumption.

Evaluation of a College-Level Nutrition Course With a Teaching Kitchen Lab

ObjectiveTo evaluate the impact of a college nutrition course with a teaching kitchen lab on students’ attitudes, self-efficacy, and behaviors about healthful eating and cooking.MethodsPreintervention and postintervention design, and anonymous online survey of sociodemographic information and students’ attitudes and self-efficacy about consuming fruits, vegetables, and whole grains and about cooking, self-reported intake, and cooking behaviors.ResultsTwo-hundred and fourteen participants enrolled in the study during 5 semesters. Of these, 171 (80%) had complete pretest and posttest data. Attitudes and self-efficacy scores about consuming fruits, vegetables, whole grains, and cooking were significantly higher in the posttest (vs pretest; all P < 0.0001). Self-reported intake of fruits (P < 0.0001) and vegetables (P = 0.0006) also increased. Cooking frequency increased (P < 0.0001), skipping meals frequency decreased (P < 0.0001), whereas no significant changes were observed for eating out, take-out, or premade meals frequency.Conclusions and ImplicationsA college nutrition course with a teaching kitchen lab could improve healthful eating and promote cooking in young adults.     

免费营养午餐政策对农村青少年超重的影响——基于中国教育追踪调查初中队列数据

目的分析免费营养午餐政策对农村青少年超重的影响。方法基于2013-2016年中国教育追踪调查4期数据, 以农村初中生为研究对象, 利用logistic模型分析免费营养午餐政策对农村青少年超重的影响, 最终纳入3 453名研究对象。结果对于农业户口学生而言, 初一开始接受免费午餐的青少年在初二和初中毕业后一年时发生超重的风险比不享有的青少年分别低35.8%(P<0.05)及31.6%(P<0.05), 初二开始接受免费午餐的青少年在初三和初中毕业后一年时发生超重的风险比不享有的青少年分别低36.7%(P<0.05)及29.9%(P<0.05), 而初三接受免费午餐的青少年其在初中毕业后一年时发生超重的风险与不享有的青少年相比, 差异无统计学意义。相较于女生, 男生更能从中受益。结论总体而言免费营养午餐在较长期内都有助于降低学生超重可能性, 且这一影响具有累积效应。这说明免费营养午餐政策对于促进青少年健康是行之有效的。     

Food and nutrient intakes of primary school children: a comparison of school meals and packed lunches

Background New school meal standards are currently being phased in by the government in an attempt to improve the nutritional composition of school food. However, no standards are applied to packed lunches. The present study aimed to compare the food and nutrient intakes of primary school children eating a school meal with those taking a packed lunch. Methods A sample of 120 children, aged 6–11 years, was observed once at a lunch time and all items consumed were recorded. Nutrient analysis was performed, and differences in nutrient intake between those children consuming packed lunches and school meals were determined. Results Mean energy and protein intakes were similar. The amount of energy provided by starchy carbohydrate was also similar but, compared with school meals, packed lunches provided twice as much energy from sugar (P < 0.001). School meals on average provided more energy from fat (P < 0.001), but intakes of saturated fat were lower in the school meals group (P = 0.021). Packed lunches provided more sodium (P < 0.001), calcium (P < 0.001) and iron (P = 0.016) than the school meals. Very few packed lunches contained vegetables, and fruit intake was particularly low for those having a school meal. Conclusions Children taking a packed lunch to school were consuming approximately double the amount of sugar and 50% more sodium and saturated fat in their midday meal compared with those having a school lunch. However packed lunches were providing children with more calcium, iron and fruit.     

Impact of the Updated USDA School Meal Standards,Chef-Enhanced Meals,and the Removal of Flavored Milk on School Meal Selection and Consumption

BackgroundIn Fall 2012, updated US Department of Agriculture school meal standards went into effect and did not result in increased food waste overall. However, consumption of school foods, especially fruits and vegetables, remains low. Therefore, strategies to improve school meal consumption are necessary.ObjectiveThis study evaluated the combined impact of the updated school meal standards and chef-enhanced, healthier meals, and the removal of flavored milk on students’ school food selection and consumption compared with students in control schools.DesignThe Project MEALS (Modifying Eating and Lifestyles at School) study was a cafeteria-based quasi-experimental intervention conducted during the 2012 to 2013 school year.Participants/settingParticipants were students (n=1,309) in grades 3 through 8 attending four intervention and four control schools in two low-income, urban school districts.InterventionChef-enhanced school meals and the removal of flavored milk combined with the updated US Department of Agriculture school meal standards.Main outcome measuresChanges in school meal selection and consumption were examined using plate waste methodology.Statistical analyses performedLogistic regression and mixed-model analysis of variance adjusting for student demographics and schools/students as a random effect (students nested within schools) were used to examine differences in selection and consumption before (Fall 2012) and after (Spring 2013) a chef-based intervention with the updated school meal standards.ResultsAfter the chef-based intervention was implemented, there were no significant differences in entrée, vegetable, or fruit selection. Significantly fewer students selected milk compared with students in control schools (56.8% vs 94.0%; P<0.0001) and milk consumption was significantly lower (54.8% vs 63.7%; P=0.004). However, consumption was significantly greater for vegetables (62.2% vs 38.2%; P=0.005) and fruits (75.2 vs 59.2%; P=0.04) in the intervention schools compared with control schools. There were no significant differences in entrée consumption.ConclusionsSchools collaborating with chefs can be an effective method to improve the consumption of fruits and vegetables with the updated US Department of Agriculture school meal standards. Further research should examine the longer-term impact of the removal of flavored milk from schools to determine whether the lower selection and consumption rates persist.     

Food Waste in a School Nutrition Program After Implementation of New Lunch Program Guidelines

ObjectiveTo assess the amount of food waste by meal components according to the new National School Lunch Program guidelines among pre-kindergarten and kindergarten students.MethodsFor 5 consecutive school days in 1 elementary school, the research team collected school lunch trays and separated meal components into bins relative to each food or beverage appearing on the school's daily menu. Bins were weighed in grams and converted to ounces and cups at the end of each lunch period.ResultsThe researchers examined 304 meals from 1 pre-kindergarten class and 5 kindergarten classes. Of 4,988 oz of food and beverages served, 2,261 oz (45.3%) were wasted during 1 full school week, totaling 141 lb. The greatest amount of food waste was generated from vegetables, the main entree, and milk, respectively.Conclusions and ImplicationsStrategies to reduce food waste in school lunch should be researched and implemented.