JOURNAL ARTICLE
MULTICENTER STUDY
RANDOMIZED CONTROLLED TRIAL

Differential Improvements in Student Fruit and Vegetable Selection and Consumption in Response to the New National School Lunch Program Regulations: A Pilot Study

Karen W Cullen, Tzu-An Chen, Jayna M Dave, Helen Jensen
Journal of the Academy of Nutrition and Dietetics 2015, 115 (5): 743-50
25556770

OBJECTIVE: To investigate changes in student food selection and consumption in response to the new National School Lunch Program meal patterns during fall 2011.

DESIGN: Eight elementary and four intermediate schools in one Houston area school district were matched on free/reduced-price meal eligibility and randomized into control or intervention conditions.

INTERVENTION: Both intervention and control school cafeterias served the same menu. The intervention school cafeterias posted the new meal pattern daily; students could select one fruit and two vegetable servings per reimbursable meal. Control school students could only select the previous meal pattern: a total of two fruit and vegetable servings per meal.

MAIN OUTCOME MEASURES: Students were observed during lunch: student sex and foods selected/consumed were recorded. Diet analysis software was used to calculate energy/food groups selected/consumed.

STATISTICAL ANALYSES PERFORMED: Cochran-Mantel-Haenszel χ² tests examined differences in the percent of students selecting each meal component by condition, controlling for sex, grade, and school free/reduced-price meal eligibility. Analysis of covariance assessed differences in amount of energy/food groups selected and consumed, and differences in percent of food groups consumed.

RESULTS: Observations were conducted for 1,149 elementary and 427 intermediate students. Compared with students in the control schools, significantly more intervention elementary and intermediate school students selected total (P<0.001, P<0.05) and starchy vegetables (P<0.001, P<0.01); more intervention intermediate school students selected fruit (P<0.001), legumes (P<0.05), and protein foods (P<0.01). There were significantly greater amounts of these foods selected and consumed, but no differences in the proportion of the foods consumed by condition. Fewer calories were consumed by elementary and intermediate school intervention students.

CONCLUSIONS: More intervention students selected fruit and vegetables at lunch and consumed them compared with control condition students. Future studies with larger and more diverse student populations are warranted.

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