Dietary quality is associated with children's academic performance, and physical and emotional well-being. Poor dietary habits increase risk for many chronic diseases, even among individuals who are not overweight, suggesting that improving children's eating behaviors is an extremely important target of public health efforts. Yet, individual or group programming targeting dietary quality and obesity prevention is time and resource- intensive, and not universally available, limiting its impact on some of the groups most vulnerable to obesity, especially lower income and minority children. Enhancing food quality in elementary schools is associated with reductions in obesity. Consistent with this research, the National School Lunch Program (NSLP) was recently revised to require students to select fruits and vegetables (F&Vs). This change has generated significant concerns from school districts about plate waste (and very vocal complaints from students about the palatability of the foods offered). This policy uses a """"""""serve"""""""" model to expose students to healthier nutritional options. However, this approach poses challenges, as research suggests that increasing (not forcing) dietary choices is associated with greater F&V consumption. This application, submitted in response to PA-13-099 (School Nutrition and Physical Activity Policies, Obesogenic Behaviors &Weight Outcomes) will make a significant contribution to pediatric obesity policy research by investigating the impact of the revised NSLP mandate aimed at increasing F&V consumption. In this application, we partner with Title I schools (85%+ ethnic/racial minority students) to assess the impact of the serve model on F&V consumption during school breakfast and lunch in 1st-3rd grade students. We will also investigate whether a brief intervention in which students'tasting of these foods is reinforced increases their consumption and perceived palatability. This project will provide important data regarding the extent of plate waste in Title I schools under the revised NSLP. In addition, we hypothesize that F&V consumption and liking of these foods will significantly increase at the intervention school, compared with the control school, and changes will persist at 6-week follow-up. Finally, we will conduct qualitative interviews with relevant stakeholders, including cafeteria staff, school administrators, teachers, and parents/caregivers. Interviews will address the perceived feasibility and acceptability of school food policies, and elicit suggestions for additional policy endeavors. Findings will inform future iterations of this (and related) school food policy. This is especially important given that many policies are mandated in the absence of data indicating whether they will have the desired effects, and if they might yield any unintended consequences. This multidisciplinary, multi-method application is highly consistent with the specific research objectives of this PA, which prioritizes investigations focused on: 1) the influence of school policies on nutritional behaviors, 2) the implementation of these policies, 3) understanding conditions that enhance the feasibility and success of school nutritional policies, and 4) increasing connections between the school and home nutritional environment.

Public Health Relevance

Recent changes to the National School Lunch Program (NSLP) were designed to improve students'consumption of nutrient-rich foods, especially fruits and vegetables (F&Vs). Yet, these changes have proven controversial, and unpopular, according to the media (although there are little scientific data on their effects). This study wil examine: 1) F &V consumption during school breakfast and lunch under the revised NSLP, and 2) whether a brief intervention in which students'tasting of these foods is reinforced increases their consumption and perceived palatability, thus enhancing the potential effectiveness of this school policy.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Small Research Grants (R03)
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Psychosocial Risk and Disease Prevention Study Section (PRDP)
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Esposito, Layla E
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Virginia Commonwealth University
Schools of Arts and Sciences
United States
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