Advertisement

Location of School Lunch Salad Bars and Fruit and Vegetable Consumption in Middle Schools: A Cross-Sectional Plate Waste Study

Published:November 26, 2015DOI:https://doi.org/10.1016/j.jand.2015.10.011

      Abstract

      Background

      The school lunch environment is a prime target for increasing a child’s consumption of fresh fruits and vegetables (F/V). Salad bars are heavily encouraged in schools; however, more research is needed to examine the contexts in which salad bars promote consumption of F/V among students.

      Objective

      To compare the amount of fresh F/V self-served, consumed, and wasted by students during lunch at schools with differing salad bar placement: inside or outside of the serving line.

      Design

      Cross-sectional plate waste study in which salad bar placement differed between schools.

      Participants/setting

      A random sample of middle school students (N=533) from six schools (three schools per district).

      Main outcome measures

      Amount of fresh F/V taken, consumed, and wasted.

      Statistical analyses

      Negative binomial multivariable regression examined placement of salad bars, adjusting for sex, grade, race/ethnicity, free/reduced status, day of the week, and nesting of students within schools.

      Results

      Almost all students (98.6%) in the schools with salad bars inside serving lines self-served F/V compared with only 22.6% of students in the schools with salad bars outside lines (adjusted prevalence ratio=5.38; 95% CI 4.04 to 7.17). Similarly, students at schools with salad bars inside the line had greater prevalence of consuming any F/V compared with students in schools with salad bars outside the line (adjusted prevalence ratio=4.83; 95% CI 3.40 to 6.81). On average, students with the salad bar outside the line wasted less F/V compared with those with salad bars inside the line (30% vs 48%, respectively).

      Conclusions

      Few students visited salad bars located outside the lunch line. Salad bars inside the lunch line resulted in significantly greater fresh F/V taken, consumed, and wasted. When possible, schools should try to include salad bars inside the line to increase students’ exposure to F/V.

      Keywords

      To read this article in full you will need to make a payment

      References

      1. Nutrition and Your Health: Dietary Guidelines for Americans 2010. 7th ed. US Government Printing Office, Washington, DC2010
        • Larson N.I.
        • Neumark-Sztainer D.
        • Hannan P.J.
        • Story M.
        Trends in adolescent fruit and vegetable consumption, 1999-2004: Project EAT.
        Am J Prev Med. 2007; 32: 147-150
        • Clark M.A.
        • Fox M.K.
        Nutritional quality of the diets of US public school children and the role of the school meal programs.
        J Am Diet Assoc. 2009; 109: S44-S56
        • Gleason P.M.
        • Suitor C.W.
        Eating at school: How the National School Lunch Program affects children's diets.
        Am J Agric Econ. 2003; 85: 1047-1061
        • Harris D.M.
        • Seymour J.
        • Grummer-Strawn L.
        • et al.
        Let's Move Salad Bars to Schools: A public-private partnership to increase student fruit and vegetable consumption.
        Child Obes. 2012; 8: 294-297
      2. Let's Move Salad Bars to Schools. 2015. http://www.saladbars2schools.org/. Accessed March 30, 2015.

      3. US Department of Agriculture. Salad bars in the National School Lunch Program. Memo: SP 31-2013. March 2013. http://www.thelunchbox.org/sites/default/files/USDA Memo SP31-2013s Revised Salad Bar.pdf. Accessed October 23, 2013.

        • Terry-McElrath Y.M.
        • O'Malley P.M.
        • Johnston L.D.
        Accessibility over availability: Associations between the school food environment and student fruit and green vegetable consumption.
        Child Obes. 2014; 10: 241-250
      4. Ohio Department of Health. Ohio Seed to Salad: Toolkit assisting schools in implementing and promoting a salad bar. 2012. http://www.healthy.ohio.gov/∼/media/HealthyOhio/ASSETS/Files/creating healthy communities/salad bar/Toolkit-SaladBar12.ashx. Accessed October 23, 2013.

        • US Department of Agriculture, Food and Nutrition Service, Office of Analysis, Nutrition and Evaluation
        School Lunch Salad Bars.
        Department of Agriculture, Alexandria, VA2003
        • Gosliner W.
        School-level factors associated with increased fruit and vegetable consumption among students in California middle and high schools.
        J Sch Health. 2014; 84: 559-568
        • Slusser W.M.
        • Cumberland W.G.
        • Browdy B.L.
        • Lange L.
        • Neumann C.
        A school salad bar increases frequency of fruit and vegetable consumption among children living in low-income households.
        Public Health Nutr. 2007; 10: 1490-1496
        • Adams M.A.
        • Pelletier R.L.
        • Zive M.M.
        • Sallis J.F.
        Salad bars and fruit and vegetable consumption in elementary schools: A plate waste study.
        J Am Diet Assoc. 2005; 105: 1789-1792
        • Adams M.A.
        • Bruening M.
        • Ohri-Vachaspati
        Use of salad bars in school to increase fruit and vegetable consumption: Where's the evidence?.
        J Acad Nutr Diet. 2015; 115: 1233-1236
        • Hanks A.S.
        • Just D.R.
        • Wansink B.
        Smarter Lunchrooms can address new school lunchroom guidelines and childhood obesity.
        J Pediatr. 2013; 162: 867-869
        • Wansink B.
        • Smith L.E.
        • Just D.R.
        Cornell's Smarter Lunchroom Initiative: Engineering smart selections.
        J Nutr Educ Behav. 2010; 42: S75
        • Hanks A.S.
        • Just D.R.
        • Smith L.E.
        • Wansink B.
        Healthy convenience: Nudging students toward healthier choices in the lunchroom.
        J Public Health (Oxford). 2012; 34: 370-376
        • Horne P.J.
        • Tapper K.
        • Lowe C.F.
        • Hardman C.A.
        • Jackson M.C.
        • Woolner J.
        Increasing children's fruit and vegetable consumption: A peer-modelling and rewards-based intervention.
        Eur J Clin Nutr. 2004; 58: 1649-1660
        • Zhang J.
        • Yu K.F.
        What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes.
        JAMA. 1998; 280: 1690-1691
        • R Core Team
        Mgcv library.
        in: R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna, Austria2014
      5. US Department of Agriculture. Annual summary of food and nutrition service programs. http://www.fns.usda.gov/pd/annual.htm. Accessed October 23, 2013.

      6. US Department of Agriculture. Healthy Hunger Free Kids Act of 2010. http://www.fns.usda.gov/cnd/governance/legislation/cnr_2010.htm. Accessed October 23, 2013.

        • Bickel W.K.
        • Vuchinich R.E.
        Reframing Health Behavior Change with Behavioral Economics.
        Lawrence Erlbaum, Mahwah, NJ2000
        • Hovell M.F.
        • Wahlgren D.R.
        • Adams M.A.
        The logical and empirical basis for the Behavioral Ecological Model.
        in: Emerging Theories in Health Promotion Practice and Research. Vol. 2. Jossey-Bass, San Francisco, CA2009
        • Smith S.L.
        • Cunningham-Sabo L.
        Food choice, plate waste and nutrient intake of elementary- and middle school students participating in the US National School Lunch Program.
        Public Health Nutr. 2014; 17: 1255-1263
        • Cohen J.F.
        • Richardson S.
        • Austin S.B.
        • Economos C.D.
        • Rimm E.B.
        School lunch waste among middle school students: Nutrients consumed and costs.
        Am J Prev Med. 2013; 44: 114-121
        • Schwartz M.B.
        • Henderson K.E.
        • Read M.
        • Danna N.
        • Ickovics J.R.
        New school meal regulations increase fruit consumption and do not increase total plate waste.
        Child Obes. 2015; 11: 242-247

      Biography

      M. A. Adams is an assistant professor of exercise and wellness, School of Nutrition and Health Promotion, Arizona State University, Phoenix.

      Biography

      M. Bruening is an assistant professor of nutrition, School of Nutrition and Health Promotion, Arizona State University, Phoenix.

      Biography

      P. Ohri-Vachaspati is an associate professor of nutrition, School of Nutrition and Health Promotion, Arizona State University, Phoenix.

      Biography

      J. C. Hurley is a doctoral student, School of Nutrition and Health Promotion, Arizona State University, Phoenix.

      Linked Article

      • Location of School Lunch Salad Bars in Cafeterias: Design and Analysis Issues
        Journal of the Academy of Nutrition and DieteticsVol. 116Issue 7
        • Preview
          Adams and colleagues1 described a novel study examining the placement of salad bars within six middle school cafeterias as it relates to students’ consumption of fruit and vegetables (F/V). The authors found that students selected and consumed more F/V when salad bars were offered as part of the lunch line as compared to when the salad bars were located outside of the line. While these findings are consistent with both theoretical and empirical evidence,2 we are concerned with several aspects of the study design and analysis of data.
        • Full-Text
        • PDF