Determine associations between consumption of fruits and vegetables (FV) at school lunch and school-based programming (nutrition education, gardening experiences, healthy school meals, schoolwide culture of health).
Study Design, Setting, Participants
A cross-sectional study design was used. Twenty FoodCorps schools in eight states, sample selected to represent range of programming and stratified on school demographics to generalize to FoodCorps schools. Participants were second and third grade students.
Outcome Measures and Analysis
FV consumption at school lunch measured with before and after meal digital photos. Inter-rater reliability for FVs, on tray was 99.5%, and for amount consumed (coded in 10% increments) was 82.7% exact match and 95.6% adjacent match. Programming level measured with Healthy School Progress Report (HSPR), 100-point scale. Analysis was hierarchical linear regression with FV consumption as student-level variable, square root transformed to account for skewed data due to many students eating no FV, and HSPR scores as school-level variable.
FV consumption (n=2571 trays): 96% of students had FV on tray, mean amount on tray: 0.96±0.49 cups, amount consumed (student who had F&V on tray): 0.45±0.40 cups. HSPR: range 24 to 97, mean 55.0±17.2. Overall HSPR not associated with consumption (p=0.119). Score on nutrition education (25 point scale, range 5 to 25) was positively associated with FV consumption (p=0.004). Students from school with score of 5 ate 0.18 cups and students from school with score of 25 ate 0.61 cups. Other HSPR sections were not significant.
Conclusions and Implications
Nutrition education appears to be associated with FV consumption at school lunch. Pre-post outcomes evaluation to determine impacts of increased programming on FV consumption is recommended.
© 2017 Published by Elsevier Inc.