The Impact of Salad Bars on Fruit, Vegetable, and Energy Intake in Elementary Schools

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PROJECT SUMMARY Despite the importance of fruits and vegetables (FV) as essential components of a healthy diet, most children do not consume the recommended number of servings of these foods. School meals account for a significant portion of children's overall dietary intake and play a major role in reducing food insecurity, a problem paradoxically linked with pediatric obesity. Changing the school nutritional environment is a cost-efficient and effective method for improving dietary intake and can significantly impact the pernicious problem of pediatric obesity. The 2010 Healthy Hunger-Free Kids Act (HHFKA) mandated enhanced focus on FV in the National School Lunch Program (NSLP), and specifically requires children to take a fruit and/or vegetable at meals (the “serve” model). However, there are significant concerns over increased FV plate waste under this mandate. Simultaneously, there is also great national support for school salad bars as a means to increase FV intake within the NSLP. Salad bars might be a particularly effective approach within the “serve” model, as they foster choice, which is linked to increased FV consumption in children. However, little empirical research has investigated the impact of salad bars on FV intake in schools. Further, although FV consumption can facilitate healthy weight management if these foods replace items high in calories, there is a great need to better understand how increasing FV intake relates to children's overall diet quality and obesity risk. This is particularly important to investigate in low income and racial/ethnic minority children, who face disproportionate obesity risks and are most likely to be impacted by school obesity policies, such as the HHFKA, given their reliance on school meals. In this application, two matched, randomly selected Title 1 elementary schools, serving predominately African American and Hispanic children will be selected; one school has a salad bar (Intervention) and one serves proportioned FV only, standard under the revised NSLP (Control). Under the Community Eligibility Provision of the HHFKA, 100% of students are eligible to receive free meals. We will conduct plate waste assessments (~1600 meals over 4 days) and compare FV selection and consumption between schools. Further, given the unclear role of FV in obesity prevention, we will also conduct nutrition analyses to investigate if higher FV intake displaces calories from other sources, thus informing obesity prevention efforts. Results will make a significant contribution to obesity policy research by investigating the effectiveness of efforts aimed at increasing FV intake within the serve model, standard under the NSLP. Results will also inform related nutrition policies aimed at alleviating pediatric obesity. Data will inform a larger trial related to enhancing the effectiveness of the NSLP under the HHFKA. No prior studies have examined the effects of salad bars on FV and caloric intake in students attending schools with universal free meals, a setting with a powerful role in children's dietary intake. As such, this study has the potential to inform school nutrition policies and programming designed to enhance dietary intake in students at high obesity risk.