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

项目摘要 尽管水果和蔬菜（FV）作为健康饮食的重要组成部分， 不要食用这些食物的推荐份量。学校膳食占很大比例， 这是儿童总膳食摄入量的一部分，在减少粮食不安全方面发挥着重要作用， 与儿童肥胖症有矛盾的联系。改变学校的营养环境是一个具有成本效益和 有效的方法，改善饮食摄入量，可以显着影响小儿恶性问题， 肥胖2010年《健康无饥饿儿童法》（HHFKA）规定，在全国范围内加强对饥饿儿童的关注。 学校午餐计划（NSLP），并特别要求儿童在用餐时服用水果和/或蔬菜（ “服务”模式）。然而，在这一任务规定下，人们对FV版浪费增加表示严重关切。 同时，国家也大力支持学校沙拉吧作为增加FV摄入量的一种手段 在NSLP中。在“服务”模式中，沙拉条可能是一种特别有效的方法，因为它们促进了 选择，这与儿童的FV消费增加有关。然而，很少有实证研究 调查了沙拉吧对学校FV摄入量的影响。此外，尽管FV消耗可以促进 健康的体重管理如果这些食物取代了高热量的食物，那么就有必要更好地 了解增加FV摄入量与儿童整体饮食质量和肥胖风险的关系。这是 特别重要的是，调查低收入和种族/少数民族儿童，他们面临不成比例的 肥胖风险，最有可能受到学校肥胖政策的影响，如HHFKA，因为他们 依靠学校的伙食。在这个应用程序中，两个匹配的，随机选择的标题1小学， 主要为非洲裔美国人和西班牙裔儿童提供服务;一所学校设有沙拉吧 （干预）和一个服务的比例FV只有，标准下修订的NSLP（控制）。下 根据HHFKA的社区资格规定，100%的学生有资格获得免费膳食。我们将 进行平板废物评估（4天内约1600餐），并比较FV选择和消耗 学校之间。此外，鉴于FV在预防肥胖中的作用尚不清楚，我们还将进行营养学研究。 分析调查较高的FV摄入量是否取代了其他来源的卡路里，从而告知肥胖 预防工作。结果将通过调查肥胖政策研究做出重大贡献， 根据《国家营养计划》的标准，在服务模式内努力增加FV摄入量的有效性。 研究结果还将为旨在减轻儿童肥胖的相关营养政策提供信息。数据将告知更大的 有关提高HHFKA下的NSLP成效的试验。以前没有研究检查过 沙拉吧对在学校上学的学生的FV和热量摄入的影响， 在儿童的饮食摄入中起着重要作用。因此，这项研究有可能为学校营养提供信息， 旨在提高肥胖风险高的学生饮食摄入量的政策和方案。

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.