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Testing the Effectiveness of Healthy School Lunchroom Interventions

In an effort to combat America’s obesity epidemic, school boards and state legislatures are increasingly turning to interventions in which less healthy food options are replaced with healthier foods such as fruits and vegetables.

Childhood obesity is undoubtedly a problem in America-currently nearly 32% of children aged 2-19 years are overweight or obese and those numbers are on an upward trajectory. This trend means that diseases associated with obesity that were once extremely rare in children, such as Type 2 Diabetes and risk factors for Cardiovascular Disease, are becoming real problems facing American children.

While there is no one single factor responsible for the obesity epidemic among children, unhealthy eating combined with a more sedentary lifestyle has been identified as a key factor influencing the increases in overweight and obese children. Unfortunately, school districts that struggle with budgetary concerns have been cutting the gym classes that represent one of the only outlets that compelled children to get some kind of physical activity in the course of their day. In spite of this, many school districts are experimenting with interventions aimed at reducing unhealthy food options in school settings.

These interventions are relatively cheaper for schools than expanding physical education programs and can be as simple as eliminating vending machines selling candy and sodas from lunchrooms. If healthy food interventions are successful in schools, they could provide a cost-effective way for budget-constrained schools to mitigate the severity of the obesity epidemic among children.

A recent study evaluated a healthy food intervention sponsored by the Smarter Lunchrooms Movement in ten upstate New York middle schools, and the results were cautious but encouraging. The ten middle schools were separated into three groups: one group promoting a fruit intervention (4 schools), one group promoting a vegetable intervention (3 schools), and one control group in which there was no intervention (3 schools). The study was conducted over the course of nine weeks, and focuses in particular on the fruit and control groups. The fruit intervention consisted of training lunchroom workers to fulfill the following conditions:


  1. Fruit is placed first on the line.
  2. At least two varieties of fruit are offered.
  3. Fruit is offered in at least two separate locations.

4.Cut fruits are displayed in small, attractive cups.

  1. Whole fruits are displayed in a large, attractive fruit bowl at eye level.
  2. Fruits are labeled with creative names.
  3. Creative fruit names are displayed on monthly and daily menus.
  4. “Fruit factoids” are displayed on dry-erase boards at eye level.

After 9 weeks of implementation, the researchers were able to discern some encouraging trends. In the fruit intervention schools fruit selection in the lunchroom was 36% higher than in the control group without any intervention, and overall fruit consumption was 23% higher. Interestingly, vegetable and milk selection also increased in the intervention schools, though the researchers are quick to point out that these numbers were not statistically significant enough to reach a definitive conclusion.

One of the limitations of this study was that the researchers were unable to track individual student behaviors, but in the future public health researchers and professionals could design research that would focus on individual-level consumption. Nevertheless, the results of this study are encouraging and show that interventions can be successful with creative design and implementation. The childhood obesity epidemic is a serious issue, but it's something that could be fixed over time. 

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Topics: Childhood Development Food obesity Health care class room