This article is more than 5 years old. Information may no longer be current.
Professional chefs, choice architecture encourage healthier food selections in schools
Click Here to Manage Email Alerts
Schools that utilized chef-enhanced meals and choice architecture significantly increased student consumption of fruits and vegetables after students were exposed to new foods for 7 months.
“More than 30 million students receive school meals daily, and many rely on school foods for up to half of their daily energy intake. Therefore, school-based interventions that encourage the selection and consumption of healthier school food components (eg, fruits, vegetables, whole grains and white milk) can have important health implications, especially if they are sustainable and economically feasible,” study researcher Juliana F.W. Cohen, ScM, ScD, of the Harvard School of Public Health, and colleagues wrote.
Juliana F. W. Cohen
The MEALS study was a randomized clinical trial conducted across 14 elementary and middle schools in two urban, low-income school districts in Massachusetts during the 2011-2012 school year. The study cohort consisted of 2,638 students (mean age, 11.5 years).
Food selection and consumption were measured at baseline. Four schools were randomized to receive a professional chef to improve meals, and 10 schools continued to receive standard school meals. Researchers measured food selection and consumption after 3 months of exposure to chef-enhanced meals. Following this, two chef schools and four control schools were randomized to receive a smart cafe intervention. Food selection and consumption were measured again 4 months later.
Schools that received a professional chef collaborated with the chef 2 to 3 days per week to create recipes to improve the taste of foods and teach school cafeteria staff culinary skills. Recipes used cost-effective commodity foods, along with whole grains, fresh and frozen produce, healthier polyunsaturated and monounsaturated fats, and seasonings with low sodium and sugar.
The smart cafe intervention included numerous changes to the school cafeteria using choice architecture strategies. For example, to encourage vegetable selection, vegetables were featured at the beginning of the lunch line.
After 3 months, entree and fruit selection did not change, but vegetable selection increased among intervention schools vs. control schools (OR = 1.75; 95% CI, 1.36-2.24).
After 7 months of exposure to the chef intervention and 4 months of exposure to the smart cafe, odds for fruit selection significantly increased in the chef (OR = 3.08; 95% CI, 2.23-4.25), smart cafe (OR = 1.45; 95% CI, 1.13-1.87) and chef plus smart cafe (OR = 3.1; 95% CI, 2.26-4.25) schools vs. control schools.
Odds for vegetable selection also increased in chef (OR = 2.54; 95% CI, 1.83-3.54), smart cafe (OR = 1.91; 95% CI, 1.46-2.5) and chef plus smart cafe (OR = 7.38; 95% CI, 5.26-10.35) schools vs. control schools.
Consumption significantly increased in schools that received professional chefs. Vegetable consumption increased 30.8% (95% CI, 17.7%-43.8%) in chef schools and by 24.5% (95% CI, 10%-39%) in chef plus smart cafe schools.
There were no significant differences in entree, fruit and vegetable selections after short- and long-term exposure to the chef intervention and extended exposure to smart cafes.
“This work expands our current understanding of how to nudge students towards healthier food choices,” Mitesh S. Patel, MD, MBA, and Kevin G. Volpp, MD, PhD, of the University of Pennsylvania, wrote in a related editorial. “Childhood obesity is a national concern. Despite numerous efforts to improve the food consumption of America’s youth, rates of obesity among school-aged children have not changed over the past decade. Strategies that are most likely to encourage healthier food choices are those that reflect individuals’ rational preferences (eg, making food taste better) and apply insights from behavioral economics to better design choice architecture.” – by Amanda Oldt
Disclosure: Volpp reports financial ties with CVS Caremark, Discovery, Humana, Merck and VAL Health. The other researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts