You can lead a child to veggies, but you can't make him eat them

Mandating healthier food options does not necessarily mean that healthier options are actually consumed — especially by children.

In the US, the Healthy, Hunger-Free Kids Act of 2010 set new nutrition standards for schools and allocated $4.5 billion for their implementation. It funded child nutrition programs and free/subsidised lunch programs in schools for five years. As a result, the 2012–13 school year saw 21.5 million US children receive a free or reduced-price lunch at school.

In the next month, Congress is due to vote on whether to re-authorise the program mandating healthier school lunches into the future.

However, a recent study shows that simply providing healthier food options does not necessarily mean that healthier options are actually consumed.

The study confirms the suspicions of school officials — many students are taking the fruits and vegetables they are now required to receive and putting them straight into the bin. The students are consuming fewer fruits and vegetables than they did before the law took effect. Students put more fruits and vegetables on their trays, as required, but consume fewer of them. Waste has increased by about 35%.

Published online in Public Health Reports, the study used digital imaging to capture students’ lunch trays before and after they exited the lunch line. It is also one of the first to compare fruit and vegetable consumption before and after the controversial legislation — the Healthy, Hunger-Free Kids Act of 2010 — was passed.

“The basic question we wanted to explore was: does requiring a child to select a fruit or vegetable actually correspond with consumption?” explained Sarah Amin, PhD, a researcher in Nutrition and Food Sciences at the University of Vermont and lead author on the study.

“The answer was clearly ‘no’,” she said. “It was heartbreaking to see so many students toss fruits like apples into the trash right after exiting the lunch line.”

Digital imaging produces fast, accurate data

The research team used a digital imaging method to measure consumption. The new methodology, which involved visual estimations and calculations based on digital photographs of trays as students reached the cashier and again after they passed the food disposal area, was faster and more accurate than conventional methodologies that simply weighed food waste.

Amin and her co-authors documented almost 500 tray observations over 10 visits to two elementary schools before implementation of the USDA guideline and almost twice as many observations afterwards. Forty to 60% of the students at the schools qualified for a free or reduced lunch, a marker for low socioeconomic status.

“The beauty of this method is that you have the data to store and code to indicate what was selected, what was consumed and what was wasted, as opposed to weighed plate waste, where everything needs to be done on site,” said Amin, who hopes to develop an online training tutorial that could be used by schools across the country to measure consumption and waste.

Revisiting past practices part of answer to increasing consumption

In an earlier study published in the Journal of Child Nutrition and Management, Amin and colleagues looked at what types of fruits and vegetables children selected prior to the new guideline.

They found that children preferred processed fruits and vegetables, such as tomato paste on pizza or 100% fruit juice, rather than whole varieties.

In addition to making sure those options are available, Amin and her colleagues offer these additional strategies in the paper for increasing fruit and vegetable consumption in school lunch programs:

• Cutting up vegetables and serving them with dip or mixing them in with other parts of the meal;
• Slicing fruits like oranges or apples, rather than serving them whole;
• Adopting promising strategies targeting school settings, such as Farm-to-School programs and school gardens, which can encourage fruit and vegetable consumption in addition to what the cafeteria is providing;
• Putting public health programs in place that encourage fruit and vegetable consumption in the home, which could carry over to school.

Once schools have fully acclimatised to the guidelines, Amin thinks consumption will increase, especially for students who entered as kindergarteners under the new guidelines in 2012 and know no other way.

“An important message is that guidelines need to be supplemented with other strategies to enrich fruit and vegetable consumption. We can’t give up hope yet.”

Amin’s co-authors include research associate Bethany Yon; Rachel Johnson, the Robert L Bickford Jr Green and Gold Professor of Nutrition and Food Sciences; and Jennifer Taylor, a graduate student at UC-Davis.

Image credit: ©iStockphoto.com/Richard Clark