Culinary Creations: A Community-Based Support for Policy Change in the Elementary School Nutrition Environment

Abstract

The purpose of this study was to evaluate the effectiveness of Culinary Creations (CC), an initiative intended to improve the elementary school nutrition environment and youth body mass index (BMI) through policy and environment changes. A quasi-experimental study was conducted in all elementary schools (n=51) in the largest school district in South Carolina during the 2012 school year. The sample included all eligible 3rd-5th graders (n=12,446) from the 29 participating schools (11 initiated CC in 2011 and 18 initiated CC in 2012) and the 22 non-participating schools. Non-participating schools will implement CC in 2013. CC improved availability of fresh, nutritionally dense meals prepared by trained cafeteria staff. Secondarily, CC encouraged schools to implement policies affecting competitive foods, classroom incentives and fundraising. Trained physical education teachers used standardized protocols to measure height and weight of 3rd-5th graders in the fall and spring of the 2012 school year. Data were merged with student socio-demographic factors. Sex-and age-specific BMI percentile was calculated. Multivariate mixed linear models assessed the change in BMI percentile. Youth BMI percentiles changed significantly (p<.05) from fall to spring, increasing by 0.05 for youth participating in CC for 2 years, decreasing by 1.18 for youth participating in CC for 1 year (p<0.05), and increasing by 0.54 for non-CC youth. Findings indicate initial exposure to CC may be helpful in reducing BMI percentile, but other factors may be involved following the first year. Additional research is necessary to determine the long-term impact of CC on BMI percentile.