Impact of the Shaping Healthy Choices Program on Students’ Lunchtime Fruit and Vegetable Consumption: A Randomized Controlled Trial of a Multi‐Component School‐Based Nutrition Intervention

Abstract

Most youth in the US do not consume recommended levels of fruits and vegetables. Multi‐component school‐based interventions are encouraged as a strategy to improve these dietary behaviors, but further evaluation of such programs is needed to assess their impact. The objective of this study was to examine the effects of the Shaping Healthy Choices Program (SHCP) on lunchtime fruit and vegetable intake, as part of a randomized controlled trial of this multicomponent nutrition education intervention. Two Northern California elementary schools were randomly assigned to control or intervention treatments. Fruit and vegetable selection, consumption, and waste from school lunches were determined at the start (fall 2012, pre‐test) and end (spring 2013, post‐test) of the implementation year using digital imaging, a plate waste method. Each fourth‐grade classroom was observed over 2–3 days within each time point. Students were included in analyses when complete fruit (n=39 control, n=72 intervention) and/or vegetable (n=39 control, n=73 intervention) data were collected on at least two days within each time point. Exact tests examined associations between school and number of students consuming no fruits and vegetables within each time point. Changes in quantities selected, consumed, and wasted were compared between schools using t‐tests and Mann‐Whitney U‐tests. Similar percentages of students consumed no vegetables at pre‐test (49% control, 47% intervention), but fewer intervention (29%) than control (72%) students consumed no vegetables at post‐test. Vegetable consumption among intervention students significantly increased relative to changes among control students (P=0.008), and percentage waste from vegetables decreased among intervention students relative to control (P=0.020). Approximately 20% of students consumed no fruit at post‐test in both schools (ns), although more intervention (26%) than control (10%) students consumed no fruit at pre‐test (P=0.052). There were no significant differences in changes in quantities of fruit selected, consumed, or wasted. Overall, the SHCP successfully improved dietary behaviors related to vegetable, but not fruit, consumption. Given the wide variability in fruit and vegetable consumption, as well as the large proportion of students consuming no vegetables, an objective for future research should be to examine other factors that may help predict these dietary behaviors and their malleability.Support or Funding InformationFunding was provided by UCANR competitive grant #11‐1018, USDA 2011‐38420‐20082, and USDA NIFA Hatch project 221082.