Patterns in Vegetable Consumption: Implications for Tailored School Meal Interventions.

Abstract

Vegetable consumption is a challenging behavioral target; consumption rates are below recommended levels and when interventions produce improvements, increases in vegetable consumption are typically a fraction of the change in fruit consumption. We describe vegetable consumption within Ohio school meals and examine how fruit selection, the more popular item, impacts vegetable consumption. Fruit and vegetable waste was collected on 11,250 trays from 17 elementary and 16 middle/high schools, using the quarter-waste visualization method. One in 4 students ate at least a one-fourth of a cup of vegetables with their school lunch. Consumption was the highest (30.8%) in elementary school buildings with a majority of regular priced meals. Fruit selection was associated with vegetable consumption (p < .001). Middle/high school students who consumed a fruit were 88% more likely to consume a vegetable as oppose to waste it (95% CI: 1.45-2.42). Fruit selection was also associated with not selecting a vegetable, but the association was of a lower magnitude (odds ratio 1.32; 95% CI: 1.06-1.64). Trends were similar in elementary schools. Fruit and vegetable consumption should be approached as 2 distinct behaviors with particular attention given to vegetables. Fruit items can be leveraged, though, as a means to encourage vegetable selection.