Abstract
ObjectiveExamine how the physical cafeteria environment contributes to 6- to 8-year-olds’ school food consumption. DesignCross-sectional observational study. Before-and-after lunch tray photos taken with iPads to capture food selection and consumption. Setting10 New York City public elementary school cafeterias. ParticipantsA total of 382 students aged 6–8 years who ate lunch in the cafeteria on observation days. Main Outcome MeasuresFruit, vegetable, or whole-grain consumption. AnalysisPearson's chi-square and multivariate logistic regression assessed associations between cafeteria environmental factors (time to eat lunch, noise, and crowding) and vegetable, fruit, and/or whole-grain consumption with 95% confidence, adjusted for school-level demographics and clustered by school. ResultsApproximately 70% of students selected fruits, vegetables, and/or whole grains. When selected, consumption was 25%, 43%, and 57%, respectively. Longer time to eat lunch was associated with higher consumption of fruits (odds ratio [OR] = 2.0; 95% confidence interval [CI], 1.1–3.8; P = .02) and whole grains (OR = 2.1; 95% CI, 1.003–4.2; P < .05). Quieter cafeterias were associated with eating more vegetables (OR = 3.9; 95% CI, 1.8–8.4; P < .001) and whole grains (OR = 2.7; 95% CI, 2.6–4.7; P < .001). Less crowding was associated with eating more fruit (OR = 2.3; 95% CI, 1.03–5.3; P = .04) and whole grains (OR = 3.3; 95% CI, 1.9–5.6; P < .001). Conclusions and ImplicationsHealthy food consumption by 6- to 8-year-old students is associated with cafeteria crowding, noise, and time to eat lunch. Implementing and enforcing changes to the cafeteria environment mandated by wellness policies may reduce plate waste.
Published Version
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