Abstract
Wellness in the Schools (WITS) is a national non-profit organization partnering with public schools to provide healthy, scratch cooked, less processed meals (called an Alternative Menu), and active recess. This study examined the effects of WITS programming on school lunch consumption, including fruit and vegetable intake, in second and third grade students in New York City public schools serving a high proportion of students from low-income households. The intervention was evaluated with a quasi-experimental, controlled design with 14 elementary schools (7 that had initiated WITS programming in fall 2015 and were designated as intervention schools, and 7 matched Control schools). School lunch consumption was assessed by anonymous observation using the System of Observational Cafeteria Assessment of Foods Eaten (SOCAFE) tool in the fall of 2015 (Time 0, early intervention) and the spring of 2016 (Time 1) and 2017 (Time 2). There were no baseline data. Data were also collected on the types of entrées served in the months of October, January, and April during the two school years of the study. Across time points, and relative to students in the Control schools, students in WITS schools ate more fruits and vegetables (units = cups): Time 0: Control 0.18 vs. WITS 0.28; Time 1: Control 0.25 vs. WITS 0.31; and Time 2: Control 0.19 vs. WITS 0.27; p < 0.001. They also had more fruits and vegetables (cups) on their trays, which included more vegetables from the salad bar. However, students in the WITS schools ate fewer entrées (grain and protein) and drank less milk than students in the Control schools. Compared to the Control schools, WITS schools offered more homestyle entrées and fewer finger foods and sandwich entrees, i.e., less processed food. Students in WITS schools who received the Alternative menu and all of the WITS programming at all data collection time points selected and consumed more fruits and vegetables. Replication studies with randomized designs and true baseline data are needed to confirm these findings and to identify avenues for strengthening the effects of the program on other school lunch components.
Highlights
This article is an open access articleThe health benefits of a diet rich in fruits and vegetables are well-recognized
We examined the effects of the Wellness in the Schools (WITS) programming on the school lunch consumption of second and third grade students in New York City (NYC) public schools serving a high proportion of students from low-income households
The Standard Mean Difference (SMD) is presented for each characteristic. Both the Control and WITS schools had a high percentage of students eligible for free- or reduced-price lunch, with a higher percentage in the Control schools at 95.1% compared to the WITS
Summary
The health benefits of a diet rich in fruits and vegetables are well-recognized. A high intake of fruits and vegetables is associated with reduced risks of cardiovascular disease, cancer, and all-cause mortality [1]. A high intake of vegetables is associated with a reduced risk of weight gain, being overweight, or obesity [2]. In light of the benefits of fruit and vegetable consumption and the fact that childhood dietary patterns are associated with food patterns later in life, encouraging children to eat more fruits and vegetables is a public health priority [4]. School-based interventions are part of the multipronged approach to promote fruit and vegetable intake in children. The school setting may provide opportunities for children to be exposed to and learn healthy eating patterns [7]
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