Healthier School Lunches Influence Kids’ Dietary Choices.

Offering healthier school lunch choices to students can improve their dietary choices outside of school, according to a new study by School of Public Health researchers.

The study, published in the journal Health Behavior and Policy Review, found that adding healthy meal choices at a middle school, through an intervention called IMOVE, led to students consuming less sugary beverages and whole-fat milk than their peers in a school that lacked such meal options.

The evaluation shows how “increased awareness and exposure to healthy choices in school can impact overall dietary behavior in a vulnerable population group in need of improved nutrition,” the authors said. They called for further research to gauge whether federal changes to school nutrition standards, approved in 2010, have improved children’s dietary behavior and health outcomes.

The research team looked at students’ eating behaviors at two middle schools in an urban district—one that offered healthy meals (IMOVE meals) alongside standard school lunches, and the other that didn’t. The school with the IMOVE program offered more servings of fruits, vegetables, and whole grains, and lunches that had reduced calories from fat and saturated fat. The IMOVE program used cafeteria promotions of fresh fruits and vegetables and raffle prizes to incentivize participation.

The study, conducted over one school year, found that there was no difference in self-reported fruit and vegetable intake at the two schools. But there was a difference in beverage consumption, with students at the IMOVE school consuming less soda and whole milk, both inside and outside of school, than their peers at the other school.

“Given the ongoing implementation of the Healthy Hunger-Free Kids Act in schools across the country, this research provides some evidence that healthy changes to lunch entrees at school positively impact overall food choices and contribute to healthier eating—an area that deserves further exploration,” says lead author Jacey Greece, clinical assistant professor of community health sciences.

She and colleagues pointed out that the IMOVE intervention did not include a classroom nutrition education component, which they said would be beneficial to further improving healthy eating.

“As evidenced by the modest impact measured in our study, an environmental intervention alone is unlikely to achieve the level of desired changes in food intake behavior without nutrition education in the classroom and access to healthy choices at school events, fundraisers and celebrations,” they wrote.

They said that in both schools, overall dietary quality was low, falling below recommended intake levels of dairy, fruits, and vegetables and suggesting the need for “integrated strategies” to promote healthy eating. They called for further research to explore “effective long-term interventions that couple nutrition education with efforts targeting multiple aspects of the home and school food environment.”

The study was the second of three analyses of the IMOVE program led by Greece and other SPH researchers. Co-authors include: Paula Quatromoni, chair and associate professor of health sciences at Sargent College and of epidemiology at SPH; William DeJong, professor of community health sciences; Yvette Cozier, assistant professor of epidemiology; and Samantha Feld, a former MPH student.

The study was funded by the Charles H. Hood Foundation, with additional funds from the Dudley Allen Sargent Research Fund at BU’s Sargent College.

—Lisa Chedekel