Author(s): Whitaker RC, Wright JA, Finch AJ, Psaty BM
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Abstract OBJECTIVE: To determine whether making a low-fat entree available as one of two choices in an elementary school lunch program would reduce the fat content of meals selected by children. DESIGN: In this before-after trial, students had a daily choice between two entrees, one of which was sometimes low-fat. For 93\% of school days during 14 consecutive school months, daily entree choices were recorded for 619,976 student meals. The fat content of entrees was assessed with a computerized nutrient database supplemented by food manufacturer's data. SETTING: Sixteen elementary schools in the Bellevue (Washington) School District. PARTICIPANTS: The number of students eating school lunch averaged 2440 per day, of whom 25\% were less than 185\% of poverty. INTERVENTION: After a baseline period of 6 months, the intervention increased the number of days per month when one of the two entrees had 30\% or fewer calories from fat. MAIN OUTCOME MEASURES: Data for the entire district were combined to estimate for each month the percent of students who selected low-fat entrees and the percent of calories from fat in the average meal selected by students. RESULTS: During the 6 months before the intervention, a low-fat entree was available on 23\% of days; it was selected by 39\% of students; and the average meal selected by students had 36\% of calories from fat. By the end of the 8-month intervention, a low-fat option was available on 71\% of days; it was selected by 29\% of students; and the fat content of the average meal dropped from 36\% to 30\% of calories from fat (P = .02). CONCLUSIONS: In this school district, many students, given the choice, selected low-fat entrees. Recommendations for dietary fat were met simply by the environmental intervention of increasing the availability of low-fat foods.
This article was published in Pediatrics
and referenced in Journal of Health Education Research & Development