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Health Beat blog: School lunch and the vegetable strategy

Offer fruit and vegetables on the school lunch menu and kids will be inspired to try them, like them and maybe even start eating them on a regular basis -- or so the theory goes.

But a new study has found this isn't necessarily the case. Although bringing raspberries, asparagus, sweet potatoes and the like into the school cafeteria did seem to have an impact, the effect wasn't particularly strong, researchers learned after scrutinizing the food choices of more than 26,000 children.

The study appears in the latest issue of the Journal of Clinical Nutrition. It's one of the first times researchers have attempted to quantify whether school-based programs actually make a difference in how many fruits and vegetables children consume each day.

A bit of background about the study: It analyzed nearly two dozen previous studies involving a total of 26,400 children ages 5 to 12 in several countries, including the U.S., Britain and Australia.

The researchers looked at two different kinds of food programs: Those in which kids received free or subsidized produce, and those that included elements such as family and nutrition education and communicating with parents. They then compared them with school lunch programs that didn't do anything specific to encourage more fruit and vegetable consumption.

The results were interesting or dismal, depending on your point of view.

On average, children in school-based food programs ate about one-fourth of a portion more of produce. The effect was especially low for vegetables -- only a tenth of a portion more, or the equivalent of half a spear of asparagus.

Notably, this wasn't confined to school lunch programs in the U.S.; the researchers found similar results in Europe and Australia.

Counting juice as a fruit raised the average consumption a little higher but not by much.

It's hard to gauge whether such small increases have an overall benefit on children's nutrition. Perhaps it did help in some subtle, long-term way. Tracking whether these same kids also ate slightly more fruits and vegetables at home and whether they continued these habits into adulthood was outside the scope of the studies selected for the analysis, but even slight changes could have added up over time.

The researchers dug up some especially interesting conclusions regarding the strategies used by schools to encourage more fruit and vegetable consumption.

It seemed to make a difference when schools included more education about nutrition and when they communicated more with families about nutrition. School garden programs also seemed to help.

There's been a fair amount of study on what schools can do to get children to eat more fruits and vegetables. Should they restrict access to chips, soda and other less desirable foods in the hope that the slack will be picked up with fruits and vegetables? If kids are given more fruit and vegetable options, will they be more likely to try at least one of them? Does it work to offer rewards when kids choose fruits and vegetables in the school lunch line? What about marketing fruits and vegetables to make them cool and fun?

The evidence suggests that most of these strategies may help in some way, albeit moderately. But school lunch programs are only one component in a food environment that also extends to how children eat at home and what they see and experience in the community around them.

On the basis of the Journal of Clinical Nutrition study, it would be easy to conclude that school-based interventions are, at best, only mildly successful and perhaps not worth the effort. There's another way of looking at it, though: In order to positively influence children's eating behavior, there may not be the blockbuster solution that many are looking for. It more than likely will take multiple strategies on many fronts -- each of them small but adding up to a whole that's greater than the sum of the parts.

Anne Polta

Anne Polta covers health care, business/economic development and general assignment. Her HealthBeat blog can be found at Follow her on Twitter at @AnnePolta.

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