School based environmental obesity policy: The good, the bad and the downright ugly

Background. The childhood obesity epidemic has spurred a range of interventions aimed at changing children's dietary habits, among them many school-based. The SchoolFood Plus (SFP) initiative in New York City public schools is a multi-faceted program designed to improve the eating habits of low-income ethnic/racial minority children at risk for poor nutrition and obesity. SFP includes changes to the school lunch program by reintroducing plant-based recipes that are cooked within schools. This study reports on the consumption of SFP recipes offered in school cafeterias.

Methods. A quasi-experimental pre-post design compared three school conditions: minimal change in lunch side dishes, substantial change in lunch side dishes, and substantial change in lunch sides plus educational program components. Digital photography assessed consumption of SFP recipes by second and fifth graders.

Results. Across school condition and time points 1,176 lunch trays were assessed. 41% of the lunch trays assessed included the SFP recipes (N=479). When they appeared on the trays, only a small minority of students consumed any of the recipes (N=88). Regardless of intervention condition, program exposure did not appear to affect the eating of SFP recipes as the percentage of children eating the recipes dropped between pre and post test.

Discussion. Policies designed to change school meal environments are appealing because they hold the promise of affecting large numbers of children and are under the control of policy-makers. Results suggest some promise of this approach but also highlight challenges to implementation and potential limitations on its effectiveness.