Student school meal perception, participation, and consumption: Implication for future school based nutritional interventions

Introduction: The Suburban Cook County Communities Putting Prevention to Work initiative funded school districts to improve school meal (SM) nutritional quality through its “Model Communities” program. SM are an important source of nutrition for students. Thus, improving SM nutritional quality could have significant impact on student nutrition. However, researchers have found an inverse relationship between appeal to students and student perceptions of the healthfulness of SM components. In this study we wanted to better understand the relationship between student SM participation, perception, and consumption to better anticipate and interpret changes associated with SM interventions. Methods: The “School Meal Questionnaire” includes questions regarding SM participation, likability and consumption and was administered to 5th and 6th grade students in 13 elementary schools. Multilevel linear regression modeling to predict students' SM perception score was used. Results: 552 students completed the survey (spring 2011). Adjusting for age, gender, and school random effects, students' perception of school lunch was positively associated with school lunch participation frequency (P < 0.05) and school lunch portion consumed (P < 0.01). Portion consumed association was stronger than school lunch participation frequency association. Portion of school breakfast consumed was positively associated with school breakfast perception (P < 0.01). Discussion: Less frequent participation in a SM program and/or limited consumption is associated with SM dislike. In order to maximize the nutritional benefits of changes to SM, schools may have to increase participation AND likability of healthier items. This suggests need for supplemental efforts to increase favorable perceptions of improved SMs.