Online Program

Impact of a smarter lunchroom intervention on food selection and consumption among adolescents and young adults with intellectual and developmental disabilities in a residential school setting

Monday, November 4, 2013 : 5:15 p.m. - 5:30 p.m.

Kristie Hubbard, PhD, MPH, RD, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
Linda Bandini, PhD, RD, EK Shriver Center, UMass Medical School, Charlestown, MA
Sara Folta, PhD, John Hancock Research Center on Physical Activity, Nutrition, and Obesity Prevention, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA
Brian Wansink, PhD, Cornell Food and Brand Lab, Cornell University, Ithaca, NY
Misha Eliasziw, PhD, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
Aviva Must, PhD, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
Schools are captive environments for public health interventions to improve dietary intake. Principles of behavioral economics and social psychology guide recent efforts to nudge students toward better food choices in school cafeteria environments. This study assessed whether a Smarter Lunchroom intervention adapted for students with I/DD, aged 9 to 22, would increase the selection and consumption of fruits, vegetables, and whole grains; and reduce the selection and consumption of refined grains. The 3-month intervention took place at a residential school between February and June 2012. We employed a quasi-experimental, pre-post design comparing 5 matched days of dietary data. Selection, consumption, and plate waste of foods at lunch were assessed using digital photography. From baseline to follow-up, the daily selection of whole grains increased by 27% from 1.62 to 2.06 servings (absolute mean difference 0.44 servings, p=0.005), and refined grains decreased by 40% from 0.82 to 0.49 servings (absolute mean difference 0.33 servings, p=0.005). The daily consumption of fruits increased by 46% from 0.39 to 0.57 servings (absolute mean difference 0.18 servings, p=0.008), whole grains increased by 27% from 1.44 to 1.83 servings (absolute mean difference 0.38 servings, p=0.008), and refined grains decreased by 46% from 0.68 to 0.37 servings (absolute mean difference 0.31 servings, p=0.004). Fruit (p=0.04) and vegetable (p=0.03) plate waste decreased. This Smarter Lunchroom intervention improved food choices and dietary intake of students with I/DD while decreasing fruit and vegetable plate waste. Nudge approaches offer promise for improving the food selection and consumption habits of youth with I/DD.

Learning Areas:

Public health or related research

Learning Objectives:
Identify that youth with I/DD have not been included broadly in school-based nutrition policies, programs, or interventions. Assess the physical and social factors within school environments that influence food choices. Describe how personal factors (cognitions, skills, behaviors,behavioral capability) of youth with I/DD interact with physical and social factors in school environments to ultimately impact health. Explain how environments can be enhanced to improve the food choices and dietary intake of youth with I/DD. Discuss strategies for including youth with I/DD in the design of interventions. Explain the potential advantages of intervention approaches that support autonomy among youth with I/DD.

Keyword(s): Disability, Food and Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a registered dietitian for 10 years and completed a Maternal and Child Health Bureau fellowship: Leadership Education in Neurodevelopmental and Related Disabilities. The study represents the work of my doctoral thesis project and was guided by a strong group of academic mentors with over 20 years of experience working to improve overall health and dietary intake of youth with I/DD.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.