# Presentation: 548027

## October 26, 2006

**Helping Students Make Better Food Choices in School**

**Alicia Moag-Stahlberg, MS, RD**
**Executive Director**

## Overview

- Background
- Project goals
- Methods
- Results
- Summary

## What Kids Are Not Eating

**Increases**
**Current Intake **
**Decreases**

**  ****Fruits ****	****    Vegetables      Grains     Meat & Beans      Milk**** **

- ***Consumption data from NHANES 2001-2002**

**Notes:**

How do the final food intake patterns compare with what Americans now eat?  This graph depicts that comparison for two age-sex groups, shown as the percent change needed to meet recommendations.

The zero line indicates the amount currently consumed, and the bars indicate the percent increase (above the zero line) or decrease (below the zero line) in consumption that is needed to meet recommendations.  This slide shows the five food groups. To meet recommendations individuals need a substantial increase in consumption for four food groups—fruits, vegetables, meat and beans, and milk.   

Consumption data is based on NHANES 01-02 data

## Translating Guidelines Into Action

- Adequate nutrients within calorie needs
- Weight management
- Physical activity
- Food Groups to Encourage – special nutrients of concern for children
- Calcium
- Potassium
- Magnesium
- Vitamin E
- Fiber

**Notes:**
Good nutrition is vital to good health and is absolutely essential for the healthy growth and development of children and adolescents.”

“...nutrient needs should be met primarily through consuming foods.”

The 2005 DGA have now identified nutrients that are of special concern for children.
Calcium
Potassium (currently not on Nutrition Facts label)
Fiber
Magnesium (not on Nutrition Facts label)
Vitamin E (not on Nutrition Facts label)

With the SMI nutrition standards, we have been tracking or monitoring certain nutrient as an indicator of an adequate diet.  These proxy nutrients are:
 calcium, 
iron,
 vitamin A, 
vitamin C and
 fiber.  
These nutrients are also identified on the Nutrition Facts Panels, making the information readily available for schools and state reviewers.

## Making Better Food Choices

- Pilot projects 2004-2005 school year with dozen Chicago-area schools
- Key Findings - Recommendations
- Involve Students
- Tastings and Promotions Get Attention
- Information is Powerful
- Support and Collaboration are Necessary
- Packaging Counts
- Price Advantage for Healthy Options
- Be Consistent and Comprehensive
- OK to Imitate

## Project Goals – Phase II

- Test simple promotional strategies to increase awareness and consumption of Food Groups to Encourage
- Low Fat Dairy, Fruit/Vegetables, Whole Grains
- Develop practical student/school evaluation methods
- Based on findings, develop model approach for schools to utilize as a component of Wellness Policy implementation
- Increase selection of key food groups
- Increase student choice and consumption
- Increase exposure to nutrition information; provide supplement to classroom nutrition education

## Participating Schools - Students

- Evanston High School (urban)
- 3200 students
- 48% Caucasian, 39% African American, 9% Hispanic, 2% Pacific Islander/Asian
- 32% enrolled free/reduced school meal
- Quincy High School (rural)
- 1726 students
- 89% Caucasian, 9% African American, 1% Hispanic, 1% Pacific Islander/Asian
- 28% enrolled free/reduced school meal

## Participating Schools - Students

- Baldwin Intermediate School (rural, Quincy)
- 1468 students
- 88% Caucasian, 10% African American, 1% Hispanic, 1% Pacific Islander/Asian
- 55% enrolled free/reduced school meal
- Thomas & South Middle School (suburban, Arlington Heights)
- 1700 students total in both schools
- 90% Caucasian, 4% African American, 2% Hispanic, 5% Pacific Islander/Asian
- 7% enrolled free/reduced school meal

## Promotion Design

- Nutrition promotion timing for each food group was one month long
- Design criteria included: cost effective, not-duplicative, complement school context, easy to administer
- Utilize Ag in Classroom materials and other USDA materials
- Target audiences for materials included food service professionals, students, teachers, and parents

- Utilize variety of communication vehicles and locations throughout school:
- Morning announcement
- Homeroom
- Parent newsletter/menu
- Posters in bathrooms, cafeteria, nurse office, halls
- Cafeteria
- Promotions included
- Taste tests
- Balloons, music, signage
- Point of choice nutrient information

## Assessment 

- What aspects of the promotion did students notice, like the most?
- Did student’s make better food choices during the promotion?
- Are student’s likely to continue choosing food groups highlighted?
- Did student’s report a willingness to select the food group outside of school?
- Did food service professionals note differences in product utilization/selection?
- Would food service be willing to conduct promotions in the future?

**Notes:**
Quantify food items purchase/utilization
Focus group with students post each promotional month
Final survey with administrator, food service professional
Final end-of-school year, student survey, computer/quantitative

## Focus Group Findings

- Formative information and immediate learnings
- After each promotion one group completed
- 15 focus groups total;  214 students total
- 83% of students were aware of promotions
- Promotional items noticed/liked most included
- Taste testing most memorable/liked
- Balloons, music
- Posters
- Majority of :
- Students understood the purpose of promotion
- Middle school students reported trying food groups/products being highlighted
- Students that did try new product/food, they did like it
- More of the school students reported NOT trying food group or product being highlighted

**Notes:**
Purpose to eat healthier, increase food item being highlighted

## Quantitative Survey Findings

- Total of 353 students completed survey
- 57% female and 43% male
- 62% middle school and 38% high school
- 93% of students were aware of promotions throughout the school year; 41% remembered all promotions similarly, 36% remembered fruit/vegetable (completed previous month) and 15% remembered dairy the most (done at start of school year)
- Promotional items most memorable/effective
- Taste tests 83%
- Posters 68%
- Balloons 45%
- Hand outs/announcements 28%

## Learned Why Important For Me

**Notes:**
I learned new information about why ____ products are important

## I Eat More In Cafeteria

- Since promotion, I eat more _____ product in cafeteria

**Notes:**
Since promotion I eat more _____ in cafeteria

## I Eat More At Home, Other Places

- Since promotion, I eat more at home and in other places

**Notes:**
Since promotion I eat more of ______ products at home and other places

## In Future, Will Eat More

- In the future, I plan to eat more

**Notes:**
Since promotion I eat more of ______ products at home and other places

## Knowledge of Servings Needed

- 63% correctly named number of servings from Dairy food group needed each day
- 40% correctly named the number of servings from Grain food group needed each day
- Less than 30% could correctly name the number of servings needed from Fruit or Vegetable food groups

## Summary

- Promoting nutrition and healthful food items is very necessary – hard to compete with current practices
- Does not replace need for nutrition and health education – supplements classroom learning to drive at point of choice nutritious decisions
- Students from 5th to 12th grade did respond to simple promotions
- More intensive, longer lasting promotions would have greater effect
- Need participation from many stakeholders for successful and lasting practices
- Although not complicated, this approach takes time and resources to implement so collaborative approach is necessary

## “Best Practices” School-based Approaches

- Cost-effective --  resources available
- Complement larger school context --  fit within school schedule, align with a coordinated school health model
- Be lasting -- not just a one-time event without additional programs, want impact to be lasting
- Supported by critical audiences -- students, administrators, school food service, teachers, families/parents, and community leaders
- On-going “body” charged with keeping the light on the issue -- School Health/Wellness Advisory Council

## Action for Healthy Kids’ Resources