Pilot Evaluation of Aggregate Plate Waste as a Measure of Students' School Lunch Consumption

The Effects of Potato Presentation on Vegetable Intake in School-Aged Children: A Cross-Over Study

Vegetables are an essential component of a healthy dietary pattern in children; however, their consumption is often insufficient due to lack of preference. To address this, the influence of combining vegetables (mixed peas and carrots-MPACs) with potatoes, a generally liked food, on overall vegetable consumption among children aged 7-13 years was explored. The research involved a cross-over study design with 65 participants who completed five lunchtime meal conditions, each with different combinations of MPACs and potatoes versus a control (MPACs with a wheat roll). The meals were provided in a cafeteria setting, and plate waste was used to measure vegetable consumption. Anthropometric data and other variables were also measured. Notably, self-reported hunger did not significantly differ between conditions. Meal condition was a significant predictor of MPACs (F = 5.20; p = 0.0005), with MPAC consumption highest when combined with shaped potato faces in the same bowl (+8.77 g compared to serving MPACs and shaped potato faces in separate bowls) and lowest when combined with diced potatoes in the same bowl (-2.85 g compared to serving MPACs and diced potatoes in separate bowls). The overall model for MPAC consumption was influenced by age, height z-score, body fat percentage z-score, and condition (likelihood ratio = 49.1; p < 0.0001). Age had the strongest correlation with vegetable consumption (r = 0.38), followed by male gender, height z-score (r = 0.30), and body fat z-score (r = -0.15). The results highlight the positive impact of combining potatoes with vegetables in school meals, particularly when using shaped potato faces. These findings emphasize the potential of potatoes as a valuable vegetable option in promoting healthier eating habits among children. Additionally, future research could explore the impact of different potato combinations and investigate other factors influencing meal consumption in school settings.

Food waste in primary schools: Evidence from peri-urban Viet Nam

Schools are a major source of food waste and an important setting for achieving dietary improvements. Few studies explore the links between food waste and nutrition. This study measured individual plate waste of about 1700 primary school children in peri-urban Viet Nam, adding to evidence on school food waste in low- and middle-income countries. We used survey data to explore whether food waste is associated with personal characteristics such as sex, knowledge and attitudes about nutritious foods. Qualitative interviews and focus groups with teachers, parents, food providers and children helped identify potential causes of food waste. The average student wasted 23% of the food served (approximately 85 g) during lunch, which roughly equates to 15.3 kg of food in a school year. Vegetables were wasted most: children left almost half of their portion unconsumed. Boys wasted less food than girls. Better knowledge and attitudes about fruits and vegetables are associated with less waste of these foods. A large portion was associated with a higher share of wasted food, suggesting the potential trade-off between efforts to cut food waste and efforts to increase consumption of nutritious foods. Students were dissatisfied with the quality of the dishes, especially vegetables were evaluated as undercooked, served too cold and too oily. To reduce food waste, it is critical for schools to prepare food in line with students' preferences. Food waste reduction could be treated as an intermediate step towards ultimate policy goals such as healthier food consumption.

Relationship Between Plate Waste and Food Preferences Among Primary School Students Aged 7-10 Years

OBJECTIVE

To assess differences in the amount of plate waste (PW) and food preferences among food categories containing vegetables and fruit and which of the student-centered reasons may influence PW.

DESIGN

A cross-sectional study (from December, 2017 to June, 2018); the aggregate selective plate waste method; the taste-and-rate method (food preferences); the multiple-choice survey (student-centered reasons for the PW occurrence).

SETTING

Fourteen primary schools (Zagreb).

PARTICIPANTS

Students aged 7-10 years; 17,163 meals (PW); 11,960 meals (PW and food preferences for meals containing vegetables and fruit); 6,507 meals (student-centered factors).

MAIN OUTCOME MEASURES

Plate waste, preferences, and student-centered reasons for PW occurrence.

ANALYSIS

Continuous and categorical data were analyzed using a 1-way analysis of variance for nonnormal distribution with post hoc Dunnett's test and chi-square test of homogeneity, respectively. Spearman's rank correlation coefficient was performed to examine the correlation between the amount of PW and served food. All statistical analyses were constructed with robust standard errors clustered at the school level.

RESULTS

Among the different types of vegetables and fruit meals, students wasted lower amounts of fruit (10.3%; P = 0.005). Plate waste was positively correlated with the amount of served food (r = 0.93; P &lt; 0.001) containing vegetables and fruit. Students preferred fruit and starchy food with vegetables. Among personal factors for not finishing meals, the most frequent reason was they did not like the taste of the food.

CONCLUSION AND IMPLICATIONS

Findings highlight the importance of food preferences and other student-centered reasons in explaining PW by primary school students.

Identification and Evaluation of Tools Utilised for Measuring Food Provision in Childcare Centres and Primary Schools: A Systematic Review

BACKGROUND

Children aged 2-11 years spend significant hours per week in early childhood education and care (ECEC) and primary schools. Whilst considered important environments to influence children's food intake, there is heterogeneity in the tools utilised to assess food provision in these settings. This systematic review aimed to identify and evaluate tools used to measure food provision in ECEC and primary schools.

METHODS

The Preferred Reporting Items for Systematic Reviews (PRISMA) was followed. Publications (2003-2020) that implemented, validated, or developed measurement tools to assess food provision within ECEC or primary schools were included. Two reviewers extracted and evaluated studies, cross checked by a third reviewer and verified by all authors. The Academy of Nutrition and Dietetics Quality Criteria Checklist (QCC) was used to critically appraise each study.

RESULTS

Eighty-two studies were included in the review. Seven measurement tools were identified, namely, Menu review; Observation; Weighed food protocol; Questionnaire/survey; Digital photography; Quick menu audit; and Web-based menu assessment. An evidence-based evaluation was conducted for each tool.

CONCLUSIONS

The weighed food protocol was found to be the most popular and accurate measurement tool to assess individual-level intake. Future research is recommended to develop and validate a tool to assess service-level food provision.

Do Behavioral Interventions Increase the Intake of Biofortified Foods in School Lunch Meals? Evidence from a Field Experiment with Elementary School Children in Ethiopia

BACKGROUND

Many African countries are seeking to improve nutrition by introducing biofortified foods in school feeding programs. These programs are generally designed to create demand for biofortified foods both in and outside of school. Finding ways to encourage child acceptance of novel biofortified foods is key to the success of this strategy.

OBJECTIVES

The aim was to assess effects of 2 behavioral interventions in promoting the consumption of biofortified foods as part of school lunch meals.

METHODS

The study is based on a field experiment involving 360 school-going children of in the third, fourth, and sixth grades. We tested if structured provision of information about the nutritional benefits of a biofortified food and its association with an aspirational figure influence its consumption when served alongside a favorite local food as part of school lunch meal. Six schools in Tigray, Ethiopia, were randomly selected to participate, with 4 participating in the Orange-Fleshed Sweetpotato (OFSP) Program. Of the 4 participating in the program, 2 were assigned to provide educational information about sweetpotato, whereas 2 presented the same information plus depictions of an aspirational figure (a famous local athlete) associated with the sweetpotato.

RESULTS

Provision of information on the nutritional benefits of biofortified food combined with an aspirational figure resulted in increased consumption of biofortified food by children. However, provision of the information alone did not detectably increase consumption. An analysis of trends over the course of the study revealed no discernable decay effect.

CONCLUSIONS

Our results highlight the potential for relatively inexpensive behavioral interventions to increase acceptance of novel biofortified foods among children in a developing-country context. Larger studies with more varied interventions and larger numbers of participating schools could address several of the weaknesses in this study and establish more robust findings.

Factors influencing food waste during lunch of fourth-grade school children

This study aims to explore the factors that influence plate waste at lunches served in primary schools. Data was collected for all fourth-grade children attending 21 primary schools from the city of Porto (Portugal) (n = 463). Plate waste was evaluated by the weighing method and factors influencing plate waste were collected by observation of menu and canteen characteristics and through the application of a questionnaire to children aiming to evaluate factors related to preferences and dietary patterns. Logistic regression was performed to identify predictors of plate waste. It was observed that fish menus and composed dishes showed a higher tendency for increased plate waste. However, this effect was not observed when adjusted for other variables. Soups without pulses and blended soups were less likely to be discarded by children. The presence of the teacher during meals and the possibility for children to leave the canteen whenever they wish, protected both the main dish and the soup from being wasted. A higher number of children in the canteen was associated with increased soup waste. As expected, children more pleased with the sensory characteristics of the main dish and soup were less likely to waste food. Children who consumed high-saturated fat content mid-morning snacks were more likely to waste soup. The main factors associated with plate waste were related to the presence of teachers during the mealtime, school meal policies and the meals' sensory characteristics. Additionally, soup waste was determined by its composition, mid-morning snacks and the number of children in the canteen.

Smaller servings vs. information provision: Results of two interventions to reduce plate waste in two university canteens

Two interventions were systematically evaluated in two university canteens on their effectiveness to reduce visitors' plate waste. The evaluation was theory-based and focused not only at the effects on the amount of plate waste, but also at the psychological predictors underlying plate waste behaviour. In Intervention A, visitors received information about food waste over a period of three weeks. In Intervention B, in addition to information, smaller servings were offered. The actual amount of plate waste and visitors' attitudes, personal norms, beliefs, perceived behavioural control, intentions and plate waste reduction behaviour were measured before and after the interventions. Intervention B reduced the amount of plate waste by 20%, whereas no reduction was found after Intervention A. In both interventions, the provided information resulted in more positive beliefs and stronger personal norms regarding avoiding plate waste. The information also caused attitudes to have a stronger influence on plate waste reduction behaviour, whereas intention to reduce became less important for reducing plate waste. Personal norms regarding food waste were the strongest predictor of plate waste reduction behaviour, before and after the interventions. The provided information was thus insufficient to reduce plate waste, simply offering smaller servings could achieve this. Although our intervention study only included two university canteens and was conducted for a short period, our data seem to imply that a combination of both information and smaller servings reduces plate waste in the food service industry.

Weighed Plate Waste Can Accurately Measure Children's Energy Consumption from Food in Quick-Service Restaurants

BACKGROUND

Quick-service restaurants (QSRs) serve one-third of US children on any given day, yet no methods can directly measure energy (kcal) consumed in QSRs. Weighed plate waste is one feasible option, but the accuracy is unknown.

OBJECTIVE

The objective of this study was to determine the accuracy of weighed plate waste for measuring children's energy consumption in QSRs.

METHODS

Children's plate waste (entrées and sides) was collected for a larger study assessing a community-wide health messaging campaign to inform parents' orders for children in QSRs; a subsample (n = 194) was used for validation. Gross energy left over estimated by weighed plate waste combined with restaurant-stated nutrition information was compared to gross energy determined by bomb calorimetry, the gold-standard energy assessment technique. Analyses were conducted at the meal level (all food items, combined) and stratified by the number of items per meal (1, 2, or 3). Pearson correlations and paired t tests analyzed agreement; Bland-Altman statistics examined differences between energy estimations for the total and stratified subsample.

RESULTS

Overall, significant agreement was observed between weighed plate waste and bomb calorimetry (r = 0.99, P < 0.001). On average, weighed plate waste underestimated energy content by <2 kcal compared with bomb calorimetry (mean percent difference ± SD of 0.3% ± 10.7%); 94% of estimations fell within the limits of agreement (-23.5 to 26.8 kcal), and 63% and 24% of estimations differed by <10 or <20 net kcal, respectively. Although stratification by item number showed slight variation, mean differences for all strata were <5 kcal (t test P > 0.80), suggesting the accuracy of weighed plate waste for measuring meals of various sizes.

CONCLUSIONS

Weighed plate waste is an accurate and valid field technique for measuring children's energy consumption from food in QSRs. Future improvements to capturing beverages, self-serve condiments, and sharing behaviors may improve the overall feasibility and accuracy.

Validity and Reliability of an Expanded Vegetable Questionnaire Among Elementary School Children

BACKGROUND

The purpose of this study was to expand the School Physical Activity and Nutrition questionnaire to include a greater variety of vegetables and to evaluate the relative validity and reliability of these revised items.

OBJECTIVES

This study utilized 2 convenience samples of third to fifth graders for an analysis: validity (n = 70) and reliability (n = 76). Validity was assessed by comparing questionnaire items with vegetable intake reported from a 24-hour dietary recall covering the same reference period. Reliability estimates were assessed via same-day test-retest.

RESULTS

Agreement correlations ranged from 0.35 to 0.71. Kappa statistics varied from 0.16 to 0.66. Percentage agreements ranged from 57% to 87%. Test-retest Spearman coefficients were greater than 0.50 for 6 items, weighted Kappa values were greater than 0.40 for all 7 items, and percentage agreement exceeded 75% for 5 items.

CONCLUSIONS

Results suggest that the questionnaire is a valid and reliable measure of the previous day's vegetable intake in third- to fifth-grade students. This trial was registered at ClinicalTrials.gov as NCT02668744.