School food options to increase vegetable consumption

Increasing children’s fruit and vegetables intake is a significant goal of paediatricians, nutritionists, and public health experts. However this goal is not easy to reach, due to a strong obesogenic environment in which children are submerged even at home and at school.

Children are bombarded by junk food advertising, through their parents’ “life rush” driving the use of pre-packed foods even at family meals, and by often flavourless school meals prepared with technical difficulties. Despite this depressing picture, research to improve children’s F&V intake is happening in different settings especially in school cafeterias. The following three papers present explorations of different strategies to improve children’s F&V intake.

Redden et al. have used a simple tool: presenting vegetables like carrots and broccoli first and at a distance from the other meal courses at the school cafeteria. The action seemed to have positive results and increased consumption seemed almost entirely driven by many students eating vegetables from cups before entering the cafeteria line to have lunch.

The paper written by Van Kleef et al. examined portion size and unit size effects to increase vegetable consumption among primary school children aged 8-13 years in The Netherlands. Their findings suggest that children’s vegetables intake can be increased by serving larger portions in smaller-sized pieces.

The third paper (Cohen JF et al.) reports the effects of a double intervention in the school cafeteria: improving palatability and changing the food-choice-architecture. The results showed that improving foods palatability is the best tool to increase F&V intakes in short (3 months) and long terms (7 months). Providing vegetables at the beginning of the lunch line, as well as displaying them in attractive containers significantly increased vegetable selection, but not overall consumption.

What can we deduce from these studies? We need to:

• Improve vegetables taste, if we want children to enjoy eating them, and return to the healthy, tasty recipes of the Mediterranean Diet,
• Eliminate the availability of junk food from the places dedicated to children’s education,
• Promote the strong cooperation of the school system as well as positive political support,
• Dismiss short term interventions as they fail to yield valuable results and could even be harmful, wasting much needed resources.

Finally, for interventions to be successful, they must be long lasting, perhaps life-long, to help “make healthier choices easier”.