Inexpensive changes to school cafeterias promote healthier foods

In January 2012, the United States Department of Agriculture passed a series of regulations designed to make school lunches more nutritious, which included requiring schools to increase whole grain offerings and making students select either a fruit or vegetable with their purchased lunch. However, children cannot be forced to eat these healthier lunches. In a new study scheduled for publication in The Journal of Pediatrics, researchers determined that small, inexpensive changes to school cafeterias influenced the choice and consumption of healthier foods.

Andrew S. Hanks, PhD, and colleagues from the Cornell Center for Behavioral Economics in Child Nutrition Programs (B.E.N. Center) studied the effects of multiple small interventions, called the smarter lunchroom makeover, in the cafeterias of two junior-senior high schools (grades 7-12) in western New York. In the lunchroom, changes were implemented to improve the convenience and attractiveness of fruits and vegetables (e.g., fresh fruit next to the cash register in nice bowls or tiered stands) and make the selection of fruits and vegetables seem standard through verbal cues from cafeteria staff (e.g., "Would you like to try an apple?"). The smarter lunchroom makeover took no more than 3 hours in one afternoon and cost less than $50 to implement. These types of changes are applications of the behavioral science principle termed "libertarian paternalism," which promotes influencing choice through behavioral cues, while preserving choices.

To measure the impact of the smarter lunchroom makeover, researchers recorded what was left on trays after lunch, both before and after the intervention. After the smarter lunchroom makeover, students were 13% more likely to take fruits and 23% more likely to take vegetables. Actual fruit consumption increased by 18% and vegetable consumption increased by 25%; students were also more likely to eat the whole serving of fruit or vegetables (16% and 10%, respectively).

These low-cost, yet effective interventions could significantly influence healthier behaviors, potentially helping to offset childhood obesity trends. Dr. Hanks notes, "This not only preserves choice, but has the potential to lead children to develop lifelong habits of selecting and consuming healthier foods even when confronted with less healthy options." These simple changes could also be effective in the cafeterias of other organizations, including hospitals, companies, and retirement homes.