Mission Possible: Kids Will Eat School Meals An Overview ...childhoodobesity2015.com/docs/uploads/MP1.3.Yon,B_MissionPossi… · An Overview of Dietary Assessment Methods . ... Gamification

B e t h a n y Y o n , P h D

N u t r i t i o n a n d F o o d S c i e n c e s U n i v e r s i t y o f V e r m o n t

B u r l i n g t o n , V T

Mission Possible: Kids Will Eat School Meals

An Overview of Dietary Assessment

Methods

Disclosures

Research Funding includes: • USDA/Vermont Agriculture Experiment Station/Hatch

Funds • Dairy Research Institute • New England Dairy and Promotion Board • Bickford Scholar Research Fund • Vermont Agency of Natural Resources

Have the new school meal regulations resulted in increased food waste? Popular Media: Yes Research: Yes and No

How do we know what children eat at school?

DIETA RY A SSESSMENTS USING CHILDREN’S SELF -REPORTED INTA KE

• Dependent on memory and cognitive abilities • Portion sizes may be difficult to estimate

DIETA RY A SSESSMENTS USING MEA L OBSERVA TIONS

• Collects information on food selection and plate waste • Objective measure independent of self-reporting errors

Dietary Assessment Methods

Weighed Plate Waste Individual Aggregate

Direct Observation 5-6 point Scales

Digital Imaging Selection And Waste Combined with Observation

Individual Aggregate

Weighed Plate Waste Methods

Salad Bar evaluation (Adams, JADA 2005)

Program evaluation (Cohen, JAMA Ped 2015)

Label Student Trays Establish baseline weights (5-10

random samples) Observe/count/weigh student

selections Collect trays and weigh

remaining food S-W = Consumption

S=weight of selected food(s) W=weight of student waste

Gamification increases fruit & vegetable consumption (Jones, Prev Med 2014). P-U-W / N = Consumption P=weight of prepared food(s)* U=weight of unserved food(s)* W=weight of student waste N=number of students *Relies on Production records

Direct Observation Methods

o New school meals in Los Angeles (Gase, Prev Med 2014)

o Home Packed vs School Lunches (Farris, JNEB 2014)

o Fruit/Vegetable Selection & Consumption (Cullen, J Acad Nutr Diet 2015)

Comstock’s 6-point scale (J Am Diet Assoc 1981)

None, Taste (10%), Some (¼), Half (½), Most (¾), All

5-point Scale (Hanks, J Acad Nutr Diet 2014)

None, ¼, ½, ¾, All

Observer training and reliability testing

Digital Imaging Method

Farm to School Program evaluation (Yoder, JNEB 2014)

Foods brought from home (Hubbard, J Acad Nutr Diet 2014)

New School Meal Regulations (Schwartz, Childhood Obes 2015)

Program Evaluation (Shaping Healthy Choices) (Scherr, JNEB 2014)

o Determination of average serving weights of FV

o FV selection image o FV plate waste image

o Percentage consumed estimated using a five or six-point scale

o C o m p a r e d D I d a t a c o l l e c t e d a n d t r a n s m i t t e d b y p a r e n t s a n d t e a c h e r s t o t h e U V M r e s e a r c h t e a m .

o T e a c h e r s m a y b e b e t t e r a t c o l l e c t i n g D I d i e t a r y a s s e s s m e n t d a t a t h a n p a r e n t v o l u n t e e r s a n d u n i v e r s i t y r e s e a r c h e r s .

Utilizing School-Based Volunteers for Digital Imaging Data Collection

Feasibility of Collecting Digital Image Pairs in Two Elementary School Cafeterias (Grades 3-5)

UVM Parents UVM Teachers

Lanyards distributed to students 320 294 401 268

Percent DI pairs 82% 74% 91% 96%

WPW: Children’s Milk Consumption

10 elementary schools (7 northeast, 3 south)

Individual WPW (grades 3-5)

Overall, no change in

flavored milk consumption.

Differences between and within schools (SES, grade, sex, milk packaging).

2010: 150-170 calories, 0-1% fat, 22-27gm total sugars 2013: 110-130 calories, 0% fat, 18-22 gm total sugars

Digital Imaging Percent of elementary student lunch

trays with fruit and/or vegetables when optional versus required

Selection

o More lunch trays contained fruits or vegetables, in larger amounts (fruit)

o Fewer children selected both fruits and vegetables

Consumption

o FV consumption decreased 12%

o FV waste increased 56% (mostly fruit)

*

*

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

F or V Both FV Fruit only Vegetableonly

Optional 2011/12 (n=498 trays)

Required 2012/13 (n=944 trays)

Farm to School Non-Farm to School

Digital Imaging Farm to School/Non-Farm to School

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

Optional 2011/12(n=258 trays)

Required 2012/13(n=402 trays)

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

Optional 2011/12(n=240 trays)

Required 2012/13(n=542 trays)

Opportunities – Universal Recycling/Composting

Aggregate WPW Method simplified

Food scrap weights can be compared to: Menu/Entrée selection Pre/Post Intervention

Next Steps

Objective dietary assessment methods can evaluate menu changes, educational programming, cafeteria environment.

Digital Imaging methods continue to evolve.

What role does the Cafeteria Environment play? Amount of time in service line/at table Increases in fruit or vegetable selection may be a result of:

greater variety placement at register/POS

R A C H E L K J O H N S O N , R D , P H D , M P H S A R A H A M I N , M P H

J E N N I F E R T A Y L O R , M S A L A N H O W A R D , M S

J E F F R E Y P R I E S T , P H D O U R S C H O O L N U T R I T I O N D I R E C T O R S

U V M ’ S D I E T A R Y A S S E S S M E N T T E A M

Acknowledgements