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