Salad Bars and Fruit and Vegetable Intake in Title I Elementary Schools

Objective

Despite widespread support for salad bars as a means to increase fruit and vegetable (F&V) intake within the National School Lunch Program (NSLP), empirical support for their use is limited. This cross-sectional study examined associations between salad bar access and F&V selection and consumption in Title I elementary schools in Virginia serving universal free meals.

Methods

Three matched pairs of schools (3 with salad bars; 3 without [control]) were randomly selected. Digital imagery plate waste methods assessed F&V selection, waste, and consumption. N = 1559 trays (N = 760 salad bar; N = 799 control) from 1^st-5^th grade students were analyzed (92.5% NSLP participation; 98.6% racial/ethnic minority).

Results

Salad bar usage varied widely (8.2%-63.8%). Different patterns of F&V selection and consumption were observed across pairs. Vegetable selection was higher in one salad bar school (+43.6g; q < .001) and vegetable consumption higher in 2 salad bar schools (+15.3g [q = .005]; +8.3g [q = .022]), compared with matched controls. Students in 2 salad bar schools selected more fruit than controls (+30.2g and +18g; qs < .001), yet fruit consumption differed across all 3 pairs.

Conclusions

Salad bar access might facilitate children's vegetable intake. Inconsistent results across school pairs suggest that school food environment factors other than salad bar access influenced F&V consumption.

Salad Bars Increased Selection and Decreased Consumption of Fruits and Vegetables 1 Month After Installation in Title I Elementary Schools: A Plate Waste Study

OBJECTIVE

To evaluate the 1-month impact of salad bars on fruit and vegetable (FV) selection, intake, and waste.

DESIGN

Pre-post quasi-experimental design.

SETTING

Title I elementary schools in a large, urban district in central Virginia.

PARTICIPANTS

Students (grades 1-5; >95% African American) from 2 elementary schools participated in plate waste assessments (282 plates were rated at baseline, 443 at post-assessment); fourth- and fifth-grade students from 15 (of 18 eligible) schools (n = 1,193) responded to surveys.

INTERVENTION

Digital imagery plate waste assessments were conducted before salad bars were installed (baseline) and 1 month afterward (post). Post-surveys examined student perceptions of salad bars.

MAIN OUTCOME MEASURES

Fruit and vegetable selection, consumption, and waste.

ANALYSIS

General linear models (without considering clustering) examined changes in outcomes, controlling for school. Frequencies and qualitative analyses were applied to survey data.

RESULTS

At post, students selected more types of FVs (1.81-2.58; P < .001), although FV consumption decreased by 0.65 cups (P < .001). Given the smaller portions selected, there was less FV waste (0.27 cups; P < .001) at post. Students liked the ability to choose FV from salad bars.

CONCLUSIONS AND IMPLICATIONS

Short-term exposure to salad bars increased the number of FV students chose but decreased FV consumption. Additional strategies are needed to increase FV consumption.

School-Level Practices and Perceptions Associated With Salad Bars in Schools

BACKGROUND

Salad bars are placed in schools to promote fruit and vegetable consumption among students. This study assessed differences in school nutrition practices and perceptions in schools with and without salad bars.

METHODS

Cross-sectional surveys were completed by school nutrition managers (N = 648) in Arizona schools participating in the National School Lunch Program during 2013-2014. Mixed general estimating equation binomial regressions assessed factors related to having a salad bar after mutually adjusting for clustering within districts, school level, free/reduced rate, and respondents' time in current position.

RESULTS

On average, 61% of schools reported having a salad bar. After adjustment, school nutrition managers were significantly more likely to report having a salad bar if they served lunch by grade level (vs mixed grades), had a full-service kitchen, and their personal perception of salad bars was positive; schools were less likely to have a salad bar if menu and food service decisions were made at the school level.

CONCLUSIONS

Several school-level nutrition practices and perceptions were associated with having a salad bar in schools. Enhancement of these factors may facilitate having salad bars in schools.

Youth Access to School Salad Bars in the United States-2011 to 2014

PURPOSE

To examine differences in students' access to school salad bars across sociodemographic groups and changes in availability over time.

DESIGN

Nonexperimental.

SETTING

Nationally representative 2011 and 2014 YouthStyles surveys.

PARTICIPANTS

A total of 833 (2011) and 994 (2014) US youth aged 12 to 17 years.

MEASURES

Youth-reported availability of school salad bars.

ANALYSIS

Multivariable logistic regression models were used to assess differences in school salad bar availability by sociodemographics and changes in availability from 2011 to 2014.

RESULTS

Youth-reported salad bar availability differed by age in 2011 and race/ethnicity in 2014, but not by sex, income, metropolitan residence, or region in either year. Salad bars were reported by 62% of youth in 2011 and 67% in 2014; the increase was not statistically significant ( P = .07). Significant increases from 2011 to 2014 were noted among youth aged 12 to 14 years (56%-69%; P < .01), youth of non-Hispanic other races (60%-85%; P < .01), and youth in the Midwest (58%-72%; P = .01).

CONCLUSION

These results suggest that youth-reported access to school salad bars does not differ significantly across most sociodemographic groups. Although overall salad bar availability did not increase significantly from 2011 to 2014, some increases were observed among subgroups. Continued efforts to promote school salad bars through initiatives such as Let's Move Salad Bars to Schools could help increase access for the nearly one-third of US youth reporting no access.

Prevalence and Implementation Practices of School Salad Bars Across Grade Levels

PURPOSE

To assess the prevalence of school salad bars in Arizona and to describe common practices of salad bar use among school nutrition managers across grade level.

DESIGN

Cross-sectional web-based surveys.

PARTICIPANTS

School nutrition managers from elementary, middle, high, and K-12 schools (N = 648).

MEASURES

Prevalence of salad bars; implementation practices such as years with salad bar, salad bar type, location, monitor, and reimbursement practices; and food-related components of salad bars including frequency of items, popular items, and sources of food.

ANALYSIS

Descriptive analyses were conducted including Fisher exact test, analysis of variance, and the Kruskal-Wallis test comparing practices across grade level (elementary, middle, high, and K-12 schools).

RESULTS

Overall, 61.1% of respondents had a salad bar; there were significant differences in the prevalence across grade level: elementary, middle, high, and K-12 schools had prevalence of 67.3%, 75.0%, 45.5%, and 51.1%, respectively ( P < .001). We observed significant differences in the implementation and food-related components of salad bars across grade levels including type, salad bar location, sources of food, and frequency of serving cut vegetables.

CONCLUSION

This study provides insights on the prevalence of salad bars and is the first to report on implementation practices of school salad bars. These results may also guide the development of interventions for nutrition educators to use for the promotion fruit and vegetable consumption via school salad bars.

Individual- and School-Level Factors Related to School-Based Salad Bar Use Among Children and Adolescents

BACKGROUND

Consumption levels of fruits and vegetables (F/V) among children/adolescents are low. Programs like school-based salad bars (SB) provide children/adolescents increased F/V access.

AIMS

The purpose of this study was to examine the relationship between SB use and individual and school-level factors among elementary and secondary school students in New Orleans public schools.

METHOD

Twelve schools receiving SB units from the Let's Move Salad Bars to Schools Campaign participated in this study. Self-reported data were collected from students ( n = 1,012), administrators ( n = 12), and food service staff ( n = 37). School environmental data were obtained through direct observation. Generalized estimating equation regression methods were used to develop a multilevel model including both school-level (e.g., length of lunchtime, SB marketing, vending machines) and individual-level (e.g., sex, food preferences, nutrition knowledge) effects.

RESULTS

Female students had higher odds of using the SB compared to males. Students with healthier food preferences had higher odds of using the SB than those who reported less healthy food preferences. Within the multilevel model for all students, only sex and healthy food preferences remained significant. In a multilevel model assessing secondary students only, student encouragement toward others for healthy eating and school-based SB marketing were significantly related to SB use.

CONCLUSIONS

Little research has examined factors related to school-based SB use. These findings suggest recommendations that may help improve student use of SBs. For example, increasing the promotion of SB, particularly in secondary schools, might encourage their use among students.