Recipient Organization
UNIVERSITY OF VERMONT
(N/A)
BURLINGTON,VT 05405
Performing Department
Nutritional Sciences
Non Technical Summary
USDA proposed regulations will make significant changes to school meals in 2012. The current school meal `offer versus serve' provision, which allows children to decline two of the five lunch components (fruit, vegetable, grain, protein, milk), will be revised such that children will be required to take at least one fruit or vegetable. Because fruits and vegetables are low in calories and rich in essential nutrients, this change is part of an effort to improve children's nutrient status while at the same time reducing the incidence and prevalence of childhood obesity. In order to determine if the new regulations are effective, we need to know exactly what children are eating. Accurate measurement of dietary intake remains a challenge. This feasibility and validation study is designed to compare school children's fruit and vegetable consumption, as estimated by direct observation and digital photography, against the gold standard of actual food weights in a variety of elementary school cafeteria environments. We aim to develop a reliable, feasible and valid tool to measure children's fruit and vegetable consumption in a variety of school cafeteria settings.
Animal Health Component
(N/A)
Research Effort Categories
Basic
(N/A)
Applied
(N/A)
Developmental
(N/A)
Goals / Objectives
The overall goal of our project is to establish a reliable, feasible, and valid methodology for assessing school children's consumption of fruits and vegetables (f/v) in a variety of school cafeteria environments. Objectives and Expected Outputs Objective 1: Train our research team in three dietary assessment methods: gold standard weighed plate waste (plate waste), visual plate waste/direct observation (observation) and digital photography/imaging (photography) in a university laboratory/controlled setting. a) Working in a controlled environment of simulated school lunches, we will test inter-rater/observer reliability for the three test methods: 1) plate waste, 2) observation, 3) photography. Objective 2: Test the feasibility of the gold standard plate waste and two test methods to measure school children's consumption of f/v in two VT school cafeterias. a) Field test the feasibility of the plate waste method in each school cafeteria. The northern schools serve lunch via a traditional lunch line where cafeteria staff portion foods onto the children's hard plastic, reusable divided trays. They also offer a self-serve salad bar. The southern schools use stations where cafeteria staff portion foods from the entree, deli, grill, and salad stations onto disposable foam trays. b) Test the feasibility of the observation method to measure school children's consumption of f/v using a check-off sheet to record what fruits and vegetables children take at lunch. At the end of lunch, record an estimate of how much each sample child has eaten using a five or six point scale (none, 25%, 50%, 75%, all). c) Test the feasibility of photography to measure school children's consumption of f/v with two camera stations. Digital images will be taken of children's lunches as they pay for their meal. At the end of lunch, a second image will be taken. The two images will be compared to estimate the amount of f/v consumed. Objective 3: Validate observation and photography against the gold standard of plate waste to measure school children's consumption of f/v in two VT school cafeterias. a) Visual plate waste will be validated against weighed measures during one school visit. Digital photography will be validated against weighed measures during a subsequent school visit when a similar lunch is served. Objective 4: Based on the results of the reliability, feasibility and validity testing, determine the best methodology for assessing school children's consumption of f/v and conduct final field tests in two schools outside of Vermont with additional cafeteria setting variations. The best methodology may be one of the three tested dietary assessment methods, or a combination of methods depending on the cafeteria environment.
Project Methods
Northeastern school districts (7) have been chosen based on varied demographics and cafeteria environments. Informed consent will be obtained from each school nutrition director and school principal. Any elementary student participating in the school lunch program and choosing a fruit and/or vegetable (f/v) can be included in the study. To randomly select children, varied colored stickers will be given to all students. The team will monitor one color at each school visit. At all visits, five lunch trays with all menu items will be purchased to determine average portion sizes served. Students will be observed during lunch to account for additions and subtractions and asked to return their tray for post-observation. Obj 1: The research team will be trained to weigh food, make visual estimates (recognizing average serving sizes), take digital images and analyze those images for serving sizes. University students will be used to simulate school children's consumption of lunches served on divided school lunch trays. Menus from each of the participating schools will be reviewed. Definitions for creditable f/v will be operationalized. Obj 2: Weighed Plate Waste: Where a salad bar is available, students will be provided with a separate salad plate which will be weighed and notes taken about the salad components. Food intake is determined by subtracting the weight of the leftover f/v from the initial portion weight. Direct Observation: Research staff will stand near the end of the serving line and using selected prepared forms, document the f/v on students' trays. Inter-observer reliability (IOR) will be determined by the percentage of agreement on the amounts of servings observed eaten for a sample of children during each lunch, with an expected reliability of at least 0.85. Digital Imaging: Five sample meals containing all f/v items will be purchased and photographed, including salad bar offerings. Two camera stations will be set up. At the first camera station (end of the foodservice line), student trays will be given an id number and photographed. Children will to stop by the exit station prior to disposing of their meal, where an after-eating picture of the tray will be taken. Team members will estimate how much of each portion has been consumed and IOR will be determined. Obj 3: The methods outlined above will be repeated, but in combination where five sample meals will be purchased with all f/v items which will be weighed to establish an average weight/serving. Plate waste methods will be combined with direct observation and the digital imaging for validation. Obj 4: Once the best methodology has been chosen, two more schools will be visited twice for final field testing with an expected IOR tested of at least 0.85. Analyses: To test validity, the estimates of food weights derived from both methods will be compared against the plate waste method using Pearson product moment correlations with an expected correlation of at least 0.80 To test whether the estimation methods significantly under or over estimate portion sizes relative to weighed foods, Students paired t-tests will be used to compare estimates against the weighed foods.