An Innovative Method of Measuring Changes in Access to Healthful Foods in School Lunch Programs: Findings from a Pilot Evaluation

PloS One
Allison P HawkesRichard L Vogt

Abstract

A large local health department in Colorado partnered with 15 school districts to develop an approach to evaluate changes in access to healthy foods in reimbursable school lunches and a la carte offerings. School district nutrition managers were engaged at the start of this project. Health department dietitians developed criteria to classify food items as "Lower Fat and less added Sugar" (LFS) and "Higher Fat and more added Sugar" (HFS) based on the percentage of calories from fat and grams of added sugar. Lunch production sheets were obtained for two time periods, food items and the number of planned servings recorded. LFS and HFS planned servings were summed for each time period, and a LFS to HFS ratio calculated by dividing LFS planned servings by HFS planned servings. Additional analyses included calculating LFS: HFS ratios by school district, and for a la carte offerings. In 2009, the LFS: HFS ratio was 2.08, in 2011, 3.71 (P<0.0001). The method also detected changes in ratios at the school district level. For a la carte items, in 2009 the ratio of LFS: HFS was 0.53, and in 2011, 0.61 (not statistically significant). This method detected an increase in the LFS: HFS ratio over time and demonstrated that the school districts...Continue Reading

References

Jan 31, 2006·Journal of the American Dietetic Association·John B Bartholomew, Esbelle M Jowers
Jan 20, 2009·American Journal of Public Health·Karen W Cullen, Kathleen B Watson
Mar 17, 2009·Journal of the American Dietetic Association·Elizabeth M CondonMary Kay Fox

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