Scheduling play before eating lunch has been suggested as a relatively simple environmental strategy to increase fruit and vegetable (FV) intake among elementary school students. However, the few small studies to date have had mixed findings. The primary aim of this observational study was to evaluate the possible relationship between the relative order of play and eating and students' lunch intake of FV. A secondary aim was to examine whether any differences existed in this relationship by student sex, ethnicity, language spoken at home, and school lunch source. A diary-assisted 24-hour recall was collected during the 2011-2012 school year from 2,167 fourth- and fifth-graders attending 31 elementary schools in California. The association of play before eating with FV intake was estimated using Generalized Estimation Equations. Overall, lunch FV intake was not significantly higher for students who had a play-before-eating vs a play-after-eating lunch schedule at school. However, variables included in the model showed significant interaction with play before eating, resulting in the need for separate effect estimates for distinct strata based on sex, ethnicity, language spoken at home, and school lunch source. For 10 of the 16 strata, no significant effect of play before eating was observed on lunch FV intake, while increases in intake were observed in four strata and decreases in two strata. Before rescheduling play before eating for the purpose of improving student FV intake, additional research is recommended.

Aim: Simple school policies that increase fruit and vegetable intake in children are needed. The study aim was to evaluate the relationship of duration of lunch and order of play and eating during the lunch period with fruit and vegetables (FV) intake. A secondary aim was to examine if differences existed in these relationships by student gender, ethnicity, language spoken at home, and school lunch source. Methods: A diary‐assisted 24‐hour recall was collected during the 2011‐12 school year from 3,463 4th‐5th graders attending 44 elementary schools in California. School lunch characteristics were attained from school staff and observation. The associations of play before eating and duration of lunch with FV intake were estimated using generalized estimation equations. Results: FV intake did not significantly differ by lunch period length. Overall, lunch FV intake was not significantly higher for students who had a play before versus after eating lunch schedule. Variables in the model showed significant interaction with play before eating, requiring separate effect estimates by gender, ethnicity, language spoken at home, and lunch source. When a significant effect was predicted, play before eating had a positive impact among students who brought lunch from home. Conclusions: Play before eating may help some elementary students to increase FV intake. Although these policies and other environmental school policies need further rigorous evaluation. Grant Funding Source: Supported by the Orfalea Foundation

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