Removing competitive foodsv. nudging and marketing school meals: a pilot study in high-school cafeterias

Abstract

Objective:To compare federally reimbursable school meals served when competitive foods are removed and when marketing and nudging strategies are used in school cafeterias operating the National School Lunch Program (NSLP). The second objective was to determine how marketing and nudging strategies influence competitive food sales.Design:In the Healthy Choices School, all competitive foods were removed; the Healthy Nudging School retained competitive foods and promoted the school meal programme using marketing and nudging strategies; a third school made no changes. Cafeteria register data were collected from the beginning of the 2013–2014 school year through the four-week intervention. Outcome measures included daily entrées served; share of entrées served with vegetables, fruit and milk; and total competitive food sales. Difference-in-difference models were used to examine outcome measure changes.Setting:Three high schools in a diverse, Northeast US urban district with universally free meals.Participants:High-school students participating in the NSLP.Results:During the intervention weeks, the average number of entrées served daily was significantly higher in the Healthy Choices School (82·1 (se 33·9)) and the Healthy Nudging School (107·4 (se 28·2)) compared with the control school. The only significant change in meal component selection was a 6 % (se 0·02) higher rate of vegetable servings in the Healthy Choices School compared with the control school. Healthy Nudging School competitive food sales did not change.Conclusions:Both strategies – removing competitive foods and marketing and nudging – may increase school meal participation. There was no evidence that promoting school meals decreased competitive food sales.

Interventions based on sensory‐hedonic strategies and on nudging to facilitate vegetable and pulses consumption in the school environment

“…In particular, 12 interventions were identified using such methods, with only one focusing on legumes (Siega‐Riz et al., 2011). Examples include restricting access to unhealthy foods (vending machines, mobile carts) (Boehm et al., 2020; Wordell et al., 2012), introducing a salad bar (Adams et al., 2005; Bean et al., 2020; Bean et al., 2018), providing additional options for purchasing meals (Machado, Burton et al., 2020), and increasing the availability and variety of vegetables (Bergamaschi et al., 2016; Birnbaum et al., 2002; Perry et al., 2004) and other healthy snacks (Lytle et al., 2004, Marcano‐Olivier et al., 2021).…”

“…Availability increasing availability and variety of vegetables and pulses (Adams et al., 2005; Bean et al., 2018; Bergamaschi et al., 2016; Birnbaum et al., 2002; Cohen et al., 2014; Machado, Burton et al., 2020; Madden et al., 2013; Perry et al., 2004; Siega‐Riz et al., 2011, Marcano‐Olivier et al., 2021), decreasing availability of unhealthy foods (Boehm et al., 2020; Wordell et al., 2012); …”

“…Restricting access to unhealthy foods provided mixed findings, with one study on students aged 12−19 ( n = 2.229) reporting no difference in vegetable consumption between intervention and control school (Wordell et al., 2012) and the other showing an increase in adolescents’ selection of vegetables ( n = 2,140), although the intervention only lasted 4 weeks and longer‐term results were not available (Boehm et al., 2020). Increasing the availability of vegetables and legumes, through the introduction of salad bars and more purchase points, showed mixed effects on the selection and consumption of the target foods.…”

“…Another strategy widely used to nudge students toward healthier options is to increase the availability of vegetables and legumes and/or to decrease the one of unhealthy foods; however, results are not very encouraging, as only 4 out of the 12 interventions reported positive effects. Authors suggested that short-term interventions (Adams et al, 2005;Boehm et al, 2020), not using a control group (Bean et al, 2018), and only using a salad bar to increase availability (Adams et al, 2005) could be among the reasons why no significant changes were observed. One explanation of why variety was not found successful in increasing vegetable consumption although it increased vegetable liking came from Bergamaschi et al (2016), who proposed that vegetable consumption is more affected by acceptability and familiarity rather than by the variety of the stimuli (Bergamaschi et al, 2016).…”

Choice architecture interventions promoting sustained healthier food choice and consumption by students in a secondary school setting: a systematic review of intervention studies

“…The remaining five studies investigated multiple CAI for a wider range of outcome parameters, including whole grain products, salads, sweets, milk and water, either recorded separately as part of the main dish, a side serving or as part of a sandwich, or included under healthy or less healthy food items or entrée (27,28,(30)(31)(32) . Two of these recorded changes occurring during the course of the Light grey = studies implementing one intervention only.…”