School lunchroom staff can help kids make healthier food choices, UGA study says

Almost one in three 10-year-olds in Georgia is overweight or obese. With childhood obesity on the rise across the U.S., states and other stakeholders have been exploring policies that may help curb its growth.

A recent study from the University of Georgia has shown that training school cafeteria staff in smarter lunchrooms concepts is a promising first step.

“Federal-level policy makes sure the health foods are served in the school lunchroom, but being served doesn’t translate into being consumed,” said Janani Thapa, assistant professor of health policy and management at UGA’s College of Public Health and lead author on the study.

“That’s where the smarter lunchroom idea kicks in, asking can we do basic, low-cost steps that translate nutrition being served into nutrition being consumed.”

Children’s Healthcare of Atlanta’s Strong4Life School Nutrition Program teaches school nutrition managers and staff members how to make changes in the lunchroom that will “nudge” children to make healthier choices. Based partly on marketing principles, the approach aims to make the healthier choices easier to make.

“The steps are as simple as changing where plain milk versus chocolate milk is placed in the lunchroom affects how kids make their choices,” said Thapa.

Displaying plain milk in front of the other milks in the cooler, for example, has been found to increase the consumption of plain milk. Smarter lunchrooms aim to promote healthy eating one small change at a time, adding up to major reductions in sugar and sodium consumption.

Strong4Life developed a training kit based on smarter lunchroom strategies and launched in-person training for over 800 Georgia public school nutrition managers and staff in 2015. The program packages proven smarter lunchroom techniques into five focus areas that managers can apply easily at no or low cost.

Strategies include guiding students’ attention to healthy foods using signs or stickers, making healthy choices highly visible and convenient, or making healthy food cheaper than unhealthy options.

Thapa’s study evaluated how well the training worked in educating lunchroom staff as well as empowering them to make changes. She found that the majority staff members retained key smarter lunchroom principles three months after receiving training, and most felt capable of applying the techniques in their schools.

Following the training, over 325 staff reported already making significant changes to their lunchroom environment. One fifth had moved plain milk in front of flavored milks, juice and sports drinks in drink coolers, while 12 percent of cafeterias were using signs or stickers to identify healthy choices, and up to 14 percent of lunchrooms were offering some form of price incentives for heathy foods.

It’s important to know how effective these policies are, says Thapa, especially in areas where the school is potentially the only place where students can access fresh, healthy foods. Yet, the availability of healthy foods is moot if kids aren’t eating it.

“Training school lunchroom staff is just one step in a larger effort to make our school lunchrooms and health eating attractive to kids,” she said.

Thapa is currently working on an analysis of whether smarter lunchroom interventions lead to kids eating more fruits and vegetables in local lunchrooms. The next step, she says, is looking at how childhood obesity rates change in schools that adopt smarter lunchroom principles.

“This is just the beginning, but hopefully we will see that schools that are active in implementing statewide physical activity policies, statewide movements like the smarter lunchroom movement can have some impact on the health of school children,” she said.

The study, “Effect of the Strong4Life School Nutrition Program on Cafeterias and on Manager and Staff Member Knowledge and Practice, Georgia, 2015” appeared in the November/December 2017 issue of Public Health Reports and is available online:

Co-authors include Ashley Bennett, Farrah Keong, Wendy Palmer, Trisha Hardy, and Jean Welsh with Children’s Healthcare of Atlanta.

– Lauren Baggett

Posted January 19, 2018.

Additional coverage at the ASPPH Friday Letter.