Education

Putting zucchini on schoolkids' A-list: Iowa research looked at how to make students eat more fruits and veggies

Research finds simple, cost effective improvements for school nutrition

Lisbon first grader Izabella Benson makes a final stop in cafeteria line for a pulled pork sandwich after receiving several servings of vegetables at the Lisbon Community School cafeteria on Tuesday, Nov. 27, 2018. Students pass the salad and fruit bars first, then have two additional opportunities in the line to pick up fruit as part of their meal. (Liz Martin/The Gazette)
Lisbon first grader Izabella Benson makes a final stop in cafeteria line for a pulled pork sandwich after receiving several servings of vegetables at the Lisbon Community School cafeteria on Tuesday, Nov. 27, 2018. Students pass the salad and fruit bars first, then have two additional opportunities in the line to pick up fruit as part of their meal. (Liz Martin/The Gazette)
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If you offer them vegetables first, kids will eat more vegetables.

If you display fruit in bright baskets, kids will take more fruit.

And if older students say jicama and red pepper hummus is delicious, kids just might try it.

“We did see changes,” said Natoshia Askelson, assistant professor of community and behavioral health with the University of Iowa College of Public Health.

The UI college, the Iowa Department of Education and the U.S. Department of Agriculture for years have been collaborating to implement and assess healthy eating initiatives and techniques aimed at improving child nutrition both at and outside school.

The most recent iteration — under the banner “Healthy Schools-Healthy Students” — employed low-cost tools like classroom education, kitchen training, lunch line arrangement and peer mentoring in 20 schools that applied to be guinea pigs. The initiative has reached more than 1,000 students.

The program wraps up in May and specific results aren’t yet public until a final report is issued. But Askelson, overseeing the university’s role in reviewing the initiatives, said her team has compiled encouraging findings — especially among high-needs, low-income students.

“We saw more changes there,” she said. “That was exciting.”

Also promising — in the program’s aim to get proven nutrition techniques in districts across the state — is that none of the tested tools cost much, if anything.

“It’s light-touch intervention,” Askelson said. “It’s not overhauling the lunch room. It’s not changing the menu … It’s small things that any school could do, especially in a rural area.”

Intervention is becoming increasingly critical in light of climbing rates of obesity, categorized as a body mass index of 30 or more. Nearly 40 percent of American adults over age 20 qualified as obese in 2015 and 2016, up from 34 percent in 2007 and 2008, according to the Journal of the American Medical Association.

National youth obesity rates climbed from 17 to 19 percent in that time.

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In Iowa, obesity rates have soared — climbing to 36 percent today from 21 percent in 2000 and 12 percent in 1990, according to an annual report produced by the Trust for America’s Health and the Robert Wood Johnson Foundation.

This state has the fourth-highest adult obesity rate in the nation and 10th highest among ages 10 to 17. Among Iowa’s high school students, the rate climbed from 11 percent in 2007 to 15 percent today.

Rural Iowa especially is susceptible to weight gain, according to Askelson, who said those regions — schools included — have limited access to fresh food and less money for costlier produce.

But reversing the state’s obesity rates must involve all of Iowa and start at a young age, according to Askelson.

“If children make healthier choices now, they will more likely make healthier choices in the future and become healthy adults,” she said.

Thus the Healthy Schools-Healthy Students pilot put out a call for interested participants, and 20 mostly-rural schools applied.

Organizers split the groups into two — with 10 receiving low-cost interventions and 10 functioning as placebos.

Interventions included adding nutrition educators at the fourth-grade level; making lunch rooms more attractive and inviting; reordering options along the lunch line; and providing modest culinary training — like how cooks, for example, can keep steamed broccoli appetizing for the entire lunch period.

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Although good nutrition can affect academic performance, weight, and other health metrics, researchers reviewing outcomes focused on changes in the students’ nutritional knowledge, attitude, preference and consumption.

Researchers gave students at participating schools pre- and post-tests to assess their nutritional smarts, also checking food production records in the kitchens to measure changes.

Most-successful interventions included:

Storing chocolate milk in the back of the cooler, increasing consumption of white milk;

Moving fresh fruit from industrial tubs to decorative baskets, doubling its popularity at some schools;

Offering vegetables at the start of the lunch line instead of the end, resulting in more colorful trays;

And creating well-lit, inviting cafeteria environments, encouraging kids to relax and make better choices.

Mary Ries, school nurse for the Maquoketa Valley Community School District, said her school received the intervention and reported multiple successes — including improved buy-in from the administration, teachers and students.

She highlighted the benefit of tapping older kids as “cafeteria captains” willing to mentor younger students about healthy choices and new foods. Just by offering lemon and lime juice, kids passed on fattier dressings, Ries said.

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Those captains going forward will move into classrooms, collaborating with teachers and administrators who then work with parents to weave the lessons into all aspects of students’ lives.

In the Lisbon Community School District, nutrition director Michele McCoy reported positive changes in food waste from the interventions her schools received — with more of the healthier but perishable items ending up on trays instead of the trash.

“We have so many fresh fruits and beautiful melons and kiwi and strawberries … they go into the line and see all that bright beautiful appealing fruit,” McCoy said. “We don’t go a day without having five different fruit options.”

As students have gotten used to eating more fruits and vegetables at school, McCoy said, she hopes they’ll do the same once they leave.

“Subconsciously, I want to push them toward healthier options,” she said. “We’re trying to do a lifestyle change.”

l Comments: (319) 339-3158; vanessa.miller@thegazette.com

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