Impact of the National School Lunch Program on Fruit and Vegetable Selection in Northeastern Elementary Schoolchildren, 2012-2013.

Increasing children's fruit and vegetable (FV) consumption is an important goal of the U.S. Department of Agriculture's (USDA's) National School Lunch Program. Since 2012, the USDA's requirement that children select FVs at lunch as part of the reimbursable school meal has been met with concern and evidence of food waste. We compared elementary schoolchildren's FV selection, consumption, and waste before (10 school visits, 498 tray observations) and after (11 school visits, 944 tray observations) implementation of this requirement using validated dietary assessment measures. More children selected FVs in higher amounts when FVs were required compared with when they were optional (0.69 cups vs. 0.89 cups, p<0.001); however, consumption decreased slightly (0.51 cups vs. 0.45 cups, p=0.01) and waste increased (0.25 cups vs. 0.39 cups, p<0.001) when FVs were required compared with when they were optional. More exposure to FVs in schools through programmatic efforts and in the home environment may help familiarize children with FV offerings and encourage consumption.