Bean Melanie K, Mazzeo Suzanne E, Raynor Hollie A, Thornton Laura M, de Jonge Lilian, Mendoza Ashley, Farthing Sarah
Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23298, USA.
Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA.
Nutrients. 2024 Nov 28;16(23):4102. doi: 10.3390/nu16234102.
Children's dietary quality is suboptimal, increasing the risk of numerous chronic illnesses. Salad bars (SBs) have potential to enhance children's nutritional intake within the National School Lunch Program (NSLP); yet, empirical support is lacking. To address this gap, we evaluated the impact of school salad bars on dietary quality and energy intake at lunch. Seven matched elementary school pairs were randomly selected. All schools served pre-portioned fruit and vegetables (F&V) at baseline. Within each pair, one school received an SB. Digital imagery plate waste methods were applied at baseline and 4-6 weeks post salad bar installation to determine intake (20% increments for food, ounces for beverages). Dietary quality (Healthy Eating Index (HEI-2015)) and energy intake (kcal) were evaluated in NDSR. Multilevel modeling evaluated group (SB vs. control) and time (baseline vs. post) differences and group-by-time interactions for: (1) HEI-2015 (total and component scores) and (2) kcal intake (overall, F&V, non-F&V, and beverage kcals). Data from 5674 trays are reported. Significant group-by-time interactions were observed for HEI-2015 total scores and Greens and Beans, Total Fruit, Whole Fruit, Refined Grains, and Added Sugar component scores ( < 0.0001), supporting improved dietary quality in SB schools. SB HEI-2015 scores were 60.1 ± 9.8 at post (+5.3 from baseline; < 0.0001) compared with 57.2 ± 9.5 in controls (+1.0 from baseline; = 0.065). Total energy intake significantly increased in SB schools (376 ± 151 kcal (baseline) → 434 ± 176 kcal (post)), driven by F&V energy (+59 kcal), with no change for controls. Within the NSLP, SBs improved dietary quality and increased energy intake due to increased F&V intake without replacing other foods. Results can inform school nutrition policies designed to reduce chronic illness risk.
儿童的饮食质量欠佳，增加了患多种慢性病的风险。沙拉吧有潜力在国家学校午餐计划（NSLP）中提高儿童的营养摄入量；然而，尚缺乏实证支持。为填补这一空白，我们评估了学校沙拉吧对午餐饮食质量和能量摄入的影响。随机选择了七对匹配的小学。所有学校在基线时都提供预先分份的水果和蔬菜（F&V）。在每一对中，一所学校设置了沙拉吧。在基线时以及沙拉吧安装后4至6周应用数字图像餐盘浪费法来确定摄入量（食物按20%增量，饮料按盎司计算）。在全国饮食与相关健康调查（NDSR）中评估饮食质量（健康饮食指数（HEI - 2015））和能量摄入（千卡）。多水平模型评估了组（沙拉吧组与对照组）和时间（基线与后期）差异以及组与时间的交互作用，涉及：（1）HEI - 2015（总分及各成分得分）和（2）千卡摄入量（总体、F&V、非F&V和饮料千卡）。报告了来自5674个餐盘的数据。观察到HEI - 2015总分以及绿叶蔬菜和豆类、总水果、全水果、精制谷物和添加糖成分得分存在显著的组与时间交互作用（<0.0001），这支持了设置沙拉吧的学校饮食质量有所改善。设置沙拉吧学校的HEI - 2015得分在后期为60.1±9.8（较基线增加5.3；<0.0001），而对照组为57.2±9.5（较基线增加1.0；P = 0.065）。设置沙拉吧的学校总能量摄入显著增加（从基线时的376±151千卡增至后期的434±176千卡），这是由F&V能量增加（+59千卡）驱动的，而对照组没有变化。在NSLP范围内，沙拉吧提高了饮食质量，并因F&V摄入量增加而增加了能量摄入，且没有替代其他食物。研究结果可为旨在降低慢性病风险的学校营养政策提供参考。
