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Tricks to Get Kids to Eat Healthier at School

Interventions to improve child nutrition at school have included everything from reducing cookie size, adding fruit to classroom cupcake celebrations, and giving vegetables attractive names, to more comprehensive strategies such as “veggiecation” curricula and transforming school cafeterias.

September 2, 2013 |
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Sources Cited

M. K. Spill, L. L. Birch, L. S. Roe, B. J. Rolls. Hiding vegetables to reduce energy density: An effective strategy to increase children's vegetable intake and reduce energy intake. Am. J. Clin. Nutr. 2011 94(3):735 - 741.

A. D. Blatt, L. S. Roe, B. J. Rolls. Hidden vegetables: An effective strategy to reduce energy intake and increase vegetable intake in adults. Am. J. Clin. Nutr. 2011 93(4):756 - 763.

C. A. Johnston, J. L. Palcic, C. Tyler, S. Stansberry, R. S. Reeves, J. P. Foreyt. Increasing vegetable intake in Mexican-American youth: A randomized controlled trial. J Am Diet Assoc 2011 111(5):716 - 720.

A. Olsen, C. Ritz, L. Kramer, P. Moller. Serving styles of raw snack vegetables. What do children want? Appetite 2012 59(2):556 - 562.

N. Beasley, S. Sharma, R. Shegog, R. Huber, P. Abernathy, C. Smith, D. Hoelscher. The quest to Lava Mountain: Using video games for dietary change in children. J Acad Nutr Diet 2012 112(9):1334 - 1336.

D. Marchiori, L. Waroquier, O. Klein. 'Split them!' smaller item sizes of cookies lead to a decrease in energy intake in children. J Nutr Educ Behav. 2012 May-Jun;44(3):251-5.

C. Vereecken, A. Rovner, L. Maes. Associations of parenting styles, parental feeding practices and child characteristics with young children's fruit and vegetable consumption. Appetite 2010 55(3):589 - 596.

B. Wansink, D. R. Just, C. R. Payne, M. Z. Klinger. Attractive names sustain increased vegetable intake in schools. Prev Med 2012 55(4):330 - 332.

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Acknowledgements

Images thanks to bookgrl via Flickr and New York Coalition for Healthy School Food. Thanks also to Ellen Reid and Shane Barrett for their keynote help.

Transcript

What happens if you give one group of kids a plate of cookies and the other group the same number of cookies, but cut in half, and tell both groups they can eat as many as they want? Researchers reported that decreasing cookie size led to 25% fewer cookie calories eaten.

The goal of this study was to help counter obesity-promoting eating behaviors facilitated by the availability of large portions of junk food, and the findings suggest that reducing the size of cookies (without altering the total amount of food) decreases children’s short-term caloric intake, a ‘‘dietary strategy’’ for guardians to discreetly decrease unhealthy behaviors. But do you know what's in these things? Partially hydrogenated oil, trans fats. No one should be eating those. In fact, I can think of another "dietary strategy" to decrease kid's intake - don't give them any.

Admittedly, this is easier said than done. Even in the ‘granola crunchy’ San Francisco Bay Area, when parents and school administrators proposed to ban junk food it sent a faction of teachers into an apoplectic fit.

In Texas, there was such parental outrage, they got lawmakers to pass a Safe Cupcake Amendment. The amendment, known as Lauren's Law, ensures that parents and grandparents of schoolchildren celebrating a birthday can bring whatever the heck they want to school.

Fine. What if you just offered fruit in addition to the cupcakes at classroom celebrations? To observe student response to the addition of fresh fruit, bowls of fresh, cut-up fruit provided by the researchers were added to the party food brought by the parents at half of the 4 kindergarten or preschool celebrations. No special effort was made to encourage students to choose the fruit: they just put it out there. Would kids actually eat fruit when there was birthday cake, ice cream, and cheese puffs taking up nearly a whopping third of their daily caloric intake? Yes! On average each kid at a full fruit serving. Take that, cheesy puffs!

There are entire curricula available now for schools, such as veggiecation, where for a whole year classrooms feature a new “veggie of the month,’ sprinkled with nutrition mantras like, ‘‘Fiber equals a happy tummy.’’ And it works! " The active engagement of students in tasting and rating of vegetable dishes seemed to have contributed to higher consumption of featured vegetables.”

One school was able in some cases to double vegetable consumption-just by giving them attractive names. Elementary students ate twice the number of carrots if they were called “X-ray Vision Carrots,” compared to when they were ‘just’ carrots, or generically named as the “Food of the Day.”

How about Power Punch Broccoli, Silly Dilly Green Beans, or calling broccoli Tiny Tasty Tree Tops? Selection of broccoli increased by 109.4%; green beans by 177%. Conclusion: “these studies demonstrate that using an attractive name to describe a healthy food in a cafeteria is robustly effective, persistent, and scalable with little or no money or experience.” These names were not carefully crafted, discussed in focus groups, and then pre-tested. They just thought them up out of thin air. And kids were suckered into eating healthier for months by putting out silly little signs. In this school, vegetable intake was up nearly 100%, while in the control school without signs, vegetable consumption started low and actually got worse. So why isn't every single school in the country doing this right now?! Bring it up at your next PTA meeting.

And if you want to get really bold, you can join the nutritious school lunch revolution led by pioneering organizations like the New York Coalition for Healthy School Food.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.

To help out on the site please email volunteer@nutritionfacts.org.

Dr. Michael Greger

Doctor's Note

What's so bad about trans fats? See Trans Fat in Meat and Dairy, Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero, and Breast Cancer Survival and Trans Fat.

Whenever I find myself frustrated by half measures, I am forced to remind myself just how SAD the Standard American Diet is. See Nation’s Diet in Crisis for a reality check. One of the problems is that parents may not even realize there is a problem (Mothers Overestimate Dietary Quality).

Feel free to check out the New York Coalition for Healthy School Food website at http://www.healthyschoolfood.org/.

This is the first of a 3-part video series on practical tips for dietary improvement. In my next two videos I will cover Tricks to Get Kids to Eat Healthier at Home and Tricks to Get Adults to Eat Healthier.

For more context, check out my associated blog posts: How to Get Kids to Eat Their Vegetables, How to Get Our Kids to Eat Their Vegetables, and How to Get Parents to Eat Their Vegetables.

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • BB

    When I was a child, we all loved to eat spinach because we saw Popeye eat it during Saturday morning cartoons. We wanted to be strong like Popeye

  • mdouble

    Thanks for another practical video. The point is well taken and entirely appropriate. There is no nutritional value to food which is not eaten. Getting kids to eat healthy can be especially problematic. Any strategy which makes it easier to overcome the apparent barriers , on both an individual and social level is much appreciated.

  • Coacervate

    Put Joan Cusack on it. The little ankle bitters will eat right, like it AND clean up their rooms!

  • Plantstrongdoc M.D.

    I like the idea with attractive names – what about non-attractive names:

    Stroke-beef
    Cancer-milk
    Inflammation-egg
    Mercury-fish
    Diabetes-cheese
    Coronary occlusion-poultry
    Cavity-candy
    :-)

    • flykath

      Plantstrongdoc, Thanks for the laugh! Great idea! Kind of along the lines of the “horrors of smoking” ads seen in recent years.

    • Thea

      Plantstrongdoc: Too funny!

      My contributions include:
      * poop-crusted legs (for chicken)
      * puss milk (or puss cheese – take your pick)
      * die-early eggs
      * constipation steak

      I don’t know if it would make any difference given what many kids and their parents seem happy to eat, but it would be worth a shot. :-)

  • Dan Lundeen

    Great vid! This is really encouraging, but the news media are still reporting the backlash. http://news.msn.com/us/some-school-districts-dropping-healthier-lunch-programs. Same story as the last year’s brouhaha from Kansas as the usual fate of such efforts. See http://www.khi.org/news/2012/oct/01/some-say-new-meal-guidelines-should-be-scrapped/. Sigh.

  • Lin

    Dr.Greger, why are you recommending that site when it recommends that 25% of diet is animal food?

    • HereHere

      That’s a good point worth reflecting on. Regardless, if the goal is healthy food, nutritionally educated people need to get involved and raise the bar so the food is actually healthy (animal-free, as you imply).

  • TG

    This is another fascinating video but what is your objection to using adverbs? Given the education context, it would have been appropriate to get the grammar right.

    • Frank

      Prescriptive grammar is arbitrary. Dr. Gregor is trying to educate people, so he writes the way they talk. I don’t think it takes away from his professionalism. He seems to be trying to make these videos accessible to the average person. Be honest, would you really say “more healthily” if you were talking to someone?

    • Lin

      This isn’t an English exam. Perfect grammar isn’t everyone’s top priority. The good and important thing is that health information is being shared, and people are being greatly helped by it. Peace

  • Dave Doctor

    It’s easier to get kids to eat fruit because kids have a sweet tooth. They don’t really crave candy, like lifesavers, they crave tart berries, sweet strawberries, tasty bananas, wonderful watermelon. They are drawn to candy because conventional, pesticide-grown fruit is bland. Put organic ripe fruit on the table and kids will drop the artificial candy and devour nature’s candy. Remember that Lifesavers got its flavors from nature.

    • Dave Doctor

      As the study suggests, adding cool names to platters of ripe, organic fruit will increase eating even more.

  • jj

    doing the cute names,making eating the food a game is just what the food companies do with their packaging & commercials