An environmental intervention to reduce dietary fat in school lunches.
OBJECTIVE
To determine whether making a low-fat entree available as one of two choices in an elementary school lunch program would reduce the fat content of meals selected by children.


METHODS
In this before-after trial, students had a daily choice between two entrees, one of which was sometimes low-fat. For 93% of school days during 14 consecutive school months, daily entree choices were recorded for 619,976 student meals. The fat content of entrees was assessed with a computerized nutrient database supplemented by food manufacturer's data.


METHODS
Sixteen elementary schools in the Bellevue (Washington) School District.


METHODS
The number of students eating school lunch averaged 2440 per day, of whom 25% were less than 185% of poverty.


METHODS
After a baseline period of 6 months, the intervention increased the number of days per month when one of the two entrees had 30% or fewer calories from fat.


METHODS
Data for the entire district were combined to estimate for each month the percent of students who selected low-fat entrees and the percent of calories from fat in the average meal selected by students.


RESULTS
During the 6 months before the intervention, a low-fat entree was available on 23% of days; it was selected by 39% of students; and the average meal selected by students had 36% of calories from fat. By the end of the 8-month intervention, a low-fat option was available on 71% of days; it was selected by 29% of students; and the fat content of the average meal dropped from 36% to 30% of calories from fat (P = .02).


CONCLUSIONS
In this school district, many students, given the choice, selected low-fat entrees. Recommendations for dietary fat were met simply by the environmental intervention of increasing the availability of low-fat foods.
Robert Wood Johnson Clinical Scholars Program, University of Washington School of Medicine, Seattle 98105.
R C
RC
Whitaker
J A
JA
Wright
A J
AJ
Finch
B M
BM
Psaty
D002648:Child; D002664:Child Nutritional Physiological Phenomena; D004041:Dietary Fats / Q000008:administration & dosage*; D005518:Food Preferences; D005522:Food Services; D006801:Humans; D008612:Menu Planning; D012574:Schools; D014861:Washington
D004041:Dietary Fats