title: Changes in the nutrient content of school lunches: results from the CATCH Eat Smart Food service Intervention.
abstract: BACKGROUND
  The Child and Adolescent Trial for Cardiovascular Health (CATCH) tested the effectiveness of a multilevel intervention aimed at promoting a healthful school environment and positive eating and physical activity behaviors in children. The CATCH Eat Smart Program targeted the school food service staff and aimed to lower the total fat, saturated fat, and sodium content of school meals.
  
  
  METHODS
  The Eat Smart intervention was conducted in 56 intervention schools over a 2(1/2)-year period.+Five consecutive days of school menu, recipe, and vendor product information were collected from intervention and control schools at three intervals, Fall 1991, Spring 1993, and Spring 1994, to assess the nutrient content of school menus as offered.
  
  
  RESULTS
  There was a significantly greater mean reduction in the percentage of calories from total fat (adjusted mean difference -4.1%; P < 0.0001) and saturated fat (adjusted mean difference -1.3%; P = 0.003) in intervention compared with control schools from baseline to follow-up. Although the sodium content of school lunches increased in both conditions, the mean increase was significantly lower in intervention schools (adjusted mean difference -89 mg; P = 0.034). There were no statistically significant differences for total amounts of cholesterol, carbohydrate, protein, dietary fiber, total sugars, calcium, iron, vitamin A value, and vitamin C. Average total calories decreased significantly; however, the mean total calories (683 kcal) for intervention schools remained above one-third of the Recommended Dietary Allowances for this age group.
  
  
  CONCLUSIONS
  The CATCH Eat Smart intervention successfully lowered the total fat and saturated fat content of school lunches as offered, while maintaining recommended amounts of calories and essential nutrients.
authors.affiliation: New England Research Institutes, Inc., Watertown, Massachusetts, 02172, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Osganian
authors.forename: M K
authors.initials: MK
authors.lastname: Ebzery
authors.forename: D H
authors.initials: DH
authors.lastname: Montgomery
authors.forename: T A
authors.initials: TA
authors.lastname: Nicklas
authors.forename: M A
authors.initials: MA
authors.lastname: Evans
authors.forename: P D
authors.initials: PD
authors.lastname: Mitchell
authors.forename: L A
authors.initials: LA
authors.lastname: Lytle
authors.forename: M P
authors.initials: MP
authors.lastname: Snyder
authors.forename: E J
authors.initials: EJ
authors.lastname: Stone
authors.forename: M M
authors.initials: MM
authors.lastname: Zive
authors.forename: K J
authors.initials: KJ
authors.lastname: Bachman
authors.forename: R
authors.initials: R
authors.lastname: Rice
authors.forename: G S
authors.initials: GS
authors.lastname: Parcel
mesh_terms: D000293:Adolescent; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002648:Child; D004041:Dietary Fats; D002149:Energy Intake; D005260:Female; D005522:Food Services / Q000592:standards*; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009751:Nutritional Requirements; D015397:Program Evaluation; D012572:School Health Services / Q000458:organization & administration*; D012982:Sodium, Dietary; D014481:United States
chemical_list: D004041:Dietary Fats; D012982:Sodium, Dietary