title: Concession stand makeovers: a pilot study of offering healthy foods at high school concession stands.
abstract: BACKGROUND
  Concession stands at high school events are exempt from the US Department of Agriculture regulations for school foods. Concessions are generally stocked with unhealthy foods since healthy foods are believed to have lower sales and profit margins.
  
  
  METHODS
  Concession stand sales for two seasons of high school fall sports in Muscatine, Iowa were compared. In between seasons, two types of changes were made: (i) addition of new healthier concession options and (ii) substitution of healthier ingredients (less saturated fat, no trans fat). Satisfaction surveys of students and parents were conducted before and after the changes. Data were collected in 2008 and 2009 and analyzed in 2012-13.
  
  
  RESULTS
  Revenue per game was similar between years, even with the introduction of healthier items and ingredient changes. In 2009, the new healthy foods comprised 9.2% of total revenue and sales of some new items increased with each game. The 'healthy makeover' had no influence on student satisfaction but it improved parent satisfaction (P < 0.001).
  
  
  CONCLUSIONS
  This compelling test of concept shows that offering healthier items can be good for both sales and satisfaction. While this study was conducted with concession stands, the principles can be carried over into other food retail settings.
authors.affiliation: Internal Medicine and Pediatrics, The University of Iowa, Iowa, IA, USA.
authors.forename: Helena H
authors.initials: HH
authors.lastname: Laroche
authors.affiliation: Nutrition Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Ford
authors.affiliation: Muskie Boosters, Muscatine, IA, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Hansen
authors.affiliation: Biostatistics and Computational Biology, The University of Rochester, Rochester, NY, USA.
authors.forename: Xueya
authors.initials: X
authors.lastname: Cai
authors.affiliation: The Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, NY, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Just
authors.affiliation: The Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, NY, USA.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Hanks
authors.affiliation: The Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, NY, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Wansink
mesh_terms: D000293:Adolescent; D002755:Choice Behavior; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D057140:Fast Foods / Q000191:economics*; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005522:Food Services / Q000458:organization & administration*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007484:Iowa; D008297:Male; D018673:Nutrition Policy; D019982:Organizational Case Studies; D010865:Pilot Projects; D012574:Schools; D013334:Students / Q000523:psychology*; D000067009:Youth Sports
keywords: children; food and nutrition; public health