title: Impact of a Smarter Lunchroom intervention on food selection and consumption among adolescents and young adults with intellectual and developmental disabilities in a residential school setting.
abstract: OBJECTIVE
  To assess whether a Smarter Lunchroom intervention based on behavioural economics and adapted for students with intellectual and developmental disabilities would increase the selection and consumption of fruits, vegetables and whole grains, and reduce the selection and consumption of refined grains.
  
  
  METHODS
  The 3-month intervention took place at a residential school between March and June 2012. The evaluation employed a quasi-experimental, pre-post design comparing five matched days of dietary data. Selection and plate waste of foods at lunch were assessed using digital photography. Consumption was estimated from plate waste.
  
  
  METHODS
  Massachusetts, USA.
  
  
  METHODS
  Students (n 43) aged 11-22 years with intellectual and developmental disabilities attending a residential school.
  
  
  RESULTS
  Daily selection of whole grains increased by a mean of 0·44 servings (baseline 1·62 servings, P = 0·005) and refined grains decreased by a mean of 0·33 servings (baseline 0·82 servings, P = 0·005). The daily consumption of fruits increased by a mean of 0·18 servings (baseline 0·39 servings, P = 0·008), whole grains increased by 0·38 servings (baseline 1·44 servings, P = 0·008) and refined grains decreased by a mean of 0·31 servings (baseline 0·68 servings, P = 0·004). Total kilojoules and total gram weight of food selected and consumed were unchanged. Fruit (P = 0·04) and vegetable (P = 0·03) plate waste decreased.
  
  
  CONCLUSIONS
  A Smarter Lunchroom intervention significantly increased whole grain selection and consumption, reduced refined grain selection and consumption, increased fruit consumption, and reduced fruit and vegetable plate waste. Nudge approaches may be effective for improving the food selection and consumption habits of adolescents and young adults with intellectual and developmental disabilities.
authors.affiliation: 1Friedman School of Nutrition Science and Policy,Tufts University,150 Harrison Avenue,Boston,MA 02111,USA.
authors.forename: Kristie L
authors.initials: KL
authors.lastname: Hubbard
authors.affiliation: 2Eunice Kennedy Shriver Center,University of Massachusetts Medical School,Waltham,MA,USA.
authors.forename: Linda G
authors.initials: LG
authors.lastname: Bandini
authors.affiliation: 1Friedman School of Nutrition Science and Policy,Tufts University,150 Harrison Avenue,Boston,MA 02111,USA.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Folta
authors.affiliation: 4Dyson School of Applied Economics and Management,Cornell University,Ithaca,NY,USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Wansink
authors.affiliation: 5Department of Public Health and Community Medicine,Tufts University School of Medicine,Boston,MA,USA.
authors.forename: Misha
authors.initials: M
authors.lastname: Eliasziw
authors.affiliation: 5Department of Public Health and Community Medicine,Tufts University School of Medicine,Boston,MA,USA.
authors.forename: Aviva
authors.initials: A
authors.lastname: Must
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D000328:Adult; D001521:Behavior Therapy; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002755:Choice Behavior; D002658:Developmental Disabilities / Q000150:complications / Q000628:therapy*; D060909:Economics, Behavioral / Q000639:trends; D002149:Energy Intake; D005260:Female; D005522:Food Services; D006801:Humans; D008607:Intellectual Disability / Q000150:complications / Q000628:therapy*; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D018673:Nutrition Policy; D009765:Obesity / Q000178:diet therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D010349:Patient Compliance; D063766:Pediatric Obesity / Q000178:diet therapy / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D012112:Residential Facilities; D012306:Risk; D012574:Schools; D055815:Young Adult
keywords: Adolescence; Developmental disability; Health promotion; Intellectual disability