MONDAY, Oct. 22, 2001 (HealthDayNews) -- Big entrees may get in the way of fruits and vegetables when your kids eat their school lunches, a new study suggests.
And shrinking the size of the main courses in the National School Lunch Program might get children to eat more of what they're not getting enough of now, say researchers at Columbus Children's Hospital in Ohio. Children in the program now consume less than 15 percent of the recommended daily servings of fruit and less than 20 percent of the recommended daily servings of vegetables.
The findings were presented yesterday at the American Academy of Pediatrics' annual meeting in San Francisco.
The discovery came by accident. The nutritionists say they were simply working with a local elementary school to develop a menu with more choices of fruits and vegetables.
"One of the things we have studied and wanted to look at was how to get kids to eat more fruits and vegetables," says lead author Kristina L. Houser. The kids would place their trays under a video camera set up in the lunchroom before throwing away what they had not eaten. After nine months and more than 5,000 meals, the researchers noticed something unexpected: When more of the entree was eaten, fewer fruits and vegetables were consumed, and visa versa.
"Students consistently ate 67 percent of their meals. The percentage of entree eaten significantly affects the amount of fruits and vegetables eaten. All the side dishes were eaten more when the entree was not as popular," Houser says.
The researchers decided that jettisoning well-liked entrees wouldn't work, but trimming portions might.
"You can't get rid of them; you can't just not have chicken nuggets. But what you can do is lower the size of the entree by a small amount and get kids to eat more fruits and vegetables," she says. "Given that we know that, then reducing the entree size just a little bit might mean they're going to eat the other side dishes. If we provide nutritious side dishes, it's better for the kids. If we're giving them too much entree, that's what they're going to eat."
And using a computer analysis to meet U.S. Department of Agriculture (USDA) nutritional guidelines for school lunch programs might work, she says.
One pediatric nutritionist thinks the idea is intriguing, but needs backup.
"I like the idea of more fruits and vegetables, but you have to find a way to keep the protein content high, and you need to combine it with education. You need to educate them [kids] about what you're putting on their plate," says Dr. Martin W. Sklaire, a clinical professor of pediatrics at Yale University. And involving parents also is key, he says.
"By itself, as a gimmick, it may not succeed. But with education and home support, it may be intriguing, and it may succeed," he says.
Another expert also says the finding holds promise.
"I think the strategy is excellent, to eat less entree and more fruits and vegetables," says Angela Dye, a pediatric dietician at the University of Chicago's Medical Center. "I think the concept is great. I think when you have a big entree on your plate, you don't go past that. We should supersize our vegetables."
Dye also says parents need to play a part: "I think the idea of teaching kids about eating a balance of foods is good. This may help show the balance."
Houser says the next study will look specifically at the main course.
"We're going to go in and fiddle with entree size," she says.
Fiddling aside, Houser is a big fan of the school lunch program, which has improved in recent years.
Levels of saturated fat in school lunches dropped from 15 percent to 12 percent between 1992 and 1999, while the saturated fat in school breakfasts went from 14 percent to just under 10 percent, the USDA reports. And the number of schools offering low-fat food choices jumped from 34 percent to 82 percent in elementary schools and from 71 percent to 91 percent in secondary schools.
The availability of vegetables, fruits, grains and breads also appears to be on the rise, with 66 percent of all schools serving more than two fruit and vegetable choices with lunch and 25 percent of all schools making five or more fruit or vegetable choices available.
Parents have to be vigilant, too, Houser says.
"We need to get kids to eat more fruits and vegetables, however we can," she says.
What To Do
To learn more about the school lunch program, visit the USDA.
And to help make sure your kids start each school day with a healthy breakfast, check the American Dietetic Association.
If you're curious to see just what nutrients you and your child are getting, check this Interactive Healthy Eating Index from the USDA.
