Kathryn E. Henderson

Background: Vegetable consumption among preschool children is below recommended levels. New evidence-based approaches to increase preschoolers' vegetable intake, particularly in the child care setting, are needed. This study tests the effectiveness of two community-based randomized interventions to increase vegetable consumption and willingness to try vegetables: (1) the pairing of a vegetable with a familiar, well-liked food and (2) enhancing the visual appeal of a vegetable. Methods: Fifty-seven preschoolers enrolled in a Child and Adult Care Food Program–participating child care center participated in the study; complete lunch and snack data were collected from 43 and 42 children, respectively. A within-subjects, randomized design was used, with order of condition counterbalanced. For lunch, steamed broccoli was served either on the side of or on top of cheese pizza. For a snack, raw cucumber was served either as semicircles with chive and an olive garnish or arranged in a visually appealing manner (in the shape of a caterpillar). Paired t-tests were used to determine differences in consumption of meal components, and McNemar's test was performed to compare willingness to taste. Results: Neither visual appeal enhancement nor pairing with a liked food increased vegetable consumption. Pairing increased willingness to try the vegetable from 79% to 95% of children (p=0.07). Greater vegetable intake occurred at snack than at lunch. Conclusions: Further research should explore the strategy of pairing vegetables with liked foods. Greater consumption at snack underscores snack time as a critical opportunity for increasing preschool children's vegetable intake.

BACKGROUND: In 2006, all local education agencies in the United States participating in federal school meal programs were required to establish school wellness policies. This study documented the strength and comprehensiveness of 1 state's written district policies using a coding tool, and tested whether these traits predicted school‐level implementation and practices.METHODS: School wellness policies from 151 Connecticut districts were evaluated. School principal surveys were collected before and after the writing and expected implementation of wellness policies. Sociodemographic variables were assessed for each district, including enrollment, population density, political climate, racial composition, and socioeconomic status. Changes in school‐level policy implementation before and after the federal wellness policy mandate were compared across districts by wellness policy strength; policies were compared based on district‐level demographics.RESULTS: Statewide, more complete implementation of nutrition and physical activity policies at the school level was reported after adoption of written policies. Districts with stronger, more comprehensive policies were more successful in implementing them at the school level. Some sociodemographic characteristics predicted the strength of wellness policies.CONCLUSIONS: Written school wellness policies have the potential to promote significant improvements in the school environment. Future regulation of school wellness policies should focus on the importance of writing strong and comprehensive policies.

This article seeks to inform state and local school food policies by evaluating the impact of Connecticut's Healthy Food Certification (HFC), a program which provides monetary incentives to school districts that choose to implement state nutrition standards for all foods sold to students outside reimbursable school meals. Food service directors from all school districts participating in the National School Lunch Program (NSLP) (N = 151) in Connecticut were surveyed about the availability of competitive foods before and after the 2006-2007 implementation of HFC. Food categories were coded as healthy or unhealthy based on whether they met the Connecticut Nutrition Standards. Data on NSLP participation were provided by the State Department of Education. Changes in NSLP participation and availability of unhealthy competitive foods in elementary, middle, and high schools were compared pre- and post-HFC across districts participating (n = 74) versus not participating (n = 77) in HFC. On average, all districts in Connecticut reduced the availability of unhealthy competitive foods, with a significantly greater reduction among HFC districts. Average NSLP participation also increased across the state. Participating in HFC was associated with significantly greater NSLP participation for paid meals in middle school; however, implementing HFC did not increase overall NSLP participation beyond the statewide upward trend. The 2006-2007 school year was marked by a significant decrease in unhealthy competitive foods and an increase in NSLP participation across the state. Participation in Connecticut's voluntary HFC further reduced the availability of unhealthy competitive foods in local school districts, and had either a positive or neutral effect on NSLP participation.