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Enquiry Article

Upshot of classroom intervention on student food selection and plate waste: Testify from a randomized control trial

• Dmytro Serebrennikov,
• Bhagyashree Katare,
• Lisa Kirkham,
• Sara Schmitt

10

• Published: January 9, 2020
• https://doi.org/ten.1371/journal.pone.0226181

Figures

Abstract

Background

U.S. children are failing to come across the recommended daily 4 cups of fruits and vegetables. New federal guidelines were implemented for healthier school lunches for the National Schoolhouse Lunch Programs (NSLP). Consequently, students waste product large amounts of fruits and vegetables. Several organizations abet implementation of classroom nutrition educational activity programs as a school nutrition policy.

Methods

Nosotros conducted a randomized command trial to evaluate the effectiveness of a classroom diet education on food consumption beliefs of public simple schoolhouse students. Our intervention was designed to improve students' preferences for fruits and vegetables. Nosotros collected data using digital-photography, and estimated the amount of fruits and vegetables selected and wasted using ordinary least squares.

Results

The nutrition educational activity program had no affect on the amount of fruits and vegetables selected by the students in the handling group. We besides detect no significant difference in the amount of fruits and vegetables wasted by students in the handling and command grouping.

Conclusion

Nutrition educational activity did not change students' consumption behavior, implying the proposed policy might not exist optimal. Inducing a behavioral alter in uncomplicated schoolhouse students is an intricate process and might require more than classroom lessons to change their dietary habits.

Citation: Serebrennikov D, Katare B, Kirkham L, Schmitt S (2020) Result of classroom intervention on student food pick and plate waste: Bear witness from a randomized control trial. PLoS ONE 15(one): e0226181. https://doi.org/10.1371/journal.pone.0226181

Editor: Lee Van Horn, University of New United mexican states, UNITED STATES

Received: Jan 15, 2019; Accepted: November 21, 2019; Published: January nine, 2020

Copyright: © 2020 Serebrennikov et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original writer and source are credited.

Information Availability: Information cannot exist shared publicly because of ethical IRB restrictions as it contains information near persons below 18 years of age. Data will be made bachelor on well justified asking. Please contact IRB at Purdue Academy (irb@purdue.edu) to request for access for data. Once the IRB has approved the request for access, the researchers will exist able to share the information used for the analysis in this manuscript.

Funding: The study was funded through the grant "Integrating Farm to School Educational Content Into Classrooms" (sponsor agency: Indiana State Department of Health).

Competing interests: The authors take alleged that no competing interests exist.

Introduction

Childhood obesity is a major U.S. public health concern. Near 32% of youth in the state are either overweight or obese [one]. The U.South. population older than i year has a diet low in vegetables and fruits and loftier in saturated fat, sodium, and added saccharide [ii]. U.S. children across all ages are declining to meet the recommended consumption of 4 cups of fruits and vegetables per day [iii]. More than than 31 1000000 students are served luncheon daily through the National School Dejeuner Program (NSLP) [4]. In response to deficiencies in children's food-consumption patterns, new federal guidelines were implemented for healthier school lunches for the NSLP [5]. Per these guidelines, schools are required to provide a serving of fruit and vegetable during lunch, and students are required to take a minimum of one serving of fruit or vegetable on their lunch plate as function of meal reimbursement [6]. Since implementation, several reports take indicated an increment in students choosing fruits and vegetables in their lunches provided by school lunchrooms [7,8]. At the aforementioned time, research has found that students participating in the NSLP are wasting a large amount of fruits and vegetables in dejeuner cafeterias [7, 8, 9]. While the increase in food waste product does non necessarily imply lower consumption, it is important to evaluate different school nutrition teaching programs intended to reduce the amount of food waste in school cafeterias. This is consistent with the USDA's long-term goal to reduce nutrient waste product and loss by 50% by 2030 [10].

The purpose of the present written report is to evaluate the effectiveness of a classroom nutrition pedagogy program on the nutrient selected and wasted past the uncomplicated school students in school lunchrooms. The American Dietetic Association, the Guild for Nutrition Education, and the American School Food Service Association are in support of implementing school and classroom nutrition didactics programs such equally a school nutrition policy [11]. Classroom nutrition education programs have been successful in improving nutrition knowledge among school students [12, xiii]. However, the final goal of school and diet programs is to improve dietary intake in schoolhouse children during school lunch. Inquiry has shown picayune robust testify to suggest the effectiveness of these school nutrition policies toward improving dietary intake in schoolhouse children during schoolhouse lunch [14, 15, 16, 17].

We conducted a randomized controlled experiment involving elementary school students at 3 public schools in a midwestern state in United states of america. The main aim of the study was to empirically mensurate schoolhouse lunch intervention effects on elementary schoolhouse students' fruits and vegetables selection and waste. Most of the studies that measure food selection and waste matter use self-reported data such as 24-hr food remember workbooks [18] or survey questionnaires [19, 20, 21] as a proxy for actual nutrient consumption. To the best of our knowledge, our study is the first to quantify the amount of food selected and wasted on lunch plates by students in the lunchrooms. We used a well-tested digital photography method to quantify the food choice and food waste data.

School environments can be instrumental in implementing policies and programs to support salubrious eating among children. Habits developed during early babyhood continue into machismo [22]. Hence, it is important to motivate elementary school students and encourage development of long-term healthy food choices. Our enquiry contributes to the growing literature on school-based nutrition teaching interventions in the United States that promote selection and consumption of fruits and vegetables in schoolhouse lunchrooms.

Research has shown that many multicomponent and multiyear schoolhouse environment nutrition programs have improved nutrition cognition and self-reported consumption of fruits and vegetables [12, 21, 23]. They have also shown to exist successful in improving consumption of fruits and vegetables in schoolhouse dining halls [24, 25]. Our written report differs from these studies as we collected observational, unbiased data on the food selection and waste product of students through digital photography. We are able to quantify the amount of food selected and wasted, and also able to separate the nutrient selected and wasted by unlike food types.

Auld et al. (1998) used a quasi-experimental, multi-component approach to ameliorate pupil dietary noesis and consumption by providing special resource teachers, lessons on food preparation, and resources for community food training. Previous literature used complementary activities in other environments such as gardening practices [18], additional lunchroom interventions [24], and school-site wellness committees [25]. To amend isolate the effect of various environments and interventions on fruit and vegetable consumption, many studies recruit separate treatment groups for different interventions. For case, Prelip et al. (2012) treated i group with multiple components consisting of traditional nutrition education, while the other treatment grouping was exposed merely to traditional nutrition education. Authors found that neither a multicomponent nor a single component diet education intervention was effective in increasing fruit and vegetable consumption. In a different study, McAleese and Rankin (2007) combined nutrition education with gardening for one treatment grouping, while arranging just nutrition education to the 2d treatment group. Their results indicated only students with access to both diet didactics and gardening increased their fruit and vegetables intake. This divergence in outcomes in multiple component studies might be due to different data drove procedures. For example, Prelip et al (2012) compiled educatee questionnaires to source consumption information, while McAleese and Rankin (2007) used self-reported data from call back workbooks.

Our study contributes in two major ways to the literature of school diet policy evaluation past estimating the effect of a unmarried component intervention on the quantity of fruits and vegetables wasted past unproblematic schoolhouse students. First, nearly of the previous studies have utilized a non-experimental or a quasi-experimental design, thus limiting the validity and restricting the generalizability of their results. We improved on these studies by conducting a randomized controlled experiment to gauge the average treatment upshot of a classroom-based intervention on students' food selection and nutrient waste. Second, most of the previous literature has utilized self-reported survey or questionnaire information for evaluating the event of nutrition policies on students' fruit and vegetable consumption. Our study too utilized the digital photography method to quantify amount of fruits and vegetables selected and wasted by the students. We used digital photographs of educatee lunch trays taken immediately earlier and later on the students had lunch. We compared the lunch tray images with the actual nutrient weight measurements to estimate the actual weight of both food selected and wasted on trays. These two estimates were used as a ground for estimating the amount of nutrient selected and wasted that formed the ii result variables for statistical analysis. More details on food consumption measurement are provided in food waste measurement section below.

The remainder of the article is organized as follows. First, we describe our experiment, information drove, digital photography method, and the estimation method. We then provide descriptive statistics and summarize the estimation results for food selected and wasted, followed by a discussion of the results, limitations of the study, and conclusion.

Materials and methods

Participants

Nosotros received parental consent from 135 students in x second grade classes, from iii public schools in a Midwestern country. Two schools had 2 classrooms each and ane schoolhouse had six classrooms participating in the study. Parents filled in a consent form and a survey providing their child's demographic information. At that place were 5 students for whom the parents did not provide demographic information. Similarly, there were 32 students who either brought lunchbox from dwelling or they were absent from the lunchroom on data collection days. Hence, nosotros could not include these students in our assay, as nosotros did not have any food option or waste data for them.

The final sample consisted of 98 students. Nosotros randomly assigned five classes to the treatment group and the remaining five classes to the control grouping. Each school had at least i treatment and one control classroom. We randomized at the classroom level to increment the potential for positive externalities of treatment such as the likelihood of classmates exchanging notes near information taught in class. The treatment group had 62 students and the control grouping had 36 students. As explained earlier, factors such as unavailability of parental consent and missing data led to a pocket-size control grouping sample size. All the students in the handling classrooms received the handling, all the same only those students with parental consents were included in lunchroom data collection. Institutional review board at Purdue University reviewed and approved the information collection protocol for this study.

Instruments

The intervention was broadly based on the Health Conventionalities Model [26], emphasizing the importance of educational strategies aimed at improving the student knowledge of perceived benefits related to intake of fruits and vegetables. The intervention involved teachers of treatment classrooms implementing a six-week, bi-weekly curriculum designed to amend students' cognition and preferences for fruits and vegetables. Each lesson was 15–20 minutes long. The teachers in the control classrooms taught regular curriculum without any specific nutrition educational activity. Teachers of handling classrooms were trained past the co-authors in the activities and lesson plans involved in the curriculum. Teachers of treatment classrooms received teaching material, schedule, manual, and all the supporting material for successful implementation of the curriculum. Control classroom teachers received no such preparation or material. During summer of 2016, the curriculum and the teaching cloth were designed by the co-authors and a group of 3^rd grade teachers not involved in the intervention. The curriculum was adult based on 4 existing programs: MyPlate Levels one and 2, Two-Bite Social club, and Put a Rainbow on Your Plate. Table 1 describes the weekly activities and lessons adult for the curriculum. The developed lessons and activities were aligned to science and health didactics standards to enable teachers to teach curriculum required by the state through the nutrition lessons. At that place were no other programs or interventions related to diet instruction taught to second class students at any of the schools.

Fidelity Check: Table 2 presents the descriptive statistics for the fidelity check. As expected, co-ordinate to the pattern and implementation of the treatment, fidelity for the intervention was high. Over the form of half dozen weeks, teachers reported delivering the lessons with targeted duration and frequency. They also reported that children were engaged in, and enjoyed, the lessons.

Procedure

The experiment was conducted in Autumn 2016. The intervention spanned for a flow of 6 weeks commencement in October and ending in November 2016.

We collected bi-weekly lunchroom data for all students in our sample for ii outcome variables: 1) amount of fruits and vegetables selected by the students on their luncheon plate and 2) amount of fruits and vegetables wasted by the students. The corporeality of fruits and vegetables consumed can be elicited by taking the difference between fruits and vegetables selected on the lunch plate and wasted. The fundamental feature of our research design is that the nutrient selection and waste material data were collected through photographs of students' lunch plates. For every data collection, nosotros collected two pictures of each student's lunch plate. One time before the kickoff of lunch, to collect information on the amount of fruits and vegetables selected on the lunch plate, and once after the end of lunch, to collect information on the leftovers/waste.

Nosotros adopted the digital photography method for data collection, as it allowed the states to record the type of food items selected and wasted past the students without interfering in the established lunchroom processes. The digital photography method has been validated as a reliable and accurate method for collecting school lunchroom food data equally compared to other methods, such as physical weighing [15, 27, 28].

Food waste matter measurement

Bi-weekly information collection was conducted for the 6-week intervention menstruum. During these 6 weeks, one of the weeks was fall suspension, and the schools were closed for partial week. Equally the data collection during this time was non consistent with the other weeks, nosotros dropped this week from the assay. Hence, we are using bi-weekly data from five weeks when the schools were open up for the entire calendar week. The data were collected every Monday and Friday of each calendar week. Two trained research assistants were allocated to each school for information drove. They employed the validated digital photography method [29, 30] to collect food selection and waste information. Each student was assigned a placemat with a unique ID that remained the same throughout the study. Before the get-go of each meal, enquiry assistants arranged the placemats on the dejeuner tables and directed the students to their seats. Students put their lunch trays on the placemats clearly displaying their IDs. Enquiry assistants used digital cameras to capture images of the lunch trays with the lunch mats earlier the students started their meals. This captured food pick. After the students were finished with their meals, research assistants captured images of the unconsumed food. This captured the food waste material.

The school dining hall managers provided us with the weights of one serving size of all fruits and vegetables (food items) offered in the lunchrooms during that semester. These weights served as reference weights, and we verified them by physically measuring the actual serving size of each nutrient detail. Photographs of bodily servings were also collected as a reference to compare them with the educatee lunch data. Fruit and vegetable waste from randomly called tiffin trays were weighted. These weights, in conjunction with the reference weight, were used to calculate the percentage of fruits and vegetables wasted on each plate. This nutrient waste data, and photographs of actual servings, were used to train graders for plate waste estimation.

Three trained independent graders visually estimated earlier-lunch and afterward-tiffin photographs using the quarter-based method. According to this method, proportions of waste were quantified on a v-point scale: zero, quarter, half, iii quarters, and one (when all fruits and vegetables are wasted). For a food item to be deemed wasted, at least ane quarter of the food item had to be left on the plate. To calculate the amount of fruit and vegetable waste, the derived proportions were multiplied past the weight of ane serving of corresponding food detail in grams. To obtain the amount of food selected on the plate, we used the reference weights of food items.

We employ intraclass correlation coefficient (ICC) to examination the agreement of food waste material estimates by iii graders [15]. The same team of graders rated each nutrient detail; hence, we used the two-manner random outcome model, ICC (ii,one). The results from the intraclass correlation test, available in S1 Table, show the degree of agreement betwixt the graders. The correlation coefficient of 0.97 with a 95% confidence interval of [0.965, 0.974] indicate that the three graders were in understanding with their estimates, and that the quarter-based method is a reliable instrument for extracting food choice and waste matter data from photographs.

Data assay

We brainstorm by calculating the boilerplate treatment effect for the nutrition education classes on the food selection and waste behavior of the students using a linear random effects model, (1) where Care for _i is a dummy variable, which is equal to 1 if educatee i belongs to the treatment group and 0 otherwise. Ten _i is a vector of student-level demographic control variables such as age, race, gender, parent's marital status, and parent'south education. Day _d is 24-hour interval fixed furnishings to command for common shocks that affect all the students on a given day (eastward.k., bad tasting food). The random portion of the model includes the class-specific deviation from the grand hateful, δ _j , and the student-specific deviation from a class' outcome, e _ij , while u _dij is the common error term. We corrected the standard errors for heteroscedasticity and cluster at classroom level to control for within classroom correlation.

Nosotros consider two different effect measures. The commencement event is the amount of food selected on the lunch plate at the first of the meal (Selected) _dij past student i from form j on twenty-four hours d. The second outcome is the amount of food wasted at the finish of the meal (Wasted) _dij by student i from class j on mean solar day d. Figs ane and two show the distribution of the two outcome variables, respectively. The results of diagnostic tests for skewness and kurtosis (S2 Tabular array) evidence difference from normality for both variables. Figs iii and 4 summarize graphical distribution of residuals from model 1. It is shown that the normality assumption more often than not holds for the residuals from the regression.

Every bit described higher up, handling classroom students were taught diet education curriculum twice a week for v weeks. To explore any heterogeneity over the treatment fourth dimension, we interact the treatment indicator with the twenty-four hour period indicator. The interaction term betwixt the day and handling captures the effect of beingness in the handling classroom equally compared to the control classroom on that mean solar day. As mentioned before, this specification contains twenty-four hour period fixed effects, and standard errors are corrected for heteroscedasticity and clustered at classroom level to control for within educatee correlation.

(2)

Results

The descriptive statistics of students' baseline characteristics for treatment and control groups is reported in Table iii. The pre-handling base variables for the sample announced to be well-counterbalanced between handling and control groups. There is no statistical difference in the pre-treatment baseline variables for the 2 groups, except for race, with low significance level (p<0.1).

Nosotros as well performed a balance test by estimating the pre-treatment student characteristics on a constant and a dummy variable for beingness in the treatment group. The results for this estimation are reported in Table four. They suggest that the differences between baseline characteristics for treatment and command group are not statistically significant, equally would be expected from random sampling.

Tabular array v presents the estimation results for Eq 1 where the outcomes are food selected (column i) and food wasted (column 2). We see that both nutrient selected and food wasted by the treatment grouping was higher than the control grouping during the intervention period. Nonetheless, the difference is non statistically significant. This implies that the classroom nutrition program had no effect on the food selected and food wasted by the students in the treatment grouping in schoolhouse lunchrooms. Noting the direction of the estimates, we see that while handling grouping students selected more than fruits and vegetables on their plate, they also wasted more fruits and vegetables as compared to the control grouping. Ane caption can be that even if the students were taking more fruits and vegetables on their plates, they were not actively consuming the contents of their plate. This raises the issues of unintended consequences (in this case, food waste) of policies targeted toward improving dietary outcomes. To facilitate the understanding of the effect of the intervention on fruit and vegetable consumption, S5 Table shows the estimates from Eq 1 with fruits and vegetables consumed as dependent variable. Every bit expected, the results exercise not show any significant upshot of classroom nutrition program on consumption.

Previous literature [29] has shown that the nutrition instruction was successful in influencing fruit consumption merely not effective for vegetable consumption. Nosotros also analyzed the fruit pick, waste, and consumption as well every bit vegetable selection, waste, and consumption. The results are available in S6 Table for fruits and S7 Table for vegetables. The estimates show that the intervention did not take whatsoever meaning effect on fruit or vegetable pick, waste product, or consumption. Results evidence that the treatment group participants wasted more vegetables than the control grouping by 19.77 grams. However, the statistical significance level is low (p<0.1), hence we practise not desire to over interpret these results.

Table 6 reports the results from the 2nd specification. These results show the weekly effect of the intervention on the result variables over the menstruation of intervention. Nosotros hypothesized that with the progress of the intervention, treatment group students will significantly increase their fruit and vegetable option, and decrease food waste every bit compared to the control grouping students. The treatment and day interaction coefficient estimates the difference in the fruits and vegetable selection, or waste material, between treatment and control group on that particular day. However, the results in Table 6 do not support our hypothesis. At that place was no significant difference in the selection of fruits and vegetables, or corresponding nutrient waste material, over the weeks between treatment and command groups. The coefficients for the interaction effects for the days are non statistically different than each other. Results comparing the coefficients for each 24-hour interval are listed in S3 Table and S4 Table. We see that the amount of nutrient selected by the handling grouping on a specific intervention day has no issue on how much food is subsequently selected by this group. In other words, the nutrition educational activity did non result in a gradual increase in the amount of fruits and vegetables selected by the treatment group through the duration of the intervention. The coefficients for day 4 (week 2) for food selected, and mean solar day iv and 24-hour interval 7 (week 4) for nutrient waste, are statistically pregnant (p<0.1) merely imprecisely estimated. Nevertheless, these results are non consistent throughout the intervention period and might lead to overinterpretation.

Minimum detectable effects size (MDE)

Results prove that the classroom nutrition program potentially had very modest effects that were not significantly different from zero. Withal, we want to investigate the largest effect that might take been detected with the given sample size and duration of the treatment. Nosotros use the formula in Eq 3 to calculate the MDE. These are ex-post calculations. MDE is the difference between the amount of fruits and vegetables selected by the students in the command and the handling group.

We utilise the pilot information collected before the first of the intervention for this analysis. During the pilot information collection, no nutrition education was provided to the students. We randomly assign placebo handling and control and estimate Eq 1 using all of the controls as specified earlier for the food selected result variable. Standard errors are corrected for heteroscedasticity and clustered at an individual level. We performed 1000 simulations to compute the average variance of distribution of the boilerplate treatment outcome. This variance was used to calculate the MDE using Eq iii.

(three)

The results for the minimum detectable effect are calculated with 95% confidence interval and 80% power. With the available sample size dependent on the parental consent and school enrollment, we should be able to observe an effect size equally small equally 25.vi grams of fruits and vegetables selected by the students. If we substitute the standard fault from Table 5 in Eq 3, we detect an event size of almost 95 grams. As our experiment design had group level randomization, it resulted in fewer degrees of freedom. This might be a potential reason for us having a lower power, and likewise the reason for the difference between the magnitude of effect from the pre-experiment data and the consequence from the estimated parameters.

Discussion

We conducted a unmarried component intervention to encourage consumption of fruits and vegetables by simple school students in school lunchrooms. The aim was to familiarize students with fruits and vegetables and, consequently, influence their consumption preferences for these food items. Nosotros employ a well-established digital photography method for information collection and quantification to avoid self-reporting bias. Results evidence that the nutrition educational activity had no effect on selection and waste of fruits and vegetables by treatment group students in school lunchrooms. Our results suggest that the implemented school diet policy may not be sufficient to motivate healthy eating habits in unproblematic school students. To develop those habits, a multi-component intervention program combining in-course nutrition lessons with more experiential activities, similar repeated tasting of vegetables or developing cooking skills, might exist required. Repeated sense of taste exposure has shown to increase liking of vegetables [31], and cooking programs can positively influence school-anile children's nutrient preferences [32]. These activities can be implemented to promote easily-on experience in the environment where they tin apply the knowledge gained through classroom nutrition education lessons [fifteen]. Another alternative would exist to offer a program involving direct fiscal incentives for taking and eating fruits and vegetables [33].

Previous studies have found mixed results when using various interventions to motivate consumption of fruits and vegetables by students in school lunchrooms. Parmer et al. (2009) posited that nutrition education is not enough to encourage students to consume more than fruits and vegetables. Domel et al. (1993) showed that nutrition education in classrooms, targeting both fruit and vegetable consumption, increased preferences for fruits only not for vegetables among elementary school students. Perry et al. (1998) conclude the multicomponent nutrition programs in schools tin have positive impact on fruit and vegetable consumption among children, whereas Blom-Hoffman et al. (2004) also as Prelip et al. (2012) did non discover any pregnant improvement in fruit or vegetable consumption after multicomponent intervention. Using a novel methodology in estimating the effect of diet education on consumption of fruits and vegetables, our results complement the results constitute in previous studies.

According to Amin et al. (2015), after implementation of the NSLP program, food waste in lunchrooms increased by 56%. Our attempt to reduce the amount of fruits and vegetables wasted by employing school nutrition instruction plan had no effect. This short-term, unmarried-component nutrition education plan proved ineffective in motivating good for you food consumption habits among elementary school students.

Limitations

The current experiment design has several shortcomings. The kickoff limitation is a relatively homogenous and minor sample size. Nevertheless, as we nerveless biweekly data over a menstruum of five weeks, we had enough ability to approximate an result size of equally small-scale as xx.ten grams. Information technology volition be important for time to come research to work with larger and diverse student samples. The 2d limitation is the short duration of the intervention. Irresolute eating habits, not only in children but also in adults, takes time. Hence, longer intervention catamenia might be required. The 3rd limitation is accumulation the amount of fruits and vegetables at individual level for both selected and wasted. Accumulation the data restricts exploring the possible changes in educatee's consumption beliefs for individual components. The fidelity check was conducted using self-reported information from the teachers. There is a possibility of overestimation of fidelity as in that location might exist a bias toward reporting college fidelity by the teachers. The nutrition education lessons were based solely on declarative knowledge that might have restricted children'due south adaptation of practical eating habits [34]. Further research is required to written report the consequence of lessons based on procedural knowledge or a combination on children's consumption behavior. Some other important limitation of our study is that the group randomization resulted in fewer degrees of liberty for our statistical analysis. This might have been a potential reason for a lower statistical power to detect any significant effect.

Decision

Our study is the outset to quantify the amount of nutrient selected and wasted by uncomplicated school students in school lunchrooms. The intervention was designed following well-established Health Belief Model. The intervention was non able to motivate a change in student consumption behavior. Our study tests the introduction of classroom nutrition education as a school diet policy advocated past dissimilar stakeholders. Our findings have implications for school-based interventions that aim to promote salubrious eating habits. Our study shows that students are not motivated to take healthy foods on their plates and are on average wasting 76% of the food on their plates. With increasing charge per unit of babyhood obesity and diabetes, information technology is important to examination and develop strategies that target school environmental factors that promote healthy dietary habits.

Elementary school students are in an historic period of forming life-long habits. Policy makers and school officials demand to work together to create an environment that would promote and foster healthy eating habits. This needs systematic approach in the course of long-term, multicomponent nutrition education programs. These programs should encompass hands-on activities, interesting to elementary schoolhouse students, for raising awareness well-nigh benefits of consuming fruits and vegetables both at schoolhouse and at habitation. Failure to create such stimulating environments may atomic number 82 to less healthy youth in the forthcoming years and inefficiencies in resource utilization.

Supporting information

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