Statement of Wendy Slusser, MD, MS, FAAP At congressional briefing on Effective Strategies to Increase Children’s Fruit and Vegetable Consumption: Benefits of Salad Bars
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December 3, 2009 - I am Wendy Slusser, a Pediatrician and Medical Director of the Mattel Children’s Hospital UCLA Fit for Health Program. Thank you for this opportunity to share with you our research and experiences with salad bars in Title 1 schools in Los Angeles Unified School District.
Los Angeles Unified School District (LAUSD) is the second largest school district in the US. There are over 730,000 students in grades K – 12 of whom 77% qualify for free or reduced price lunch. These same students who are most at risk for hunger are also at great risk of obesity since their neighborhoods often lack safe spaces to play and have limited access to fresh and healthy food. As an Associate Professor of Pediatrics at UCLA, I have been working with the school district for over 10 years to help innovate and evaluate their nutrition programs to address childhood hunger and obesity.
The salad bar program is LA Unified School District’s flagship environmental intervention to support health, wellness and school performance in the predominately low-income and minority student population of the district. I will never forget how skeptics in 1999 told me “oh you will never get rid of the Sloppy Joes!” But, today you have to go visit Hooper Elementary School in South Central where 800 children, even the little kindergarteners, are grabbing the fruit and vegetables from the salad bar on their way to the hot lunch window. Yes, it was a daunting task, but now there are over 60 salad bars in LAUSD.
Thanks to the combined forces of the LAUSD food services, USDA, the school board, Occidental College, UCLA, Anthem Blue Cross of CA, the principals, the cafeteria managers, the children and their parents; we combined our strengths of organizing, inspiring, supporting, funding, studying, trying and changing to accomplish this.
This all started by working collaboratively with a forward thinking food service administrator, Carol Noelting. Carol wanted to ameliorate the high rates of student obesity and food insecurity in LAUSD, she asked us what she could do? After a lunch visit to Santa Monica School District where she saw first hand how even the youngest student can pick up the strawberry or broccoli with tongs in a hygienic manner, and the children were returning to the salad bars for seconds, she agreed to launch the pilot salad bar program.
This salad bar program was piloted in 3, Title 1 schools with predominately Latino, African American and Asian elementary school children in 2000. As evaluators from UCLA, we evaluated the 24-hour food recalls of a total of 337 2nd-5th grade children. We compared their 24- hour food recall consumption before and after the salad bar program was instituted and we found the following significantly positive outcomes:
1. Children significantly increased their daily fruit and vegetable consumption by 1 serving.
2. The increase in total fruit and vegetable consumption was almost all due to an increase during lunch (84%).
3. Children significantly decreased their daily total calories, fat from calories, cholesterol and saturated fat consumption.
4. Over half the children chose the salad bar for their lunch on any given day.
From: Slusser WM, Cumberland WG, Browdy B, Lange L, & Neumann C. (2007) A School Salad Bar increases frequency of fruit and vegetable consumption among children living in low-income households Public Health Nutrition: 10 (12): 1490-1496.)
Benefits to Students and Families:
• Increasing availability and accessibility to fruit and vegetables in school meals is recommended by the Institute of Medicine as a goal to promote child health and to meet recommended Dietary Guidelines for Americans. Children need to eat nutrient dense not energy dense foods.
• Increasing the availability of fruits and vegetables by having a salad bar with a wide variety during lunch and making them more accessible by cutting the fruit and vegetables up will increase the likelihood the children will eat them.
• Increasing access and availability of fruits and vegetables through salad bars sets up opportunities for children to have repeated exposures to fruit and vegetables and this impacts their preferences.
• Our study shows the salad bar program influences the quantity and the variety of fruits and vegetables students eat thus leading to potentially long-term positive healthy habits.
Benefits to School
• Salad bars, or fruit and vegetable bars, increase participation in the federal school lunch program.
• Salad Bars are an environmental change and contribute to creating healthier school food environments.
• Salad Bars complimented other USDA funded nutrition education efforts in LAUSD delivered through the Network for Healthy California.
• The salad bar program includes point of decision prompts to eat more fruits and vegetables contributing to long-term healthier eating habits.
Benefits to all LAUSD Schools and other schools in the US
Now, over 60 schools in LAUSD have salad bars, benefiting thousands of children every day. In addition thanks to the collaboration with LAUSD, a “How to Set Up a Salad Bar Manual” was developed and is available free on line for all schools to use. Many states, including New York and Vermont, utilize the manual.
Research Leads to Policy
Because LAUSD felt so strongly about the benefits of salad bars, in 2003 the Obesity Motion passed directing the Superintendent to provide a vegetable and fruit bar, where facilities permit, to all high middle and elementary schools in the district.
I will never forget the first day of the salad bar program at Hooper Elementary School when I saw a third grader kissing his orange and saying it was the best day of his life. Or, on a recent visit in October, when students were loading up their plates with baby carrots, broccoli, cherry tomatoes, lettuce and gala apples. I hope you can bring the best day to every child’s life in the US. The 2010 Child Nutrition Act is the opportunity for Congress to
(1) Provide increased funding so schools can serve more fruits and vegetables;
(2) Encourage salad bars in every school; and
(3) Provide increased funding for salad bar equipment and other needed cafeteria equipment, so more schools can have salad bars.