SCHOOLS ENCOURAGE HEALTHIER EATING WITH "’NUDGES’

Jorge Barrientos, Education Reporter, Bakersfield Californian | http://bit.ly/vgAKdJ

^Presenting a turkey pepperoni pizza, left, and a veggie pizza, both with whole-wheat crust, are Kern High School District food service workers Diana Sanchez, Cathie Davis, Shawna Kennedy and Angie Ramirez.   Whole-wheat dough is used to make the pizzas for the Kern High School District.> Images: Felix Adamo / The Californian
^Kern High School District food service worker Cynthia Clark stretches whole-wheat pizza dough at the district's kitchen.	^ Candy Abbott maneuvers another rack of pizzas to the oven at the Kern High School District food service facilities. The oven can cook 36 pizzas at a time, taking about nine minutes.

Monday, Dec 26 2011 03:45 PM :: Food Services Director Sharon Briel laughed as Stockdale High School students sprinkled their salads with white slivers that looked a lot like mozzarella.

"They're raw yams," she said as she watched the unsuspecting students. "It was serendipitous that the yams we were using were the white version."

Briel might have stumbled onto the yam/cheese swap, but she's increasingly attuned to the inconspicuous cues that influence food choice. Everything from food appearance and placement to staff prodding can influence how students pile their trays.

The need for innovative approaches to student dining is especially relevant in Kern County where the percentage of overweight and obese children is among the highest in California. A recent report found 43.8 percent of local students surveyed were overweight or obese, a more than 5 percent jump from 2005.

Subtle nudges toward healthier eating might work better than completely altering student choices, a strategy that is flopping in the Los Angeles Unified School District, according to recent news reports. Eliminating favorites such as nachos and nuggets for vegetarian curries hasn't gone over well, with cafeteria sales plummeting, the Los Angeles Times reported.

But health experts say using "behavioral economics" to influence student purchasing is a less drastic way to combat childhood obesity and encourage healthier eating. The idea behind this mix of economics and psychology is that subconscious signals affect decisions to eat healthier.

Simple tweaks to the lunch line can shift perceptions, steering students toward healthier choices while still allowing choice.

"We receive so many messages every day from food marketers," said Ginny Ehrlich, CEO of the Alliance for a Healthier Generation. "Why not use that in a positive way?"

Research has found that placing healthier items in the front of the lunch line, promoting food with descriptive names and letting students choose among good-for-you options all have significant impacts. Putting fruit in attractive baskets instead of stainless steel bins or charging less for healthier items has been found to influence student choices.

Some of these tactics are probably familiar to dieters. People are more likely to order healthy items ahead of time versus facing salty, high-calorie goodies on the spot. And keeping unhealthy items out of sight limits purchases, too.

The best part of these behavioral psychology tactics is they're inexpensive, Ehrlich said. The challenge for many school districts nationwide is simply finding the time to take the extra steps.

In Kern County, food services leaders are paying attention. Briel has made numerous tweaks to her team's approach at the Kern High School District. She has learned that lots of color in dishes appeals to the eyes.

Salad bars are set away from the wall, allowing for easy mobility. Sampling gives children an opportunity to try fruits and vegetables that might be unusual for them and creates positive associations. And the size of a serving spoon can affect how much people take, an important tactic when students pile on the calorie-laden potato salad.

"I think mothers have always been using behavioral economics but it didn't have those fancy words," she said.

At Bakersfield City School District, Nutrition Services Director Brenda Robinson has found the shifts in cafeteria choices often follow nutrition education. Introducing students to fruits and vegetables in the classroom makes those items more familiar and appealing in the lunch line.

Through a grant, the district has brought items such as mangos, persimmons and jicama to the classroom. Teachers will squeeze a lime or lemon over produce and discuss the flavor change, or ask students how bell peppers are different that chiles.

"They can see and taste differences so they're not afraid to try them," Robinson said.

Robinson said she's also aware of how visual diversity, size and shape influence selection. An orange quarter fits nicely on a salad plate without rolling off. And the power of suggestion can't be underestimated.

"My staff will encourage them to try new things," Robinson said. "Johnny, did you know that's a pear? They're really crunchy like an apple. Would you like to try one?"

At the Panama-Buena Vista Union School District, Nutrition Services Manager Marilou Onaindia is interested in implementing those subtle nudges, too.

Recently, Onaindia attended a webinar looking at where white and chocolate milk are placed in the cafeteria. She learned that students will often pick the first item they see, even if that's the healthier white milk -- a strategy she may be interested in implementing locally.

Something as basic as menu labeling can also change student picks, she said.

"Instead of just saying broccoli, use descriptive words that make it sound more inviting," she said. "Words entice them to think it's cool to eat something like the 'big bad banana.'"

Simply having a choice makes a difference, too. Being able to select your own salad's components encourages students who may reject a pre-made option because it contains an item they dislike.

Back at Stockdale High School, the salad bar's wide offerings are part of what makes it a hit with the students, said Samanda Hall, a sophomore.

"I like all the fruits, vegetables and meat in it," Hall said. "There are so many different choices."

Nearby, a group of boys were eating their custom salad creations piled high with fresh vegetables, including a healthy sprinkle of those raw white yams.

"I don't know what they are," said one student, shrugging as he dug in his fork. "But they're good."