Melissa Pflugh Prescott’s research while affiliated with Case Western Reserve University School of Medicine and other places

School nutrition programs reach approximately 30 million American children each year and provide an ideal opportunity to improve child dietary behaviors, including food waste reduction. Yet, school nutrition programs are challenging to implement and can be difficult research settings. As such, many schools seek low-cost strategies to improve diet quality and reduce food waste. This chapter explores the role of community partnerships, using Cooperative Extension as a case study, to implement nudge interventions to improve fruit and vegetable consumption while reducing waste. In this mixed-methods study, plate waste outcomes were used to evaluate the efficacy of the nudge interventions; interviews with school nutrition staff were used to assess the implementation of the intervention that was delivered in partnership with Cooperative Extension. Nutrition services staff viewed their partnerships with Cooperative Extension as a key facilitator in implementing the interventions and reportedly may not have implemented the nudges without this collaboration. These findings underscore the importance of community partnerships to facilitate innovation in school nutrition programs.

Food waste reduction is essential for supporting the sustainability of food systems. Wasteful behaviours are difficult to change after they have been formed, highlighting the importance of early interventions. Here we present an assessment of school plate food waste from 29 countries, and examine the environmental implications, causes, and interventions. School plate waste ranged from 4% to 46% per capita per meal and was positively correlated with country income levels. On a global scale, this waste embodies ∼150 Mha of cropland and ∼770 MtCO2e of greenhouse gas emissions; hence, reducing school plate food waste offers potentially large environmental gains. We propose a comprehensive, multistakeholder framework centred around sustainable food education that cultivates food systems knowledge and skills, and an appreciation for nature and food labour to reduce the psychological distance between youth and their food waste. To effectively implement the framework requires the support and engagement of families, communities and the broader society beyond the confines of schools.

Background Only a few adolescents are meeting their daily vegetable requirement. At the same time, spicy food is increasingly popular and familiar across cultures. Objectives To explore the implementation of spicy vegetables into school meals, the primary objective is to determine adolescents’ preferred degree of hot spice on steamed broccoli. Secondary objectives include estimating the appropriateness and acceptability of spicy vegetables in the National School Lunch Program and identifying strategies to promote spicy vegetables within school meals. Methods One hundred participants between the age 11 and 17 y sampled 4 steamed broccoli florets with varying levels of a ground red and cayenne pepper spice blend (0, 0.9, 2.0, and 4.0 g). Participants rated their likeability of each broccoli sample on a 9-point hedonic scale and answered a survey assessing chili liking, chili consumption patterns, appropriateness, and acceptability. An interview assessed perspectives on spicy vegetables within school lunch. Regression analyses assessed relationships between participant attributes and sample ratings and survey outcomes. Agglomerative hierarchical cluster analysis was conducted to cluster together participants with similar sample liking ratings. Results Seventy-seven percent of participants reported that chili pepper makes food taste better, and 67% consumed spicy food weekly or daily. Chili likers (n = 41) were the dominant cluster group, compared with moderates (n = 31) and chili dislikers (n = 28). Thematic analysis results suggested that most participants support incorporating spicy vegetables into school lunch but mushy vegetable texture may undermine the impact of changing school vegetable spice levels. Conclusions Spicy foods are commonly consumed by adolescents, and these findings support the inclusion of spicy vegetables in school lunch. Additional research is needed to identify policies and practices to improve the texture of vegetables in school meals and determine additional strategies to support cultural humility in child nutrition programs.

The National School Lunch Program (NSLP) provides healthy food to millions of children annually. To promote increased lunch consumption, policy, systems, and environmental (PSE) change strategies are being implemented in child nutrition programs. An evaluation of the current evidence supporting PSE interventions in school nutrition programs is needed to facilitate evidence-based practices across the nation for programs. This systematic review aims to determine the quality and breadth of available evidence of the effectiveness of PSE strategies on the consumption and waste of fruits, vegetables, milk, and water in the NSLP. The inclusion criteria required studies to occur in a United States K-12 school setting, data collection after 2012, report consumption and waste findings for fruit, vegetable, milk, or water, and be an original research article. Articles included in the review are restricted to positive or neutral quality. Thirty studies are included, policy level (n = 4), systems level (n = 8), environmental level (n = 10), and multi-category (n = 8). Results from positively rated policy-level studies suggest that recess before lunch may increase milk consumption, whereas removing flavored milk may decrease consumption. System-level studies of offering vegetables first in isolation of other meal components and offering spiced vegetables compared with traditional preparations may increase vegetable consumption, and locally procuring produce may increase fruit and vegetable consumption. Environmental-level studies such as water promotion strategies such as placing cups near drinking fountains may increase water consumption. Improving the convenience, attractiveness, and palatability of fruits and vegetables may increase consumption. Future PSE research in child nutrition programs should incorporate implementation aides and metrics into their study designs to allow a better understanding of how to sustain interventions from the perspective of school nutrition professionals.

Cooking-related literacy and attitudes may play important roles in preventing and reducing diet-related chronic diseases and nutrition disparities. People living alone are an under-researched but growing population who face above average food insecurity rates. This study's objectives were to 1) test how cooking self-efficacy and attitude are stratified demographically among a sample of people living alone, focusing on variations across gender, age, and food security, and 2) examine how cooking self-efficacy and attitude are associated with two indicators of cooking behavior - cooking frequency and convenience orientation. We draw from a cross-sectional survey analysis of 493 adults living alone in Illinois, USA with validated measures for cooking self-efficacy, attitude, frequency, convenience orientation, and demographic characteristics. Hierarchical linear regression models were used to examine demographic factors explaining variation in self-efficacy and attitude, with attention to interactions between gender, food insecurity, and age. Poisson and OLS linear regression models were used to examine associations between self-efficacy and attitude and cooking frequency and convenience orientation. We find cooking-related self-efficacy and attitude showed strong but distinct associations with cooking frequency and convenience orientation. Overall, food insecure groups had lower self-efficacy than those who were food secure; however, food insecure women had higher self-efficacy than men in similar positions, apart from older-adult women who held particularly low efficacy. Cooking attitudes varied in small ways, notably with food insecure younger and older women possessing more negative cooking attitudes than middle-aged women. This research highlights the importance of understanding the cooking-related orientations of single-living people, while demonstrating that this group's ability to prevent and manage food insecurity is not uniform. These results can inform targeted interventions around food and nutrition insecurity, cooking attitudes, and self-efficacy among single-living populations.