Serving vegetables first: A strategy to increase vegetable consumption in elementary school cafeterias

Vegetable consumption in the United States is low despite the wealth of evidence that vegetables play an important role in reducing risk of various chronic diseases. Because eating patterns developed in childhood continue through adulthood, we need to form healthy eating habits in children. The objective of this study was to determine if offering vegetables before other meal components would increase the overall consumption of vegetables at school lunch. We served kindergarten through fifth-grade students a small portion (26-33 g) of a raw vegetable (red and yellow bell peppers) while they waited in line to receive the rest of their lunch meal. They then had the options to take more of the bell peppers, a different vegetable, or no vegetable from the lunch line. We measured the amount of each vegetable consumed by each child. Serving vegetables first greatly increased the number of students eating vegetables. On intervention days most of the vegetables consumed came from the vegetables-first portions. Total vegetable intake per student eating lunch was low because most students chose to not eat vegetables, but the intervention significantly increased this value. Serving vegetables first is a viable strategy to increase vegetable consumption in elementary schools. Long-term implementation of this strategy may have an important impact on healthy eating habits, vegetable consumption, and the health consequences of vegetable intake.