Reducing elementary school children's risks for chronic diseases through school lunch modifications, nutrition education, and physical activity interventions

Many behaviors, such as physical inactivity or a poor diet, that put adults at risk for chronic diseases are established in childhood. This manuscript describes the outcomes of a comprehensive school health project, the Kansas LEAN School Intervention Project. The Kansas LEAN School Intervention Project in Salina and Dighton had four components, three of which were school based: (a) modified school lunches, (b) enhanced nutrition education, and (c) increased opportunities for physical activity. The fourth component, actions taken by a community partnership, is described elsewhere. Data from two case studies were used to address three primary evaluation questions: (a) did changes in the school lunch menu reduce the fat content yet maintain calories in meals served? (b) did nutrition knowledge, skills, and attitudes of students improve? and (c) did students' physical fitness improve? The findings suggest that the project was successful in reducing the fat content in school lunches in both communities from baseline levels of approximately 38% calories from fat to the target goal of 30% calories from fat during the 1993-94 school year. The schools also maintained adequate calories for students in this age group. Students' knowledge, skills, and behaviors related to nutrition as well as their physical fitness improved in both Kansas communities. The strengths and limitations of this strategy of making healthy choices easy choices through school-based intervention are discussed.