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PubMed1975

Major nutrients in the Type A lunch. II. Amounts consumed by students.

Plate waste from Type A school lunches was collected during the period that fifth, seventh, and tenth grade students ate lunch. Twelve elementary, three junior high, and seven high schools distributed among three geographic regions of North Carolina were included in the sample. Nutrients served and nutrients in plate waste were determined by laboratory analyses of two five-day composites of meals and of waste from each school. Nutrients consumed were determined by difference. Relative to the Type A goal, protein intake was highest; riboflavin and vitamin A values were consumed in satisfactory (one-third or more of the allowances) amounts. Younger students consumed adequate iron and calcium, and calcium intake approached adequacy among older students. High school students consumed only 69 per cent of their goal for iron and 75 per cent of the goal of energy value; among the three groups, however, this was the highest percentage of the goal for energy value consumed. Ascorbic acid intake was least satisfactory for fifth and seventh grade students. Overall, fifth graders consumed a significantly (P less than .01) lower percentage of the nutrients served than the two older groups. With a few exceptions, students consumed 80 to 90 per cent of the various nutrients which were served: 62 to 66 per cent of the vitamin A value served was consumed; fifth grade students consumed only 77 per cent of the iron served; and the two younger groups consumed only 69 per cent of the ascorbic acid served. Although the most marked regional differences in nutrients consumed occurred with vitamin A and ascorbic acid, overall elementary students in the eastern region consumed a significantly (P less than .01) higher percentage of nutrients served than did those in other two regions.

Adolescent↗

PubMedDate not supplied

Do Japanese take more folate from traditional Japanese dish than is conventionally estimated?-Actual folate contents in hospital diets and marketed lunch boxes.

Folic acid deficiency is very rare in Japan. However, recent concerns in relation to causal relationships between cancer and low folic acid levels necessitate information on actual folate intake by Japanese, which has hitherto not been well studied. We therefore evaluated folate contents of a hospital diet for 7 consecutive days and of 16 lunch boxes purchased at convenience stores. Dietary intake was assessed for weighed food items after cooking using our previously published data on folate contents of various foods and also by using Standard Tables of Food Composition in Japan (STFCJ). Mean daily folate intake from the hospital diet was 723.9 microg/day using our data but only 359.2 microg/day if calculated using the STFCJ. Twenty-nine % of the total daily folate intake was through rice. Mean folate intake through lunch boxes was 491.7 microg/day by our tabulation and 139.5 microg/day with the STFCJ. Folic acid intake of Japanese is far above the levels taken in other countries and over half of this amount is taken from rice. Levels of folic acid contents (especially in rice) listed in the STFCJ are too low and revision is strongly suggested.

Diet↗

PubMed1977

Effect of a flavored milk option in a school lunch program.

An analysis of nutrient intake and of plate waste for four hundred elementary school children, when an option of chocolate milk was provided in the school lunch program, shows significantly higher intakes of calcium and riboflavin, lower intakes of iron, greater food waste, and significantly less waste of milk. Participation in the school lunch program was not affected by the announced availability of flavored milk in ten schools serving 3,700 children; however, significantly (p less than 0.01) more children bought milk alone.

Animals↗

PubMed1980

Alternate lunch patterns in high schools. I. Labor requirements and meal costs.

Meal costs were compared in forty-eight high schools as a function of the lunch pattern. The patterns evaluated were: Type A "offer vs. serve," traditional Type A, four food groups (Basic 4), and free choice. Participation in school lunch increased with free choice, resulting in a reduction in labor and total meal costs. Sixteen per cent of foodservice work involved administration, 37 per cent preparation, 16 per cent service, 25 per cent clean-up, and 6 per cent other, which did not vary with the menu pattern.

Adolescent↗

PubMed1980

Alternate lunch patterns in high schools. II. Student and foodstaff reactions.

Reactions to alternate menu patterns used in high school lunches were measured. Students rated food in Basic 4 and free-choice patterns more positively than Type A. The environment in the lunchroom was not rated differently with different menu patterns. Based on overall student reactions, the free-choice pattern was preferred. School lunch managers found the free-choice pattern more difficult to serve because of reimbursement and pricing problems but felt there was less plate waste and better student response with this system.

Administrative Personnel↗

PubMed1980

Alternate lunch patterns in high schools. III. Food acceptability.

Food acceptability was assessed in forty-eight high schools using alternate methods of menu planning for school lunches. The free-choice pattern resulted in a significant reduction of total plate waste, particularly in the vegetable and salad categories. Girls consistently wasted more food than did boys, regardless of menu pattern. Overall plate waste was 7 and 13 per cent of food service for boys and girls, respectively. The data suggest that a free-choice lunch may be effective in reducing plate waste, particularly for poorly consumed menu items.

Female↗

PubMed1993

An environmental intervention to reduce dietary fat in school lunches.

OBJECTIVE: To determine whether making a low-fat entree available as one of two choices in an elementary school lunch program would reduce the fat content of meals selected by children. DESIGN: In this before-after trial, students had a daily choice between two entrees, one of which was sometimes low-fat. For 93% of school days during 14 consecutive school months, daily entree choices were recorded for 619,976 student meals. The fat content of entrees was assessed with a computerized nutrient database supplemented by food manufacturer's data. SETTING: Sixteen elementary schools in the Bellevue (Washington) School District. PARTICIPANTS: The number of students eating school lunch averaged 2440 per day, of whom 25% were less than 185% of poverty. INTERVENTION: After a baseline period of 6 months, the intervention increased the number of days per month when one of the two entrees had 30% or fewer calories from fat. MAIN OUTCOME MEASURES: Data for the entire district were combined to estimate for each month the percent of students who selected low-fat entrees and the percent of calories from fat in the average meal selected by students. RESULTS: During the 6 months before the intervention, a low-fat entree was available on 23% of days; it was selected by 39% of students; and the average meal selected by students had 36% of calories from fat. By the end of the 8-month intervention, a low-fat option was available on 71% of days; it was selected by 29% of students; and the fat content of the average meal dropped from 36% to 30% of calories from fat (P = .02). CONCLUSIONS: In this school district, many students, given the choice, selected low-fat entrees. Recommendations for dietary fat were met simply by the environmental intervention of increasing the availability of low-fat foods.

Child↗

PubMed1986

The composition of lunch determines afternoon plasma tryptophan ratios in humans.

It is well established that the ratio of the plasma tryptophan concentration to those of the other large neutral amino acids determines the transport of tryptophan into the brain. Brain tryptophan levels, in turn, control production of the neurotransmitter serotonin. Protein-rich meals, when consumed in the morning after an overnight fast, have been shown to decrease the plasma tryptophan ratio, while carbohydrate-rich meals have the opposite effect. We now show that these meals have similar effects when consumed for lunch, even if they are preceded by a small breakfast meal.

Adult↗

PubMed1993

Effects of sleep deprivation, lunch, and personality on performance, mood, and cardiovascular function.

The present study examined the effects of sleep deprivation on performance, mood, and cardiovascular functioning in the late morning and early afternoon. The results showed that the sleep-deprived subjects felt less alert and detected fewer targets in a cognitive vigilance task. Selective impairments due to sleep deprivation were also observed in a logical reasoning task. There was little evidence to suggest that consumption of lunch altered these effects of sleep deprivation. However, individual differences in the effects of sleep deprivation were apparent, with trait anxiety being related to the changes in subjective alertness produced by sleep deprivation, and sleep-deprived extraverts showing greater performance impairments than the sleep-deprived introverts.

Adolescent↗

PubMed2005

Squire's Quest: intervention changes occurred at lunch and snack meals.

This study identified fruit, 100% juice and vegetables (FJV) consumption changes by meal among fourth grade students participating in Squire's Quest!, a 10-session individually focused psychoeducational multimedia game with many meal/environment specific behavioral change techniques incorporated into the programming. Participants in 26 elementary schools were randomly assigned to treatment or control groups. Four days of dietary intake were assessed before and after the intervention to determine FJV servings consumed by meal. Overall, students receiving the intervention consumed 1.0 serving FJV more per day compared with control condition students. Using mixed model analysis of covariance, significant increases were found for servings of fruit and 100% fruit juice at snacks, and regular vegetables at lunch for intervention school children compared with children in control condition schools. These meals and snacks were targeted by the intervention activities and appear to represent eating occasions for which the children might have had more control. Interventions need to incorporate new procedures to more directly target intake at breakfast and dinner.

Beverages↗

PubMed2004

Using forecasting techniques to predict meal demand in Title IIIc congregate lunch programs.

The purpose of this study was to determine which forecasting model would most accurately predict meal demand in Title IIIc congregate lunch programs designed for serving older adults. Forecasting techniques including naïve, moving average (three versions) and simple exponential smoothing were applied to data collected over a 4-month period from seven meal sites located in a large urban area. An analysis of the forecasting models using mean absolute deviations and mean squared errors indicated that simple mathematical forecasting techniques provided better predictions of meal demand than did the naïve method for all sites. In four of the seven sites, exponential smoothing was the best forecasting model, whereas in the remaining sites, moving average models provided the best forecast. Implications are discussed.

Aged↗

PubMed2005

Who's buying lunch: are gifts to surgeons from industry bad for patients?

Why does gifting exist in the medical marketplace? It provides a sales advantage in a competitive marketplace by establishing crucial relationships with the patients' fiduciary: the physician and surgeon. Do gifts to physicians from industry harm patients? One can cite mountains of indirect evidence that they do, and maybe in the case of recalled devices and drugs there are actual corpses, but these examples are retrospective and it is impossible to prove that removing detailing eliminates the harm. Banning gifts to surgeons would not completely fix the ethical problem of pharmaceutical and device marketing. Gifts are important because they buy access and foster relationships, but inherent bias in research and the medical literature makes it very difficult to remain objective. It is a race, and education has not kept pace with advertising; only 10% of 575 internal medicine physicians thought they had had sufficient training during medical school and residency regarding professional interaction with sales representatives. Would banning gifts help at all? Would enforcing an unpopular ethical code protect patients? There might be a small improvement, but not as significant as eliminating representatives and product samples altogether. This is not likely to happen without an enormous fight against the wealthiest industry in America. The solution is education. To borrow industry's argument, physicians and surgeons are ethical creatures with capacity for judgment and integrity. They need to understand and believe the magnitude of the problem. Detailing exists because there is a market for it, empowering surgeons with ethical training reduces the demand for goodies, and at some point the popular choice will be to buy their own lunch. Business ethics are not medical ethics. Industry is behaving exactly as it must to maximize profits. Although it is painful for some surgeons, surgical residencies, and professional organizations to envision a future with diminished corporate gifts, it is every surgeon's responsibility to consider whether their dealings with the pharmaceutical and medical equipment industries withstand the harsh light of realities presented herein.

Drug Industry↗

PubMed2000

Prompting methods affect the accuracy of children's school lunch recalls.

OBJECTIVES: To evaluate the feasibility of implementing 3 specific prompting methods among students in the first and fourth grades (mean age = 7.2 and 10.1 years, respectively), to validate recall accuracy of first- and fourth-grade students against observation, to develop a single measure of inaccuracy that cumulated errors in reporting food items and amounts without allowing underreporting and overreporting to cancel each other, and to establish information regarding the measure of inaccuracy for use in future studies. DESIGN: Children were interviewed the morning after they were observed eating lunch provided by the school. Interviews included free recall, nonsuggestive prompted recall, and specific prompted recall (either preference, food category, or visual). SUBJECTS/SETTING: Ninety-six children (48 students per grade) were studied--32 per the specific prompting method--stratified by grade, sex, and ethnicity (African-American or white). Specific prompting method was randomly assigned to children within strata. STATISTICAL ANALYSIS: Food items were categorized and weighted as: combination entree = 2, condiments = 1/3, and other = 1. To calculate inaccuracy of recall, absolute differences between amounts reported and observed eaten were calculated for each item and then multiplied by each item's weight; these values were then summed across all items for each child. Inaccuracy of recall was determined before specific prompting and after specific prompting and for the difference (inaccuracy after specific prompting minus inaccuracy before specific prompting). RESULTS: Before specific prompting, median inaccuracy was 2.7 servings for the 48 first-grade students and 1.7 servings for the 48 fourth-grade students. The median difference in inaccuracy from before to after specific prompting was 0 for both grades. Specific prompting increased recall accuracy for 9 first-graders and 12 fourth-graders, but decreased recall accuracy for 21 first-graders and 7 fourth-graders, and did not change recall accuracy for 18 first-graders and 29 fourth-graders. Among children whose recall accuracy increased after specific prompting, 5 first-graders and 8 fourth-graders received prompting for food category. APPLICATIONS/CONCLUSIONS: Among first-grade students, specific prompting (either preference, food category, or visual) may hurt more than help recall accuracy. Among fourth-grade students, prompting for food category yields small gains in recall accuracy with minimal losses. Validation studies are needed with larger sample sizes to determine prompting methods that produce more accurate dietary recalls from children of various socioeconomic status groups, other racial/ethnic groups, and at other meals.

Analysis of Variance↗

PubMed2003

Reverse versus forward order reporting and the accuracy of fourth-graders' recalls of school breakfast and school lunch.

BACKGROUND: Do children recall school breakfast and school lunch intake during 24-h recalls more accurately when prompted to report meals and snacks in reverse versus forward order? METHODS: One hundred twenty-one fourth-graders stratified by race (Black, White) and gender were each observed and interviewed twice (once per order) regarding the previous day's intake. Omission and intrusion rates determined accuracy for reporting items. Total inaccuracy determined accuracy for reporting items and amounts. RESULTS: Results failed to indicate significant effects of interviewer, weekday, sequence (first or second recall), or race on omission rates, intrusion rates, or total inaccuracy. A significant order by gender interaction was found for omission rates, which were lower (i.e., better) for males for reverse (53%) versus forward recalls (62%), but not females (61 versus 53%) (P < 0.008). Intrusion rates were acceptable for males for 54% of reverse recalls and 40% of forward recalls (P = 0.095). Means were 57 and 32%, and 6.4 servings for omission rate, intrusion rate, and total inaccuracy for reverse recalls, and 56 and 39%, and 6.9 servings for forward recalls. CONCLUSIONS: Prompting children to report in reverse versus forward order improved omission and intrusion rates for males more so than females. Regardless of reverse or forward order, children reported <50% of items observed; furthermore, >30% of items reported were not observed. Research is needed to enhance accuracy of children's dietary recalls.

Child↗

PubMedDate not supplied

A non-invasive method for measuring cardiac output: the effect of Christmas lunch.

Cardiac output was measured in ten patients at routine cardiac catheterisation and three patients with severe heart failure by means of a carbon dioxide rebreathing technique with a computer-assisted mass spectrometer and compared with cardiac output measured by thermodilution. There was a close correlation (r = 0.96, p less than 0.01) between the two methods. Cardiac output measured by the carbon dioxide rebreathing technique increased after a typical Christmas lunch by a mean of 1.6 1/min in a group of healthy volunteers.

Carbon Dioxide↗

PubMed2003

Time to eat: the relationship between the number of people eating and meal duration in three lunch settings.

We conducted an observational study of customers in three different types of lunch settings: a worksite cafeteria, a fast-food restaurant, and a moderately priced restaurant, and assessed the relationship between meal duration and the number of people eating at each table (group size). Results suggest a significant positive correlation between group size and meal duration, collapsing over eating settings. Analysis of variance yielded significant main effects of both eating setting and of group size, indicating that meal durations were longest in the moderately priced restaurant and shortest in the fast-food restaurant. An interaction between group size and eating setting indicates that the magnitude of the group size effect on meal duration differed in the different situations, with the effect of group size on duration being smallest, but still significant, in the fast-food setting compared with the other two settings.

Eating↗

PubMed2004

Salmonella Enteritidis outbreak associated with a school-lunch dessert: cross-contamination and a long incubation period, Japan, 2001.

A Salmonella Enteritidis (SE) outbreak in Japan was investigated with an observational study, analytical epidemiology and bacteriological examination (including phage typing). The outbreak occurred among 96 schoolchildren, and was caused by SE phage type 1. The outbreak source was dessert buns served at a school lunch (RR 42.55, 95 % CI 5.93-305.11, P < 0.001). The buns were probably cross-contaminated from eggs from a factory with a history of SE-contaminated products. The incubation period was longer than usual (3-16 days, median 8 days). A low contaminating dose may account for the long incubation period and low attack rate. Outbreak detection was hampered by the absence of routine Salmonella surveillance in Japan. The investigation was complicated by concurrent illnesses from other SE phage types. It was successful, in part, because adequate food samples were available for microbiological testing.

Child↗

PubMed2005

Differences in survival of Escherichia coli O157:H7 under various conditions that re-enact the cooking of lunches implicated in an outbreak of haemorrhagic diarrhoea.

Two elementary schools were served lunches that were cooked in the same kitchen. An outbreak of Escherichia coli O157:H7 occurred at one school where the dishes that were prepared for the school were lukewarm and kept for 33 min at an average temperature of 45 degrees C before serving. However, no outbreak occurred at the other school where dishes were hot and were kept for 60 min at an average temperature of 50 degrees C before serving. In a series of experiments on the survival of E. coli O157:H7 in the liquid portion of similarly prepared food, the population of E. coli O157:H7 was reduced by 10-3 by heating at 50 degrees C for 60 min and by only 10-1 by heating at 45 degrees C for 40 min. Further, E. coli O157:H7 survived at 45 degrees C for 40 min but not at 50 degrees C for 60 min at pH 4.0 with a 4.0% salt concentration that was similar to that of the liquid part of the food. These results indicate that pH and salt concentration of cooked food markedly affect the survival of E. coli O157:H7 and help to explain the occurrence of the disease outbreak at only one of the schools.

Diarrhea↗