Abstract
BACKGROUND: Concession stands at high school events are exempt from the US Department of Agriculture regulations for school foods. Concessions are generally stocked with unhealthy foods since healthy foods are believed to have lower sales and profit margins. METHODS: Concession stand sales for two seasons of high school fall sports in Muscatine, Iowa were compared. In between seasons, two types of changes were made: (i) addition of new healthier concession options and (ii) substitution of healthier ingredients (less saturated fat, no trans fat). Satisfaction surveys of students and parents were conducted before and after the changes. Data were collected in 2008 and 2009 and analyzed in 2012-13. RESULTS: Revenue per game was similar between years, even with the introduction of healthier items and ingredient changes. In 2009, the new healthy foods comprised 9.2% of total revenue and sales of some new items increased with each game. The 'healthy makeover' had no influence on student satisfaction but it improved parent satisfaction (P < 0.001). CONCLUSIONS: This compelling test of concept shows that offering healthier items can be good for both sales and satisfaction. While this study was conducted with concession stands, the principles can be carried over into other food retail settings.