Abstract
AIMS: Numerous interventions have been designed to impact children's diet in the elementary school setting. One popular strategy is to label foods in the elementary cafeteria as more or less healthy. An example is the Coordinated Approach To Child Health (CATCH) labels of 'go', 'slow', or 'whoa' foods. In many respects, this has been successful, as food purveyors have responded by offering more healthy versions of popular foods (e.g. hamburgers with a high soy content) in an effort to avoid the less healthy, 'whoa' label. While this provides an obvious benefit to children's dietary choices and overall risk of obesity, it may have the unintended consequence of not setting up youth to make healthy choices in the environment outside of schools where these foods have not been altered. In response, the current study was designed to compare school labels and registered dietitian (RD) recommendations of common elementary lunch options. METHODS: In the spring of 2010, 28 RDs provided their recommendation of 'generally healthy, choose often'; 'generally less healthy, choose less often'; and 'generally unhealthy, choose rarely' for 48 common school lunch options. RDs were not told how schools categorised each selection. Kappa analyses were used to determine agreement between school labels and RD recommendations. RESULTS: Results indicate some disagreement between school labels and RD recommendations, with higher fat/calorie entrées showing greater discrepancies. CONCLUSIONS: Given these inconsistencies, nutrition education in schools should be designed to help children and their parents understand how foods offered in school may differ from those outside the school environment.