Healthy Lunchbox Challenge helps influence healthy eating habits in children

During the school year, 21 million children receive free or reduced-price lunches, yet less than 10% of those children participate in the Department of Agriculture's Summer Food Service Program. This discrepancy places responsibility for food choices during the summer on parents. Previous efforts to improve the healthfulness of foods and beverages provided by parents have resulted in little to no improvement in the amount of fruits, vegetables, whole grains, and/or water.

To address the issues of food selection and rapid weight gain among children observed in the summertime, a group of researchers from the University of South Carolina used summer day camps as a unique opportunity to influence food and beverage choices of the children attending. By implementing the Healthy Lunchbox Challenge (HLC), an innovative theory and incentive-based program, at four large-scale, community-based summer day camps, Michael W. Beets, MEd, MPH, PhD, and colleagues noted significant increases in the amount of healthy food brought by children as well as decreases in untargeted foods such as sugar-sweetened beverages and salty snacks.

The HLC is a low-cost program requiring minimal resources. In the current study, two intervention components were developed: parent and staff education, as well as an incentive program for children. For education, parents and staff were given the HLC mission and procedures, as well as, a guide to choosing healthy foods and beverages. Incentives, identified by the summer day camps, were distributed based on points accumulated by the children and staff for bringing fruits, vegetables, and water.

Among the nearly 2,000 children observed, of which 50% were eligible for free or reduced lunch, researchers noted increases of 12% for fresh fruit, 11% for vegetables, and 14% for water brought, on average from baseline to posttest. Likewise, they observed decreases of 15% and 13% in the amount of chips and non-100% juices brought, respectively. For the staff, of which more than 200 were observed, researchers noted an increase in fruit and vegetables brought of 18% and 13%, respectively, and decreases of 31% for chips and 6.4% for soda.

"With over 14 million children attending summer day camps, introduction of the HLC can serve as a way to influence the eating habits of children during the summer," said lead author Falon Tilley, MS, Department of Exercise Science, Arnold School of Public Health, University of South Carolina. "These findings have important implications for summer day camps and other child care settings where there is minimal control over the foods brought on-site."

The researchers believe the HLC can be easily implemented in summer day camps and consequently influence the eating behavior of children. However, further research is needed to determine the success of HLC in other settings. Future research should also explore additional modes of education for parents and any other barriers to implementation.