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Fruit and Vegetable Waste from School Lunches: A Systematic Review and Meta-Analysis
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This work used the systematic review and meta-analysis techniques to assess fruit and vegetable (F&V) plate waste from school lunches, to determine whether there is a difference in F&V waste pre- and post- implementation of the new school meal standards, and to identify factors associated with plate waste. It followed the Cochrane Collaboration Guidelines, USDA’s Nutrition Evidence Library (NEL) Bias Assessment Tool, and USDA NEL Conclusion Statement Evaluation Criteria. Meta-analysis of percentage selection and effect size of percentage plate waste was performed in STATA. Twenty-three studies were included in the systematic review and twenty-one in the meta-analysis. The estimated mean percentage of students that selected fruits and vegetables were 60% (95% CI: 46%-75%), and 48% (95% CI: 31%-65%), respectively. The percentage of students who selected fruits increased significantly after the implementation of the new standards. This increase was consistent across all the studies and ranged from 5% to 24%. Fruit waste was estimated to be 34.7% (95% CI: 31.0%-38.6%) and vegetables waste was 44.5% (95% CI: 34.7%-54.5%). The estimated mean percentage fruits waste was 35.7% pre- and 39.5% post-implementation, and for vegetables was 45.5% pre- and 50.5% post-implementation, with no significant difference between them. Child related factors such as age, gender, and ethnicity/race were not statistically significant to explain the aggregate waste across studies. Mandatory/optional selection of F&V had no effect on plate waste. Only few studies on plate waste explored the relationship between variables such as preferences or attitudes, preparation methods, availability of competitive food, time devoted to eating, and F&V waste, we could not establish any other relation beyond the descriptions provided in the original studies. The low percentage of F&V selection and the high mean percentage waste are worrisome outcomes in the NSLP. The change in standards has had a positive effect in increasing the number students selecting fruits. We could not draw any conclusions on the change in percentage of students selecting vegetables. The mean percentage waste of F&V after the implementation of the HHFKA 2010 has not been significantly higher than before implementation of new standards. Acceptance and consumption of dark green vegetables appears to be one of the challenging aspects of the new regulation, and this type of vegetables could be a focus of future research.
Tabares Villarreal, Elizabeth (2017). Fruit and Vegetable Waste from School Lunches: A Systematic Review and Meta-Analysis. Master's thesis, Texas A & M University. Available electronically from