Conclusion: Give Generously
But Verify Effectiveness
Jim Prevor’s Perishable Pundit, March 18, 2013
The enthusiasm bubbles over, and one of the reasons is that the industry clearly sees business when a salad bar is put in a school. Items that schools never ordered before are suddenly being delivered and fresh consumption probably increases in the school because such a wider assortment of fresh product typically becomes available.
Besides, so many people in the industry take such pride in being on the side of the angels. They yearn to use our wonderful products to help children to lead healthier, more achieving lives. And as Diane Harris of the CDC points out in regard to salad bars and related efforts to encourage healthy eating: "There’s nothing bad about encouraging schools to bring in salad bars and try these activities."
But Dr. Harris also makes another point about the long term future of this effort: "In the long run, it’s hard to project. We don’t know the sustainability of the program for the future."
The produce industry, of course, cares about the moment at hand, but it also cares about the sustainability of the effort. That sustainability revolves around 10 questions:
1) If salad bars are so good, why is it necessary for the industry or any charity to fund the acquisition of salad bars? There are no similar efforts for ovens or refrigerators or sinks. Shouldn’t schools be expected to budget for needed equipment as part of their normal costs of business?
2) Do salad bars actually increase produce sales to schools? If so, is this total produce sales volume or is it more fresh replacing frozen and canned volume? Is it sustained over time as the novelty wears off?
3) Do salad bars actually lead students to take more produce on their plates than on a served cafeteria line? Or do they take less because they are in control?
4) For reasons of economy and convenience, most salad bars are not refrigerated… Does this have negative impacts on food safety, palatability, etc.?
5) Is there increased food safety risks associated with salad bars as opposed to pre-packaged salads? As opposed to hot line cooked produce?
6) Even if salad bars do increase sales, consumption and health, are they the optimal way to do this? Maybe putting wok stations in every school would boost consumption more. Maybe pre-packaged fruits and vegetables will be perceived as more sanitary and lead to still higher consumption. Perhaps students prefer hot food to cold, and more emphasis should be placed there to achieve the optimal result.
7) Giving away salad bars unconditionally is nice, but when Coke or Pepsi or an ice cream company give away equipment, they typically lend it with the condition that it be used to display the products of the company. To what degree are these salad bars continuously used rather than abandoned? If they are used, to what degree is it to display non-produce items, say cheese or hard boiled eggs? To what degree are the schools actually changing product so as to introduce children to new fruits and vegetables? And is there anything we can do to make sure this is all done according to the donor’s preference?
8) Do salad bars actually increase produce consumption? In school only? All week? Just of fresh or all produce?
9) Even if the presence of salad bars does increase produce consumption, does this result in better health or other improvements such as better academic performance?
10) Does being exposed to salad bars in school change eating habits and expectations in such a way that this pattern is sustained even after the circumstances change? Put another way, do students whose high schools had salad bars eat more produce in college than those who did not? If so, how long does this effect last and what is the degree of difference?
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The truth is we don’t really have very good answers to many of these questions, especially to those related to the question of how salad bars actually impact consumption and human health.
This is not a trivial matter. For a while, a program can grow based on enthusiasm but, in the end, that enthusiasm is unlikely to be sustained if there is not hard evidence as to its efficacy.
Diane Harris of the CDC identifies what she calls the “most rigorous research” in support of the salad bar program in this study — A School Salad Bar Increases Frequency Of Fruit And Vegetable Consumption Among Children Living In Low-Income Households — but the truth is this study is very weak. If this is all we have in three years when we have to make the case to a new President or need to demonstrate to donors that their last gifts achieved something, we will be in big trouble.
The study looked at data from children collected in 1998, before a salad bar was introduced, and then again in 2000 after the salad bar had been introduced.
Look at just a few of the obvious limitations of this study:
A) It is dated. It was submitted in 2006 based on data from 2000! How is it possible that with the tremendous expansion of the salad bar program there is no more recent and rigorous study?
B) There is no control group. The study really can tell us almost nothing because there is nothing to compare it to. You need to do the same interviews in schools that don’t add a salad bar to be able to see if the salad bar caused changes. Otherwise, you are using the salad bar as a kind of “residual” and crediting it with any changes one can’t account for in another way.
C) The study only applies to children eligible for the USDA reimbursable lunch program. It tells us nothing at all about children who don’t get free meals.
D) The study only covers children in schools in which 100% of the students are eligible for free lunches. Its finding may be inapplicable to mixed environments.
E) The study relies entirely on the recall ability and honesty of 7 to 11 year-old children. No attempt is made to cross-verify with adults or purchase data, food diaries, etc. Children’s recall could easily have been impacted by the educational component which taught them what the “right” answers are.
F) The importance of salad bars is muddied by the inclusion of an educational program. Whatever changes occurred may be due to the educational element and have happened without regard to the salad bar.
G) The research didn’t study the same children over time. Although researchers interviewed children in the same school over time, they were not the same children. No efforts seem to have been made to control for any variables such as religion, household income, single parent status, education of the parents, etc.
Now, none of this means we shouldn’t support salad bars in schools. All of us often have to make decisions based on imperfect or limited information. It is not an unreasonable thing to believe that salad bars can be a force for good in the schools.
But it is also reasonable for the industry to expect that its leaders will have a plan down the road to prove the efficacy of these efforts.
Research is expensive and does take time but, perhaps, after the California effort is done we should decide to raise the price of each salad bar by 5% with that overage going into a fund that the United Fresh Research and Education Foundation could use to conduct research to determine the efficacy of this effort.
Research may be expensive, but spending industry money on things without being certain of the results is not an acceptable option.
We need to move ahead right now. We urge the whole industry to support the salad bar effort by donating here or here, but we also need to move ahead with the research that will prove we are spending money wisely. It has to be a two-track approach or all the good we do now will be at risk when we can’t demonstrate we are making a difference.
We think this effort will make a difference, and we believe we should collect the data to prove it.
Many thanks to Pundit Investigator and Special Projects Editor Mira Slott for conducting these interviews and to Diane Harris, Lorelei DiSogra, Dick Spezzano, Lisa McNeece, Karen Caplan and Margaret D’Arrigo-Martin for exerting leadership and sharing that leadership with the industry at large.