Healthy Eating Decisions
Parents Students Schools Lunch Menus

Proven Effectiveness: The Program's Success!

We tested our program at 2 elementary schools with different demographics. School 1 (n=503) was a suburban elementary school with demographics similar to Spartanburg County (45% female, 55% male; 63% Caucasian, 27% African-American, 4% Hispanic, 6% other; 41% free or reduced school lunch). School 2 (n=370) was an urban elementary school with Title 1 status (47% female, 53% male; 2% Caucasian, 95% African-American, 2% Hispanic, 2% other; 96% free or reduced school lunch). The Healthy Eating Decisions program was equally successful at both schools!


As shown above, we measured the percent of students choosing the healthy menu items plus white milk for 9 days (baseline) before our program and 9 days after our program (incentive). Before our program less than 3% of both schools were choosing the healthy lunch with white milk. After our program, over 40% of the students were choosing the healthy meal plus white milk each day!

Flavored milk contains over twice the amount of sugar and 40-70% more calories than white milk. A child that consumes flavored milk instead of white milk will eat over 5 pounds of extra sugar in a single school year. That is more than 10% of most children's body weight!

Pie charts of decision habits

Before our program only 20% of the students at either school were choosing white milk for lunch. After our program over 2/3 of the students at both schools switched to drinking white milk even though the flavored milk choices were still available!

Long-term sustainability of healthy eating decisions.

In the spring of 2012, we conducted a four week follow-up study to assess the longitudinal effects of the program. Participating schools self-reported the percent of students selecting the identified healthiest food and beverage choices during elementary school lunch service. The five participating schools had implemented the Healthy Eating Decisions program for varied amounts of time. Two of the schools had implemented the program for one year, two schools had two years of implementation and one school had been using the Healthy Eating Decisions program for three years. As seen above, all schools had significantly increased percentages of students making healthy eating decisions compared to our baseline measurements of 3% on average prior to implementation.

Our study is now published online in the prestigious nature publishing group journal, International Journal of Obesity:
Cost-free and sustainable incentive increases healthy eating decisions during elementary school lunch by Pittman DW, Parker JS, Getz BR, Jackson CM, Le TA, Riggs SB, Shay JM.

A Program Profile on how to implement Healthy Eating Decisions was featured in the journal Childhood Obesity:
Ring My Bell: They Healthy Eating Decisions Program by Pittman DW.