Retooling food service for early elementary school students in Somerville, Massachusetts: the Shape Up Somerville experience.

Background: Changes in the school food environment are a logical target to prevent childhood overweight. We describe the food service component of a 2-year research intervention to prevent excess weight gain in children.
Context: The goals of the food service component were to improve the presentation and nutrient quality of school meals and to incorporate more fruits and vegetables into students' diets. The project engaged food service staff, students, parents, teachers, and school leaders to improve school nutrition.
Methods: Modifications addressed needs and barriers identified though dialogue with the food service director, focus groups, key informant interviews, and surveys of school employees, students, and parents and guardians. Attitudes and behavior changes were measured through surveys, direct observation, and sales data.
Consequences: More fruits, vegetables, whole grains, and low-fat dairy products were available during the intervention years; menus and à la carte choices were brought into closer compliance with recommended guidelines for children; attitudes of students, parents and guardians, school faculty, and food service staff improved; and policies related to food service were adopted.
Interpretation: Strategic modification to improve nutrition and increase acceptability of the food served in schools is feasible and sustainable. These results demonstrate that changes to food service can lead to improved nutrient profiles and more favorable attitudes toward food served at school meals. Such changes can help prevent childhood obesity.