SMART lunch box intervention to improve the food and nutrient content of children's packed lunches: UK wide cluster randomised controlled trial

• Published in: Journal of epidemiology and community health (1979) Vol. 64; no. 11; pp. 970 - 976
• Main Authors: Evans, C E L, Greenwood, D C, Thomas, J D, Cleghorn, C L, Kitchen, M S, Cade, J E
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.11.2010; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Biological and medical sciences; Cafeterias; Child health; Child nutrition; Children; Diet - standards; Female; Food; Food - classification; Food Preferences; Food processing industry; Food security; Foodborne illnesses; Fruits; General aspects; Government standards; Humans; Intervention; Lunches; Male; Meals; Medical sciences; Miscellaneous; Nutrient content; Nutrients; nutrition; Obesity; Public health. Hygiene; Public health. Hygiene-occupational medicine; RCTS; Research report; School meals; Schools; Vegetables; United Kingdom; Europe; United Kingdom > UK; Human; Medicine; Improvement; Content; Cluster; Clinical trial; Nutrient; Child; Public health; Food; CHILD HEALTH; RCTS; NUTRITION
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech.2008.085837

BackgroundGovernment standards are now in place for children's school meals but not for lunches prepared at home. The aim of this trial is to improve the content of children's packed lunches.MethodsA cluster randomised controlled trial in 89 primary schools across the UK involving 1291 children, age 8–9 years at baseline. Follow-up was 12 months after baseline. A “SMART” lunch box intervention programme consisted of food boxes, bag and supporting materials. The main outcome measures were weights of foods and proportion of children provided with sandwiches, fruit, vegetables, dairy food, savoury snacks and confectionery in each packed lunch. Levels of nutrients provided including energy, total fat, saturated fat, protein, non-milk extrinsic sugar, sodium, calcium, iron, folate, zinc, vitamin A and vitamin C.ResultsModerately higher weights of fruit, vegetables, dairy and starchy food and lower weights of savoury snacks were provided to children in the intervention group. Children in the intervention group were provided with slightly higher levels of vitamin A and folate. 11% more children were provided with vegetables/salad in their packed lunch, and 13% fewer children were provided with savoury snacks (crisps). Children in the intervention group were more likely to be provided with packed lunches meeting the government school meal standards.ConclusionsThe SMART lunch box intervention, targeting parents and children, led to small improvements in the food and nutrient content of children's packed lunches. Further interventions are required to bring packed lunches in line with the new government standards for school meals.Current controlled trialsISRCTN77710993.