How Changes in Menu Quality Associate with Subsequent Expenditure on (Un)Healthy Foods and Beverages in School Cafeterias: A Three-year Longitudinal Study

Preventive Medicine

20 Pages Posted: 11 Mar 2021

See all articles by Bernardo Andretti

Bernardo Andretti

Getulio Vargas Foundation (FGV) - Brazilian School of Public and Business Administration (EBAPE)

Rafael Goldszmidt

Fundação Getulio Vargas (FGV)

Eduardo B. Andrade

FGV/EBAPE

Date Written: March 8, 2021

Abstract

Evidence of the association between the school food environment and children’s and adolescents’ diet is mostly cross-sectional, usually based on self-reported behavior, and often conducted in high-income countries. Also, relatively little is known about how variations in menu quality associate with subsequent expenditure on foods and beverages of the same (vs. cross-) nutritional value. Based on a three-year longitudinal dataset comprised of 4,268,457 purchases made by 20,333 children and adolescents from 54 private schools in Brazil, we unobtrusively assess how changes in (un)healthy product availability associate with students’ subsequent purchase behavior. Our results reveal that, on average, only 11.6% of the products offered in the school cafeterias were of high nutritional value (HNV). Critically, expenditure on HNV products increased following both the addition of one HNV product to the menu (β = 0.18; 95% CI = 0.128,0.240) and, to a lesser extent, the withdrawal of one low nutritional value (LNV) product from the menu (β = −0.03; 95% CI = −0.042,-0.016). Cross-nutritional value effects were stronger for beverages. The inclusion of one HNV beverage was associated not only with a subsequent increase in expenditure on HNV beverages (β = 0.19; 95% CI = 0.115, 0.264) but also with a decrease in expenditure on LNV beverages (β = −0.18; 95% CI = −0.352, −0.010). Although only a small percentage of foods and beverages consumed in private school cafeterias in Brazil are of high nutritional value, improvements to menu quality have the potential to increase the consumption of healthier products and decrease the consumption of unhealthy ones.

Keywords: School food environment, Product availability, Adolescent, Healthy diet, Longitudinal data

Suggested Citation

Andretti, Bernardo and Goldszmidt, Rafael and Andrade, Eduardo B., How Changes in Menu Quality Associate with Subsequent Expenditure on (Un)Healthy Foods and Beverages in School Cafeterias: A Three-year Longitudinal Study (March 8, 2021). Preventive Medicine, Available at SSRN: https://ssrn.com/abstract=3800029

Bernardo Andretti (Contact Author)

Getulio Vargas Foundation (FGV) - Brazilian School of Public and Business Administration (EBAPE) ( email )

Brazil
2498806359855 (Phone)
25685050 (Fax)

Rafael Goldszmidt

Fundação Getulio Vargas (FGV) ( email )

Rio de Janeiro
Brazil

Eduardo B. Andrade

FGV/EBAPE ( email )

R. Jornalista Orlando Dantas 30
Botafogo
Rio de Janeiro, Rio de Janeiro 22231-010
Brazil

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
8
Abstract Views
169
PlumX Metrics