Research suggests that small changes to a school environment can help reduce childhood obesity and improve nutrition


While a growing body of research suggests that small changes to a school environment can help reduce childhood obesity and improve nutrition, 80 percent of school-aged children still fall short of national dietary guidelines for fruit and vegetable intake.

New research from the University of Notre Dame suggests ways to approach this problem in elementary school cafeterias, especially for high-risk and underserved student populations.

Kim Rollings, assistant professor of architecture and psychology at Notre Dame, in collaboration with Nancy Wells, professor of design and environmental analysis at Cornell University, recently published the Cafeteria Assessment for Elementary Schools (CAFES) in BMC Public Health.

Developed by Rollings and Wells, the CAFES tool scores elementary school cafeteria environments, suggesting improvements that promote healthier eating.

Many strategies are low- or no-cost.

CAFES is also the first comprehensive, reliable and validated assessment tool that quantifies physical attributes of cafeterias linked to selection and consumption of fruits and vegetables.

The CAFES tool will soon be accompanied by a free, automated mobile app, available at

“Research suggests that establishing healthy eating habits at an early age is best, but not all schools are aware of small environmental changes that can help,” Rollings said.

“CAFES generates a list of improvements for elementary schools specific to their cafeterias, and provides data needed for the development of healthy school cafeteria design guidelines.”

Rollings’ research examines how the built and natural environments impact mental and physical health.

Ways CAFES suggests to promote healthier eating include placing fresh fruit by the checkout, manipulating portion sizes by changing bowl and plate size, and improving food and menu presentation.

Attractive cafeteria design that limits noise and crowding, has bright lighting and provides adequate food storage and preparation space was also linked to healthier eating choices.

“There is great potential for CAFES to be used by school personnel, researchers, public health practitioners and design professionals,” said Rollings.

“Not only can CAFES identify barriers to healthy eating at the outset, but it can also measure the effectiveness of cafeteria improvements.”

More information: Kimberly A. Rollings et al. Cafeteria assessment for elementary schools (CAFES): development, reliability testing, and predictive validity analysis, BMC Public Health (2018). DOI: 10.1186/s12889-018-6032-2

Journal reference: BMC Public Health search and more info website

Provided by: University of Notre Dame


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