Pasting photos of vegetables onto school lunch trays induced kids to eat a greater amount of the genuine thing in a small controlled trial, specialists said.

The proportion of elementary-school kids taking green beans doubled and the number who took carrots tripled when their trays featured photos of these vegetables, reported Marla Reicks, PhD, and colleagues at the University of Minnesota in Minneapolis.

“We expected these photos to indicate to the children that others regularly select and place vegetables in those compartments and that they should do as such as well,” the specialists clarified in a research letter published online in the Journal of the American Medical Association.

Some 37 percent of children in a Richfield, Minn., elementary school helped themselves to carrots and 15 percent took green beans when photographs of these vegetables were placed in the appropriate tray compartments on one day last May.

That compared with 6 percent who took green beans and 12 percent who took carrots on an earlier day when regular trays were used.

Students in the school had the option of taking applesauce or orange slices instead of the vegetables. Reicks and colleagues noted that these choices remained the most popular even with the visual cue to take carrots or green beans.

Otherwise, the meal was the same on both days of the review. Cafeteria staff doled out the main course and all portions — including those of the fruits and vegetables — were standardized.

Even though vegetable utilization stayed low with the intervention, falling short of government recommendations, Reicks and colleagues recommended the picture cues had value.

“Placing photos in cafeteria lunch trays requires no unique training and incurs minimal costs and labor (in this review, about $3 and 20 minutes for each 100 trays),” they argued.

The increase in vegetable utilization was additionally “within range … found in more expensive interventions,” the specialists added.

Reicks and colleagues noticed that the review included a single school and two days. “Further research is needed to assess how well the impacts generalize to other settings and persist over time,” they wrote.

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