200-2007-22643-003). CDC staff has reviewed the project’s evaluation design and data collection methodology and the article for scientific accuracy. All authors have read and approved the final version. “
“To stem and reverse childhood obesity, a number of policymakers and public health authorities at the federal, state,

and local levels have intensified their efforts to improve the nutritional quality of school meals through the establishment of institutional policies or practices that promote healthy food procurement (Institute of Medicine, 2010 and United States Department of Agriculture, 2012). These practices have included such strategies as setting upper limits for calories, sodium, and other nutrients per serving in the contracts of

food services vendors; institutional Quizartinib procurement of healthier options such as whole grains and plant-based foods; and/or complementary approaches such as nutrition education, signage, and product placement to increase student selection of healthy food. Collectively, these institutional practices aim to improve the quality of foods served in schools, increase food security, and positively influence student dietary intake (IOM, 2010). The Los Angeles Unified School District (LAUSD), the second largest school district in the United States, serves more than 650,000 meals per day. With such volume and purchasing power, LAUSD has become a national leader in increasing student access to

healthy foods through changes to its school meal program (Cummings et al., 2014). AZD2281 in vivo In the 2011–2012 school year (SY), the LAUSD Food Services Branch (FSB) launched a new menu that included more fresh fruits and vegetables, whole grains, vegetarian items, and a range of ethnic foods; it also eliminated flavored milk. These menu changes currently exceed the USDA school Final Rule on school meal nutrition standards, released in 2012 (USDA, 2012). In developing the revised menu, LAUSD held community taste tests during the summer of 2011 at its central kitchen. While taste testing because results suggest that students reacted favorably to the new menu options, there were anecdotal reports that students reacted negatively when the meals were served in the actual school cafeterias (Wantanabe, 2011). The national Communities Putting Prevention to Work (CPPW) program, funded by the Centers for Disease Control and Prevention (CDC), supports increasing access to healthier food options, including establishing healthy food procurement practices in schools ( Bunnell et al., 2012). Despite growing support for such school-based practices ( Institute of Medicine, 2010 and Story et al., 2008), limited evidence exists to support the effectiveness of such efforts for changing student food selection and eating behaviors. A key question is how students react to these changes to the menu.