The Efficacy and Cost-Effectiveness of Replacing Whole Apples with Sliced in the National School Lunch Program

Shelly Palmer, Jessica Jarick Metcalfe, Brenna Ellison, Toni Kay Wright, Lindsey Sadler, Katherine Hinojosa, Jennifer McCaffrey, Melissa Pflugh Prescott

Research output: Contribution to journalArticlepeer-review


The National School Lunch Program (NSLP) serves 29.6 million lunches each day. Schools must offer ½ a cup of fruit for each lunch tray. Much of this fruit may be wasted, leaving the schools in a dilemma. The objectives of this study were to evaluate the consumption of whole vs. sliced apples and determine the cost-effectiveness of the intervention. Researchers weighed apple waste at baseline and three post-intervention time points in one rural Midwest school. The costs of the intervention were collected from the school. The cost-effectiveness analysis estimates how often apples need to be served to offset the costs of the slicing intervention. A total of (n = 313) elementary student students participated. Students consumed significantly more sliced as compared to whole apples in intervention months 3 (β = 21.5, p < 0.001) and 4 (β = 27.7, p < 0.001). The intervention cost was USD 299. The value of wasted apple decreased from USD 0.26 at baseline to USD 0.23 wasted at post-intervention. The school would need to serve 9403 apples during the school year (54 times) to cover the expenses of the intervention. In conclusion, serving sliced apples may be a cost-effective way to improve fruit consumption during school lunch.
Original languageEnglish (US)
Article number13157
JournalInternational journal of environmental research and public health
Issue number24
StatePublished - Dec 1 2021


  • school nutrition
  • food waste
  • implementation science
  • behavioral economics
  • Food waste
  • School nutrition
  • Implementation science
  • Behavioral economics

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Pollution
  • Health, Toxicology and Mutagenesis


Dive into the research topics of 'The Efficacy and Cost-Effectiveness of Replacing Whole Apples with Sliced in the National School Lunch Program'. Together they form a unique fingerprint.

Cite this