Journal of Public Health | Vol. 37, No. 1, pp. 116 –124 | doi:10.1093/pubmed/fdu015 | Advance Access Publication 12 March 2014
Concession stand makeovers: a pilot study of offering healthy
foods at high school concession stands
Helena H. Laroche 1, Christopher Ford2, Kate Hansen3, Xueya Cai4, David R. Just5,
Andrew S. Hanks5, Brian Wansink5
1
Internal Medicine and Pediatrics, The University of Iowa, Iowa, IA, USA
Nutrition Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
3
Muskie Boosters, Muscatine, IA, USA
4
Biostatistics and Computational Biology, The University of Rochester, Rochester, NY, USA
5
The Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, NY, USA
Address correspondence to Helena H. Laroche, E-mail: [email protected]
2
A B S T R AC T
Background Concession stands at high school events are exempt from the US Department of Agriculture regulations for school foods.
Concessions are generally stocked with unhealthy foods since healthy foods are believed to have lower sales and profit margins.
Methods Concession stand sales for two seasons of high school fall sports in Muscatine, Iowa were compared. In between seasons, two types of
changes were made: (i) addition of new healthier concession options and (ii) substitution of healthier ingredients (less saturated fat, no trans fat).
Satisfaction surveys of students and parents were conducted before and after the changes. Data were collected in 2008 and 2009 and analyzed in
2012– 13.
Results Revenue per game was similar between years, even with the introduction of healthier items and ingredient changes. In 2009, the new
healthy foods comprised 9.2% of total revenue and sales of some new items increased with each game. The ‘healthy makeover’ had no influence
on student satisfaction but it improved parent satisfaction (P , 0.001).
Conclusions This compelling test of concept shows that offering healthier items can be good for both sales and satisfaction. While this study
was conducted with concession stands, the principles can be carried over into other food retail settings.
Keywords children, food and nutrition, public health
Background
Concession stand food sales across America—from professional and college athletics to high school football games—
are big business. For most high schools Booster clubs,
parent-led volunteer organizations, run concession sales to
raise money for student organizations and sports teams. Such
groups may be resistant to changing concession stand offerings because of the general fear that this would hurt both
sales and customer satisfaction.1 – 6 The executive director of
the National Booster Club Training Council said, ‘We know
that cutting back on some of those traditional product groups
is going to make revenue go down’.5 The 2006 School Health
Policies and Programs Study found that 23 state policies
recommended prohibiting selling junk food at concession
116
stands, but only 4 states required them.7 Given current trends
in childhood obesity8 and potential links to foods high
in sugar and solid fats,9 – 12 there is need to encourage
Helena H. Laroche, Assistant Professor of Internal Medicine and Pediatrics
Christopher Ford, Doctoral Student in Nutrition Epidemiology
Kate Hansen (formerly Anderson), Muskie Boosters Past President in Muscatine
Xueya Cai, Assistant Professor of Biostatistics and Computational Biology
David R. Just, Associate Professor at the Charles H. Dyson School of Applied
Economics and Management
Andrew S. Hanks, Post-Doctoral Fellow at the Charles H. Dyson School of Applied
Economics and Management
Brian Wansink, John S. Dyson Professor of Marketing at the Charles H. Dyson School
of Applied Economics and Management
# The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: [email protected].
CO N C E S S I O N S TA N D MA K E OV E R S
consumption of healthier options. This research examines
whether a gradual targeted approach to healthy change can be
made without hurting sales and satisfaction.
For some people, concession food may be a snacking indulgence, but for others it may be their evening meal.13,14
School lunches and competitive foods have been targeted by
the USDA as an important area for change in the fight against
childhood obesity,15 but their policies do not apply to concession stands. The inclusion of healthier foods in school cafeterias has proved to be popular when combined with other
‘smarter lunchroom’ techniques that have made them more
convenient,16 attractive17 or normative.18 Similarly, there may
be a market for healthier foods at concession stands, but this
is not evident if the foods are not offered.
One approach to making concession stands healthier would
be to simply replace the less healthy foods, such as pizza and
nachos, with healthier foods such as chicken sandwiches and
carrots. Unfortunately, replacements and restrictions can backfire due to reactance while other changes may avoid such behavior.19 – 21 A less restrictive approach would be to offer new,
healthier options and serve healthier versions of popular items.
In partnership with booster club members two changes were
chosen to test which were most feasible and acceptable to the
booster club: (i) offer a critical mass of healthier foods and
display them prominently and (ii) improve the ingredients of
certain items (less saturated fat and no trans fat).
This research involved a unique partnership between the
parent booster organization of a large high school in Muscatine,
IA (1700 students) and a research team from a public university.
The aim of this partnership was to involve stakeholders in the
implementation of concession stand changes while evaluating
the effect of these changes on concession sales and consumer
satisfaction. The partnership also aimed to describe barriers to
and solutions for making changes to inform others interested in
adopting similar changes.
By making these changes and testing them over the course
of two seasons in this high school, this research makes four
contributions. First, it offers a pilot test of a concession stand
makeover. Secondly, it illustrates some specific changes that
were more successful than others. Thirdly, it documents sales
effectiveness and satisfaction across both students and their
parents. Fourthly, it provides an example of a win – win idea
that can be championed by Health and Wellness boards,
parent – teacher associations or booster organizations.
Methods
Following the tenets of Community-Based Participatory
Research,22 academic and community partners worked as
equal partners in all phases of the research. The research team
117
worked with Booster club members—parent volunteers—to
choose concession stand changes, design surveys and gather
sales data. Booster club members contributed expertise in
running concession stands and ties to community resources,
including businesses and media.
Intervention
This team of researchers and Booster club members reviewed
the nutritional content of current items served at the concession stand ( based on nutrition labels, manufacturer information and published values23) and compared them with the
2007 Team Nutrition USDA guidelines for competitive foods
[total fat (,35%), saturated fat (,10%) and sugar content
(35% sugar by weight)]. These guidelines are used to recognize school food programs for healthy changes.24 Additionally,
the Boosters decided to eliminate trans fats and introduce
fruits and vegetables.
When determining which foods to introduce, the team
contacted food distributers and local grocery stores, and used
on-line resources to gather information on the nutritional
content, cost and availability of possible new concession
items. After generating a list of possible new items, student
and parent opinions of these items were gathered through the
baseline survey. Using all available information, the team generated a final list of additional healthier foods and foods that
could be modified to improve their nutritional content. Many
new items were first sold during the winter 2008 –09 season.
In the fall sports season of the 2009 –10 school year, all of
the final new concession items were available for sale along
with the all items sold in fall 2008 – 09 (Table 1).
New items were priced based on the lowest profitable
price. The price of candy bars increased from 75¢ in 2008 to
$1 in 2009 to reflect the increased cost for candy bars.
Sales data
Baseline sales data were collected during the fall 2008 sports
season. Post-intervention sales data were collected in the fall
2009 season. Receipts for all concession-related purchases
were collected during both fall seasons. A designated inventory manager, who was trained by the project’s researchers,
kept counts of food items in the concession inventory both
before and after each fall sports season. This manager also
kept a log of food discarded due to perishability. The Booster
club’s treasurer kept detailed income and expense data. From
these data, total concession revenues were calculated for both
seasons. These inventories, receipts and income records were
used to generate Table 1. In the 2009 – 10 fall season, trained
researchers took pre- and post-game concession inventory
counts during four football games for verification purposes.
118
CHO (g)
Sugar (g)
Fat (g)
Saturated fat (g)
Trans fat (g)a
Fiber (g)
Chol (mg)
Naþ (mg)
Product
Serving size
Calories
Calories from fat
Protein (g)
Hot dog with bun—Bar S classic jumbo
1 hot dog
440
278
13
30
6
31
9
0
1
110
740
Pizza—cheese
1 slice
300
100
13
36
3
11
6
NA
2
30
260
Pizza—pepperoni
1 slice
300
100
12
36
3
11
6
NA
2
25
340
Candy bars (example snickers)
1 bar
250
110
4
33
27
12
5
0
1
5
120
Other candy (i.e. laffy taffy rope)
1 piece
80
10
0
18
11
2
1
0
NA
NA
40
Other candy (i.e. caramel apple sucker)
1 sucker
60
5
0
15
10
1
0
0
NA
NA
15
Pork sandwich—6 oz
1 sandwich
280
100
25
21
3
11
4
0
0
60
520
Modified products
Super nachos with meat (previous)
1 container
905
500
25
69
6
58
15
6
7
5
2695
Super nachos with meat (improved)
1 container
830
450
25
67
3
50
16
0
7
10
2895
Nachos (previous)
1 container
350
176
4
35
1
20
4
3
3
73
718
Nachos (improved)
1 container
320
156
4
34
1
17
4
0
3
85
798
Popcorn (previous)—large boxb
1 container
597
310
13
78
1
27
20
3
15
NA
617
Popcorn (improved) —large boxb
1 container
597
310
13
78
1
27
3
0
15
NA
617
New products
a
14 pieces
35
0
0
8
5
0
0
0
2
0
65
Grocer’s garden lite ranch dressing
2 tbsp
60
50
0
3
1
6
1
0
0
5
350
Apples
1, 3 oz
90
0
0
23
18
,1
0
0
4
0
Super pretzel (a large soft pretzel)
1 pretzel
160
10
5
34
1
1
0
0
1
0
920c
Chicken breast sandwich w/bun
1, 5 oz.
264
30
30
23
2
4
1
0
1
80
230
Pickle
1 l g pickle
20
0
0
0
0
0
0
0
0
0
928
Frigo string cheese
1 cheese
80
50
6
,1
0
6
4
0
0
15
200
Nature Valley granola bars (oats ’n honey)
2 bars
190
60
4
29
12
6
1
0
2
0
160
Nature Valley granola bars (peanut butter)
2 bars
190
60
5
28
11
7
1
0
2
0
180
Kars yogurt apple nut mix (trail mix)
1 bag
220
130
5
20
7
15
4
0
3
0
130
NA, information not available.
b
c
Baby carrots
Popcorn numbers based on ingredients used to make the popcorn—actual values may be slightly less due to oil in the bottom of the popper and unpopped kernels not eaten.
One hundred and thirty without the salt and customers were given the option of no or less salt.
1
J O U RN A L O F P U B LI C H E A LT H
Table 1 Nutrition content of old, new and modified concession stand foods
CO N C E S S I O N S TA N D MA K E OV E R S
Nachos and popcorn were estimated using an algorithm
based on the amount of individual components used during
the season. Unfortunately, the necessary data were not available for this analysis in 2008 after an alternative plan to count
these difficult items proved unfeasible.
Survey data
Satisfaction surveys were administered at the end of the fall
season in 2008 and 2009 to both parents and students.
Respondents were asked, ‘Thinking about your most recent
experience with the concessions stands at Muscatine High
School during sports events, please indicate your overall level
of satisfaction with food and drinks offered’. This question
was modeled after validated satisfaction questions and uses
standard validated Likert answer choices (very unsatisfied; unsatisfied; neither satisfied nor unsatisfied; satisfied; very satisfied).25,26 The question was pilot tested with parents and
students to gage understanding of the questions. The surveys
also asked other questions about the concession stand and
included respondent’s gender, sports attended and frequency
of concession purchases.
Email notifications including the survey link were sent to a
random sample of parents. This sample was generated from
the email list that school administrators used to send
announcements. Respondents were given a coupon for food
or merchandise sold by the Booster club. The same list was
used for the follow-up survey after parents of graduated
students had been removed.
A convenience sample of students completed paper surveys. Surveys were handed out in the high school cafeteria
during lunch. Survey collection ceased once we ran out of
prizes for completion (300 items). In both years, almost all
surveys were completed during the first lunch period. Thus,
585 and 559 students had the opportunity to complete
surveys.
Analysis
Data were analyzed in 2012 and 2013. Item-specific revenue
amounts were generated for both years by multiplying the
number of items sold by the item’s respective selling price.
Percentages of total revenue were calculated by dividing itemspecific revenue by total revenue. Because prices increased for
candy bars and soft drinks in 2009, we also adjusted 2009
revenue data to reflect this price increase by decreasing the
total revenue by that generated by the increase and using 2008
prices for item revenue calculations.
Comparisons between years were based on revenue per
game and an item’s respective percentage of total revenue.
Since sales data collected for both years were mainly aggregate
119
values, with the exception of four football games in 2009,
statistical comparisons cannot be made. Nonetheless, differences in magnitude provide suggestive evidence of the impact
of the concession makeover.
Responses to the satisfaction surveys were compared
between the 2 years. This comparison was done using a
Wilcoxon rank-sum (Mann–Whitney U) test since the data
were ordinal, not normally distributed, and unpaired.27 A sensitivity analysis showed that 2009 respondents who reported
completing the survey in 2008 did not differ in their level of
satisfaction from other respondents. Power calculations show
80% power to detect a difference as small as 0.07 in average
satisfaction in the 2008 and 2009 student samples and the 2008
parent sample, and a 0.13 difference in the 2009 parent sample.
Results
Sales data
The fall sports season in 2008 included five varsity football
games and three freshman only football games. 2009 included
four varsity football games and five freshman only. Both
years included five swim meets and seven volleyball games.
Concession item descriptions and their nutritional content are
shown in Table 1. In 2009 Booster members used canola oil
for popping popcorn (instead of coconut oil bars), which
decreased the amount of saturated fat and eliminated the
trans fats. Nachos were changed to a cheese that did not
contain trans fats. Unit sales of specific items in all sporting
events during the fall 2008 and 2009 sports season are
reported in Table 2, along with each item’s share of total
revenues.
Of the new items sold in 2009, the chicken sandwich
accounted for nearly 5% of all revenues and soft pretzels
accounted for 2.6%. All of the other new items—apples,
carrots with dip, granola bars, pickles, string cheese and trail
mix—accounted for 1.7% of all revenues. When comparing
revenue across the 2 years, the data suggest that a portion of
pizza revenue may have been replaced by revenue from the
new chicken sandwich. Overall, the newer, healthier options
accounted for 9.2% of total revenue in 2009, which amounted
to $3405. Of note, 2009 had one less varsity football game
resulting in fewer total items sold, though per cent revenue
values can still be compared between years.
After adjusting for price increases in candy and soda,
average revenue per varsity football game was $6599 in 2008
and $6849 in 2009 (P ¼ 0.88). The average profit margin for
the standard items was $1.01 versus $0.78 for the healthier
new items. Nachos and popcorn had a combined profit
margin of $1.19 prior to the ingredient modification and
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J O U RN A L O F P U B LI C H E A LT H
Table 2 Sales data for standard, modified and new items during the pre-intervention (2008) and post-intervention (2009) fall sports seasons (note: data
was not available for all items)a
Food sales pre-concession
Food sales post-concession makeover (2009)
makeover (2008)b
Units sold
% Total revenue
Units sold
% Total revenue
Adjusted % total revenuec
Standard items sold in both years
Candy—suckers ($0.25)
5344
3.5
4430
3.0
3.3
942
4.9
1138
6.1
6.7
Candy bars ($0.75 – $1.00)d
2823
5.5
2861
7.7
6.3
Pork sandwiches ($3.00)
1455
11.4
1261
10.2
11.2
Pizza ($2.50)
2608
17.0
1978
13.3
14.6
Hot dogs ($2.00)
Items modified in 2009
Nachose,f ($2 plain, $3 with meat)
NA
NA
3067
20.6
22.9
Popcorne,f,g ($1.00)
NA
NA
1827
4.9
5.5
String cheese ($0.50)
—
—
100
0.1
0.1
Apples ($0.75)
—
—
115
0.2
0.3
Carrots with dip ($1.25)
—
—
60
0.2
0.2
Granola bars ($1.00)
—
—
118
0.3
0.3
Trail mix ($1.25)
—
—
136
0.4
0.5
Pickles ($1.00)
—
—
172
0.5
0.5
New items in 2009
Pretzels ($1.00)
—
—
978
2.6
2.9
Chicken ($3.00)
—
—
600
4.9
5.3
25.0
19.4
Otherh (2008 includes nachos, popcorn)
57.7
a
Study was conducted in Muscatine, Iowa in 2008– 09.
b
Data for 2008 sales were incomplete.
c
Adjusted total revenue—total revenue adjusted down by subtracting out the increase revenue from the $0.25 increase in the candy bars and drinks in
2009 Candy then calculated based on $0.75 price equivalent to 2008.
d
Price increase to $1.00 in 2009. Unadjusted total revenue 2009 based on increased price, adjusted the $0.75 price.
e
There were no sales records for nachos and popcorn in 2008.
f
Modified to contain no trans fats.
g
Modified to contain less saturated fat.
h
Predominantly beverages, occasionally extra cheese for $0.25 and items specific to morning events (bagels, donuts, bananas). 2008 includes nachos and
popcorn.
$1.28 afterwards. Of the eight new items offered, six had a
profit margin above candy bars ($0.50). On average, profit
margins of the healthier items were lower yet average sales per
varsity football game were up by 4% in 2009.
Unit sales from four varsity football games were kept
during the fall 2009 –10 season. Figure 1 shows sales of items
which were individually packaged or easily counted and thus
could be inventoried accurately from game to game. Granola
bars and trail mix each sold ,5 per varsity game and thus
were left out of the figure. Game-by-game data in 2009 show
gradual increases in purchases of string cheese, apples and
carrots (Fig. 1a). Quantities of candy bars sold demonstrate
strong preferences for these food items. Data in Figure 1b
represent sales as a percentage of total revenue. Over the four
games, revenue percentages for many of the healthier items
increased, as well as for the unhealthy items. Inclement
weather during the last game inhibited the sale of chicken and
pork, thus boosting sales of other items, such as pizza and
hot dogs. While these unit sales data are incomplete, they
support the evidence from total sales in the 2009 –10 fall
season that there was moderate though increasing interest in
the new food items.
Survey data
In 2008, 303 students and 213 parents filled out the survey
compared with 314 students and 104 parents in 2009. In
CO N C E S S I O N S TA N D MA K E OV E R S
Table 3 Satisfaction scores of students and parents before and after
changes to concession stand offerings; mean score (standard errors
in parentheses)
Overall satisfactiona
2008
2009
Students
3.83 (0.95)
3.79 (1.06)
Parents
3.83 (0.82)
3.99** (1.08)
a
Parents and students were asked to indicate their overall level of
satisfaction with food and drinks offered. Five responses: very
unsatisfied; unsatisfied; neither satisfied nor unsatisfied; satisfied; very
satisfied; not applicable. Responses from the last choice were omitted
from the analysis. Wilcoxon rank-sum test (Mann – Whitney U) was used
for analysis.
121
stable or improved. Although per capita sales are not possible
to determine because of this school’s record keeping system,
average revenue per varsity football game remained unchanged. The sales of healthier items went on to comprise
9.2% of the total sales within 1 year, and modified items still
generated 25.5% of revenue. In a number of categories, sales
of healthier items increased game after game suggesting
growing demand for healthier foods as customer awareness
increased. Even though the new items on average had a slightly smaller profit margin (due to high profit margins on nachos
and pork), the most popular new item (chicken) had profit
margin equivalent to or better than all older items, six of eight
new items had profit margins better than the candy bars, and
modifications to popcorn and nachos increased their profit
margin by 7.6%.
*P , 0.05,
**P , 0.01,
What is already known on this topic
***P , 0.001.
There are no published comparable studies on school concessions, though results from a few case studies shaped sentiment regarding offering healthier foods. For example, in
Canada a study of one recreation facility showed that after implementation of new healthy food guidelines, only 16% of
concession items offered met criteria for being healthy.2,3 No
satisfaction data were collected. Limited sales data provided
by the vendor suggested decreased sales, though there was no
thorough analysis to determine what drove down sales.
Unpublished research examining concessions for 6 parks and
recreation sites compared before and after sales data to determine whether branding healthier items with a ‘smart choices’
logo would improve sales of water and fruit.28 Three sites that
consistently used the promotional signs, combined with
serving and prominently displaying fresh fruit, experienced
increased fruit sales, though overall fruit sales remained flat.
School-based studies have examined whether or not increasing the amount of healthy foods in vending machines would
increase sales of these items.29 – 31 These studies revealed no
change or a decline in sales. There is evidence, however, that
holding menu items constant in a school lunchroom, making
foods more convenient, attractive and normative, nudges children to eat healthier lunches.18
2008 51% of student respondents were female compared
with 40% in 2009 (P ¼ 0.013). Samples were not different
regarding percentage attending football games (74%), rating
of the importance of having healthy foods at concession
stands or frequency of concession stand purchases. Estimates
of response rates indicate that 51 and 56% of students took
the survey in 2008 and 2009, respectively. Estimates show
that in 2008, 19% of emailed parents responded, compared
with 12% in 2009 (estimates are low secondary to households
with multiple different emails in the list). Students show no
change in overall satisfaction (3.83– 3.79, P ¼ 0.99) but were
more satisfied with the healthy foods offered (3.42 – 3.56 P ¼
0.049). Parents were more satisfied overall with the foods
offered (3.83 – 3.99, P ¼ 0.005).
Discussion and implications
Main findings of the study
Whereas concession stand food has generally been criticized
for not being healthy, this pilot study shows two types of
changes that can successfully improve the general healthfulness
of concession foods. The first change was the introduction of a
critical mass of eight healthier foods, which in this study,
accounted for 9.2% of sales. Secondly, ingredients were altered
to eliminate the trans fat in the nacho cheese sauce, and switch
from coconut oil to canola oil in the popcorn.
The general concern that a concession stand makeover
would be unwanted by students and parents and would result
in lost sales appears unfounded. Indeed, satisfaction remained
What this study adds
This study is the first to evaluate the results on satisfaction
and sales of making changes to concession stand offerings in
school settings. This study provides preliminary evidence that
altering offerings and adding healthy options can be done by
working in concert with parent groups. Furthermore, these
modifications can provide reasonable revenue and profit
margins without negative effects on customer satisfaction.
122
J O U RN A L O F P U B LI C H E A LT H
(a) 500
450
Number of servings sold
400
350
Pizza
300
Candy bars
250
Hot dogs
Pretzels
200
String cheese
150
Apples
Carrots
100
50
0
8/28/2009
9/11/2009
10/9/2009†
9/25/2009
Game date
0.5
14
12
Pizza
10
Candy
bars
Hot dogs
8
Pretzels
6
Carrots
String
cheese
Apples
4
2
0
0
/2
8
/2
8
9
1
/1
†
9*
09
09
0
/2
9
/
25
0
20
0.4
Percentage revenue
Percentage revenue
(b)
0.3
0.2
0.1
0
0
20
9
9/
1
Game date
9
00
/
9
0/
2
8/
2
8/
1
9/
†
9*
00
2
1/
/
25
9/
09
0
20
0
/2
/9
10
Fig. 1 (a) Sales of selected items over four football games during the fall 2009 –10 sports season. (b) Sales as a percentage of revenue over four football
games, fall 2009 –10. *Homecoming. †Due to poor weather chicken and pork were not sold at this game.
Data also suggest that overall revenue is not substantially
impacted. This study provides support for groups advocating
changes in concession offerings and suggests evaluation
methods that may be used to trial future changes to concessions. Future research can investigate a wider range of questions, such as how the sales between healthy and less healthy
foods shift depending on the weather, the type of sporting
event or whether a team is winning or losing. There is also opportunity to examine how the signage and convenience of
food packages and presentation can influence sales.16,32
Limitations of this study
While the results for this pilot study are promising, it is important to note key limitations. First, robust sales data for
some items were missing and per-game sales data were not
collected in 2008. In addition, concession stands at the high
school did not have registers and so it was impossible to track
individual level purchases, leaving only aggregate data for analysis. With this lack of data, valid statistical tests for revenue
could not be constructed and results are based on magnitude
comparisons only.
CO N C E S S I O N S TA N D MA K E OV E R S
Next, all changes to concession foods were implemented
simultaneously, eliminating the chance to identify the impact
of new offerings versus favorite foods with healthier ingredients. Also, there were no control sites for the study, thus unmeasured external factors may bias results.
Survey response data collected were sufficient for this
study’s purposes, though response rates for parents were low.
This may have led to selection bias, especially in 2009.
Furthermore, limited demographic information was collected
on both the students and parents.
Conclusion
123
2 Olstad DL, Lieffers JR, Raine KD et al. Implementing the Alberta
nutrition guidelines for children and youth in a recreational facility.
Can J Diet Pract Res 2011;72(4):177.
3 Olstad DL, Raine KD, McCargar LJ. Adopting and implementing
nutrition guidelines in recreational facilities: public and private
sector roles. A multiple case study. BMC Public Health 2012;
12:376.
4 Longley C, Sneed J. Attitudes of school foodservice directors about
the potential benefits of school wellness policies. J Child Nutr Manage
2009;33(1).
5 Popke M. Healthier Concessions Menus Present new Booster Club Challenges.
Portland, ME: Athletic Business, 2012.
6 School Nutrition Association. From cupcakes to carrots: local wellness policies one year later. National Harbor, MD: School Nutrition
Association, 2007.
As a test of concept, these results show there is great promise
in improving the nutrition at a concession stand. A key understanding is that this was not accomplished by replacing less
healthy foods with healthier ones; rather, it was accomplished
by making ingredient substitutions and offering a critical mass
of fun and healthier foods. These results offer a compelling
test of concept for concession stand operators as well as food
suppliers. Moreover, this has relevance for concession operators for professional and college sports as well as music and
other entertainment events.
9 Reedy J, Krebs-Smith SM. Dietary sources of energy, solid fats, and
added sugars among children and adolescents in the United States.
J Am Diet Assoc 2010;110(10):1477 – 84.
Acknowledgements
10 Popkin BM, Adair LS, Ng SW. Global nutrition transition and the
pandemic of obesity in developing countries. Nutr Rev 2012;
70(1):3 – 21.
The authors thank the Muskie Boosters for their enthusiasm
and incredible work on this project, Christine Hradek for research assistance and Julia Hastings-Black, Kelsey Gatto and
Rosemarie Hanson for editorial assistance.
Funding
This research was supported by a grant from the Wellmark
Foundation of Iowa and by a Cooperative Agreement
Number U48/CCU 720075 from the Centers for Disease
Control and Prevention. The article’s contents are solely the
responsibility of the authors and do not necessarily represent
the official views of the Centers for Disease Control and
Prevention. Dr. Laroche was supported by a NHLBI career
development award (K23HL093354).
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