Simple changes in school lunchrooms cost little or nothing and have proven to be effective ways to nudge kids to choose healthier food, according to Cornell research.

Two Cornell experts in food and childhood obesity presented their findings at a press conference March 26 at the Hall of the States in Washington, D.C.

Brian Wansink, the John S. Dyson Professor of Marketing and director of the Cornell Food and Brand Lab, has discovered that even changing how fruit is presented can make a difference.

“Put it in a nice bowl and put it in a well-lit part of the lunch lines,” said Wansink, who had been asked by the New York State Department of Health to help with ideas to get students to eat more apples in school cafeterias. “Sales increased 103 percent.”

Wansink’s research helped launch the Smarter Lunchrooms Movement in 2009, a grassroots organization focused on nutrition in school lunches. The Smarter Lunchrooms Self-Assessment, available at smarterlunchrooms.org, is a checklist of simple changes schools can use.

Recommendations include: Move the salad bar to a lunch room’s center, which could increase salad sales 200-300 percent; place white milk in front of sugary drinks at eye level, within easy reach; move pizza to the end of the line; and put cookies just out of reach.

Childhood obesity has more than doubled in children and quadrupled in adolescents over the past 30 years, national data shows, and obese children are likely to become obese adults, with an increased risk for heart disease, diabetes, stroke, several types of cancer and osteoarthritis, according the Centers for Disease Control.

“Obesity raises medical care costs by $2,700 per year, per obese adult,” said John Cawley, professor of policy analysis and management and of economics. “If you aggregate that up it’s $190 billion a year, or roughly one in five health care dollars that we spend in the U.S.”

There are other consequences: A coalition of retired generals and admirals has called obesity a threat to military readiness. Excess weight is the No. 1 reason why military applicants are rejected.

“Among white females, the heavier you are, the lower your wages tend to be, and that’s controlling for education, height, all sorts of other things we tend to think matter – even intelligence test score,” Cawley said.

Research is ongoing to determine if financial incentives could achieve weight loss. “It is seen as a promising approach because it could be a win-win: employers can reduce job absenteeism, health insurance companies can reduce costs, and individuals can achieve their weight loss goals. However, our study of financial incentives for weight loss finds high attrition and modest weight loss, so the devil’s in the details of figuring out how to design these incentives to make them more effective,” Cawley said.

His work also finds that, while increased physical education in schools makes kids more active, for most youth there is no detectable impact on their risk of obesity.

Wansink has distributed the Smarter Lunchroom Movement’s Self Assesment tool to 15,000 schools to get benchmark data, and an app will be available in August that will allow parents to see how well their children’s schools are doing with the checklist.

Marijo Wright is a freelance writer based in the Washington, D.C., area.