A cost-consequence analysis of a menu intervention in early childhood education and care

Achieving a more climate-friendly, healthy, and sustainable food system that follows the principles of the green economy requires a revision of the current practices in Finland. The early childhood education and care (ECEC) provides a potentially fruitful platform for a systemic change. This study assessed the costs and consequences of a menu intervention as part of the FoodStep-project that aims to develop a novel food system model in ECEC. A randomized controlled study was carried out in 23 ECEC centers to investigate the health, climate, and economic impacts of a novel food system model that was co-created together with the municipality decision makers and professionals in food catering and ECEC. A menu-level cost-consequence analysis was performed to summarize information on the costs and the several essential consequences. Bottom-up micro-costing using data from municipal food services was applied to assess the costs. Differences in nutritional supply in relation to national ECEC meal recommendations and climate impact between existing and new diets were assessed. According to preliminary results, the moderate menu modifications resulted in a slight decrease in mean daily meal costs (breakfast, lunch, snack). A substantial increase in the supply of vegetables, legumes, and poultry was observed, while the servings of red meat decreased notably. New diets did not remove the observed imbalances in energy supply from different sources at the baseline nor the excess supply of salt, however, the overall energy supply was found to be sufficient within both menus. Menu changes resulted in a notable decrease in the unfavorable climate impacts compared with the baseline menus. The implemented changes improved the dietary quality of the menus and decreased the negative climate impact with a modest decrease in costs. Despite the promising results, further analysis of the intervention's cost-effectiveness is required to assess the potential of the novel food system model. KEY MESSAGES: • The implemented changes improved the dietary quality of the menus and decreased the negative climate impact with a modest decrease in costs. • The intervention shows potential for a wider application with the aim of achieving a more climate-friendly, healthy, and sustainable food system.