School-based Nutrition Programs Produced a Moderate Increase in Fruit and Vegetable Consumption: Meta and Pooling Analyses from 7 Studies

Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland.
Journal of Nutrition Education and Behavior (Impact Factor: 1.77). 07/2007; 39(4):186-96. DOI: 10.1016/j.jneb.2007.01.010
Source: PubMed


To evaluate, through study- and individual-level analyses of data from 7 studies, the effectiveness of school-based nutrition interventions on child fruit and vegetable (FV) consumption.
To find original studies on school-based nutrition interventions, the authors searched electronic databases from 1990 to 2002. First authors of the 13 eligible studies were contacted to request their data. Data from 7 studies were received for inclusion in this pooled analysis.
8156 children were matched from pretest to posttest. Participants were primarily elementary school-aged (75.5%) and white (66%), and 50.4% were males.
Net FV difference and net FV relative change (%).
Data were analyzed at both the study and individual levels. A fitted multivariable fixed-effects model was used to analyze the role of potential covariates on FV intake. Statistical significance was set at alpha = .05.
At the individual level, the net difference in FV consumption was 0.45 (95% CI 0.33-0.59) servings; the net relative change was 19% (95% CI 0.15-0.23) servings.
School-based nutrition interventions produced a moderate increase in FV intake among children. These results may have implications for chronic disease prevention efforts, including cardiovascular disease and cancer.

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    • "The significant psychosocial, health-related, and financial costs associated with obesity suggest a need for preventive interventions in childhood (Datar & Sturm, 2004; Koplan, Liverman, & Kraak, 2005; Oude Luttikhuis et al., 2009; Strauss, Rodzilsky, Burack, & Colin, 2001). Schools may be an ideal setting for delivering obesity prevention programs (Dietz & Gortmaker, 2001; Howerton et al., 2007; Story et al., 2000). Reviews and meta-analyses suggest that school-based obesity prevention interventions can be effective, at least in the short term, for reducing the prevalence of childhood obesity, improving protective factors (e.g., consumption of fruits and vegetables, increased physical activity) and creating a healthier environment (Dietz & Gortmaker, 2001; Dobbins, De Corby, Robeson, Husson, & Tirilis, 2009; Gonzalez-Suarez, Worley, Grimmer-Somers, & Dones, 2009). "
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    ABSTRACT: Previous research has demonstrated the importance of ensuring that programs are implemented as intended by program developers in order to achieve desired program effects. The current study examined implementation fidelity of Pathways to Health (Pathways), a newly developed obesity prevention program for fourth- through sixth-grade children. We explored the associations between self-reported and observed implementation fidelity scores and whether implementation fidelity differed across the first 2 years of program implementation. Additionally, we examined whether implementation fidelity affected program outcomes and whether teacher beliefs were associated with implementation fidelity. The program was better received, and implementation fidelity had more effects on program outcomes in fifth grade than in fourth grade. Findings suggest that implementation in school-based obesity programs may affect junk food intake and intentions to eat healthfully and exercise. School support was associated with implementation fidelity, suggesting that prevention programs may benefit from including a component that boosts school-wide support.
    Evaluation &amp the Health Professions 06/2013; 38(1). DOI:10.1177/0163278713489879 · 1.91 Impact Factor
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    • "Successful intervention studies have included a variety of components; integrating teaching about fruit and vegetables into the curriculum, training teachers in theories of behaviour change and nutritional education, increasing fruit and vegetable availability at school and in school meals, training of catering staff (verbal encouragement), hands-on exposure (tasting and preparation sessions), parental involvement through newsletters and homework activities, whole school approach (developing a nutrition policy, evening activities) and community involvement (local fruit and vegetable industry)[20,23-30]. These intervention programmes report a moderate increase in children’s fruit and vegetable consumption of approximately one third of a portion of fruit and or vegetables [22,31,32]. "
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    ABSTRACT: The current academic literature suggests there is a potential for using gardening as a tool to improve children's fruit and vegetable intake. This study is two parallel randomised controlled trials (RCT) devised to evaluate the school gardening programme of the Royal Horticultural Society (RHS) Campaign for School Gardening, to determine if it has an effect on children's fruit and vegetable intake. Trial One will consist of 26 schools; these schools will be randomised into two groups, one to receive the intensive intervention as "Partner Schools" and the other to receive the less intensive intervention as "Associate Schools". Trial Two will consist of 32 schools; these schools will be randomised into either the less intensive intervention "Associate Schools" or a comparison group with delayed intervention. Baseline data collection will be collected using a 24-hour food diary (CADET) to collect data on dietary intake and a questionnaire exploring children's knowledge and attitudes towards fruit and vegetables. A process measures questionnaire will be used to assess each school's gardening activities. The results from these trials will provide information on the impact of the RHS Campaign for School Gardening on children's fruit and vegetable intake. The evaluation will provide valuable information for designing future research in primary school children's diets and school based interventions. ISRCTN11396528.
    BMC Public Health 04/2012; 12(1):304. DOI:10.1186/1471-2458-12-304 · 2.26 Impact Factor
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    • "• are seen as an effective instrument for improving F&V intake by children (e.g. Howerton et al. 2007). • have been introduced in the EU in 2008 (European School Fruit Scheme (SFS)). "

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