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Merlo C, Smarsh BL, Xiao X. School Nutrition Environment and Services: Policies and Practices That Promote Healthy Eating Among K-12 Students. THE JOURNAL OF SCHOOL HEALTH 2023; 93:762-777. [PMID: 37670594 PMCID: PMC10502941 DOI: 10.1111/josh.13365] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/06/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Changes to policies at the federal, state, and local levels over the last decade have influenced the school nutrition environment and services. METHODS This systematic review includes an analysis of individual research articles and government reports published from 2010 to 2021 that examine interventions to improve the school nutrition environment and services and increase the availability, selection, and consumption of healthier foods and beverages in K-12 schools in the United States. RESULTS Nutrition standards for school meals and food outside of meals improved access to healthier options in school. Providing school nutrition professionals with professional development, improving the palatability of school meals, offering taste tests, pre-slicing fruit, providing recess before lunch, offering incentives for trying healthier options, and providing access to drinking water resulted in increased selection and consumption of healthier items. There were inconclusive or mixed findings for some intervention strategies including adequate seat time for meals. CONCLUSIONS Despite demonstrated improvements to school meal programs and competitive foods, more work is needed to change the selection and consumption of healthier options among K-12 students. Schools can use multiple interventions to improve the school nutrition environment and services and help students adopt food and beverage choices that support health.
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Affiliation(s)
- Caitlin Merlo
- Healthy Schools Branch, Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Brianna L Smarsh
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Xiangxue Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV
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Sliwa SA, Hawkins GT, Lee SM, Hunt H. A Whole School, Whole Community, Whole Child Approach to Support Student Physical Activity and Nutrition: Introduction/Methods. THE JOURNAL OF SCHOOL HEALTH 2023; 93:750-761. [PMID: 37670601 PMCID: PMC11181341 DOI: 10.1111/josh.13374] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/24/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND We introduce the Whole School, Whole Community, Whole Child approach to supporting student and school staff physical activity and nutrition and describe the methods used to generate the evidence synthesized across the special issue articles. METHODS A 2-phase literature review search included a search of systematic reviews (2010-2018) for individual qualifying articles (Phase 1) and a search for individual articles on topics not addressed by a review (2010-2020) or that needed an update because they were in a review that was older (2010-2016) or showed insufficient evidence (Phase 2). Research librarians developed search strategies. In each phase, pairs of subject matter experts applied criteria to review abstracts and full-text articles and extracted data using standardized forms. We included 314 articles, describing 293 studies. FINDINGS Most of the included studies looked at elementary or secondary school level interventions; 51% were rated poor quality, and few took place in a rural setting. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Most of the identified studies engaged majority minority or racially/ethnically diverse schools, suggesting that these interventions are feasible in a variety of settings. CONCLUSIONS This collection of 10 articles identifies evidence-based interventions, gaps in research, and implications for health equity.
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Affiliation(s)
- Sarah A Sliwa
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Georgianne Tiu Hawkins
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Sarah M Lee
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Holly Hunt
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
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Richardson AS, Nugroho A, Dubowitz T, Schultz D, Martin CK. Students' consumption of high and low nutrition foods and reduced plate waste by schools' wellness-related policies and garden program participation. J Hum Nutr Diet 2023; 36:864-874. [PMID: 36890709 PMCID: PMC10853945 DOI: 10.1111/jhn.13167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/25/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Participation in school-based programs that may support children's nutritious dietary behaviours varies across schools. We examined school participation in wellness-related policies, school-based garden programs and students' dietary behaviours. METHODS Among matching schools who did and did not participate in school-based garden programs, we analysed the lunches of 80 Pittsburgh Public Schools (PPS) students in 1st, 2nd, 6th and 7th grades during Autumn 2019 using digital food photography. We also acquired school wellness policy data. Using cross-sectional linear regression, we estimated the association between school-based garden programming, wellness-related policies and dietary outcomes, adjusting for grade. RESULTS School's implementation of nutrition services policies was negatively associated with energy wasted from lunch (β = - 44.7 , p = 0.01 ${\rm{\beta }}=-44.7,{p}=0.01$ ). The number of semesters the students' school had participated in the garden program was positively associated with students' whole grain consumption (β = 0.07 , p < 0.001 ${\rm{\beta }}=0.07,{p}\lt 0.001$ ). CONCLUSIONS Cross-sectional associations suggest that schools that are more engaged in wellness policies and garden programs may provide environments that are more supportive of students' nutrition than in other schools.
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Affiliation(s)
- Andrea S Richardson
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Alvin Nugroho
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Tamara Dubowitz
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Dana Schultz
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
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Davis JN, Landry MJ, Vandyousefi S, Jeans MR, Hudson EA, Hoelscher DM, van den Berg AE, Pérez A. Effects of a School-Based Nutrition, Gardening, and Cooking Intervention on Metabolic Parameters in High-risk Youth: A Secondary Analysis of a Cluster Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2250375. [PMID: 36626172 PMCID: PMC9856961 DOI: 10.1001/jamanetworkopen.2022.50375] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
IMPORTANCE Although school-based gardening programs for children have consistently been shown to improve dietary behaviors, no cluster randomized clinical trial (RCT) has evaluated the effects of a school-based gardening intervention on metabolic outcomes. OBJECTIVE To evaluate the effects of a school-based gardening, nutrition, and cooking intervention (Texas Sprouts) on changes in metabolic outcomes in elementary schoolchildren. DESIGN, SETTING, AND PARTICIPANTS This study was a secondary analysis of a cluster RCT, conducted over 3 years from 2016 to 2019, at low-income elementary schools with majority Hispanic students in the greater Austin, Texas, area. Data were analyzed from January to August 2022. INTERVENTIONS Texas Sprouts was 1 school year long (9 months) and consisted of (1) Garden Leadership Committee formation; (2) a 0.25-acre outdoor teaching garden; (3) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school year; and (4) 9 monthly parent lessons. The delayed intervention was implemented the following academic year and received an identical intervention. MAIN OUTCOMES AND MEASURES The following measures were obtained at baseline and postintervention (9 months): demographics via survey; measured height, weight, and body mass index parameters; and glucose, insulin, homeostatic model assessment of insulin resistance, and a lipid panel via an optional fasting blood draw. RESULTS Sixteen elementary schools were randomly assigned to either Texas Sprouts intervention (8 schools) or to delayed intervention (control, 8 schools). A total of 3302 children (aged 7-12 years) were enrolled in Texas Sprouts, and fasting blood samples were obtained from 1104 children (or 33% of those enrolled) at baseline. The final analytic sample included 695 children (307 boys [44.17%]; mean [SE] age, 9.28 [0.04] years; 480 Hispanic children [69.02%]; 452 [65.03%] eligible for free or reduced lunch) with complete demographic data and baseline and postintervention (9-month) fasting blood draws. Compared with control schools, children from Texas Sprouts schools had a 0.02% reduction in mean hemoglobin A1c (95% CI, 0.03%-0.14%; P = .005) and a 6.40 mg/dL reduction in mean low-density lipoprotein cholesterol (95% CI, 3.82-8.97 mg/dL; P = .048). There were no intervention effects on glucose, insulin, homeostatic model assessment of insulin resistance, or other lipid parameters. CONCLUSIONS AND RELEVANCE In this cluster RCT, Texas Sprouts improved glucose control and reduced low-density lipoprotein cholesterol in high-risk youth. These findings suggest that elementary schools should incorporate garden-based interventions as a way to improve metabolic parameters in children. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02668744.
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Affiliation(s)
- Jaimie N. Davis
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin
| | - Matthew J. Landry
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, California
| | - Sarvenaz Vandyousefi
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin
- Bellevue Hospital Center, Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, New York
| | - Matthew R. Jeans
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin
- Health Equity Alliance, The Health Management Academy, Arlington, Virginia
| | - Erin A. Hudson
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin
| | - Deanna M. Hoelscher
- Michael & Susan Dell Center for Healthy Living, Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Austin
| | - Alexandra E. van den Berg
- Michael & Susan Dell Center for Healthy Living, Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Austin
| | - Adriana Pérez
- Michael & Susan Dell Center for Healthy Living, Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Austin
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Wells NM, Todd LE, Henderson Jr. CR, Myers BM, Barale K, Gaolach B, Ferenz G, Aitken M, Hendrix L, Taylor C, Wilkins JL. The effects of school gardens on fruit and vegetable consumption at school: a randomized controlled trial with low-income elementary schools in four U.S. states. Prev Med Rep 2022; 31:102053. [DOI: 10.1016/j.pmedr.2022.102053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 11/16/2022] Open
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Reyes N, Ganderats-Fuentes M, Acciai F, Eliason J, Ohri-Vachaspati P. School Garden Prevalence Before and After the Implementation of the Healthy Hunger-Free Kids Act. THE JOURNAL OF SCHOOL HEALTH 2022; 92:907-915. [PMID: 35702897 PMCID: PMC9397583 DOI: 10.1111/josh.13197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/17/2022] [Accepted: 04/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Healthy Hunger-Free Kids Act (HHFKA) of 2010 supported implementation of school gardens for promoting fruit and vegetable consumption. We examined school garden prevalence over time by school-level factors during the period before and after the implementation of HHFKA. METHODS Using data from the New Jersey Child Health Study, conducted in 4 low-income New Jersey cities, prevalence of school gardens among K-12 schools (n = 148) was assessed between school year 2010-2011 and 2017-2018. Multivariable analysis estimated changes in garden prevalence over time adjusting for school-level factors. RESULTS Overall, the sample included 97 elementary and 51 middle/high schools. Multivariable logistic regression showed that compared to 2010-2011 (19%) a higher proportion of schools reported having a garden in 2013-2014 (32%, p = 0.025). Over the entire study period, schools with majority Hispanic student enrollment had approximately half the odds of having a garden compared to schools with majority Black students (p = 0.036). CONCLUSION School garden prevalence increased in the year immediately following the implementation of the HHFKA but this increase was not sustained over time. Future research should investigate the reasons for this decline and potential disparities by race/ethnicity.
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Affiliation(s)
- Naomi Reyes
- College of Health Solutions, Arizona State University, 425 N 5th Street, Phoenix, AZ, 85004
| | | | - Francesco Acciai
- College of Health Solutions, Arizona State University, 425 N 5th Street, Phoenix, AZ, 85004, USA
| | - Jessica Eliason
- College of Health Solutions, Arizona State University, 425 N 5th Street, Phoenix, AZ, 85004, USA
| | - Punam Ohri-Vachaspati
- College of Health Solutions, Arizona State University, 425 N 5th Street, Phoenix, AZ, 85004
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Zozaya N, Oliva-Moreno J, Vallejo-Torres L. Association between maternal and paternal employment and their children's weight status and unhealthy behaviours: does it matter who the working parent is? BMC Public Health 2022; 22:1331. [PMID: 35821024 PMCID: PMC9277834 DOI: 10.1186/s12889-022-13735-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background The growing number of employed women has been associated with an increase in the prevalence of overweight and obesity in children. We sought to determine whether childhood overweight/obesity in Spain is associated with labour participation of mothers and fathers, and whether the identity of the main caregiver has an influence on child’s weight and unhealthy behaviour. Methods We used microdata from the 2010 and 2014 Health Behaviour in School-Aged Children surveys performed in Spain (n = 32,694). Logistic and linear multi-level regression models were applied to assess the association between parental employment and children’s self-reported weight status, accounting for school effects and controlling for socioeconomic factors. Separated binary models were also fitted for consumption of fruit, sweets, screen viewing and sedentarism. Results In most cases, the significant associations between children’s weight and their parents’ work status disappeared once the models were adjusted for family wealth and education. However, we found persistent associations for some groups. Girls under 13 years-old living in households where the mother was the only employed parent were more likely to be affected by obesity and to report a higher body mass index value. Children in this type of household were more likely to show unhealthy lifestyles related to diet and leisure time activities. Conclusions Parents’ socioeconomic characteristics had a protective effect on their children’s risk of obesity. Unhealthy behaviours were observed in households with a non-working father and a working mother, although the link with obesity was limited to girls. Our results suggest the need for a more equally shared burden of caregiving. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13735-3.
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Affiliation(s)
- Néboa Zozaya
- Department of Quantitative Methods in Economics and Management, Universidad de Las Palmas de Gran Canaria, Calle Saulo Torón, 4 Las Palmas de Gran Canaria, 35017, Las Palmas, Spain. .,Weber Economía Y Salud, Calle Moreto 17, 28014, Madrid, Spain.
| | - Juan Oliva-Moreno
- Department of Economic Analysis and Finance, Universidad de Castilla La Mancha, Cobertizo de San Pedro Mártir, s/n, 45002, Toledo, Spain
| | - Laura Vallejo-Torres
- Department of Quantitative Methods in Economics and Management, Universidad de Las Palmas de Gran Canaria, Calle Saulo Torón, 4 Las Palmas de Gran Canaria, 35017, Las Palmas, Spain
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Kang E, Kim S, Yun YH. Comparison of eating habits and inappropriate weight control efforts of secondary school students enrolled in a weight control program. Nutr Res Pract 2021; 15:628-638. [PMID: 34603610 PMCID: PMC8446692 DOI: 10.4162/nrp.2021.15.5.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/22/2020] [Accepted: 12/18/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/OBJECTIVES Numerous school-based weight control programs have been initiated for weight loss among adolescents. However, the relationship between these programs and inappropriate weight control efforts, dietary habits and behavior of students, have not been investigated sufficiently. This study was undertaken to investigate the association between body mass index (BMI) of adolescents, and their health status and inappropriate weight-control efforts. We further examined the relationship between attendance to school-based weight-control programs and attempting inappropriate weight-control efforts, dietary habits, and behavior. SUBJECTS/METHODS A survey of 1,742 students was conducted in Korea. Logistic regression was used to assess differences in the health status (grouped by BMI and improper weight control) and dietary habits, based on attendance to the weight-control programs. RESULTS Obese students were significantly more dissatisfied with physical, mental and spiritual health. Students who attended weight-control programs were likely to be underweight (P < 0.001), whereas those who did not attend weight-control programs were likely to attempt weight control improperly (P < 0.001). Students who participated in the program also had relatively healthy dietary habits (P < 0.001-0.027), and students who did not attend had comparatively unhealthy dietary habits (P < 0.001-0.008). Students who attended weight-control programs were likely to be underweight (P < 0.001) with relatively healthy dietary habits (P < 0.001-0.027), whereas students who did not attend the programs were likely to attempt weight control improperly (P < 0.001) and had comparatively unhealthy dietary habits (P < 0.001-0.008). CONCLUSIONS Attending school-based weight-control programs was significantly associated with not attempting inappropriate weight-control efforts, as well as following healthy dietary habits. Our data indicates that offering school-based weight-control programs is valuable to student health, and is anticipated to reducing the public health burden.
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Affiliation(s)
- EunKyo Kang
- Public Healthcare Center, Seoul National University Hospital, Seoul 03080, Korea
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
| | - Soojeong Kim
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Young Ho Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul 03080, Korea
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Strochlic R, Woodward-Lopez G, Hewawitharana S, Streng K, Richardson J, Whetstone L, Gorshow D. A Harvest of the Month Curriculum Increases Fruit and Vegetable Intake among 4th-6th Grade Students. THE JOURNAL OF SCHOOL HEALTH 2021; 91:750-760. [PMID: 34291460 DOI: 10.1111/josh.13066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 11/30/2020] [Accepted: 02/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Most children do not eat enough fruits and vegetables (FV). Schools are a critical setting for supporting children to consume FV. To fill a gap in available materials, a classroom curriculum was developed and evaluated to determine impacts on student FV-related knowledge, attitudes, and behaviors. METHODS A pre-/post-intervention survey was administered to 4th-6th grade students in 3 intervention and one comparison schools. Post-intervention student focus groups, parent/guardian surveys, and teacher surveys provided complementary information. RESULTS Intervention students had a significantly greater increase in total FV intake, fruit intake, and 100% juice consumption, and preference for several types of FV relative to comparison group students. Students, teachers, and parents reported overall high levels of satisfaction with the curriculum. CONCLUSIONS The Harvest of the Month curriculum is effective at increasing fruit intake among a low-income, diverse student population in grades 4-6, is acceptable to students, teachers, and parents, and is feasible to implement. Findings suggest this impact is the result of changes in preferences, skills, and motivation but not self-efficacy or perceived social norms. Some tailoring of the curriculum may be needed to increase its appropriateness for 6th-grade students, increase the impact on vegetable intake, and limit intake of juice.
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Affiliation(s)
- Ron Strochlic
- Academic Coordinator, , Division of Agriculture & Natural Resources, Nutrition Policy Institute, University of California, 1111 Franklin Street, 5th Floor, Oakland, California, 94607., USA
| | - Gail Woodward-Lopez
- Associate Director of Research, , Division of Agriculture & Natural Resources, Nutrition Policy Institute, University of California, 1111 Franklin Street, 5th Floor, Oakland, California, 94607., USA
| | - Sridharshi Hewawitharana
- Research Data Analyst, , Division of Agriculture & Natural Resources, Nutrition Policy Institute, University of California, 1111 Franklin Street, 5th Floor, Oakland, California, 94607., USA
| | - Katharina Streng
- Health Program Specialist, , California Department of Public Health, Nutrition Education and Obesity Prevention Branch, 1616 Capitol Avenue, Sacramento, California, 95814., USA
| | - Jackie Richardson
- Health Program Manager, , California Department of Public Health, Nutrition Education and Obesity Prevention Branch, 1616 Capitol Avenue, Sacramento, California, 95814., USA
| | - Lauren Whetstone
- Research Science Supervisor, , California Department of Public Health, Nutrition Education and Obesity Prevention Branch, 1616 Capitol Avenue, Sacramento, California, 95814., USA
| | - Derek Gorshow
- Program Director, College of Education, , Alameda County Office of Education, 313 West Winton Avenue, Hayward, California, 94544., USA
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The Effects of Horticultural Activity Program on Vegetable Preference of Elementary School Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158100. [PMID: 34360393 PMCID: PMC8345950 DOI: 10.3390/ijerph18158100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/24/2022]
Abstract
This study was conducted to investigate effects of a horticultural activity program based on a mediating variable model for improving vegetable preference among elementary students. A quasi-experimental design was employed with 136 students and 136 primary carers in Seoul, South Korea. Based on the mediation model for improving children’s vegetable preference, 12 sessions were conducted, including gardening, nutrition education, and cooking activities using harvests. The program was conducted weekly for 12 weeks from March to July 2019. To investigate the effect of this program, mediating factors of the children were evaluated before and after the program. Pearson correlation analysis was used to identify the mediating factors. The nutrition index, attitude, knowledge, and eating habits of the primary carers were evaluated. Results showed children’s nutrition and gardening knowledge, dietary self-efficacy, outcome expectancies, and vegetable preference were significantly improved (p < 0.001). Primary carers showed significant improvement in the nutrition index, knowledge, and attitude (p < 0.05). The correlation analysis confirmed that most of the mediating factors had significant correlations (p < 0.05). Therefore, administering a structured program involving horticultural activities and nutrition education as mediating factors for 12 sessions was effective in improving eating behavior for vegetables elementary school students and primary carers.
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Hoover A, Vandyousefi S, Martin B, Nikah K, Cooper MH, Muller A, Marty E, Duswalt-Epstein M, Burgermaster M, Waugh L, Linkenhoker B, Davis JN. Barriers, Strategies, and Resources to Thriving School Gardens. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:591-601. [PMID: 33910772 DOI: 10.1016/j.jneb.2021.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To identify school garden attributes and practices that most strongly contribute to garden use and sustainability and translate them into recommendations for improving garden-based nutrition education. DESIGN Surveys were developed and administered to school stakeholders to assess the barriers, strategies, and resources for successful school garden-based nutrition education. A panel of school garden experts identified thriving school gardens. Logistic regression was used to identify which attributes predicted thriving school garden programs. SETTING Approximately 109 schools across Greater Austin, TX. PARTICIPANTS A total of 523 school teachers and 174 administrators. OUTCOMES Barriers, strategies, and resources relevant to successful school gardening nutrition programs. RESULTS Thriving school gardens were 3-fold more likely to have funding and community partner use (P = 0.022 and P = 0.024), 4 times more likely to have active garden committees (P = 0.021), available garden curriculum (P = 0.003), teacher training (P = 0.045), ≥ 100 students who used the garden annually (P = 0.047), and 12 times more likely to have adequate district and administrator support (P = 0.018). CONCLUSIONS AND IMPLICATIONS Adequate administrative and district support is fundamental when implementing a school garden. Schools may benefit from finding additional funding, providing teacher garden training, providing garden curriculum, forming garden leadership committees, and partnering with local community organizations to improve garden-based nutrition education.
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Affiliation(s)
- Amy Hoover
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX
| | - Sarvenaz Vandyousefi
- Department of Pediatrics, Division of General Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, NY
| | - Bonnie Martin
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX
| | - Katie Nikah
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX
| | | | - Anne Muller
- Austin Independent School District, Austin, TX
| | - Edwin Marty
- City of Austin Office of Sustainability, Austin, TX
| | | | - Marissa Burgermaster
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX; Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, TX
| | | | | | - Jaimie N Davis
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX.
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Chiero JD, Mobley AR. Evaluation of a Farm-to-School Intervention to Improve Locally Grown Vegetable Choices of Low-Income, Primary School Students. THE JOURNAL OF SCHOOL HEALTH 2021; 91:410-417. [PMID: 33768581 DOI: 10.1111/josh.13019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The study objective was to determine impact of a Farm-to-School intervention on low-income, diverse elementary school students' nutrition-related attitudes, self-efficacy, behaviors, and locally grown vegetable choices. METHODS Six elementary schools within 1 US school district were equally assigned to 1 of 3 conditions: Local Message, Nutrition Message, or Control. Locally grown vegetables (kale, green beans, zucchini, butternut squash, and beets) were served twice during lunch over 16 weeks. "Local" and "Nutrition" groups also received biweekly nutrition education and a messaging campaign in the cafeteria. Knowledge, attitudes, self-efficacy, and related behaviors were assessed using a validated questionnaire. Vegetable selection was assessed using the food service daily production records. General linear model analysis, analysis of covariance, and t tests were performed. RESULTS Students in the "Local" group (N = 81) had significantly improved nutrition-related attitudes (p = .0001), preferences (p = .001), and overall vegetable behavior score (p = .002), compared to control (N = 79). There was no difference in overall locally grown vegetable choices, but local beet choices were higher in the "Local" (p = .005) and "Nutrition" (p = .02) groups compared to control. CONCLUSIONS Messages about local foods in school cafeterias may improve students' attitudes, preferences, and selection of certain locally grown vegetables.
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Affiliation(s)
- Jesse D Chiero
- Graduate Research Assistant, , Nutritional Sciences, University of Connecticut, 27 Manter Road, Unit 4017, Storrs, CT, 06269., USA
| | - Amy R Mobley
- Associate Professor, , Health Education and Behavior, University of Florida, PO Box 118210, Gainesville, FL, 32611-8210., USA
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Davis JN, Pérez A, Asigbee FM, Landry MJ, Vandyousefi S, Ghaddar R, Hoover A, Jeans M, Nikah K, Fischer B, Pont SJ, Richards D, Hoelscher DM, Van Den Berg AE. School-based gardening, cooking and nutrition intervention increased vegetable intake but did not reduce BMI: Texas sprouts - a cluster randomized controlled trial. Int J Behav Nutr Phys Act 2021; 18:18. [PMID: 33485354 PMCID: PMC7825209 DOI: 10.1186/s12966-021-01087-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 01/14/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Although school garden programs have been shown to improve dietary behaviors, there has not been a cluster-randomized controlled trial (RCT) conducted to examine the effects of school garden programs on obesity or other health outcomes. The goal of this study was to evaluate the effects of a one-year school-based gardening, nutrition, and cooking intervention (called Texas Sprouts) on dietary intake, obesity outcomes, and blood pressure in elementary school children. METHODS This study was a school-based cluster RCT with 16 elementary schools that were randomly assigned to either the Texas Sprouts intervention (n = 8 schools) or to control (delayed intervention, n = 8 schools). The intervention was one school year long (9 months) and consisted of: a) Garden Leadership Committee formation; b) a 0.25-acre outdoor teaching garden; c) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school-year; and d) nine monthly parent lessons. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Child outcomes measured were anthropometrics (i.e., BMI parameters, waist circumference, and body fat percentage via bioelectrical impedance), blood pressure, and dietary intake (i.e., vegetable, fruit, and sugar sweetened beverages) via survey. Data were analyzed with complete cases and with imputations at random. Generalized weighted linear mixed models were used to test the intervention effects and to account for clustering effect of sampling by school. RESULTS A total of 3135 children were enrolled in the study (intervention n = 1412, 45%). Average age was 9.2 years, 64% Hispanic, 47% male, and 69% eligible for free and reduced lunch. The intervention compared to control resulted in increased vegetable intake (+ 0.48 vs. + 0.04 frequency/day, p = 0.02). There were no effects of the intervention compared to control on fruit intake, sugar sweetened beverages, any of the obesity measures or blood pressure. CONCLUSION While this school-based gardening, nutrition, and cooking program did not reduce obesity markers or blood pressure, it did result in increased vegetable intake. It is possible that a longer and more sustained effect of increased vegetable intake is needed to lead to reductions in obesity markers and blood pressure. CLINICAL TRIALS NUMBER NCT02668744 .
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Affiliation(s)
- Jaimie N Davis
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA.
| | - Adriana Pérez
- Michael & Susan Dell Center for Healthy Living - Department of Biostatistics and Data Science - The University of Texas Health (UTHealth) Science Center at Houston, Austin Campus, Austin, USA
| | - Fiona M Asigbee
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Matthew J Landry
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Sarvenaz Vandyousefi
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Reem Ghaddar
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Amy Hoover
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Matthew Jeans
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Katie Nikah
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Brian Fischer
- Michael & Susan Dell Center for Healthy Living - Department of Biostatistics and Data Science - The University of Texas Health (UTHealth) Science Center at Houston, Austin Campus, Austin, USA
| | - Stephen J Pont
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Daphne Richards
- Texas A&M AgriLife Extension Service, Travis County, Austin, USA
| | - Deanna M Hoelscher
- Michael & Susan Dell Center for Healthy Living - Department of Health Promotion and Behavioral Sciences - UTHealth Science Center at Houston, Austin Campus, Austin, USA
| | - Alexandra E Van Den Berg
- Michael & Susan Dell Center for Healthy Living - Department of Health Promotion and Behavioral Sciences - UTHealth Science Center at Houston, Austin Campus, Austin, USA
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14
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“I prepared my own carrots”. The effect of participation in an out-of-home cooking session on Dutch 4–6-year-old children’s vegetable consumption. Food Qual Prefer 2020. [DOI: 10.1016/j.foodqual.2020.104022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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15
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Roseman MG, Riddell MC, McGee JJ. Kindergarten to 12th Grade School-Based Nutrition Interventions: Putting Past Recommendations Into Practice. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:808-820. [PMID: 32279938 DOI: 10.1016/j.jneb.2020.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/09/2020] [Accepted: 02/11/2020] [Indexed: 06/11/2023]
Abstract
School-based nutrition interventions are used to improve dietary habits of schoolchildren and reverse trends on obesity. This article reports on kindergarten through 12th grade nutrition interventions published between 2009 and 2018 compared with interventions published between 2000 and 2008 based on (1) behaviorally focused, (2) multicomponent, (3) healthful food/school environment (4) family involvement, (5) self-assessments, (6) quantitative evaluation, (7) community involvement, (8) ethnic/heterogeneous groups, (9) multimedia technology, and (10) sequential and sufficient duration. These 10 recommendations help guide educators, researchers, and nutritionists on more effective nutrition interventions. Future use of implementation science to determine potential drivers of adoption, nonadoption, and effectiveness of the recommendations is encouraged.
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Affiliation(s)
- Mary G Roseman
- Department of Nutrition and Hospitality Management, University of Mississippi, Oxford, MS.
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16
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Rivera Medina C, Briones Urbano M, de Jesús Espinosa A, Toledo López Á. Eating Habits Associated with Nutrition-Related Knowledge among University Students Enrolled in Academic Programs Related to Nutrition and Culinary Arts in Puerto Rico. Nutrients 2020; 12:nu12051408. [PMID: 32422880 PMCID: PMC7285020 DOI: 10.3390/nu12051408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/30/2020] [Accepted: 05/12/2020] [Indexed: 12/22/2022] Open
Abstract
University students frequently develop unhealthy eating habits. However, it is unknown if students enrolled in academic programs related to nutrition and culinary arts have healthier eating habits. We evaluated the relationship of eating habits and nutritional status of students in academic programs with knowledge on nutrition, as well as cooking methods and techniques. A descriptive cross-sectional study was conducted in spring of 2019, while we completed a survey measuring eating habits and knowledge on nutrition, as well as cooking methods and techniques. Anthropometric measurements were collected for nutritional status estimation. The non-probabilistic convenience sample comprised 93 students pursuing degrees at Universidad Ana G. Mendez, Puerto Rico. Inadequate body mass index (BMI) was observed in 59% of the students. Eating habits, knowledge on nutrition, and knowledge on cooking methods and techniques were inadequate in 86%, 68%, and 41% of the population, respectively. Eating habits were associated with knowledge on nutrition and academic program, but not with knowledge on cooking methods and techniques. Most students reported having inadequate eating habits and BMI. Nutrition and dietetics students had the best knowledge on nutrition compared to culinary management students, a majority of whom had inadequate knowledge. We can conclude that there are other factors inherent to students’ life that may have a stronger influence on eating habits.
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Affiliation(s)
- Christian Rivera Medina
- Jose A Tony Santana International School of Hospitality & Culinary Arts, Universidad Ana G Méndez, San Juan 00901, Puerto Rico
- Correspondence: ; Tel.: +1-(787)-257-7373 (ext. 3100)
| | | | - Aixa de Jesús Espinosa
- Neurosurgery Section, University of Puerto Rico Medical Science Building, San Juan 00921, Puerto Rico;
| | - Ángel Toledo López
- Social and Human Sciences, Universidad Ana G Méndez, San Juan 00921, Puerto Rico;
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17
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Rochira A, Tedesco D, Ubiali A, Fantini MP, Gori D. School Gardening Activities Aimed at Obesity Prevention Improve Body Mass Index and Waist Circumference Parameters in School-Aged Children: A Systematic Review and Meta-Analysis. Child Obes 2020; 16:154-173. [PMID: 32091934 DOI: 10.1089/chi.2019.0253] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Childhood obesity, due to its increasing prevalence, is one of the most challenging problems in public health and prevention. Recent strategies have been implemented to tackle this trend, including school gardening projects. This systematic review analyzes the main elements of school gardening with a specific meta-analysis about its impact on anthropometric parameters. Materials and Methods: We searched studies in PubMed, EMBASE, and Cochrane Library on school gardening projects carried out until February 2019 and addressed to children aged 6 to 13 years. Results: Thirty-three studies passed the screening selection. Outcomes analyzed were fruits and vegetables consumption/knowledge, nutritional attitudes and behavior, anthropometric outcomes (i.e., BMI, waist circumference-WC) and other outcomes (i.e., blood pressure, science achievement, and physical activity). We performed descriptive analyses of these outcomes and found a general benefit from school gardening projects. We subsequently performed a meta-analysis on anthropometric outcomes, highlighting a significant reduction of both BMI percentile (%) (-1.37%) and WC (-1.30 cm). Conclusions: Although more high-quality studies are needed on this topic, along with a greater homogeneity of anthropometric measurements, the results of our article show a modest but positive impact of school gardening projects on anthropometric measures and more generally on children's health.
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Affiliation(s)
- Andrea Rochira
- School of Hygiene and Preventive Medicine, University of Bologna, Bologna, Italy
| | - Dario Tedesco
- IRCCS Rizzoli Orthopedic Institute Hospital Health Direction, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Andrea Ubiali
- School of Hygiene and Preventive Medicine, University of Bologna, Bologna, Italy
| | - Maria Pia Fantini
- School of Hygiene and Preventive Medicine, University of Bologna, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Davide Gori
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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18
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Asigbee FM, Davis JN, Markowitz AK, Landry MJ, Vandyousefi S, Ghaddar R, Ranjit N, Warren J, van den Berg A. The Association Between Child Cooking Involvement in Food Preparation and Fruit and Vegetable Intake in a Hispanic Youth Population. Curr Dev Nutr 2020; 4:nzaa028. [PMID: 32258989 PMCID: PMC7108796 DOI: 10.1093/cdn/nzaa028] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/22/2020] [Accepted: 02/27/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Cooking interventions have been linked to reductions in obesity and improvements in dietary intake in children. OBJECTIVE To assess whether child cooking involvement (CCI) was associated with fruit intake (FI), vegetable intake (VI), vegetable preference (VP), and vegetable exposure (VE) in children participating in the Texas, Grow! Eat! Go! (TGEG) randomized controlled trial. METHODS Baseline data from TGEG included 1231 3rd grade students and their parents. Conducted in 28 low-income, primarily Hispanic schools across Texas, TGEG schools were assigned to: 1) Coordinated School Health (CSH) only (control group), 2) CSH plus gardening and nutrition intervention (Learn, Grow, Eat & Go! or LGEG group), 3) CSH plus physical activity intervention (Walk Across Texas or WAT group), and 4) CSH plus LGEG plus WAT (combined group). Height, weight, dietary intake, VE, VP, and CCI were collected at baseline and postintervention. Linear regressions were used to assess the relation between baseline CCI and fruit and vegetable (FV) intake, VE, and VP. A priori covariates included age, sex, race/ethnicity, and TGEG treatment group. RESULTS Children who were always involved in family cooking had higher VP and VE when compared with children who were never involved in family cooking (β = 3.26; 95% CI: 1.67, 4.86; P < 0.01 and β = 2.26; 95% CI: 0.67, 3.85; P < 0.01, respectively). Both VI and FI were higher for children who were always involved in family cooking compared with children who never cooked with their family (β = 2.45; 95% CI: 1.47, 3.44; P < 0.01 and β = 0.93; 95% CI: 0.48, 1.39; P < 0.01, respectively). VI and fruit consumption were higher for children who reported being sometimes involved in family cooking compared with children who were never involved in family cooking, (β = 1.47; 95% CI: 0.51, 2.42; P < 0.01, and β = 0.64; 95% CI: 0.20, 1.08; P < 0.01, respectively). CONCLUSIONS Results show a positive relation between family cooking and FV intake and preference in high-risk, minority children.
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Affiliation(s)
- Fiona M Asigbee
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Jaimie N Davis
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Annie K Markowitz
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Matthew J Landry
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Sarvenaz Vandyousefi
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Reem Ghaddar
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Nalini Ranjit
- Michael & Susan Dell Center for Healthy Living—Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHEALTH), Austin Campus, Austin, TX, USA
| | - Judith Warren
- Texas AgriLife Extension Service, Texas A&M University, College Station, TX, USA
| | - Alexandra van den Berg
- Michael & Susan Dell Center for Healthy Living—Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHEALTH), Austin Campus, Austin, TX, USA
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19
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Prescott MP, Cleary R, Bonanno A, Costanigro M, Jablonski BBR, Long AB. Farm to School Activities and Student Outcomes: A Systematic Review. Adv Nutr 2020; 11:357-374. [PMID: 32173754 PMCID: PMC7442359 DOI: 10.1093/advances/nmz094] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/03/2019] [Accepted: 08/13/2019] [Indexed: 11/14/2022] Open
Abstract
Farm to school programs (F2SPs) operate in 42% of school districts and are supported in part through federal and state policies as well as philanthropic funding. Although research evaluating the effects of farm to school-related activities on student outcomes is growing, a systematic review of the results and thus a synthesis of implications for future programming have not occurred. The primary objective of this systematic literature review is to summarize and evaluate studies on student outcomes associated with farm to school-related activities up to 1 September, 2017. Four databases spanning 4 research disciplines were used to identify full-text, English-language studies. Twenty-one studies were reviewed: 7 explicitly investigated F2SPs, and 14 evaluated the impact of school-based interventions that were relevant to activities reported in the 2013 and/or 2015 Farm to School Census. All of the F2SP studies (n = 7) and 85.7% of farm to school-related activity studies (n = 12) were multicomponent, and there was a wide variety of implemented intervention components across the reviewed studies. Results from F2SP and farm to school-related activity studies consistently show positive impacts on food and nutrition-related knowledge; most studies also suggest a positive relation between farm to school-related activities and healthy food selection during school meals, nutrition self-efficacy, and willingness to try fruits and vegetables. The impact of farm to school activities on fruit and vegetable consumption and preferences is unclear. The most common F2SP study limitations were study designs that preclude causal inference, outcome measurement with no reported or limited psychometric testing, lack of long-term outcome evaluation, and challenges related to quantifying intervention implementation. These findings underscore the need for more conclusive evidence on the relation between farm to school-related activities and changes in fruit and vegetable consumption.
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Affiliation(s)
- Melissa Pflugh Prescott
- Department of Food Science and Human Nutrition, University of Illinois at Urbana–Champaign, Urbana, IL, USA,Address correspondence to MPP (e-mail: )
| | - Rebecca Cleary
- Department of Agricultural and Resource Economics, Colorado State University, Fort Collins, CO, USA
| | - Alessandro Bonanno
- Department of Agricultural and Resource Economics, Colorado State University, Fort Collins, CO, USA
| | - Marco Costanigro
- Department of Agricultural and Resource Economics, Colorado State University, Fort Collins, CO, USA
| | - Becca B R Jablonski
- Department of Agricultural and Resource Economics, Colorado State University, Fort Collins, CO, USA
| | - Abigail B Long
- Department of Agricultural and Resource Economics, Colorado State University, Fort Collins, CO, USA
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20
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Garden-Based Integrated Intervention for Improving Children's Eating Behavior for Vegetables. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041257. [PMID: 32075303 PMCID: PMC7068610 DOI: 10.3390/ijerph17041257] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 01/04/2023]
Abstract
This study was conducted to develop and verify the effects of a garden-based integrated intervention for improving children’s eating behavior for vegetables. A pre-post-test experimental design was employed. The participants were 202 elementary school students (average age: 11.6 ± 1.5 years). The garden-based integrated intervention program was conducted during regular school hours for a total of 12 weeks. The program, based on a mediator model for improving children’s eating behavior, included gardening, nutritional education, and cooking activities utilizing harvests. In order to examine effects of the program, the mediating factors related to children’s eating behavior were evaluated using pre-post questionnaires. As a result of the program, dietary self-efficacy, outcome expectancies, gardening knowledge, nutrition knowledge, vegetable preference, and vegetable consumption were significantly increased, and food neophobia was significantly decreased. In addition, there were positive correlations between most mediating factors. Thus, the garden-based integrated intervention developed in this study was effective in improving children’s eating behavior for vegetables.
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21
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Shrestha A, Schindler C, Odermatt P, Gerold J, Erismann S, Sharma S, Koju R, Utzinger J, Cissé G. Nutritional and health status of children 15 months after integrated school garden, nutrition, and water, sanitation and hygiene interventions: a cluster-randomised controlled trial in Nepal. BMC Public Health 2020; 20:158. [PMID: 32013901 PMCID: PMC6998817 DOI: 10.1186/s12889-019-8027-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 12/02/2019] [Indexed: 12/04/2022] Open
Abstract
Background It has been suggested that specific interventions delivered through the education sector in low- and middle-income countries might improve children’s health and wellbeing. This cluster-randomised controlled trial aimed to evaluate the effects of a school garden programme and complementary nutrition, and water, sanitation and hygiene (WASH) interventions on children’s health and nutritional status in two districts of Nepal. Methods The trial included 682 children aged 8–17 years from 12 schools. The schools were randomly allocated to one of three interventions: (a) school garden programme (SG; 4 schools, n = 172 children); (b) school garden programme with complementary WASH, health and nutrition interventions (SG+; 4 schools, n = 197 children); and (c) no specific intervention (control; 4 schools, n = 313 children). The same field and laboratory procedures were employed at the baseline (March 2015) and end-line (June 2016) surveys. Questionnaires were administered to evaluate WASH conditions at schools and households. Water quality was assessed using a Delagua kit. Dietary intake was determined using food frequency and 24-h recall questionnaire. Haemoglobin levels were measured using HemoCue digital device and used as a proxy for anaemia. Stool samples were subjected to a suite of copro-microscopic diagnostic methods for detection of intestinal protozoa and helminths. The changes in key indicators between the baseline and end-line surveys were analysed by mixed logistic and linear regression models. Results Stunting was slightly lowered in SG+ (19.9 to 18.3%; p = 0.92) and in the control (19.7 to 18.9%). Anaemia slightly decreased in SG+ (33.0 to 32.0%; p < 0.01) and markedly increased in the control (22.7 to 41.3%; p < 0.01), a minor decline was found in the control (43.9 to 42.4%). Handwashing with soap before eating strongly increased in SG+ (from 74.1 to 96.9%; p = 0.01, compared to control where only a slight increase was observed from 78.0 to 84.0%). A similar observation was made for handwashing after defecation (increase from 77.2 to 99.0% in SG+ versus 78.0 to 91.9% in control, p = 0.15). Conclusions An integrated intervention consisting of school garden, WASH, nutrition and health components (SG+) increased children’s fruit and vegetable consumption, decreased intestinal parasitic infections and improved hygiene behaviours. Trial registration ISRCTN17968589 (date assigned: 17 July 2015).
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Affiliation(s)
- Akina Shrestha
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland.,School of Medical Sciences, Kathmandu University, Dhulikhel, Nepal
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Peter Odermatt
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Jana Gerold
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Séverine Erismann
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Subodh Sharma
- School of Science, Aquatic Ecology Centre, Kathmandu University, Dhulikhel, Nepal
| | - Rajendra Koju
- School of Medical Sciences, Kathmandu University, Dhulikhel, Nepal
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Guéladio Cissé
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland. .,University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
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Massarani FA, Citelli M, Canella DS, Koury JC. Healthy eating promoting in a Brazilian sports-oriented school: a pilot study. PeerJ 2019; 7:e7601. [PMID: 31523523 PMCID: PMC6717494 DOI: 10.7717/peerj.7601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 08/01/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Adolescents, particularly athletes, have high exposure to ultra-processed foods, which could be harmful to their health and physical performance. School environments are capable of improving eating patterns. Our study is aimed at capturing changes in students' food consumption three years after they enrolled at an experimental school, considered a model of health promotion in Rio de Janeiro city. We also aimed to depict the promising nature of the healthy eating promotion program implemented in the school and share the learnings from its implementation. METHODS Our pilot study was a follow-up on the implementation of a school garden, experimental kitchen activities, and health promotion classes. We evaluated 83 adolescent athletes' food consumption twice during the study: at its beginning (2013) and end (2016), by administering a food frequency questionnaire (FFQ) that inquired about the frequency of foods consumed in the past week. To evaluate how effectively the activities were established, integrated, and sustained in schools, the Garden Resources, Education, and Environment Nexus (GREEN) tool was used, and the school's adherence to the school garden program was classified as high (scored 47 points out of 57). RESULTS In 2013, 89 adolescents (mean ± SD 11.9 ± 0.4 years, 54% male) participated in the study, of which 83 continued until 2016 (14.8 ± 0.5 years, 55% male). In 2013, the mean frequency of raw salad and fruits consumption was 1.4 (CI [1.0-1.9]) and 4.3 (CI [3.8-4.9]) days per week, respectively. Three years later, the frequency of raw salad and fruits consumption was 2.2 (CI [1.6-2.7]) and 5.0 (4.5-5.5), respectively. Considering that five meals were offered at school (five days/week), it may be possible to assume that the program raised awareness on the importance of healthy eating. CONCLUSION Our results suggest that such integrated healthy eating promotion programs may improve adolescent athletes' eating habits, by increasing the frequency of their consumption of unprocessed foods. This pilot study's results inspired us to implement an expanded project at the municipal level. Since 2018, teachers who participated in this program are working with Rio de Janeiro's Municipal Secretary of Education for Coordination of Curricular Projects. Some learnings from this pilot study on implementing the garden/experimental kitchen project in this school are being applied in 65 schools of the municipal network: joint activities must be fostered among students, teachers, and parents; healthy eating needs to be a respected value among adolescent athletes and become an example for parents and teachers.
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Affiliation(s)
| | - Marta Citelli
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Daniela Silva Canella
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Josely Correa Koury
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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23
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Davis J, Nikah K, Asigbee FM, Landry MJ, Vandyousefi S, Ghaddar R, Hoover A, Jeans M, Pont SJ, Richards D, Hoelscher DM, Van Den Berg AE, Bluestein M, Pérez A. Design and participant characteristics of TX sprouts: A school-based cluster randomized gardening, nutrition, and cooking intervention. Contemp Clin Trials 2019; 85:105834. [PMID: 31449880 DOI: 10.1016/j.cct.2019.105834] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/15/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022]
Abstract
AIMS To outline the study design, outcome measures, protocol and baseline characteristics of enrolled participants of Texas (TX) Sprouts, a one-year school-based gardening, nutrition, and cooking cluster randomized trial. METHODS Eight schools were randomly assigned to the TX Sprouts intervention and eight schools to the delayed intervention over three years (2016-2019). The intervention arm received: formation/training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly during school hours by hired educators throughout one school year; and nine parent lessons taught monthly to families. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Primary outcomes included: dietary intake, dietary-related behaviors, obesity, and metabolic parameters. Child measures included: height, weight, waist circumference, body composition, blood pressure, and dietary psychosocial variables. A subsample of children were measured for glucose, hemoglobin-A1C, and 24-hour dietary recalls. Parent measures included: height and weight, dietary intake, and related dietary psychosocial variables. RESULTS Of the 4239 eligible students, 3137 students consented and provided baseline clinical measures; 3132 students completed child surveys, with 92% of their parents completing parent surveys. The subsamples of blood draws and dietary recalls were 34% and 24%, respectively. Intervention arm baseline descriptives, clinical and dietary data for children and parents are reported. CONCLUSION The TX Sprouts intervention targeted primarily low-income Hispanic children and their parents; utilized an interactive gardening, nutrition, and cooking program; and measured a battery of dietary behaviors, obesity and metabolic outcomes.
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Affiliation(s)
- JaimieN Davis
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA.
| | - Katie Nikah
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
| | - Fiona M Asigbee
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
| | - Matthew J Landry
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
| | - Sarvenaz Vandyousefi
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
| | - Reem Ghaddar
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
| | - Amy Hoover
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
| | - Matthew Jeans
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
| | - Stephen J Pont
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | | | - Deanna M Hoelscher
- Michael & Susan Dell Center for Healthy Living, Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Austin Campus, Austin, USA
| | - Alexandra E Van Den Berg
- Michael & Susan Dell Center for Healthy Living, Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Austin Campus, Austin, USA
| | - Meagan Bluestein
- Michael & Susan Dell Center for Healthy Living, Department of Biostatistics and Data Science, University of Texas Health (UTHealth) Science Center, Austin Regional Campus, Austin, USA
| | - Adriana Pérez
- Michael & Susan Dell Center for Healthy Living, Department of Biostatistics and Data Science, University of Texas Health (UTHealth) Science Center, Austin Regional Campus, Austin, USA
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Improving the quality of foods available in a rural kibbutz cafeteria in Israel to align with a freshly prepared Mediterranean-style diet through a community culinary coaching programme. Public Health Nutr 2019; 22:3229-3237. [PMID: 31327325 DOI: 10.1017/s1368980019001721] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the impact of a community culinary coaching programme (CCCP) on cafeteria food alignment with a freshly prepared Mediterranean-style diet, and diners' consumption habits and satisfaction. DESIGN A non-randomized, controlled, community-based participatory research programme. CCCP included eight 90 min coaching sessions with a community steering committee, 22 h of kitchen staff training, 12 h of pre-school staff training and 30 h of education for diners; control communities received no intervention. Outcomes, measured before and 12 months after programme initiation, included cafeteria food alignment with a freshly prepared Mediterranean-style diet through a food items list derived from the cafeteria food purchasing software, and adult diners' consumption habits and satisfaction through questionnaires. SETTING Communal cafeterias of rural kibbutzim. PARTICIPANTS Intervention: kibbutz with 493 adults and 214 children. Control: Two kibbutzim with a total of 487 adults and 206 children. RESULTS Intervention cafeteria food improved significantly in all Mediterranean index categories except nuts (legumes, wholegrain products, fish, MUFA/SFA P < 0·0001; fruits, vegetables P < 0·001; processed meats P = 0·004), and in the proportion of ultra-processed and unprocessed or minimally processed foods categories of the NOVA classification (-22 %, P < 0·001 and +7 %, P < 0·001, respectively), compared with the control community. The intervention group's satisfaction was significantly improved in twenty-five (83 %) out of the thirty satisfaction items, compared with twelve (40 %) in the control group. No changes were identified in diners' consumption habits in either intervention or control communities. CONCLUSIONS CCCP might be useful in improving alignment of cafeteria food with a freshly prepared Mediterranean-style diet.
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Landry MJ, Markowitz AK, Asigbee FM, Gatto NM, Spruijt-Metz D, Davis JN. Cooking and Gardening Behaviors and Improvements in Dietary Intake in Hispanic/Latino Youth. Child Obes 2019; 15:262-270. [PMID: 30907624 PMCID: PMC6622558 DOI: 10.1089/chi.2018.0110] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: School gardening interventions typically include cooking and gardening (CG) components; however, few studies have examined associations between CG psychosocial behaviors (attitudes, self-efficacy, and motivation), dietary intake, and obesity parameters. This study assessed the association between changes in CG behaviors with changes in dietary intake and obesity in participants of the LA Sprouts study, an after-school, 12-week, randomized controlled CG intervention conducted in four inner-city elementary schools in Los Angeles. Methods: Process analysis using data from 290 low-income, primarily Hispanic/Latino third through fifth-grade students who were randomized to either the LA Sprouts intervention (n = 160) or control group (n = 130). Height, weight, waist circumference, dietary intake via questionnaire, and CG behaviors were collected at baseline and postintervention. Linear regressions determined whether changes in CG behaviors predicted changes in dietary intake and obesity outcomes. Results: There were no differences in changes in CG psychosocial behaviors between intervention and control groups, therefore groups were combined. Participants were 49% male, 87% Hispanic/Latino, and an average age of nine. Increases in cooking behaviors significantly predicted increases in dietary fiber intake (p = 0.004) and increases in vegetable intake (p = 0.03). Increases in gardening behaviors significantly predicted increased intake of dietary fiber (p = 0.02). Changes in CG behaviors were not associated with changes in BMI z-score or waist circumference. Conclusions: Results from this study suggest that school-based interventions should incorporate CG components, despite their potentially costly and time-intensive nature, as these behaviors may be responsible for improvements in dietary intake of high-risk minority youth.
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Affiliation(s)
- Matthew J. Landry
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX
| | - Annie K. Markowitz
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX
| | - Fiona M. Asigbee
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX
| | - Nicole M. Gatto
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Donna Spruijt-Metz
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA
| | - Jaimie N. Davis
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX.,Address correspondence to: Jaimie N. Davis, PhD, RD, Department of Nutritional Sciences, The University of Texas at Austin, 103 W. 24th Street, Building PAI 3.24, Austin, TX 78712
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Newton G, Racey M, Marquez O, McKenney A, Preyde M, Wosnick D. A Systematic Review of Tools Measuring Nutrition Knowledge of Pre-Adolescents and Adolescents in a School-Based Setting. THE JOURNAL OF SCHOOL HEALTH 2019; 89:402-416. [PMID: 30895628 DOI: 10.1111/josh.12752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 04/30/2018] [Accepted: 05/12/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Measurement of nutrition knowledge is common in interventions targeting dietary modifications in a school-based setting. Previous research has noted a general lack of disclosure regarding the details and psychometric properties of nutrition knowledge tools, which makes uptake of previously used instruments extremely difficult. METHODS Our systematic literature review sought to identify interventions measuring nutrition knowledge in school settings to students aged 9 to 18. Studies were categorized according to content subject and relevant descriptive characteristics and psychometric properties were extracted. RESULTS Following the initial screening of 16,868 articles, 308 papers were evaluated for eligibility. Sixty-seven studies consistent with the inclusion criteria were included in the review. A minority of studies reported analysis of validity (31.3%) and/or reliability (40.3%), and 73.1% of studies had at least one unknown relevant descriptive characteristic. The majority (68.7%) of studies were custom developed, of which only 13 reproduced the tool in the publication. CONCLUSION Overall, there was an alarming lack of reporting across studies, both in terms of the description of knowledge tools as well as their psychometric properties. These omissions make the selection of appropriate instruments for use in novel contexts difficult, and highlight the need for greater disclosure and pre-intervention testing.
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Affiliation(s)
- Genevieve Newton
- Department of Human Health & Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
| | - Megan Racey
- Department of Human Health & Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
| | - Olivia Marquez
- Department of Human Health & Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
| | - Andrew McKenney
- Department of Human Health & Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
| | - Michèle Preyde
- Department of Family Relations and Applied Human Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
| | - David Wosnick
- Department of Human Health & Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
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Harley A, Lemke M, Brazauskas R, Carnegie NB, Bokowy L, Kingery L. Youth Chef Academy: Pilot Results From a Plant-Based Culinary and Nutrition Literacy Program for Sixth and Seventh Graders. THE JOURNAL OF SCHOOL HEALTH 2018; 88:893-902. [PMID: 30392187 PMCID: PMC6546111 DOI: 10.1111/josh.12703] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND National data confirm that youth are not eating recommended amounts of fruits and vegetables (F/V), legumes, and whole grains (WGs). Establishing plant-based eating patterns early in life may positively impact long-term health through tracking of adolescent eating patterns into adulthood and through potential associations between adolescent dietary intake and adult disease risk. The study aim was to examine the effectiveness of Youth Chef Academy (YCA), a classroom-based experiential culinary and nutrition literacy intervention for sixth and seventh graders (11- to 13-year-olds) designed to impact healthy eating. METHODS Study used a nonequivalent control group design with 8 schools selected for similarity in: free/reduced-price lunch, race/ethnicity, and student mobility rate (N = 248). Primary outcomes were times per day of F/V, vegetable, and WG consumption. Students completed a survey to assess primary outcomes and other measures at baseline and post-intervention. RESULTS Significant increases in times per day of F/V (p = .022) and vegetable only (p = .015) consumption in the intervention group compared to the control group. Increases in WG consumption showed trended toward significance (p = .071). Student engagement and nutrition knowledge showed significant intervention effects. CONCLUSIONS YCA positively impacts behavioral and knowledge variables related to healthy eating and increases students' engagement in their classrooms.
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Affiliation(s)
- Amy Harley
- Associate Professor, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201-0413
| | - Melissa Lemke
- TRIUMPH, Program Manager, Center for Urban Population Health, 1020 North 12th Street, Suite 4180, Milwaukee, WI 53233
| | - Ruta Brazauskas
- Associate Professor, Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI
| | - Nicole B. Carnegie
- Assistant Professor of Statistics, Department of Mathematical Sciences, College of Letters and Science, Montana State University, P.O. Box 172400, Bozeman, MT 59717-2400
| | - Lori Bokowy
- Graduate Assistant, Joseph J. Zilber School of Public Health, UW-Milwaukee, P.O. Box 413, Milwaukee, WI 53201-0413
| | - Lisa Kingery
- Public Health Nutritionist, Culinary Educator, Founder, FoodRight, LLC, P.O. Box 510622, Milwaukee, WI 53203
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Ortega Hinojosa AM, MacLeod KE, Balmes J, Jerrett M. Influence of school environments on childhood obesity in California. ENVIRONMENTAL RESEARCH 2018; 166:100-107. [PMID: 29883903 DOI: 10.1016/j.envres.2018.04.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/19/2018] [Accepted: 04/19/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To conduct a state-wide examination of public schools and the school neighborhood as potential targets for environmental public health tracking to address childhood obesity. METHODS We examined the relationship of social and physical environmental attributes of the school environment (within school and neighborhood) and childhood obesity in California with machine learning (Random Forest) and multilevel methods. We used data compiled from the California Department of Education, the U.S. Geological Survey, ESRI's Business Analyst, the U.S. Census, and other public sources for ecologic level variables for various years and assessed their relative importance to obesity as determined from the statewide Physical Fitness Test 2003 through 2007 for grades 5, 7, and 9 (n = 5,265,265). RESULTS In addition to individual-level race and gender, the following within and school neighborhood variables ranked as the most important model contributors based on the Random Forest analysis and were included in multilevel regressions clustered on the county. Violent crime, English learners, socioeconomic disadvantage, fewer physical education (PE) and fully credentialed teachers, and diversity index were positively associated with obesity while academic performance index, PE participation, mean educational attainment and per capita income were negatively associated with obesity. The most highly ranked built or physical environment variables were distance to the nearest highway and greenness, which were 10th and 11th most important, respectively. CONCLUSIONS Many states in the U.S. do not have school-based surveillance programs that collect body mass index data. System-level determinants of obesity can be important for tracking and intervention. The results of these analyses suggest that the school social environment factors may be especially important. Disadvantaged and low academic performing schools have a higher risk for obesity. Supporting such schools in a targeted way may be an efficient way to intervene and could impact both health and academic outcomes. Some of the more important variables, such as having credentialed teachers and participating in PE, are modifiable risk factors.
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Affiliation(s)
- Alberto M Ortega Hinojosa
- School of Public Health, University of California, Berkeley, Berkeley, CA 94720, United States; IMPAQ International, LLC, Oakland, CA 94612, United States
| | - Kara E MacLeod
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - John Balmes
- School of Public Health, University of California, Berkeley, Berkeley, CA 94720, United States
| | - Michael Jerrett
- School of Public Health, University of California, Berkeley, Berkeley, CA 94720, United States; Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, United States.
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Overcash F, Ritter A, Mann T, Mykerezi E, Redden J, Rendahl A, Vickers Z, Reicks M. Impacts of a Vegetable Cooking Skills Program Among Low-Income Parents and Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:795-802. [PMID: 29242140 DOI: 10.1016/j.jneb.2017.10.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 10/26/2017] [Accepted: 10/31/2017] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To evaluate the impact of a vegetable-focused cooking skills and nutrition program on parent and child psychosocial measures, vegetable liking, variety, and home availability. DESIGN Baseline and postcourse surveys collected 1-week after the course. SETTING Low-income communities in Minneapolis-St Paul. PARTICIPANTS Parent-child dyads (n = 89; one third each Hispanic, African American, and white) with complete pre-post course data; flyer and e-mail recruitment. INTERVENTION(S) Six 2-hour-weekly sessions including demonstration, food preparation, nutrition education lessons, and a meal. MAIN OUTCOME MEASURES Parental cooking confidence and barriers, food preparation/resource management, child self-efficacy and cooking attitudes, vegetable liking, vegetable variety, and vegetable home availability. ANALYSIS Pre-post changes analyzed with paired t test or Wilcoxon signed-rank tests. Results were significant at P < .05. RESULTS Increased parental cooking confidence (4.0 to 4.4/5.0), healthy food preparation (3.6 to 3.9/5.0), child self-efficacy (14.8 to 12.4; lower score = greater self-efficacy), vegetable variety (30 to 32/37 for parent, 22 to 24/37 for child), and home vegetable availability (16 to 18/35) (all P < .05). CONCLUSIONS AND IMPLICATIONS A short-term evaluation of a vegetable-focused cooking and nutrition program for parents and children showed improvements in psychosocial factors, variety, and home availability.
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Affiliation(s)
- Francine Overcash
- Department of Food Science and Nutrition, University of Minnesota, St Paul, MN.
| | - Allison Ritter
- Department of Food Science and Nutrition, University of Minnesota, St Paul, MN
| | - Traci Mann
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Elton Mykerezi
- Department of Applied Economics, University of Minnesota, St Paul, MN
| | - Joseph Redden
- Carlson School of Management, University of Minnesota, Minneapolis, MN
| | - Aaron Rendahl
- Department of Statistics, University of Minnesota, St Paul, MN
| | - Zata Vickers
- Department of Food Science and Nutrition, University of Minnesota, St Paul, MN
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, St Paul, MN
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Measuring implementation fidelity of school-based obesity prevention programmes: a systematic review. Int J Behav Nutr Phys Act 2018; 15:75. [PMID: 30103764 PMCID: PMC6088402 DOI: 10.1186/s12966-018-0709-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/26/2018] [Indexed: 02/01/2023] Open
Abstract
Background Until now, there is no clear overview of how fidelity is assessed in school-based obesity prevention programmes. In order to move the field of obesity prevention programmes forward, the current review aimed to 1) identify which fidelity components have been measured in school-based obesity prevention programmes; 2) identify how fidelity components have been measured; and 3) score the quality of these methods. Methods Studies published between January 2001–October 2017 were selected from searches in PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library and ERIC. We included studies examining the fidelity of obesity prevention programmes (nutrition and/or physical activity and/or sitting) at school (children aged 4–18 year) measuring at least one component of implementation fidelity. A data extraction was performed to identify which and how fidelity components were measured. Thereafter, a quality assessment was performed to score the quality of these methods. We scored each fidelity component on 7 quality criteria. Each fidelity component was rated high (> 75% positive), moderate (50–75%) or low (< 50%). Results Of the 26,294 retrieved articles, 73 articles reporting on 63 different studies were included in this review. In 17 studies a process evaluation was based on a theoretical framework. In total, 120 fidelity components were measured across studies: dose was measured most often (N = 50), followed by responsiveness (N = 36), adherence (N = 26) and quality of delivery (N = 8). There was substantial variability in how fidelity components were defined as well as how they were measured. Most common methods were observations, logbooks and questionnaires targeting teachers. The quality assessment scores ranged from 0 to 86%; most fidelity components scored low quality (n = 77). Conclusions There is no consensus on the operationalisation of concepts and methods used for assessing fidelity in school-based obesity prevention programmes and the quality of methods used is weak. As a result, we call for more consensus on the concepts and clear reporting on the methods employed for measurements of fidelity to increase the quality of fidelity measurements. Moreover, researchers should focus on the relation between fidelity and programme outcomes and determine to what extent adaptations to programmes have been made, whilst still being effective. Electronic supplementary material The online version of this article (10.1186/s12966-018-0709-x) contains supplementary material, which is available to authorized users.
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A process and outcome evaluation of an in-class vegetable promotion program. Appetite 2018; 125:182-189. [PMID: 29427693 DOI: 10.1016/j.appet.2018.01.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/18/2018] [Accepted: 01/22/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Nutrition interventions that target both fruits and vegetables are effective in increasing fruit consumption, but have been limited in their ability to improve vegetable intake. To address the low proportion of children meeting vegetable intake guidelines, approaches specifically targeting vegetables are needed. This paper reports on a mixed-method analysis of a 10-week vegetable promotion pilot project that aimed to increase vegetable intake as part of the existing Crunch&Sip in-class fruit and vegetable break program. DESIGN The intervention was designed to promote vegetable consumption through the implementation of vegetable-focused resources, including curriculum resources and parent education materials. Teachers completed pre- and end-of-intervention surveys. Process measures related to the use of resources and teachers' perceptions of barriers to implementation. The outcome evaluation included measures of children's vegetable consumption during Crunch&Sip breaks and teachers' attitudes and confidence relating to educating students about the benefits of consuming vegetables. SUBJECTS Twenty-one Western Australian primary schools already participating in the Crunch&Sip program participated in the pilot intervention and evaluation. Coverage included 35 primary school teachers representing 818 students aged 4-11 years. RESULTS The proportion of children bringing vegetables for Crunch&Sip more than doubled over the 10-week intervention (21% vs 46%; p < 0.001). Improvements were observed in teachers' perceived knowledge about the nutritional benefits of vegetables (p = 0.001) and confidence to educate students about the benefits of vegetable consumption (p = 0.028). CONCLUSIONS Preferentially promoting vegetable consumption as part of an existing school-based nutrition program may be an effective strategy to increase children's vegetable intake.
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Schreinemachers P, Rai BB, Dorji D, Chen HP, Dukpa T, Thinley N, Sherpa PL, Yang RY. School gardening in Bhutan: Evaluating outcomes and impact. Food Secur 2017. [DOI: 10.1007/s12571-017-0673-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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DeCosta P, Møller P, Frøst MB, Olsen A. Changing children's eating behaviour - A review of experimental research. Appetite 2017; 113:327-357. [PMID: 28286164 DOI: 10.1016/j.appet.2017.03.004] [Citation(s) in RCA: 189] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 03/03/2017] [Accepted: 03/04/2017] [Indexed: 01/10/2023]
Abstract
The interest in children's eating behaviours and how to change them has been growing in recent years. This review examines the following questions: What strategies have been used to change children's eating behaviours? Have their effects been experimentally demonstrated? And, are the effects transient or enduring? Medline and Cab abstract (Ovid) and Web of Science (Thomson Reuters) were used to identify the experimental studies. A total of 120 experimental studies were identified and they are presented grouped within these 11 topics; parental control, reward, social facilitation, cooking programs, school gardens, sensory education, availability and accessibility, choice architecture and nudging, branding and food packaging, preparation and serving style, and offering a choice. In conclusion, controlling strategies for changing children's eating behaviour in a positive direction appear to be counterproductive. Hands-on approaches such as gardening and cooking programs may encourage greater vegetable consumption and may have a larger effect compared to nutrition education. Providing children with free, accessible fruits and vegetables have been experimentally shown to positively affect long-term eating behaviour. The authors recommend future research to examine how taste and palatability can positively affect children's attitudes and eating behaviour.
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Affiliation(s)
- Patricia DeCosta
- Food Design and Consumer Behaviour, Department of Food Science (FOOD), University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark.
| | - Per Møller
- Food Design and Consumer Behaviour, Department of Food Science (FOOD), University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark.
| | - Michael Bom Frøst
- Nordic Food Lab, Food Design and Consumer Behaviour, Department of Food Science (FOOD), University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark.
| | - Annemarie Olsen
- Food Design and Consumer Behaviour, Department of Food Science (FOOD), University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark.
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Gatto NM, Martinez LC, Spruijt-Metz D, Davis JN. LA sprouts randomized controlled nutrition, cooking and gardening programme reduces obesity and metabolic risk in Hispanic/Latino youth. Pediatr Obes 2017; 12:28-37. [PMID: 26909882 PMCID: PMC5362120 DOI: 10.1111/ijpo.12102] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 12/05/2015] [Accepted: 12/10/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many programmes for children that involve gardening and nutrition components exist; however, none include experimental designs allowing more rigorous evaluation of their impact on obesity. OBJECTIVES The objective of this study is to explore the effects of a novel 12-week gardening, nutrition and cooking intervention {'LA Sprouts'} on dietary intake, obesity parameters and metabolic disease risk among low-income, primarily Hispanic/Latino youth in Los Angeles.. METHODS This study used a randomized control trial involving four elementary schools [two randomized to intervention {172, 3rd-5th grade students}; two randomized to control {147, 3rd-5th grade students}]. Classes were taught in 90-min sessions once per week for 12 weeks. Data collected at pre-intervention and post-intervention included dietary intake via food frequency questionnaire, anthropometric measures {body mass index, waist circumference}, body fat, and fasting blood samples. RESULTS LA Sprouts participants compared with controls had significantly greater reductions in body mass index z-scores {-0.1 vs. -0.04, respectively; p = 0.01} and waist circumference {-1.2 vs. 0.1 cm; p < 0.001}. Fewer LA Sprouts participants had the metabolic syndrome after the intervention than before, while controls with metabolic syndrome increased. LA Sprouts participants compared with controls increased dietary fiber intake {+3.4% vs. -16.5%; p = 0.04}. All participants decreased vegetable intake, but decreases were less in LA Sprouts than controls {-3.7% vs. -26.1%; p = 0.04}. Change in fruit intake did not differ between LA Sprouts and controls. CONCLUSIONS LA Sprouts was effective in reducing obesity and metabolic risk; however, additional larger and longer-term studies are warranted.
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Affiliation(s)
- Nicole M. Gatto
- Center for Nutrition, Healthy Lifestyles & Disease Prevention, School of Public Health, Loma Linda University
| | | | - Donna Spruijt-Metz
- Department of Preventive Medicine, University of Southern California
- Center for Economic and Social Research, University of Southern California
- Department of Psychology, University of Southern California
| | - Jaimie N. Davis
- Department of Nutritional Sciences, University of Texas at Austin
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Savoie-Roskos MR, Wengreen H, Durward C. Increasing Fruit and Vegetable Intake among Children and Youth through Gardening-Based Interventions: A Systematic Review. J Acad Nutr Diet 2016; 117:240-250. [PMID: 27964852 DOI: 10.1016/j.jand.2016.10.014] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 10/12/2016] [Indexed: 11/28/2022]
Abstract
Although there are numerous health benefits associated with eating fruit and vegetables (F/V), few children are consuming recommended amounts. Gardening interventions have been implemented in various settings in an effort to increase children's F/V consumption by expanding knowledge, exposure, and preferences for a variety of F/V. The purpose of this review was to identify the effectiveness of gardening interventions that have been implemented to increase F/V consumption among children. A systematic review was conducted using four electronic databases: Web of Science, PubMed, Scopus, and the Cumulative Index to Nursing and Allied Health Literature. English language studies conducted in developed countries between January 2005 and October 2015 were included in this review. Included studies measured F/V consumption among children aged 2 to 15 years before and after implementation of a gardening intervention in a school, community, or afterschool setting. All study designs were included in this review. A total of 891 articles were identified through database searching and cross-referencing. After removing duplicates, 650 articles remained and were screened using inclusion and exclusion criteria. Twenty-seven full-text articles were analyzed and 14 articles were included in this review. Of the 14 articles reviewed, 10 articles found statistically significant increases in fruit or vegetable consumption among participants after implementation of a gardening intervention. However, many studies were limited by the use of convenience samples, small sample sizes, and self-reported measurements of F/V consumption. Although the evidence is mixed and fraught with limitations, most studies suggest a small but positive influence of gardening interventions on children's F/V intake. Future studies that include control groups, randomized designs, and assessments of F/V consumption over at least 1 year are needed to advance the literature on this topic.
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van Lier LE, Utter J, Denny S, Lucassen M, Dyson B, Clark T. Home Gardening and the Health and Well-Being of Adolescents. Health Promot Pract 2016; 18:34-43. [PMID: 27765876 DOI: 10.1177/1524839916673606] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The current article explores the associations between home gardening and dietary behaviors, physical activity, mental health, and social relationships among secondary school students in New Zealand. METHOD Data were drawn from a national youth health and well-being survey, conducted in 2012. In total, 8,500 randomly selected students from 91 randomly selected secondary schools completed the survey. RESULTS Two thirds of students had a vegetable garden at home and one quarter of all students participated in home gardening. Students participating in gardening were most likely to be male, of a Pacific Island ethnicity, of younger age, and living in a rural area. Gardening was positively associated with healthy dietary habits among students, such as greater fruit and vegetable consumption. Gardening was also positively associated with physical activity and improved mental health and well-being. Students who participate in gardening report slightly lower levels of depressive symptoms and enhanced emotional well-being and experience higher family connection than students who do not participate in gardening. CONCLUSIONS Gardening may make a difference for health and nutrition behaviors and may contribute to adolescents' health and well-being in a positive manner. Health promoters should be encouraged to include gardening in future interventions for young people.
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Affiliation(s)
| | | | - Simon Denny
- 2 University of Auckland, Auckland, New Zealand
| | | | - Ben Dyson
- 2 University of Auckland, Auckland, New Zealand
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Battjes-Fries MC, Haveman-Nies A, van Dongen EJ, Meester HJ, van den Top-Pullen R, de Graaf K, van ’t Veer P. Effectiveness of Taste Lessons with and without additional experiential learning activities on children’s psychosocial determinants of vegetables consumption. Appetite 2016; 105:519-26. [DOI: 10.1016/j.appet.2016.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 06/10/2016] [Accepted: 06/13/2016] [Indexed: 11/25/2022]
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Racey M, O'Brien C, Douglas S, Marquez O, Hendrie G, Newton G. Systematic Review of School-Based Interventions to Modify Dietary Behavior: Does Intervention Intensity Impact Effectiveness? THE JOURNAL OF SCHOOL HEALTH 2016; 86:452-63. [PMID: 27122145 DOI: 10.1111/josh.12396] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 11/03/2015] [Accepted: 01/09/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND Owing to the associations between diet and health, it is important that effective health promotion strategies establish healthful eating behaviors from an early age. We reviewed the intensity of school-based interventions aimed to modify dietary behavior in preadolescent and adolescents and related intervention characteristics to effectiveness. METHODS Our systematic literature search of 8 databases sought to identify interventions measuring dietary intake in school settings to students aged 9 to 18. We evaluated these studies for effectiveness, intensity, intervention category, and follow-up measures. RESULTS Of the 105 interventions 81 were found to be effective immediately postintervention, irrespective of intensity. Studies that were 6 weeks to 5 months in duration, targeted students' environment or group (alone or in combination), and reached students only in schools were more effective. Only one-fifth of interventions conducted a follow-up measure, and a majority showed a loss of effectiveness from postintervention to follow-up. CONCLUSIONS We identified characteristics of effective interventions. These findings may inform the development of future interventions targeting dietary behavior in preadolescents and adolescents in the school-based setting.
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Affiliation(s)
- Megan Racey
- University of Guelph, Department of Human Health & Nutritional Science, Guelph, ON N1G 2W1, Canada.
| | - Charlene O'Brien
- University of Guelph, Department of Human Health & Nutritional Science, Guelph, ON N1G 2W1, Canada.
| | - Sabrina Douglas
- University of Guelph, Department of Human Health & Nutritional Science, Guelph, ON N1G 2W1, Canada.
| | - Olivia Marquez
- University of Guelph, Department of Human Health & Nutritional Science, Guelph, ON N1G 2W1, Canada.
| | - Gilly Hendrie
- CSIRO Food and Nutritional Sciences, PO BOX 10041, Adelaide 5000, South Australia.
| | - Genevieve Newton
- University of Guelph, Department of Human Health & Nutritional Science, Guelph, ON N1G 2W1, Canada.
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Ritchie B, O'Hara L, Taylor J. 'Kids in the Kitchen' impact evaluation: engaging primary school students in preparing fruit and vegetables for their own consumption. Health Promot J Austr 2016; 26:146-149. [PMID: 25995023 DOI: 10.1071/he14074] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 01/31/2015] [Indexed: 11/23/2022] Open
Abstract
ISSUE ADDRESSED Children's fruit and vegetable (FV) consumption in Australia is below levels recommended for optimal growth, development and health. METHODS 'Kids in the Kitchen' is a classroom-based program that engages students in preparing FV. Impact evaluation was conducted with students from Grade 1 (around 6 years old) and Grade 5 (around 11 years old) who participated in the program. A questionnaire was used to collect pre- and post-program data on knowledge, attitudes and consumption of FV, FV preparation skills and environmental supports for FV consumption. A skill audit was also conducted for Grade 1 students. RESULTS Study participants (n = 118) included 70 Grade 1 and 48 Grade 5 students. There was an increase in the median number of fruits correctly identified (from 14 to 16), tried (from 14 to 16) and liked (from 10.5 to 12; P = 0.0001 for all changes). The median number of vegetables correctly identified increased from 10 to 12 (P = 0.0001), but there was no change in the number of vegetables tried or liked. The proportion of participants who rated their skills in using a knife to prepare FV as 'not really that good' decreased by 15%, from 42% to 27% (P = 0.04). Grade 1 participants' skills in cutting, grating and peeling improved (P = 0.0001 for all changes). CONCLUSIONS If children are involved in the preparation of FV, they are more likely to correctly identify them, try them, like them and eat them. SO WHAT? Primary schools have the potential to contribute to children's nutrition through hands-on food preparation activities.
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Affiliation(s)
- Barbara Ritchie
- Chancellor State College, PO Box 7066, Sippy Downs, Qld 4556, Australia
| | - Lily O'Hara
- Emirates College for Advanced Education, PO Box 126662, Abu Dhabi, United Arab Emirates
| | - Jane Taylor
- School of Health and Sport Sciences, Faculty of Science, Health and Education, University of the Sunshine Coast, Sippy Downs Drive, Sippy Downs, Qld 4556, Australia
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Berezowitz CK, Bontrager Yoder AB, Schoeller DA. School Gardens Enhance Academic Performance and Dietary Outcomes in Children. THE JOURNAL OF SCHOOL HEALTH 2015; 85:508-518. [PMID: 26149306 DOI: 10.1111/josh.12278] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 12/06/2014] [Accepted: 01/14/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Schools face increasing demands to provide education on healthy living and improve core academic performance. Although these appear to be competing concerns, they may interact beneficially. This article focuses on school garden programs and their effects on students' academic and dietary outcomes. METHODS Database searches in CABI, Web of Science, Web of Knowledge, PubMed, Education Full Text, Education Resources Information Center (ERIC), and PsychINFO were conducted through May 2013 for peer-reviewed literature related to school-day garden interventions with measures of dietary and/or academic outcomes. RESULTS Among 12 identified garden studies with dietary measures, all showed increases/improvements in predictors of fruit and vegetable (FV) consumption. Seven of these also included self-reported FV intake with 5 showing an increase and 2 showing no change. Four additional interventions that included a garden component measured academic outcomes; of these, 2 showed improvements in science achievement and 1 measured and showed improvements in math scores. CONCLUSIONS This small set of studies offers evidence that garden-based learning does not negatively impact academic performance or FV consumption and may favorably impact both. Additional studies with more robust experimental designs and outcome measures are necessary to understand the effects of experiential garden-based learning on children's academic and dietary outcomes.
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Affiliation(s)
- Claire K Berezowitz
- Department of Nutritional Sciences and Department of Educational Psychology, University of Wisconsin-Madison, 1415 Linden Drive, Madison, WI 53706.
| | - Andrea B Bontrager Yoder
- Department of Nutritional Sciences, University of Wisconsin-Madison, 1415 Linden Drive, Madison, WI 53706.
| | - Dale A Schoeller
- Department of Nutritional Sciences, University of Wisconsin-Madison, 1415 Linden Drive, Madison, WI 53706.
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Hutchinson J, Christian MS, Evans CEL, Nykjaer C, Hancock N, Cade JE. Evaluation of the impact of school gardening interventions on children's knowledge of and attitudes towards fruit and vegetables. A cluster randomised controlled trial. Appetite 2015; 91:405-14. [DOI: 10.1016/j.appet.2015.04.076] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 04/17/2015] [Accepted: 04/27/2015] [Indexed: 11/28/2022]
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Gatto NM, Martinez LC, Spruijt-Metz D, Davis JN. LA sprouts randomized controlled nutrition and gardening program reduces obesity and metabolic risk in Latino youth. Obesity (Silver Spring) 2015; 23:1244-51. [PMID: 25960146 PMCID: PMC4446151 DOI: 10.1002/oby.21077] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 02/09/2015] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To assess the effects of a 12-week gardening, nutrition, and cooking intervention ("LA Sprouts") on dietary intake, obesity parameters, and metabolic disease risk among low-income, primarily Hispanic/Latino youth in Los Angeles. METHODS The randomized controlled trial involved four elementary schools [two schools randomized to intervention (172 third-through fifth-grade students); two schools randomized to control (147 third-through fifth-grade students)]. Classes were taught in 90-minute sessions once a week to each grade level for 12 weeks. Data collected at pre- and postintervention included dietary intake via food frequency questionnaire (FFQ), anthropometric measures [BMI, waist circumference (WC)], body fat, and fasting blood samples. RESULTS LA Sprouts participants had significantly greater reductions in BMI z-scores (0.1-vs. 0.04-point decrease, respectively; P = 0.01) and WC (-1.2 cm vs. no change; P < 0.001). Fewer LA Sprouts participants had the metabolic syndrome (MetSyn) after the intervention than before, while the number of controls with MetSyn increased. LA Sprouts participants had improvements in dietary fiber intake (+3.5% vs. -15.5%; P = 0.04) and less decreases in vegetable intake (-3.6% vs. -26.4%; P = 0.04). Change in fruit intake before and after the intervention did not significantly differ between LA Sprouts and control subjects. CONCLUSIONS LA Sprouts was effective in reducing obesity and metabolic risk.
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Affiliation(s)
- Nicole M. Gatto
- Center for Nutrition, Healthy Lifestyles & Disease Prevention, School of Public Health, Loma Linda University
| | | | - Donna Spruijt-Metz
- Department of Preventive Medicine, University of Southern California
- Center for Economic and Social Research, University of Southern California
- Department of Psychology, University of Southern California
| | - Jaimie N. Davis
- Department of Nutritional Sciences, University of Texas at Austin
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Goldberg JP, Folta SC, Eliasziw M, Koch-Weser S, Economos CD, Hubbard KL, Tanskey LA, Wright CM, Must A. Great Taste, Less Waste: a cluster-randomized trial using a communications campaign to improve the quality of foods brought from home to school by elementary school children. Prev Med 2015; 74:103-10. [PMID: 25735605 PMCID: PMC4640453 DOI: 10.1016/j.ypmed.2015.02.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 02/18/2015] [Accepted: 02/21/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Great Taste, Less Waste (GTLW), a communications campaign, capitalized on the synergy between healthy eating and eco-friendly behaviors to motivate children to bring more fruits and vegetables and fewer sugar-sweetened beverages (SSBs) to school. METHODS A cluster-randomized trial in Eastern Massachusetts elementary schools in 2011-2012 tested the hypothesis that GTLW would improve the quality of foods from home more than a nutrition-only campaign--Foods 2 Choose (F2C)--or control. Lunch and snack items from home were measured at baseline and 7 months later using digital photography. Mixed linear models compared change in mean servings of fruits, vegetables, and SSBs among groups, and change in mean prevalence of packaging type. Change in prevalence of food items of interest was compared among groups using generalized linear models. RESULTS Five hundred and eighty-two third and fourth graders from 82 classrooms in 12 schools participated. At follow-up, no significant differences were observed between groups in change in mean servings or change in prevalence of items of interest. No packaging differences were observed. CONCLUSION GTLW was well received, but no significant changes were observed in the quality of food brought to school. Whether classrooms are an effective environment for change remains to be explored. ClinicalTrials.gov identifier: NCT0157384.
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Affiliation(s)
- Jeanne P Goldberg
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
| | - Sara C Folta
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
| | - Misha Eliasziw
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.
| | - Susan Koch-Weser
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.
| | - Christina D Economos
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
| | - Kristie L Hubbard
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
| | - Lindsay A Tanskey
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
| | - Catherine M Wright
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
| | - Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.
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Martinez LC, Gatto NM, Spruijt-Metz D, Davis JN. Design and methodology of the LA Sprouts nutrition, cooking and gardening program for Latino youth: A randomized controlled intervention. Contemp Clin Trials 2015; 42:219-27. [PMID: 25896115 DOI: 10.1016/j.cct.2015.04.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 04/08/2015] [Accepted: 04/10/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The LA Sprouts 12-week nutrition, cooking and gardening intervention targets obesity reduction in Latino children. While other gardening and nutrition programs are shown to improve dietary intake, LA Sprouts is unique in that it utilized a curriculum demonstrated to decrease obesity. This methodology paper outlines the design and processes of the LA Sprouts study, and discusses key strategies employed to foster successful implementation of the program. SETTING After-school program in four Los Angeles elementary schools. SUBJECTS 3rd-5th grade students. DESIGN Randomized controlled trial. Gardens were built on two of four school campuses, and the 90-minute weekly lessons focused on strategies to increase fruit and vegetable consumption, gardening at school and home, and cooking healthy meals/snacks. Data collection was conducted pre- and post-intervention and included basic clinical and anthropometric measures, dietary intake and psychosocial constructs measured by questionnaire, and an optional fasting blood draw. RESULTS Baseline data was collected from 364 children, and 320 (88%) completed follow-up. No participants withdrew from the program (data were missing for other reasons). Intervention students attended 9.7 ± 2.3 lessons. Fasting blood samples were collected on 169 children at baseline, and 113 (67%) at follow-up. Questionnaire scales had good internal consistency (IC) and intra-rater reliability (IRR; in child scales: 88% items with IC > 0.7 and 70% items with IRR > 0.50; in parent scales: 75% items with IC > 0.7). CONCLUSIONS The intervention was successfully implemented in the schools and scales appear appropriate to evaluate psychosocial constructs relevant to a gardening intervention.
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Affiliation(s)
- Lauren C Martinez
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N Soto St, 3rd floor, Los Angeles, CA 90089, United States
| | - Nicole M Gatto
- Center for Nutrition, Healthy Lifestyles, & Disease Prevention, Loma Linda University, 24951 North Circle Drive, Nichol Hall 2025, Loma Linda, CA 92350, United States
| | - Donna Spruijt-Metz
- Center for Economic and Social Research, University of Southern California, 635 Downey Way, Suite 305, Los Angeles, CA 90089-3332, United States
| | - Jaimie N Davis
- Department of Nutritional Sciences, University of Texas, Austin, 200 W. 24th Street, Stop A2700, Austin, TX 78712, United States.
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Factors affecting fruit and vegetable school lunch waste in Wisconsin elementary schools participating in Farm to School programmes. Public Health Nutr 2015; 18:2855-63. [PMID: 25728060 DOI: 10.1017/s1368980015000385] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To examine characteristics potentially associated with school lunch fruit and vegetable waste, both overall and pre/post implementation of the Healthy, Hunger-Free Kids Act. DESIGN Multi-year (2010-2013) cross-sectional study using pre- and post-meal digital photographs of students' school lunch trays to estimate fruit and vegetable availability and consumption. Fruit and vegetable items were categorized for factors suspected to impact waste: prior farm to school years, placement (main menu, salad bar), procurement (local, conventional), preparation (cooked, raw) and meal component (entrée, side, topping). Analyses to assess within-category differences in waste volume were performed using a Tobit model. SETTING Wisconsin elementary schools participating in farm to school programmes, USA. SUBJECTS Children in third to fifth grade. RESULTS Many within-factor differences were detected overall and/or across time. Cooked fruits were wasted less than raw, while cooked vegetables were wasted more than raw. Where identified, locally sourced items were wasted more than conventionally sourced (+0·1 cups, P<0·0001) and salad bar items more than main menu items (+0·01 cups, P<0·0001). Increasing prior farm to school years decreased waste (-0·02 cups, P<0·0001). Items previously tried were wasted at the same volume whether reported as liked or not. New school lunch meal pattern requirement implementation did not uniformly impact fruit and vegetable waste across all categories and there was no change in waste for seven of fifteen assessed categories. CONCLUSIONS Many factors impact elementary students' school lunch waste. These factors may be helpful for school food-service authorities to consider when planning school menus.
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Ickes MJ, McMullen J, Haider T, Sharma M. Global school-based childhood obesity interventions: a review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:8940-61. [PMID: 25170684 PMCID: PMC4198999 DOI: 10.3390/ijerph110908940] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 08/19/2014] [Accepted: 08/20/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. METHODS A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and (7) studies that reported outcome data. RESULTS A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. DISCUSSION Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.
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Affiliation(s)
- Melinda J Ickes
- Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, KY 40506, USA.
| | - Jennifer McMullen
- Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, KY 40506, USA.
| | - Taj Haider
- The Legal Aid Society, 199 Water Street, New York, NY 10038, USA.
| | - Manoj Sharma
- Behavioral & Environmental Health, Jackson State University, Jackson, MS 39213, USA.
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Christian MS, Evans CEL, Nykjaer C, Hancock N, Cade JE. Evaluation of the impact of a school gardening intervention on children's fruit and vegetable intake: a randomised controlled trial. Int J Behav Nutr Phys Act 2014; 11:99. [PMID: 25128211 PMCID: PMC4142134 DOI: 10.1186/s12966-014-0099-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 07/18/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Current academic literature suggests that school gardening programmes can provide an interactive environment with the potential to change children's fruit and vegetable intake. This is the first cluster randomised controlled trial (RCT) designed to evaluate whether a school gardening programme can have an effect on children's fruit and vegetable intake. METHODS The trial included children from 23 schools; these schools were randomised into two groups, one to receive the Royal Horticultural Society (RHS)-led intervention and the other to receive the less involved Teacher-led intervention. A 24-hour food diary (CADET) was used to collect baseline and follow-up dietary intake 18 months apart. Questionnaires were also administered to evaluate the intervention implementation. RESULTS A total of 641 children completed the trial with a mean age of 8.1 years (95% CI: 8.0, 8.4). The unadjusted results from multilevel regression analysis revealed that for combined daily fruit and vegetable intake the Teacher-led group had a higher daily mean change of 8 g (95% CI: -19, 36) compared to the RHS-led group -32 g (95% CI: -60, -3). However, after adjusting for possible confounders this difference was not significant (intervention effect: -40 g, 95% CI: -88, 1; p = 0.06). The adjusted analysis of process measures identified that if schools improved their gardening score by 3 levels (a measure of school gardening involvement - the scale has 6 levels from 0 'no garden' to 5 'community involvement'), irrespective of group allocation, children had, on average, a daily increase of 81 g of fruit and vegetable intake (95% CI: 0, 163; p = 0.05) compared to schools that had no change in gardening score. CONCLUSIONS This study is the first cluster randomised controlled trial designed to evaluate a school gardening intervention. The results have found very little evidence to support the claims that school gardening alone can improve children's daily fruit and vegetable intake. However, when a gardening intervention is implemented at a high level within the school it may improve children's daily fruit and vegetable intake by a portion. Improving children's fruit and vegetable intake remains a challenging task. TRIAL REGISTRATION ISRCTN11396528.
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Affiliation(s)
- Meaghan S Christian
- />Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT UK
- />School of Health and Wellbeing, Faculty of Health and Social Sciences, Leeds Metropolitan University, City Campus, Calverley Street, Leeds, LS1 3HE UK
| | - Charlotte EL Evans
- />Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT UK
| | - Camilla Nykjaer
- />Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT UK
| | - Neil Hancock
- />Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT UK
| | - Janet E Cade
- />Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT UK
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Involving children in meal preparation. Effects on food intake. Appetite 2014; 79:18-24. [DOI: 10.1016/j.appet.2014.03.030] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 03/06/2014] [Accepted: 03/28/2014] [Indexed: 11/19/2022]
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Christian MS, Evans CEL, Cade JE. Does the Royal Horticultural Society Campaign for School Gardening increase intake of fruit and vegetables in children? Results from two randomised controlled trials. PUBLIC HEALTH RESEARCH 2014. [DOI: 10.3310/phr02040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundChildren’s fruit and vegetable intake in the UK is low. Changing intake is challenging. Gardening in schools might be a vehicle for facilitating fruit and vegetable intake.ObjectivesTo undertake the first clustered randomised controlled trials (RCTs) of a gardening intervention. To evaluate the impact of a school gardening programme, the Royal Horticultural Society (RHS) Campaign for School Gardening, on children’s fruit and vegetable intake.MethodsPrimary school children aged 8–11 years from eight London boroughs were included in one of two related RCTs. Trial 1 consisted of 23 schools, randomised to receive either a RHS-led or teacher-led intervention. Trial 2 consisted of 31 schools, randomised to either the teacher-led intervention or a comparison group. A 24-hour food diary [the Child And Diet Evaluation Tool (CADET)] collected baseline and follow-up dietary intake. Questionnaires measured children’s knowledge and attitudes towards fruit and vegetables and assessed intervention implementation. Data were collected by fieldworkers who were blind to the original allocation of the school. The primary outcome was change in fruit and vegetable intake analysed using a random effects model, based on intention to treat.ResultsTotal sample size at baseline for both trials (2529 children) was lower than the original aim of 2900 children. The final sample size was 1557, with 641 children completing trial 1 (RHS-led,n = 312; teacher-led,n = 329) and 916 children completing trial 2 (teacher-led,n = 488; control,n = 428). The response rate at follow-up for the two combined was 62%.Baseline analysis of children’s fruit and vegetable intake showed that eating a family meal together, cutting up fruit and vegetables, and parental modelling of fruit and vegetable intakes were all associated with higher intakes of fruit and vegetables in children.The primary trial outcome, combined fruit and vegetable intake, showed that in trial 1 the teacher-led group had a mean change in intake of 8 g [95% confidence interval (CI) –19 to 36 g], compared with a mean of –32 g (95% CI –60 to –3 g) in the RHS-led group. However, this difference was not significant (intervention effect –43 g, 95% CI –88 to 1 g;p = 0.06). In trial 2, the teacher-led group consumed 15 g (95% CI –36 to 148 g) more fruit and vegetables than the comparison group; this difference was not significant. No change was found in children’s knowledge and attitudes. However, if schools improved their RHS gardening score by three levels, children had a higher intake of 81 g of fruit and vegetables (95% CI 0 to 163 g;p = 0.05) compared with schools with no change in gardening score.ConclusionResults from these trials provide little evidence that school gardening alone can improve children’s fruit and vegetable intake. In both trials, gardening levels increased across all groups from baseline to follow-up, with no statistically significant difference between groups in terms of improvement in gardening level. This lack of differentiation between groups is likely to have influenced the primary outcome. However, when the gardening intervention was implemented at the highest intensities there was a suggestion that it could improve children’s fruit and vegetable intake by a portion. Analysis of the baseline data showed that family support for fruit and vegetable intakes was associated with higher intakes of fruit and vegetables in children. This study highlights the need for more sophisticated and accurate tools to evaluate diet in children. Future intervention designs should include a greater level of parental involvement in school interventions, along with related components such as cooking, to substantially improve children’s fruit and vegetable intake. In addition, the home environment has been demonstrated to be an important focus for intervention.Trial registrationCurrent Controlled Trials ISRCTN11396528.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 2, No. 4. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Meaghan S Christian
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Charlotte EL Evans
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
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Cunningham-Sabo L, Lohse B. Impact of a school-based cooking curriculum for fourth-grade students on attitudes and behaviors is influenced by gender and prior cooking experience. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:110-120. [PMID: 24268970 DOI: 10.1016/j.jneb.2013.09.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 09/14/2013] [Accepted: 09/17/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To compare effects of the Cooking With Kids (CWK) cooking and tasting curriculum (CWK-CT) with a less-intense, tasting-only curriculum (CWK-T) and to conduct a non-treatment comparison on fourth graders' cooking self-efficacy (SE), cooking attitudes (AT), and fruit and vegetable preferences (FVP). DESIGN Pre-post, quasi-experimental, 2 cohorts. SETTING Eleven low-income public schools in a Southwestern city. PARTICIPANTS Fourth-grade students, 50% female and 84% Hispanic. INTERVENTIONS School-based experiential nutrition education program of 5 2-hour cooking and/or 5 1-hour fruit and vegetable tasting lessons throughout the school year. MAIN OUTCOME MEASURES Cooking self-efficacy, AT, and FVP were assessed with 3 tested, validated scales administered in a 37-item survey pre- and post-classroom intervention. ANALYSIS General linear modeling with gender and prior cooking experience were fixed factors. RESULTS Among 961 students, CWK positively affected FVP, especially in CWK-CT students and males (P = .045 and .033, respectively); vegetable preference drove this outcome. Independent of treatment, students without cooking experience (61% male) had more than twice the gains in cooking self-efficacy (P = .004) and an improved AT response (P = .003). CONCLUSIONS AND IMPLICATIONS Cooking With Kids increased FVP, especially with vegetables. Greatest gains in preferences and self-efficacy were seen in boys without prior cooking experience. For fourth graders, experiential nutrition education improved cognitive behaviors that may mediate healthful food choices.
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Affiliation(s)
- Leslie Cunningham-Sabo
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Barbara Lohse
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA
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