Impact of School-Based Interventions on Children’s Healthful Nutritional Outcomes (2009-2013): Implications for Future Research
DOI:
https://doi.org/10.6000/1929-4247.2015.04.03.7Keywords:
Children, vegetables, fruits, consumption, schoolsAbstract
Objective: The objective was to review the literature on school-based interventions during compulsory education (published in 2009-2013) that may be effective in increasing healthful nutritional outcomes in children. Specific strategies and their limitations will be identified.
Methods: A qualitative systematic analysis of seventeen school-based interventions applied to six-eleven year-old children, and published in peer-reviewed journals from 2009-2013 was carried out.
Results: These studies taken as a whole used a variety of fourteen strategies, such as provision of nutritional and gardening education; repeated exposure to vegetables (V); peer and adult modelling; chefs going into schools to teach healthy nutritional issues. These studies showed four types of limitations: limitations derived from the experimental designs and experimental procedures used and limitations affecting participant samples and data collection. Fifteen recommendations for overcoming the targeted research limitations were identified, such as applying the intervention during longer time intervals; examining the effectiveness of these interventions in different ethnicities and socioeconomic groups; including larger participant samples; using randomized designs. Finally, six new working hypotheses to guide future studies are proposed here. For example, a small number of V offered might lead to insufficient opportunities to learn to like the flavour of V; schools’ previous experience with these interventions might distort children’s post-intervention data related to their nutritional outcomes; providing children with nutritional and gardening education might increase their fruit (F) selection, consumption and preferences and application of evaluative conditioning under more appropriate experimental conditions might increase child V consumption.
Conclusion: seventeen school-based interventions were included. These studies taken as a whole used a variety of strategies (fourteen), and showed four types of limitations. Fifteen recommendations for overcoming the targeted research limitations as well as six new hypotheses are proposed here. Future research in this field should focus on overcoming its research limitations, such as the ones highlighted here, and building new working hypotheses, such as those proposed here.
References
World Health Organization (WHO) [Internet]. [Updated 2009 July 17; cited 2009 Jul 17]. Available from http://www.who.int/dietphysicalactivity/fruit/en/index.html.
Aranceta J, Pérez-Rodrigo C, Serra-Majem L, Bellido D, de la Torre, ML, Formiguera X, Moreno B. Prevention of overweight and obesity: a Spanish approach. Public Health Nutr 2007; 10(10A): 1187-93. http://dx.doi.org/10.1017/S1368980007000699
Van Duyn MAS, Pivonka E. Overview of the health benefits of fruit and vegetable consumption for the dietetics professional: selected literature. J Am Diet Assoc 2000; 100: 1511-1521. http://dx.doi.org/10.1016/S0002-8223(00)00420-X
Maynard M, Gunnell D, Emmett P, Frankel S, Davey S. Fruit, vegetables, and antioxidants in childhood and risk of adult cancer: the Boyd Orr cohort. Journal Epidemiol Commun 2003; 57(3): 218-25. http://dx.doi.org/10.1136/jech.57.3.218
Mikkilä V, Räsänen L, Raitakari OT, Pietinen P, Viikari J. Longitudinal changes in diet from childhood into adulthood with respect to risk of cardiovascular diseases: the cardiovascular risk in young finns study. Eur J Clin Nutr 2004; 58(7): 1038-45. http://dx.doi.org/10.1038/sj.ejcn.1601929
Lorson BA, Melgar-Quinonez HR, Taylor Ch A. Correlates of fruit and vegetable intakes in US children. J Am Diet Assoc 2009; 109(3): 474-8. http://dx.doi.org/10.1016/j.jada.2008.11.022
Yngve A, Wolf A, Poortvliet E, et al. Fruit and vegetable intake in a sample of 11-year-old children in 9 European countries: the pro children cross-sectional survey. Ann Nutr Metab 2005; 49(4): 236-45. http://dx.doi.org/10.1159/000087247
Baxter SD, Thompson WO, Davis HC. Fourth-grade children’s observed consumption of, and preferences for, school lunch foods. Nutr Res 2000; 20(3): 439-43. http://dx.doi.org/10.1016/S0271-5317(00)00136-6
Jaramillo SJ, Yang SJ, Hughes SO, Fisher JO, Morales M, Nicklas TA. Interactive computerized fruit and vegetable preference measure for African-American and Hispanic preschoolers. J Nutr Educ Behav 2006; 38(6): 352-9. http://dx.doi.org/10.1016/j.jneb.2006.06.003
Burguess-Champoux T, Marquart L, Vickers Z, Reicks M. Perceptions of children, parents, and teachers regarding whole-grain foods, and implications for a school-based intervention. J Nutr Educ Behav 2006; 38(4): 230-7. http://dx.doi.org/10.1016/j.jneb.2006.04.147
Nicklaus S, Boggoi V, Chabanet C, Issanchou S. A prospective study of food preferences in childhood. Food Qual Prefer 2004; 15(7-8): 805-18. http://dx.doi.org/10.1016/j.foodqual.2004.02.010
Unusan N. University students’ food preference and practice now and during childhood. Food Qual Prefer 2006; 17(5): 362-8. http://dx.doi.org/10.1016/j.foodqual.2005.04.008
Kimura A, Wada Y, et al. Eating habits in childhood relate to preference for traditional diets among young Japanese. Food Qual Prefer 2010; 21(7): 843-8. http://dx.doi.org/10.1016/j.foodqual.2010.05.002
Birch LL. Development of food preferences. Annu Rev Nutr 1999; 19: 41-62. http://dx.doi.org/10.1146/annurev.nutr.19.1.41
Gibson EL, Wardle J, Watts CJ. Fruit and vegetable consumption, nutritional knowledge and beliefs in mothers and children. Appetite 1998; 31(2): 205-228. http://dx.doi.org/10.1006/appe.1998.0180
Mennella JA, Beauchamp GK. Flavor experiences during formula feeding are related to preferences during childhood. Early Hum Dev 2002; 68(2): 71-82. http://dx.doi.org/10.1016/S0378-3782(02)00008-7
Mennella JA, Kennedy JM, Beauchamp GK. Vegetable acceptance by infants: effects of formula flavors. Early Hum Dev 2006; 82(7): 463-8. http://dx.doi.org/10.1016/j.earlhumdev.2005.12.001
Skinner JD, Carruth BR, Wendy B, Ziegler PJ. Children’s food preferences: a longitudinal analysis. J Am Diet Assoc 2002; 102(11): 1638-1647. http://dx.doi.org/10.1016/S0002-8223(02)90349-4
Spanish Department of Education [Internet]. Madrid: Spanish Department of Education, Science and Sports [updated 2014 February 7; cited 2014 February 7]. Available from: http://www.mecd.gob.es/educacion-mecd/areas-educacion/ sistema-educativo/ensenanzas/educacion-primaria.html.
Spanish Department of Education [Internet]. Madrid: Spanish Department of Education, Science and Sports [updated 2014 February 7; cited 2014 February 7]. Available from: http://www.mecd.gob.es/educacion-mecd/areas-educacion/ sistema-educativo/ensenanzas/educacion-infantil.html.
Aranceta Bartrina J, Pérez Rodrigo C, Serra Majem L, Delgado Rubio A. Hábitos alimenarios de los alumnos usuarios de comedores españoles. Estudio “Dime cómo comes”. Aten Prim 2004; 33(3): 131-9. http://dx.doi.org/10.1016/S0212-6567(04)79373-7
Macairt J, Perros HG. A standardized frozen meals service for Irish schools. Eur J Oper Res 1982; 9(3): 248-256. http://dx.doi.org/10.1016/0377-2217(82)90032-7
American Dietetic Association: Briggs M, Society for Nutrition Education: Safaii S, and American School Food Service Association: Beall DL. Position of the 218 American Dietetic Association, Society for Nutrition Education and American School Food Service Association-nutrition services: an essential component of comprehensive school health programs. J Am Diet Assoc 2003; 103(4): 505-14. http://dx.doi.org/10.1016/S0002-8223(03)00163-9
Engström R, Carlsson-Kanyama A. Food losses in food service institutions. Examples from Sweden. Food Policy 2004; 29(3): 203-13. http://dx.doi.org/10.1016/j.foodpol.2004.03.004
Sosa M, Hough G. Sensory acceptability of menus and sweet snacks among children and adults from low- and medium-income households in Argentina. Food Qual Pref 2006; 17(7-8): 590-7. http://dx.doi.org/10.1016/j.foodqual.2006.04.001
Moore SN, Murphy S, Tapper K, Moore L. From policy to plate: barriers to implementing healthy eating policies in primary schools in Wales. Health Policy 2010; 94(3): 239-45. http://dx.doi.org/10.1016/j.healthpol.2009.10.001
Briefel RR, Crepinsek MK, Canili Ch, Wilson A, Gleason PM. School food environments and practices affect dietary behaviors of US public school children. J Am Diet Assoc 2009; 109(Suppl 2): S91-107. http://dx.doi.org/10.1016/j.jada.2008.10.059
Lytle LA. Measuring the food environment. Am J Prev Med 2009; 36(Suppl 4): S134-44.
Krishnaswami J, Martinson M, Wakimoto P, Anglemeyer A. Community-engaged interventions on diet, activity, and weight outcomes in U.S. schools. A systematic review. Am J Prev Med 2012; 43(1): 81-91.
Fung CH, McIsaac JLD, Kuhle S, Kirk SFL, Veugelers PJ. The impact of a population-level school food and nutrition policy on dietary intake and body weights of Canadian children. Prev Med 2013; 57(6): 934-40. http://dx.doi.org/10.1016/j.ypmed.2013.07.016
Berengueras-Pont MM. El sistema educativo de Alemania. Rev Asoc Inspec Edu Esp [Internet]. 2014 May [cited 2014 May 10]. Available from: http://www.adide.org/revista/index. php?option=com_content&task=view&id=266&Itemid=71.
USA Embassy-Buenos Aires. Estructura de la educación en EE.UU [Internet]. 2014 January [cited 2014 January 10]. Available from: http://spanish.argentina.usembassy.gov/ media/pdfs/estructuraeducativa.pdf.
Aghaei A, Afsar F, Nouri A. A comparison of the psychological characteristics of adolescence and drawing its profile according to parents and adolescents in Isfahan City (Iran). Procedia Soc Behav Sci 2012; 46: 2193-7. http://dx.doi.org/10.1016/j.sbspro.2012.05.453
Padilla ML, Pfefferbaum A, Sullivan EV, Baker FC, Colrain IM. Dissociation of preparatory attention and response monitoring maturation during adolescence. Clin Neurophisiol 2013; 125(5): 962-70. http://dx.doi.org/10.1016/j.clinph.2013.10.012
Roseman MG, Riddell MC, Haynes JN. A content analysis of kindergarten-12th grade school-based nutrition interventions: taking advantage of past learning. J Educ Behav 2011; 43(1): 2-18. http://dx.doi.org/10.1016/j.jneb.2010.07.009
Tuuri, G, Zanovec, M, Silverman, L, Geaghan J, Solmon M, Holston D, Guarino A, Roy H, Murphy E. "Smart Bodies" school wellness program increased children's knowledge of healthy nutrition practices and self-efficacy to consume fruit and vegetables. Appetite 2009; 52(2): 445-51. http://dx.doi.org/10.1016/j.appet.2008.12.007
Swanson, M, Branscum A, Nakayima. Promoting consumption of fruit in elementary school cafeterias. The effects os slicing apples and oranges. Appetite 2009; 53(3): 264-7. http://dx.doi.org/10.1016/j.appet.2009.07.015
Parmer SM, Salisbury-Glennon J, Shannon D, Struempler B. School gardens: an experimental learning approach for a nutrition education program to increase fruit and vegetable knowledge, preference and consumption among second-grade students. J Nutr Educ Behav 2009; 41(3): 212-7. http://dx.doi.org/10.1016/j.jneb.2008.06.002
Lakkakula A, Geaghan J, Zanovec M, Pierce S, Tuuri G. Repeated taste exposure increases liking for vegetables by low-income elementary school children. Appetite 2010; 55(2): 226-31. http://dx.doi.org/10.1016/j.appet.2010.06.003
Wang MC, Rauzon S, Studer N, Martin AC, Craig L, Merlo C, Fung K, Kursunoglu D, Shannguan M, Crawford P. Exposure to a comprehensive school intervention increases vegetable consumption. J Adolescent Health 2010; 47(1): 74-82. http://dx.doi.org/10.1016/j.jadohealth.2009.12.014
Jones S, Spence M, Hardin S, Clemente N, Schoch A. Youth can! results of a pilot trial to improve the school food environment. J Nutr Educ Behav 2011; 43(4): 284-7. http://dx.doi.org/10.1016/j.jneb.2010.10.005
Lakkakula A, Geaghan JP, Wong WP, Zanovec M, Pierce SH, Tuuri G. A cafeteria-based tasting program increased liking of fruits and vegetables by lower, middle and upper elementary school-age children. Appetite 2011; 57(1): 299-302. http://dx.doi.org/10.1016/j.appet.2011.04.010
Hoffman JA, Thompson DR, Franko DL, Power TJ, Leff SS, Stallings VA. Decaying behavioral effects in a randomized, multi-year fruit and vegetables intake intervention. Prev Med 2011; 52(5): 370-375. http://dx.doi.org/10.1016/j.ypmed.2011.02.013
Olsen A, Ritz Ch, Kraaij LW, Möller P. Children's liking and intake of vegetables: a school-based intervention study. Food Qual Prefer 2012; 23(2): 90-8. http://dx.doi.org/10.1016/j.foodqual.2011.10.004
Prelip M, Kinsler J, Le Thai Ch, Toller Erausquin J, Slusser W. Evaluation of a school-based multicomponent nutrition education program to improve young children's fruit and vegetable consumption. J Nutr Educ Behav 2012; 44(4): 310-8. http://dx.doi.org/10.1016/j.jneb.2011.10.005
Schindler JM, Corbett D, Forestell CA. Assessing the effect of food exposure on children's identification and acceptance of fruit and vegetables. Eat Behav 2013; 14(1): 53-6. http://dx.doi.org/10.1016/j.eatbeh.2012.10.013
Cohen JFW, Kraak, VI, Silvina F. The change study: a healthy-lifestyles intervention to improve rural children's diet quality. J Acad Nutr Diet 2013; 114(1): 48-53. http://dx.doi.org/10.1016/j.jand.2013.08.014
Caraher M, Seeley A, Wu M, Lloyd S. When chefs adopt a school? An evaluation of a cooking intervention in English primary schools. Appetite 2013; 62: 50-9. http://dx.doi.org/10.1016/j.appet.2012.11.007
Rohlfs Domínguez P, Gámiz F, Gil M, Moreno H, Márquez Zamora R, Gallo M, De Brugada I. Providing choice increases children’s vegetable intake. Food Qual Prefer 2013; 30(2): 108-13. http://dx.doi.org/10.1016/j.foodqual.2013.05.006
Perikkou A, Gavrieli A, Kougioufa MM, Tzirkali M, Yannakoulia M. A novel approach for increasing fruit consumption in children. J Acad Nutr Diet 2013; 113(9): 1188-93. http://dx.doi.org/10.1016/j.jand.2013.05.024
Leines DA, Gold A, Van Offelen S. Go wild with fruits and veggies! curriculum encourages children to eat more fruits and vegetables. J Nutr Educ Behav 2013; 46(1): 82-84. http://dx.doi.org/10.1016/j.jneb.2013.03.018
Wengreen HJ, Madden GJ, Aguilar SS, Smits RR, Jones BA. Incentivizing children's fruit and vegetable consumption: Results of a US pilot-study of the Food Dudes program. J Nutr Educ Behav 2013; 45(1): 54-9. http://dx.doi.org/10.1016/j.jneb.2012.06.001
Gast A, Gawronski B, De Houwer J. Evaluative conditioning: recent developments and future directions. Learn Motiv 2012; 43(3): 79-88. http://dx.doi.org/10.1016/j.lmot.2012.06.004
Downloads
Published
How to Cite
Issue
Section
License
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .