Garden-enhanced nutrition curriculum improves fourth-grade school children's knowledge of nutrition and preferences for some vegetables

Students' consumption of high and low nutrition foods and reduced plate waste by schools' wellness-related policies and garden program participation

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.

A Pilot Study Exploring Practices that Support the Longevity of Community Gardens Supported by Religious Organizations

Current food production methods in the United States (US) contribute to environmental degradation as well as food insecurity. Food production by means of community gardens has the potential to reduce the deleterious effects of current production methods. However, many community gardens face challenges that hinder their longevity, thereby reducing the likelihood of the support they might provide for environmentally sustainable food production and decreased food insecurity for community members. Researchers conducted a literature review regarding best practices for community gardens, and used ethnographic research methods to inform a culturo-behavioral systems analysis using the Total Performance System and matrix (systems interdependency) analysis to better understand the cultural practices of two established community gardens in the southwest region of the US. The results of the analyses are presented in terms of recommendations to support each community garden's sustainability. Recommendations regarding future research include environmental manipulations to identify functional relations and potential outcome measures for improving the longevity of community gardens.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42822-023-00124-7.

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

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.

School Garden Prevalence Before and After the Implementation of the Healthy Hunger-Free Kids Act

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.

Trends in the Number of Behavioural Theory-Based Healthy Eating Interventions Inclusive of Dietitians/Nutritionists in 2000-2020

Nutrition interventions developed using behaviour theory may be more effective than those without theoretical underpinnings. This study aimed to document the number of theory-based healthy eating interventions, the involvement of dietitians/nutritionists and the behaviour theories employed from 2000 to 2020. We conducted a review of publications related to healthy eating interventions that used behaviour change theories. Interventional studies published in English between 2000 and 2020 were retrieved from searching Medline, Cinahl, Embase, Psycinfo and Cochrane Central. Citation, country of origin, presence or absence of dietitian/nutritionist authors, participants, dietary behaviours, outcomes, theories and any behaviour change techniques (BCTs) stated were extracted. The publication trends on a yearly basis were recorded. A total of 266 articles were included. The number of theory-based interventions increased over the two decades. The number of studies conducted by dietitians/nutritionists increased, but since 2012, increases have been driven by other researchers. Social cognitive theory was the most used behaviour theory. Dietitians/nutritionists contributed to growth in publication of theory-based healthy eating interventions, but the proportion of researchers from other professions engaged in this field increased markedly. The reasons for this growth in publications from other professions is unknown but conjectured to result from greater prominence of dietary behaviours within the context of an obesity epidemic.

To plant a garden is to believe in tomorrow: A case study of a Chicago community-based organization focused on health education through school gardens

Nutrition education through school-based garden programs is a promising intervention to promote youth health and development. Gardeneers is a Chicago-based nonprofit, leading garden programming across area schools. To better understanding their impact on youth health, Gardeneers aimed to define their model more clearly. Using a collective case study design, this mixed-method, formative program evaluation focused on describing program implementation variation across schools. General program design included nutrition education through hands-on garden-based learning. Stakeholder engagement was a strength for some schools and a challenge for others. Sustainability was an ongoing challenge for all schools, particularly funding. Priority student outcomes also varied between schools. Adaptability is core to Gardeneers' approach-the challenge lies in replicable program design and manageable growth, but the strength lies in the ability to meet specific school and student needs. Using these findings, Gardeneers refined their program model and identified program improvements opportunities.

Barriers and facilitators to the implementation of nutrition standards for school food: a mixed-methods systematic review protocol

Background: The importance of nutrition during childhood and the high prevalence of child and adolescent obesity has resulted in several countries implementing nutritional standards for school food as a way of providing healthy school food environments. Yet, there has been less focus on the barriers and facilitators influencing the process of implementing school food standards. This mixed-methods systematic review aims to address this evidence gap by synthesising the empirical evidence on the factors that may influence the implementation of school food standards. Methods: This mixed-methods systematic review will use qualitative, quantitative and mixed-methods evidence from peer-reviewed publications retrieved from the following databases; PubMed, CINAHL, Scopus, EMBASE, Medline, PsycINFO and Web of Science. Grey literature will be accessed through Google Scholar, Open Access Theses and Dissertations, OpenGrey, RIAN, EThOS, ProQuest, WorldCat, Networked Digital Library of Theses and Dissertations, and public health organisation websites will also be accessed. Screening reference lists and citation chaining of all included studies will also be undertaken. No restrictions on publication date or language will be applied, however, only primary research studies relevant to supply-side stakeholders will be eligible for inclusion. Study quality will be assessed using the Mixed Methods Appraisal Tool. Study titles and abstracts will be screened to decide whether the full-text manuscript should be retrieved. For screening reliability, a second review author will assess a random sample of 20%. Kappa statistics will be used to assess inter-rater reliability, with values of 0.75 and higher representing high agreement. Two authors will independently extract data and factors reported to influence implementation. This will be synthesized using the Theoretical Domains Framework. Discussion: A comprehensive understanding of these factors can provide guidance to relevant stakeholders to enhance the adoption, implementation and sustainability of nutrition standards for school meals. Systematic review registration: PROSPERO CRD42019117904.

Barriers and facilitators to the implementation of nutrition standards for school food: a mixed-methods systematic review protocol

Background: The importance of nutrition during childhood and the high prevalence of child and adolescent obesity has resulted in several countries implementing nutritional standards for school food as a way of providing healthy school food environments. Yet, there has been less focus on the barriers and facilitators influencing the process of implementing school food standards. This mixed-methods systematic review aims to address this evidence gap by synthesising the empirical evidence on the factors that may influence the implementation of school food standards.

Methods: This mixed-methods systematic review will use qualitative, quantitative and mixed-methods evidence from peer-reviewed publications retrieved from the following databases; PubMed, CINAHL, Scopus, EMBASE, Medline, PsycINFO and Web of Science. Grey literature will be accessed through Google Scholar, Open Access Theses and Dissertations, OpenGrey, RIAN, EThOS, ProQuest, WorldCat, Networked Digital Library of Theses and Dissertations, and public health organisation websites will also be accessed. Screening reference lists and citation chaining of all included studies will also be undertaken. No restrictions on publication date or language will be applied, however, only primary research studies relevant to supply-side stakeholders will be eligible for inclusion. Study quality will be assessed using the Mixed Methods Appraisal Tool. Study titles and abstracts will be screened to decide whether the full-text manuscript should be retrieved. For screening reliability, a second review author will assess a random sample of 20%. Kappa statistics will be used to assess inter-rater reliability, with values of 0.75 and higher representing high agreement. Two authors will independently extract data and factors reported to influence implementation. This will be synthesized using the Theoretical Domains Framework.

Discussion: A comprehensive understanding of these factors can provide guidance to relevant stakeholders to enhance the adoption, implementation and sustainability of nutrition standards for school meals.

Systematic review registration: PROSPERO CRD42019117904

Barriers and facilitators to the implementation of nutrition standards for school food: a mixed methods systematic review protocol

Background: The importance of nutrition during childhood and the high prevalence of child and adolescence obesity has resulted in several countries implementing nutritional standards for school food as a way of providing healthy school food environments. Yet there has been less focus on the barriers and facilitators influencing the process of implementing school food standards. This mixed methods systematic review aims to address this evidence gap by synthesising the empirical evidence on the factors that may influence implementation of school food standards. Methods: This mixed methods systematic review will use qualitative, quantitative and mixed methods evidence from peer reviewed publications retrieved from the following databases; PubMed, CINAHL, Scopus, EMBASE, Medline, PsycINFO and Web of Science. Grey literature will be accessed through Google Scholar, Open Access Theses and Dissertations, OpenGrey, RIAN, EThOS, ProQuest, WorldCat, Networked Digital Library of Theses and Dissertations, and public health organisation websites will also be accessed. Screening reference lists and citation chaining of all included studies will also be undertaken. No restrictions on publication date or language will be applied, however, only primary research studies relevant to supply-side stakeholders will be eligible for inclusion. Study quality will be assessed using the Mixed Methods Appraisal Tool. Study titles and abstracts will be screened to decide whether the full text manuscript should be retrieved. For screening reliability, a second review author will assess a random sample of 20%. Kappa statistics will be used to assess inter-rater reliability, with values of 0.75 and higher representing high agreement. Two authors will independently extract data and factors reported to influence implementation. This will be synthesized using the Theoretical Domains Framework. Discussion: A comprehensive understanding of these factors can provide guidance to relevant stakeholders to enhance the adaption, implementation and sustainability of nutrition standards for school meals. Systematic review registration: PROSPERO CRD42019117904

"Sow, Grow, Know, and Show": The Impact of School Gardens on Student Self-Perception in the Mississippi Delta

This research evaluates the impact of participation in school garden programs on fifth grade student garden knowledge, self-perception, and standardized test scores in the Mississippi Delta. We collected pre and posttest participant data for two years, compared garden participants' standardized test scores with non-participants, and conducted participant observation and interviews in three school gardens for eight months during the 2017-2018 school year. While no effect on standardized test scores could be determined, students increased garden knowledge and reported feeling positive about their future, teamwork, and leadership ability. These results were supported by observations of student joy, confidence, leadership, and teamwork.

Mental Health and the COVID-19 Crisis: The Hopes and Concerns for Children as Schools Re-open

The COVID-19 crisis has affected everyone, especially elementary school-aged children who might be too young to fully understand the sudden changes in familiar social norms as well as the unprecedented pandemic-induced educational context. This article is based on a case study that explores the perspective of the experiences of ten parents of elementary school children in French Immersion programs from different school boards during the March–June 2020 schools’ closure in Alberta. The findings show that parents had a special concern for the mental health of their children during the transition into lockdown and the ramifications of such experiences in the future as students return to school at the start of the academic year under a different climate. This includes adapting to new social norms and a certain apprehension of how school hygiene and safety measures in place will prevent a new coronavirus outbreak in schools.

Nutrition Education Intervention Increases Fish Consumption among School Children in Indonesia: Results from Behavioral Based Randomized Control Trial

This study aimed to analyze the effectiveness of behavioral-based nutrition education to increase fish consumption among school children using a raised bed pool. This was a randomized control trial study with a 3-months nutrition education intervention using a raised bed pool, as a medium to improve their internalization to increase fish consumption behavior. A paired t-test was used to calculate the difference in the increase of fish consumption, knowledge, attitude, perceived behavioral control, subjective norm, and intention. This study took place in a majority of low to medium urban households in Surabaya in Sidotopo Wetan I and Sidotopo Wetan II elementary school. Elementary school children at 4th and 5th grade and mother of elementary school children with 104 children were eligible and willing to participate. After the completion of interventions, significant improvement in delta-mean and effectiveness observed in attitude, subjective norm, perceived behavioral control, intention, knowledge, and fish consumption (p < 0.001). The 3 months of nutrition education intervention based on the theory of planned behavior significantly increase fish consumption among elementary school children. The increased consumption was believed to be related to the increase in children’s knowledge and attitude towards consuming fish.

Evaluation of the Impact of School Garden Exposure on Youth Outlook and Behaviors toward Vegetables in Southern Arizona

BACKGROUND

Our objective was to evaluate the effect of garden-based learning on outlook and behaviors toward vegetables among primarily Latinx students. An educational strategy, garden-based learning is a teaching tool that complements other disciplines.

METHODS

Third- and fourth-grade students at 4 elementary schools with different garden programs completed a bingo survey and participated in class discussions to measure outlook and behaviors toward vegetables.

RESULTS

Students in schools with more garden exposure were more likely to answer "Yes" to survey questions reflecting a positive attitude and behaviors toward vegetables. In class discussions, students most often mentioned vegetables grown in the school garden as their favorite vegetables.

CONCLUSION

For third- and fourth-grade students, the length of exposure to a school garden appears to have a positive impact on both perceptions of and desire to consume vegetables. Other studies have shown that positive outlook and behaviors toward vegetables can change vegetable consumption habits in children. Integrating garden-based learning into the school curriculum may positively influence eating behaviors over the long-term future.

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

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.

The Association Between Child Cooking Involvement in Food Preparation and Fruit and Vegetable Intake in a Hispanic Youth Population

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.

Initial Findings of a Multicomponent School Health Intervention in Rural Appalachia: The Greenbrier CHOICES Project

Background. Schools are an important setting for health promotion because they afford children and adolescents numerous opportunities to accumulate the recommended physical activity (PA) minutes and make other health-related decisions, including healthy eating. Unfortunately, there is little evidence of coordinated school-based health interventions in rural Appalachia. The Greenbrier Children's Health Opportunities Involving Coordinated Efforts in Schools Project was a federally funded, 3-year, multicomponent school-based health intervention focused on PA, healthy eating, and weight management. Aims. The purpose of this study was to evaluate the impact of Greenbrier Children's Health Opportunities Involving Coordinated Efforts in Schools on adolescent PA, dietary behaviors, and weight status. Method. Measures of PA, dietary behaviors, and body mass index were collected across 14 data points throughout the intervention (including a baseline in Year 1). Results. Participants included 4,633 randomly selected middle school students (M = 2,289, F = 2,344) across the intervention. Baseline to Year 3 findings revealed a 12.8 percentage point increase in students achieving 60 minutes of daily PA. There were no significant differences in either dietary behavior or body mass index. Discussion. Findings provide evidence of the positive impact comprehensive school-based health interventions can have on middle school student health-related behaviors. Conclusion. Schools remain an ideal setting for health promotion. Initiatives targeting more than one level of influence on health-related behaviors are more likely to succeed.

Adolescent Obesity: Diet Quality, Psychosocial Health, and Cardiometabolic Risk Factors

Obesity is a multifaceted chronic condition with several contributing causes, including biological risk factors, socioeconomic status, health literacy, and numerous environmental influences. Of particular concern are the increasing rates of obesity in children and adolescents, as rates of obesity in youth in the United States have tripled within the last three decades. Youth from historically disadvantaged backgrounds tend to have higher rates of obesity compared to other groups. Adolescents often do not meet intake recommendations for certain food groups and nutrients, which may contribute to a heightened risk of obesity. With obesity disproportionately affecting adolescents (ages 12–19 years), negative effects of excess adiposity may be particularly salient during this critical period of development. The presentation of chronic cardiometabolic disease symptoms typically observed in adults, such as hypertension, hyperglycemia, dyslipidemia, and inflammation, are becoming increasingly common in adolescents with obesity. Additionally, there is dynamic interplay between obesity and psychosocial health, as adolescents with obesity may have increased levels of stress, depressive symptoms, and reduced resilience. To reduce and prevent adolescent obesity, the implementation of theory-driven multicomponent school- and community-based interventions have been suggested. These interventions promote knowledge and self-efficacy for healthful practices that have the potential to progress to sustained behavior change.

Effects of a School Based Intervention on Children's Physical Activity and Healthy Eating: A Mixed-Methods Study

Combined diet and physical activity school-based interventions (rather than only diet or physical activity interventions) are more likely to help prevent children from becoming overweight in the long term. However, such interventions are less prevalent, and therefore, this pilot study aimed to assess the feasibility of a gardening intervention coupled with awareness about plant-based meals among 9-10 year old children in a London primary school. We recruited 60 children from two Year 5 classes, one class participated as an intervention group, and results were compared against another class who acted as the control group. Children's physical activity (PA) was measured using GENEActiv wrist-worn accelerometers. Their fruit and vegetable intake and attitudes to and preferences in eating fruits and vegetables were measured using a self-report questionnaire. Furthermore, three focus groups were held with children in the intervention group to understand the reasons behind any change as a result of the intervention. Results are inconclusive; however, they indicate some impact on reduction of sedentary behaviour, increase of moderate to vigorous PA, knowledge of nutrition and some level of acceptance in trying new vegetables. School-based interventions involving gardening show some promise to increase children's PA and improve their attitudes to eating fruits and vegetables.

Farm-to-school education grants reach low-income children and encourage them to learn about fruits and vegetables

Oregon’s Farm to School Education Grant Program reached students in low-income districts, enabled districts to conduct farm to school educational activities, and allowed children to learn about local produce.

Healthy eating promoting in a Brazilian sports-oriented school: a pilot study

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.

Design and participant characteristics of TX sprouts: A school-based cluster randomized gardening, nutrition, and cooking intervention

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.

The Impact of Canadian School Food Programs on Children’s Nutrition and Health: A Systematic Review

The quality of children’s diets has declined over the past few decades, giving rise to a variety of health-related consequences. In response to this trend, school food programs have become an increasingly effective method to support nutrition and lifelong healthy eating habits. This systematic review synthesizes current academic literature pertaining to school nutrition programs in Canada to identify existing interventions and their impacts on children’s nutritional knowledge, dietary behaviour, and food intake. The review was conducted through a search of the following databases: ERIC, Education Source, CINAHL, PubMed, SagePub, SCOPUS, EMBASE, and CBCA. Information extracted from the articles included the program objectives, intervention design and components, research evaluation, and primary outcomes. A total of 11 articles evaluating Canadian school nutrition programs were identified. The programs incorporated a variety of intervention components including policy, education, family and community involvement, and/or food provision. These multi-component interventions were positively associated with children’s development of nutrition knowledge, dietary behaviour changes, and intake of healthy foods; however, barriers associated with intervention duration, intensity, and availability of resources may have influenced the extent to which these programs impacted children’s diets and overall health.

Cooking and Gardening Behaviors and Improvements in Dietary Intake in Hispanic/Latino Youth

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.

Sprouts Growing Healthy Habits: Curriculum Development and Pilot Study

High rates of childhood obesity and the impact this has on children's health make it important to establish a healthy lifestyle during the early school years. This pilot study explored the impact of a newly developed healthy habits curriculum. The Sprouts: Growing Healthy Habits curriculum presents topics such as energy balance, healthy sleep habits, and food groups through short activities and interactive book-reading. A nonrandomized controlled experimental study design was used to assess impact. Fifty-seven children between 5 and 6 years of age participated from two elementary schools (36 from the intervention school, 21 from the control school). Knowledge was assessed pre- and post-intervention in five content areas (farm to table, bedtime routines, portion size, energy expenditure, sugar content of beverages) using card sorting, ranking, and sequence activities. Within- and between-school comparisons were conducted using differences between groups and mixed modeling approaches. Within the intervention school, significant increases in knowledge were observed for farm to table, sugar content of beverages, and bedtime routines. For the control school, there was a significant increase in knowledge of portion sizes. Considering between-schools, only change in knowledge of bedtime routines remained significant, with greater increases in the intervention school. Results seem promising given the short dosage of curriculum. Increases in knowledge of healthy habits in early childhood may help in promoting healthy behaviors and combatting the effects of obesity.

Effect and process evaluation of a real-world school garden program on vegetable consumption and its determinants in primary schoolchildren

OBJECTIVES

This study aimed to investigate the effectiveness of a school garden program on children's vegetable consumption and determinants and to gain insight into the process of the program.

METHODS

The "Taste Garden" is a real-world nine-week school garden program developed and implemented by a local organization. A total of 350 children (149 intervention group, 201 control group) filled out questionnaires on vegetable consumption, determinants and process of the program. Additionally, teachers filled out a process evaluation questionnaire. For effect evaluation, interaction effects (time x group) were considered, using multilevel repeated measures analyses in MLwiN 3.02. Interaction effects were repeated, taking into account quality of implementation (time x implementation group). Process evaluation was descriptively assessed with SPSS 24.0.

RESULTS

Overall, beside some practical concerns of teachers, the program was well perceived by teachers and children. However, an intervention effect of "The Taste Garden" was only found for knowledge (p = 0.02), with a very small effect size (0.55%). When taking into account implementation quality, only small effects were found for awareness (p between 0.005 and 0.007 and an effect size of 0.63%) and knowledge (p between 0.04 and 0.09 and an effect size of 0.65%).

CCONCLUSIONS

Evaluation of the real-world "Taste Garden" program, which was positively perceived by teachers, showed no effects on vegetable consumption and small effects on its determinants. Adaptations of the current format and longer follow-up periods are therefore recommended.

The effects of a nutrition education curriculum on improving young children’s fruit and vegetable preferences and nutrition and health knowledge

Objective

The main objective of the present study was to develop and evaluate a nutrition education curriculum to enhance young children’s dietary behaviours and nutrition and health knowledge.

Design

A randomized controlled design was utilized. The intervention was designed to improve children’s nutrition and health knowledge and preferences for fruits and vegetables through classroom lessons and activities, including direct instruction and tastings (implemented twice per week for 6 weeks).

Setting

The study took place in elementary schools in a Midwestern US state.

Subjects

One hundred and thirty-one 2nd grade children from ten classrooms (n 82 intervention, n 49 control) participated.

Results

Multiple regression analyses that adjusted se for clustering by classroom were used to test hypotheses. Children in the intervention condition demonstrated significantly higher scores on the nutrition and health survey (β=0·47, P=0·001) and showed greater preferences for fruits and vegetables at post-test than the control group (β=0·19, P=0·003).

Conclusions

Findings suggest that a short, 6-week intervention that aligns with educational standards has the ability to significantly enhance children’s outcomes and thus may be a more feasible option for teachers to incorporate into their classrooms than what is currently available.

School gardening increases knowledge of primary school children on edible plants and preference for vegetables

At least 10% of children worldwide are diagnosed with overweight. Part of this problem is attributed to low vegetable intake, for which preference at a younger age is an indicator. Few studies examined long-term effects of school garden interventions on the knowledge about and preference for vegetables. Therefore, in this study, an intervention period of 7 months (17 lessons) was organized for primary school students (n = 150) of age 10-12 years in the Municipality of Nijmegen (the Netherlands). Surveys were conducted before and after the intervention period to test the ability of students to identify vegetables, to measure their self-reported preference for vegetables, and to analyze students' attitudes toward statements about gardening, cooking, and outdoor activity. The long-term effects were measured by repeating the survey 1 year after the intervention (n = 52). Results were compared with a control group of students (n = 65) with similar background and tested for significance with α = 0.05. School gardening significantly increases the knowledge of primary schoolchildren on 10 vegetables as well as their ability to self-report preference for the vegetables. The short-term (n = 106) and long-term (n = 52) preference for vegetables increased (p < 0.05) in comparison with the control group. The latter did not show a significant learning effect (p > 0.05). This implies that the exposure to vegetables generated by school gardening programs may increase willingness to taste and daily intake of vegetables on the long term. Students' attitudes toward gardening, cooking, and outdoor activity were unaffected by the intervention.

Gardening Experience Is Associated with Increased Fruit and Vegetable Intake among First-Year College Students: A Cross-Sectional Examination

BACKGROUND

Gardening interventions have been shown to increase fruit and vegetable (F/V) intake among school-aged children. It is unknown whether these effects persist into later adolescence or adulthood, and little is known about whether gardening in later adolescence is related to F/V intake.

OBJECTIVE

To identify the relationship between both childhood and recent (within the past 12 months) gardening experiences and current F/V intake among college students.

DESIGN/PARTICIPANTS

A cross-sectional evaluation of 1,121 college freshmen with suboptimal F/V consumption from eight US universities.

MAIN OUTCOME MEASURES

Participants completed the National Cancer Institute Fruit and Vegetable Screener and questions about gardening experiences. Respondents were grouped as having gardened or not gardened during childhood and recently.

STATISTICAL ANALYSES PERFORMED

A linear mixed model was used to evaluate the relationship between childhood and recent gardening and current F/V intake.

RESULTS

Of the student participants, 11% reported gardening only during childhood, 19% reported gardening only recently, 20% reported gardening both as a child and recently, and 49% of students reported never having gardened. Students who gardened both during childhood and recently had a significantly higher mean current intake of F/V compared with students who never gardened (2.5±0.6 vs 1.9±0.5 cup equivalents [CE], respectively; P<0.001). In addition, F/V intake increased with frequency of recent gardening engagement when comparing students who did not garden with those who gardened monthly or weekly (2.1±0.5 CE, 2.4±0.6 CE, and 2.8±0.7 CE, respectively; P<0.001).

CONCLUSIONS

This analysis suggests that the combination of childhood and recent gardening experience is associated with greater current F/V intake among first-year college students not currently meeting national F/V recommendations. In addition, a greater frequency of gardening experience may further enhance this effect.

Gardening and age-related weight gain: Results from a cross-sectional survey of Denver residents

This study examined whether gardening modifies the association between age and body mass index (BMI). We used data from the Neighborhood Environments and Health Survey, which was conducted in Denver (N = 469) between 2006 and 2007. We fit two general linear mixed models. The base model had BMI in kg/m2 as the outcome, and age, an indicator variable for non-gardening status and the age-by-non-gardening status interaction as predictors. The adjusted model included as covariates the potential confounders of education, ethnicity and self-reported health. We assessed self-selection bias and confounding. BMI was 27.18 kg/m2 for non-gardeners, 25.62 kg/m2 for home gardeners, and 24.17 kg/m2 for community gardeners. In the base model, a statistically significant association was observed between age and BMI for non-gardeners but not for the combined community and home gardening group (F = 9.27, ndf = 1, ddf = 441, p = 0.0025). In the adjusted model, the association between age and BMI in non-gardeners was not statistically significant (F = 1.72, ndf = 1, ddf = 431, p = 0.1908). Gardeners differed on social and demographic factors when compared to non-gardeners. The results from the base model are consistent with the hypothesis that gardening might offset age-related weight gain. However, the cross-sectional design does not permit differentiation of true causal effects from the possible effects of bias and confounding. As a follow-up study, to remove bias and confounding, we are conducting a randomized clinical trial of community gardening in Denver.

School Gardens: A Qualitative Study on Implementation Practices

School gardens have beneficial effects on children's dietary behaviors but information on its implementation is scarce. The current study aimed to gain insight in implementation practices of school gardens and in perceptions of key members and children towards a school garden. We conducted twelve interviews involving 14 key members and five focus groups with 38 children from fifth to sixth grade (10-13 years old) in four primary schools in Ghent (Flanders, Belgium). We analyzed the interviews and focus groups in NVivo, using thematic analysis. School gardens were mainly initiated to involve children in nature, not to improve vegetable consumption. Participants were positive about having a school garden, experienced facilitating factors (e.g., adaptability of the garden, having a person responsible for the garden), but also various barriers (e.g., difficulties with startup, maintenance during summer holidays and integration in the school curriculum) and suggested some solutions (e.g., involving external organizations and parents, expanding the garden) and motivating factors for children (e.g., colorful plants, use of gloves). In order to improve implementation and to contribute to children's health, future school gardening projects should take the recommendations of key members and children into account.

Fruit and Vegetable Preferences and Identification by Kindergarteners through 2nd-Graders With or Without the US Department of Agriculture Fresh Fruit and Vegetable Program

OBJECTIVE

The US Department of Agriculture Fresh Fruit and Vegetable Program (FFVP) allows schools to increase fruit and vegetable (FV) exposure by distributing FV as snacks. The objective of this study was to compare kindergarten through second (K-2nd)-graders who were exposed or not to FFVP for preferences and identification.

DESIGN, SETTING, PARTICIPANTS

The FV Preference Survey for K-2nd-graders contained 12 fruits and 12 vegetables, a 3-Likert scale (liked it, okay, don't like it), and an I don't know option. Data were collected from K-2nd-graders at 2 elementary schools near Chicago, IL (n = 435, FFVP school, n = 235 with 12 teachers; non-FFVP school, n = 200 with 10 teachers).

MAIN OUTCOME MEASURE(S)

Mean preference scores.

ANALYSIS

Chi-square, Mann-Whitney U, and multiple linear regression analyses compared school data (P < .05).

RESULTS

There were significant differences in mean preference scores, with higher fruit scores at the FFVP school (1.8 ± 0.6) than at the non-FFVP school (1.7 ± 0.6). In contrast, there was a higher vegetable score for the non-FFVP school (1.3 ± 0.9) than for the FFVP school (1.2 ± 0.9). The school variable had weak impact on fruit ranking (multivariate coefficient = 0.01; P < .05). For fruits and vegetables and combined, there were fewer I don't know responses in the FFVP (χ² = 149.080; P < .01).

CONCLUSIONS AND IMPLICATIONS

At the FFVP school, fewer I don't know responses suggested better FV identification. Non-FFVP students had higher vegetable preferences than did FFVP students. Tasting a variety of FV may help with identifying FV, but more research is needed to determine the impact on preferences.

Facilitating Fresh: State Laws Supporting School Gardens Are Associated With Use of Garden-Grown Produce in School Nutrition Services Programs

OBJECTIVE

To examine whether state laws are associated with the presence of school gardens and the use of garden-grown produce in school nutrition services programs.

DESIGN

Nationally representative data from the School Health Policies and Practices Study 2014 were combined with objectively coded state law data regarding school gardens.

MAIN OUTCOME MEASURES

Outcomes were: (1) the presence of a school garden at each school (n = 419 schools), and (2) the use of garden-grown items in the school nutrition services program.

ANALYSIS

Multivariate logistic regression was used to examine each outcome. Contextual covariates included school level, size, locale, US Census region, student race/ethnic composition, and percentage of students eligible for free and reduced-priced meals.

RESULTS

State law was not significantly associated with whether schools had a garden, but it was associated with whether schools used garden-grown items in nutrition services programs (odds ratio, 4.21; P < .05). Adjusted prevalence of using garden-grown items in nutrition services programs was 15.4% among schools in states with a supportive law, vs 4.4% among schools in states with no law.

CONCLUSIONS AND IMPLICATIONS

State laws that support school gardens may facilitate the use of garden-grown items in school nutrition service programs. Additional research is needed regarding the types of messaging that might be most effective for motivating school administrators to appreciate the value of school gardens. In addition, another area for further research pertains to scaling garden programs for broader reach.

A Multicomponent, School-Based Intervention, the Shaping Healthy Choices Program, Improves Nutrition-Related Outcomes

OBJECTIVE

To evaluate the effectiveness of the Shaping Healthy Choices Program (SHCP).

DESIGN

A clustered, randomized, controlled intervention lasting 1 school year.

SETTING

Schools in northern and central California.

PARTICIPANTS

Fourth-graders (aged 9-10 years) at 2 control schools (n = 179) and 2 intervention schools (n = 230).

INTERVENTION

Garden-enhanced education, family, and community partnerships; increased regionally procured produce in the lunchroom; and school-site wellness committees.

MAIN OUTCOME MEASURES

Changes in body mass index (BMI) percentiles/Z-scores; nutrition knowledge, science process skills, and vegetable identification and preferences; and reported fruit and vegetable intake.

ANALYSIS

Student t test, chi-square, ANOVA of change, and multilevel regression mixed model to evaluate change in outcomes with school as a random effect to account for cluster design effects. Statistical significance was set at P < .05.

RESULTS

There was a greater improvement in BMI percentile (-6.08; P < 0.01), BMI Z-score (-0.28; P < .001), and waist-to-height ratio (-0.02; P < .001) in the intervention compared with the control schools.

CONCLUSIONS AND IMPLICATIONS

The SHCP resulted in improvements in nutrition knowledge, vegetable identification, and a significant decrease in BMI percentiles. This supports the concept that the SHCP can be used to improve the health of upper elementary school students.

Changing children's eating behaviour - A review of experimental research

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.

Increasing Prevalence of US Elementary School Gardens, but Disparities Reduce Opportunities for Disadvantaged Students

BACKGROUND

We examined the prevalence of school garden programs at US public elementary schools. The study examined time trends, demographic and regional disparities, and associations with related programs such as farm-to-school.

METHODS

Annual surveys were gathered from nationally representative samples of elementary schools between 2006-2007 and 2013-2014. Annual samples ranged from 553 to 748 schools.

RESULTS

The prevalence of gardens increased steadily from 11.9% in 2006-2007 to 31.2% in 2013-2014 (p < .001). In multivariate logistic regressions the prevalence of garden programs varied significantly by school characteristics. Gardens were more prevalent in the west than in other regions. Gardens were less prevalent at schools serving higher proportions of lower-income students, and were more prevalent at urban schools than in suburbs, towns, or rural areas. Gardens were more common at schools with farm-to-school programs. Gardens also were associated with offering formal classroom-based nutrition education.

CONCLUSIONS

Garden programs in elementary schools have increased over time, but there is room for wider implementation, particularly at schools serving lower-income students. Given the role of childhood in establishing food preferences and dietary consumption habits, such programs are important and can reinforce the messages imparted through nutrition education.

Evaluating the Relationships Among Teacher Characteristics, Implementation Factors, and Student Outcomes of Children Participating in an Experiential School-Based Nutrition Program

The purpose of this study was to examine whether teacher characteristics and implementation factors influenced the effectiveness of a multicomponent nutrition education program to improve nutrition-related knowledge and behavior among fourth-grade children. Schools implemented the Shaping Healthy Choices Program (SHCP), a multicomponent nutrition intervention, during 2013-2014. Fourth-grade teachers ( n = 8) at two schools facilitated nutrition education using an experiential, garden-enhanced nutrition curriculum among students ( n = 173) in their classrooms. Teacher characteristics of teaching experience, self-efficacy in teaching nutrition, and knowledge about nutrition were collected at baseline. Implementation factors of fidelity and completion were measured using self-reports and qualitative observations. Student outcomes included body mass index percentile-for-age, nutrition knowledge, critical thinking skills, and identification of vegetables and were measured pre/post. Relationships were analyzed using multivariate mixed-model regression with classroom as a random effect. Pre/post changes were analyzed using t tests. Students improved body mass index percentile-for-age (−1.99 ± 7.95) and increased nutrition knowledge (2.28 ± 3.40), critical thinking skills (1.98 ± 3.28), and the ability to identify vegetables (0.87 ± 1.09). Teachers’ characteristics of teaching experience, experience teaching nutrition, attendance in a college nutrition course, self-efficacy, and nutrition knowledge were significantly related to fidelity and completeness of program implementation. This study demonstrated implementation of SHCP by teachers can positively influence student outcomes, though program implementation depends on teacher characteristics.

Perceptions and use of sources of health knowledge by young adolescents

BACKGROUND

Understanding how adolescents acquire health knowledge and where they currently seek answers to health-related questions may facilitate the development of interventions that will be both engaging and effective, and may help to improve health over the short- and long-term.

OBJECTIVE

The present study sought to investigate the perception and use of sources of health knowledge by young adolescents as stratified by gender.

METHODS

Thirty 50-min long focus groups were conducted with 143 participants. Focus group questions were built around the following three main categories: sources of knowledge, including preferred sources, sources accessed for general health, and sources accessed for personal/sensitive health; health information and behaviour change, including characteristics of health knowledge presentation that have influenced behaviour change; and learning preferences to promote behaviour change. Content analysis of focus group transcripts was performed.

RESULTS

The use of sources of health knowledge was similar between genders, with some differences noted between sources accessed for general as compared to personal health questions. As well, motivation appeared to be the primary influence of health behaviour change, with knowledge being reported as both as positive and neutral influence, most notably in the areas of diet and exercise. Lastly, adolescents reported several characteristics of health knowledge presentation that they felt would motivate positive behaviour change, including engaging and participatory activities.

CONCLUSION

These results should be considered in the development of interventions to improve health-related behaviour in adolescents, although future research to quantify the use of sources of health knowledge by this population is recommended.

Effectiveness of Taste Lessons with and without additional experiential learning activities on children's willingness to taste vegetables

This study assessed the effectiveness of the Dutch school programme Taste Lessons with and without additional experiential learning activities on children's willingness to taste unfamiliar vegetables. Thirty-three primary schools (877 children in grades 6-7 with a mean age of 10.3 years) participated in Taste Lessons Vegetable Menu (TLVM, lessons and extra activities), Taste Lessons (TL, lessons), or a control group. A baseline and follow-up measurement was used to assess for each child: number of four familiar and four unfamiliar vegetables tasted, quantity tasted, choice of vegetable of which to eat more, and number of vegetables willing to taste again later. Furthermore, children filled out a questionnaire on daily vegetable intake and food neophobia. Multilevel and Cox regression analyses were conducted to compare changes in the outcome measures between the three study groups. No significant intervention effects were found on willingness to taste unfamiliar vegetables. Neither were effects found on familiar vegetables, except for number of familiar vegetables tasted (p < 0.05). Furthermore, no significant intervention effects were found on daily vegetable consumption and food neophobia. These results indicate that more intensive school-based nutrition education activities are needed to increase children's willingness to taste unfamiliar vegetables and increase their vegetable intake.

A systematic review of the health and well-being impacts of school gardening: synthesis of quantitative and qualitative evidence

BACKGROUND

School gardening programmes are increasingly popular, with suggested benefits including healthier eating and increased physical activity. Our objectives were to understand the health and well-being impacts of school gardens and the factors that help or hinder their success.

METHODS

We conducted a systematic review of quantitative and qualitative evidence (PROSPERO CRD42014007181). We searched multiple databases and used a range of supplementary approaches. Studies about school gardens were included if they reported on physical or mental health or well-being. Quantitative studies had to include a comparison group. Studies were quality appraised using appropriate tools. Findings were narratively synthesised and the qualitative evidence used to produce a conceptual framework to illustrate how benefits might be accrued.

RESULTS

Evidence from 40 articles (21 quantitative studies; 16 qualitative studies; 3 mixed methods studies) was included. Generally the quantitative research was poor. Evidence for changes in fruit and vegetable intake was limited and based on self-report. The qualitative research was better quality and ascribed a range of health and well-being impacts to school gardens, with some idealistic expectations for their impact in the long term. Groups of pupils who do not excel in classroom activities were thought to particularly benefit. Lack of funding and over reliance on volunteers were thought to threaten success, while involvement with local communities and integration of gardening activities into the school curriculum were thought to support success.

CONCLUSION

More robust quantitative research is needed to convincingly support the qualitative evidence suggesting wide ranging benefits from school gardens.

Increasing vegetable intakes: rationale and systematic review of published interventions

Purpose

While the health benefits of a high fruit and vegetable consumption are well known and considerable work has attempted to improve intakes, increasing evidence also recognises a distinction between fruit and vegetables, both in their impacts on health and in consumption patterns. Increasing work suggests health benefits from a high consumption specifically of vegetables, yet intakes remain low, and barriers to increasing intakes are prevalent making intervention difficult. A systematic review was undertaken to identify from the published literature all studies reporting an intervention to increase intakes of vegetables as a distinct food group.

Methods

Databases—PubMed, PsychInfo and Medline—were searched over all years of records until April 2015 using pre-specified terms.

Results

Our searches identified 77 studies, detailing 140 interventions, of which 133 (81 %) interventions were conducted in children. Interventions aimed to use or change hedonic factors, such as taste, liking and familiarity (n = 72), use or change environmental factors (n = 39), use or change cognitive factors (n = 19), or a combination of strategies (n = 10). Increased vegetable acceptance, selection and/or consumption were reported to some degree in 116 (83 %) interventions, but the majority of effects seem small and inconsistent.

Conclusions

Greater percent success is currently found from environmental, educational and multi-component interventions, but publication bias is likely, and long-term effects and cost-effectiveness are rarely considered. A focus on long-term benefits and sustained behaviour change is required. Certain population groups are also noticeably absent from the current list of tried interventions.

Harvest of Hope: The impact of a church garden project on African American youth and adults in the rural American South

A pilot study was conducted of the feasibility of a church garden program to impact health outcomes in rural African American youth and adults. Thirty-six workdays were held at a Black church. Pre and post-intervention attitudes, diet, weight and blood pressure were measured. T-tests were used to test for significant within group differences. Spearman's rank correlation coefficients were used to test for significant bivariate associations. Youth showed improved attitudes about farming and gardening. No statistically significant changes were observed in adults. Church garden interventions can improve farming and gardening attitudes for rural, African American youth.