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Jones AM, Keihner A, Mills M, MkNelly B, Khaira KK, Pressman J, Scherr RE. Measuring Skin Carotenoids Using Reflection Spectroscopy in a Low-Income School Setting. Nutrients 2021; 13:3796. [PMID: 34836051 PMCID: PMC8618146 DOI: 10.3390/nu13113796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 11/24/2022] Open
Abstract
Dietary behavior change is difficult to accurately measure in a low-income youth population. Objective tools to measure fruit and vegetable consumption without relying on self-report present the opportunity to do this with less respondent burden and bias. A promising tool for quantifying fruit and vegetable consumption via proxy is skin carotenoids as measured by reflection spectroscopy through a device called the Veggie Meter®. To assess whether the Veggie Meter® is able to detect changes in skin carotenoids as a proxy for fruit and vegetable consumption in a low-income school setting, skin carotenoid measurements were collected at three time points, along with student level demographics, anthropometric measurements, and nutrition knowledge. A secondary goal of this study was to refine the protocol to be used based on researcher observations. Repeated measures analysis of variance with Bonferroni correction for multiple comparisons indicate that there was a significant difference in VM scores over the course of the study (F(2, 68) = 6.63, p = 0.002), with an increase in skin carotenoids from Fall 2018 to Spring 2019 (p = 0.005). This increase was sustained over the summer months when measured in Fall 2019. Changes to the protocol included the addition of a hand cleaning step and using the non-dominant ring finger for data collection. With these refinements, the results demonstrate that the Veggie Meter® is usable as a non-invasive tool for measuring fruit and vegetable consumption in a population that is traditionally difficult to assess.
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Affiliation(s)
- Anna M. Jones
- CalFresh Healthy Living, University of California, Davis, CA 95618, USA; (A.M.J.); (A.K.); (M.M.); (B.M.); (K.K.K.)
- Department of Nutrition, University of California, Davis, CA 95616, USA
- Center for Nutrition in Schools, Department of Nutrition, University of California, Davis, CA 95616, USA
| | - Angie Keihner
- CalFresh Healthy Living, University of California, Davis, CA 95618, USA; (A.M.J.); (A.K.); (M.M.); (B.M.); (K.K.K.)
| | - MaryAnn Mills
- CalFresh Healthy Living, University of California, Davis, CA 95618, USA; (A.M.J.); (A.K.); (M.M.); (B.M.); (K.K.K.)
| | - Barbara MkNelly
- CalFresh Healthy Living, University of California, Davis, CA 95618, USA; (A.M.J.); (A.K.); (M.M.); (B.M.); (K.K.K.)
| | - Kamaljeet K. Khaira
- CalFresh Healthy Living, University of California, Davis, CA 95618, USA; (A.M.J.); (A.K.); (M.M.); (B.M.); (K.K.K.)
| | - Jona Pressman
- University of California Cooperative Extension Butte County, Oroville, CA 95965, USA;
| | - Rachel E. Scherr
- Department of Nutrition, University of California, Davis, CA 95616, USA
- Center for Nutrition in Schools, Department of Nutrition, University of California, Davis, CA 95616, USA
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Thorsteinsdottir S, Njardvik U, Bjarnason R, Olafsdottir AS. Taste education - A food-based intervention in a school setting, focusing on children with and without neurodevelopmental disorders and their families. A randomized controlled trial. Appetite 2021; 167:105623. [PMID: 34371121 DOI: 10.1016/j.appet.2021.105623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 07/10/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
Children with neurodevelopmental disorders (ND) such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactive Disorder (ADHD) have high levels of fussy eating. However, no school-based food interventions exist for children with ASD and ADHD. To investigate the effect of Taste Education, 81 children with ND (n = 33), and without (n = 48), aged 8-12 years, and their parents, participated in a 7-week food intervention. Children were matched on age, ND, and sex, and randomized into Immediate-intervention and Delayed-intervention groups. Parents completed the Children's Eating Behaviour Questionnaire (CEBQ), and a food-variety questionnaire. After adjusting for baseline measures, repeated-measures analysis-of-variance with time-points, and condition as factors (Immediate intervention and Delayed intervention) were used to examine changes in CEBQ-scores, with a robust linear mixed-model fitted. Changes in percentage of accepted foods were tested using a logistic-regression model adjusting for baseline acceptance. Results showed superior results for Intervention compared to waiting, on Food fussiness, but not Enjoyment of food, with stable effects through six-months follow-up. There were non-significant differences between children with and without ND. Results also showed increased odds of accepting vegetables by a factor of 1.6 (95% Confidence Interval [CI]: 1.33-1.93, p < .001); nuts and seeds by a factor of 1.4 (95% CI: 1.27-1.6, p < .001), but no significant association for fruit (OR 1.12, 95% CI: 0.92-1.34, p = .244). Trends were similar for children regardless of ND-status. The Taste Education program, shows promise, as a simple, non-invasive way to decrease fussy eating and increase food variety in the long-term.
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Affiliation(s)
| | - Urdur Njardvik
- School of Health Sciences, University of Iceland, Iceland.
| | - Ragnar Bjarnason
- School of Health Sciences, University of Iceland, Iceland; Department of Paediatrics, National University Hospital, Iceland.
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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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Nutrition across the curriculum: a scoping review exploring the integration of nutrition education within primary schools. Nutr Res Rev 2021; 35:181-196. [PMID: 33926596 DOI: 10.1017/s0954422421000111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Primary schools contribute to promoting healthy eating behaviour and preventing overweight and obesity by providing nutrition education. Research highlights the importance of improving teachers' programme implementation to enhance intervention effectiveness. An integrative approach has been suggested to reduce time barriers that teachers currently experience in teaching nutrition. This scoping review explores use and effectiveness of integrative teaching in primary-school-based nutrition education programmes. Six databases were searched for primary-school-based interventions on nutrition education. Papers reporting on integration of nutrition topics within core curriculum were included. Abstracts and full texts of potentially relevant articles were screened to determine eligibility. Next, data were extracted and tabulated. Findings were collated and summarised to describe intervention characteristics, subject integration and effectiveness of the included programmes. Data describing integration of nutrition into the primary school curriculum were extracted from 39 eligible papers. Nutrition education programmes often involve lessons about food groups and are frequently embedded within the mathematics, science or literacy syllabus. Although articles report on the integration of nutrition, the use of this approach was not commonly described in detail. Only seven papers discussed student outcomes related to the integration of nutrition education within core subjects. The ability to draw strong conclusions about school-based nutrition intervention effectiveness is limited by the current lack of programme description and methodological issues. Hence, more research is warranted to inform evidence on effectiveness of integrative nutrition education for both teacher and student outcomes. Future studies that include greater detail regarding the integrative approach are needed.
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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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Impact of permagarden intervention on improving fruit and vegetable intake among vulnerable groups in an urban setting of Ethiopia: A quasi-experimental study. PLoS One 2019; 14:e0213705. [PMID: 31790404 PMCID: PMC6886767 DOI: 10.1371/journal.pone.0213705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 11/04/2019] [Indexed: 01/15/2023] Open
Abstract
Background Increasing nutrient intake through home gardening is a sustainable way to address multiple micronutrient deficiencies in developing countries. This study investigated the impact of permagarden intervention in increasing the frequency and diversity of vegetable and fruit consumption among vulnerable families in seven cities of Ethiopia. Method A quasi-experimental study was conducted from August 10 to September 30, 2015. A total of 884 care givers (427 from intervention and 457 from control) participated in the study. Data were collected through face to face interviews with caregivers of highly vulnerable children. Propensity score matching (PSM) was used as implemented in STATA software. Program impact on the frequency and diversity of households’ fruit and vegetable consumption between intervention and control groups was assessed using chi square test. Results Intervention participants had a 13% higher increase in frequency of vegetable and fruit consumption compared with control participants (p<0.01). Diversity (consumption of 2 or more groups of vegetable and fruit) is higher among intervention groups than control groups (percentage difference = 9, p-value<0.05). A significant higher percentage of participants in intervention group reported getting the one-week vegetable and fruit mainly from their own garden (percentage difference 58.3%, p<0.05). A significantly larger proportion of participants in the intervention group compared to control group reported “high likelihood” on intention to grow vegetables in the future (percentage difference = 30%, and P<0.01). Perceived importance to include vegetable in everyday meal was higher among intervention group participants than control group participants (percentage difference = 11.5%, P<0.01). Conclusions The observed higher FV intake among permagarden intervention group compared to control group suggest that nutrition and health programs need to promote permagarden as a means to improve FV intake among vulnerable societies in resource limited countries.
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Turner L, Eliason M, Sandoval A, Chaloupka FJ. Increasing Prevalence of US Elementary School Gardens, but Disparities Reduce Opportunities for Disadvantaged Students. THE JOURNAL OF SCHOOL HEALTH 2016; 86:906-912. [PMID: 27866388 DOI: 10.1111/josh.12460] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 03/31/2016] [Accepted: 04/01/2016] [Indexed: 06/06/2023]
Abstract
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.
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Affiliation(s)
- Lindsey Turner
- Boise State University, 1910W, University Drive, Mailstop 1745, Boise, ID 83725
| | - Meghan Eliason
- Mill Creek Elementary School, Middleton School District, 500 N, Middleton Road, Middleton, ID 83644
| | - Anna Sandoval
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W, Roosevelt Road, #558, Chicago, IL 60608
| | - Frank J Chaloupka
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W, Roosevelt Road, #558, Chicago, IL 60608
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Linnell JD, Zidenberg-Cherr S, Briggs M, Scherr RE, Brian KM, Hillhouse C, Smith MH. Using a Systematic Approach and Theoretical Framework to Design a Curriculum for the Shaping Healthy Choices Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:60-69.e1. [PMID: 26547274 DOI: 10.1016/j.jneb.2015.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 09/15/2015] [Accepted: 09/22/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To examine the use of a systematic approach and theoretical framework to develop an inquiry-based, garden-enhanced nutrition curriculum for the Shaping Healthy Choices Program. METHODS Curriculum development occurred in 3 steps: identification of learning objectives, determination of evidence of learning, and activity development. Curriculum activities were further refined through pilot-testing, which was conducted in 2 phases. Formative data collected during pilot-testing resulted in improvements to activities. RESULTS Using a systematic, iterative process resulted in a curriculum called Discovering Healthy Choices, which has a strong foundation in Social Cognitive Theory and constructivist learning theory. Furthermore, the Backward Design method provided the design team with a systematic approach to ensure activities addressed targeted learning objectives and overall Shaping Healthy Choices Program goals. CONCLUSIONS AND IMPLICATIONS The process by which a nutrition curriculum is developed may have a direct effect on student outcomes. Processes by which nutrition curricula are designed and learning objectives are selected, and how theory and pedagogy are applied should be further investigated so that effective approaches to developing garden-enhanced nutrition interventions can be determined and replicated.
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Affiliation(s)
- Jessica D Linnell
- Department of Nutrition, University of California, Davis, CA; Center for Nutrition in Schools, University of California, Davis, CA
| | - Sheri Zidenberg-Cherr
- Department of Nutrition, University of California, Davis, CA; Center for Nutrition in Schools, University of California, Davis, CA; University of California Cooperative Extension, Division of Agriculture and Natural Resources, Davis, CA
| | - Marilyn Briggs
- Department of Nutrition, University of California, Davis, CA; Center for Nutrition in Schools, University of California, Davis, CA
| | - Rachel E Scherr
- Department of Nutrition, University of California, Davis, CA; Center for Nutrition in Schools, University of California, Davis, CA
| | - Kelley M Brian
- Department of Nutrition, University of California, Davis, CA; University of California Cooperative Extension, Division of Agriculture and Natural Resources, Davis, CA
| | - Carol Hillhouse
- Agricultural Sustainability Institute, School Garden, University of California, Davis, CA
| | - Martin H Smith
- University of California Cooperative Extension, Division of Agriculture and Natural Resources, Davis, CA; Department of Human Ecology, University of California, Davis, CA; Department of Population Health and Reproduction, University of California, Davis, CA.
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Davis JN, Martinez LC, Spruijt-Metz D, Gatto NM. LA Sprouts: A 12-Week Gardening, Nutrition, and Cooking Randomized Control Trial Improves Determinants of Dietary Behaviors. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:2-11.e1. [PMID: 26453367 PMCID: PMC5266541 DOI: 10.1016/j.jneb.2015.08.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 08/03/2015] [Accepted: 08/13/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the effect of an exploratory 12-week nutrition, cooking, and gardening trial (LA Sprouts) on preference for fruit and vegetables (FV); willingness to try FV; identification of FV; self-efficacy to garden, eat, and cook FV; motivation to garden, eat, and cook FV; attitudes toward FV; nutrition and gardening knowledge; and home gardening habits. DESIGN Randomized controlled trial. SETTING Four elementary schools. PARTICIPANTS Three hundred four predominately Hispanic/Latino third- through fifth-grade students were randomized to either the LA Sprouts group (n = 167 students) or control group (n = 137 students). INTERVENTION Twelve-week after-school nutrition, cooking, and gardening intervention. MAIN OUTCOME MEASURES Determinants of dietary behavior as measured by questionnaire at baseline and postintervention. ANALYSIS Analyses of covariance. RESULTS After the 12-week program, compared with controls, LA Sprouts participants improved scores for identification of vegetables (+11% vs +5%; P = .001) and nutrition and gardening knowledge (+14.5% vs -5.0%; P = .003), and were more likely to garden at home (+7.5% vs -4.4%; P = .003). CONCLUSIONS The LA Sprouts program positively affected a number of determinants of dietary behaviors that suggest possible mechanisms by which gardening and nutrition education act to improve dietary intake and health outcomes.
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Affiliation(s)
- Jaimie N Davis
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX.
| | - Lauren C Martinez
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Donna Spruijt-Metz
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA
| | - Nicole M Gatto
- Center for Nutrition, Healthy Lifestyles and Disease Prevention, School of Public Health, Loma Linda University, Linda Loma, CA
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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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Sustenance and sustainability: maximizing the impact of school gardens on health outcomes. Public Health Nutr 2015; 18:2358-67. [DOI: 10.1017/s1368980015000221] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveSchool garden programmes have become popular action-oriented learning environments in many countries, often driven by converging priorities of environmental sustainability and healthful diets. Many of these programmes have assessed the impact on dietary intake, specifically fruit and vegetable intake, and related dietary behaviours, such as knowledge, preference, motivation, intention and self-efficacy to eat and prepare fruit and vegetables. The objective of the present study was twofold: (i) to review published garden-based programmes conducted in schools targeting dietary intake and/or determinants of dietary behaviour in children; and (ii) to identify similar strategies and components employed by these garden-based programmes.DesignThe review included thirteen studies that have examined the impact of garden-based programmes conducted in school, either during school hours or in after-school settings, on dietary behaviours in children (kindergarten through 8th grade students).ResultsThree of the reviewed studies did not have a comparison or control group and simply evaluated within-group changes after a garden intervention. None of the reviewed studies were randomized, but were assigned based on school’s interest and timing of new school gardens being built. Out of the eleven programmes that examined dietary intake, six found that the programme resulted in increased vegetable intake, whereas four showed no effect. Seven of the eight studies that measured preference found that the programmes resulted in increased preference for vegetables. Gardening programmes also resulted in improved attitudes towards, willingness to taste, identification of and self-efficacy to prepare/cook fruit and vegetables. Similar strategies/components employed by the majority of the programmes included: ‘hands on’ curriculum, incorporation of a cooking component, providing the instructors, parental and stakeholder support, food provision and using the garden as the focal point for media promotion.ConclusionsSome of the garden programmes resulted in increased vegetable intake, which has positive implications for both environment sustainability and health-related outcomes. Further, the majority resulted in some improvement in behaviour determinants more generally. However, more research is warranted to understand how to achieve long-term improvements in dietary behaviours and how to sustain the garden-based programmes in schools.
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Bontrager Yoder AB, Liebhart JL, McCarty DJ, Meinen A, Schoeller D, Vargas C, LaRowe T. Farm to elementary school programming increases access to fruits and vegetables and increases their consumption among those with low intake. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:341-349. [PMID: 24953435 DOI: 10.1016/j.jneb.2014.04.297] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 04/22/2014] [Accepted: 04/27/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To assess the effectiveness of Wisconsin Farm to School (F2S) programs in increasing students' fruit and vegetable (FV) intake. DESIGN Quasi-experimental baseline and follow-up assessments: knowledge and attitudes survey, food frequency questionnaire (FFQ), and lunch tray photo observation. SETTING Wisconsin elementary schools: 1 urban and 8 rural. PARTICIPANTS Children, grades 3-5 (n = 1,117; 53% male, 19% non-Caucasian). INTERVENTION(S) Farm to School programming ranging from Harvest of the Month alone to comprehensive, including school garden, locally sourced produce in school meals, and classroom lessons. MAIN OUTCOME MEASURES Knowledge, attitudes, exposure, liking, willingness; FFQ-derived (total), and photo-derived school lunch FV intake. ANALYSIS t tests and mixed modeling to assess baseline differences and academic-year change. RESULTS Higher willingness to try FV (+1%; P < .001) and knowledge of nutrition/agriculture (+1%; P < .001) (n = 888), and lunch FV availability (+6% to 17%; P ≤ .001) (n = 4,451 trays), both with increasing prior F2S program exposure and across the year. There was no effect on overall dietary patterns (FFQ; n = 305) but FV consumption increased among those with the lowest intakes (FFQ, baseline very low fruit intake, +135%, P < .001; photos: percentage of trays with no FV consumption for continuing programs decreased 3% to 10%, P ≤ .05). CONCLUSIONS AND IMPLICATIONS Farm to School programming improved mediators of FV consumption and decreased the proportion of children with unfavorable FV behaviors at school lunch. Longer-term data are needed to further assess F2S programs.
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Affiliation(s)
| | - Janice L Liebhart
- Wisconsin Department of Health Services, Nutrition, Physical Activity, and Obesity Prevention Program, Madison, WI
| | - Daniel J McCarty
- School of Health Care Professions, University of Wisconsin-Stevens Point, Stevens Point, WI
| | - Amy Meinen
- Wisconsin Obesity Prevention Network, School of Medicine and Public Health, Institute for Clinical and Translational Research, University of Wisconsin-Madison, Madison, WI
| | - Dale Schoeller
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | - Camilla Vargas
- Wisconsin Department of Agriculture, Trade, and Consumer Protection, Madison, WI
| | - Tara LaRowe
- Department of Family Medicine, University of Wisconsin-Madison, Madison, WI
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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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Gibbs L, Staiger PK, Townsend M, Macfarlane S, Gold L, Block K, Johnson B, Kulas J, Waters E. Methodology for the evaluation of the Stephanie Alexander Kitchen Garden program. Health Promot J Austr 2013; 24:32-43. [PMID: 23575587 DOI: 10.1071/he12905] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 10/21/2012] [Indexed: 11/23/2022] Open
Abstract
ISSUES ADDRESSED Community and school cooking and gardening programs have recently increased internationally. However, despite promising indications, there is limited evidence of their effectiveness. This paper presents the evaluation framework and methods negotiated and developed to meet the information needs of all stakeholders for the Stephanie Alexander Kitchen Garden (SAKG) program, a combined cooking and gardening program implemented in selectively funded primary schools across Australia. METHODS The evaluation used multiple aligned theoretical frameworks and models, including a public health ecological approach, principles of effective health promotion and models of experiential learning. The evaluation is a non-randomised comparison of six schools receiving the program (intervention) and six comparison schools (all government-funded primary schools) in urban and rural areas of Victoria, Australia. A mixed-methods approach was used, relying on qualitative measures to understand changes in school cultures and the experiential impacts on children, families, teachers, parents and volunteers, and quantitative measures at baseline and 1 year follow up to provide supporting information regarding patterns of change. RESULTS The evaluation study design addressed the limitations of many existing evaluation studies of cooking or garden programs. The multistrand approach to the mixed methodology maintained the rigour of the respective methods and provided an opportunity to explore complexity in the findings. Limited sensitivity of some of the quantitative measures was identified, as well as the potential for bias in the coding of the open-ended questions. CONCLUSION The SAKG evaluation methodology will address the need for appropriate evaluation approaches for school-based kitchen garden programs. It demonstrates the feasibility of a meaningful, comprehensive evaluation of school-based programs and also demonstrates the central role qualitative methods can have in a mixed-method evaluation. So what? This paper contributes to debate about appropriate evaluation approaches to meet the information needs of all stakeholders and will support the sharing of measures and potential comparisons between program outcomes for comparable population groups and settings.
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Affiliation(s)
- L Gibbs
- The McCaughey VicHealth Centre of Community Wellbeing, The University of Melbourne, Australia.
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Gibbs L, Staiger PK, Johnson B, Block K, Macfarlane S, Gold L, Kulas J, Townsend M, Long C, Ukoumunne O. Expanding children's food experiences: the impact of a school-based kitchen garden program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2013; 45:137-146. [PMID: 23472931 DOI: 10.1016/j.jneb.2012.09.004] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 09/04/2012] [Accepted: 09/04/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Evaluate achievement of the Stephanie Alexander Kitchen Garden Program in increasing child appreciation of diverse, healthy foods. DESIGN Comparative 2-year study. SETTING Six program and 6 comparison primary schools in rural and metropolitan Victoria, Australia, matched for socioeconomic status and size. PARTICIPANTS A total of 764 children in grades 3 to 6 (8-12 years of age) and 562 parents recruited. Retention rates at follow-up included 85% children and 75% parents. INTERVENTION Each week of the school year, children spent 45 to 60 minutes in a garden class and 90 minutes in a kitchen class. PHENOMENON OF INTEREST Program impact on children's willingness to try new foods, capacity to describe foods, and healthy eating. ANALYSIS Qualitative data analyzed using inductive thematic analysis. Quantitative data analyzed using random-effects linear regressions adjusted for school clustering. RESULTS Child and parent qualitative and quantitative measures (if never tried before, odds ratio 2.0; confidence interval, 1.06-3.58) showed increases in children's reported willingness to try new foods. No differences in articulation of food descriptions (program vs comparison groups). Qualitative evidence showed that the program extended its influence to healthy eating, but this was not reflected in the quantitative evidence. CONCLUSIONS AND IMPLICATIONS Findings indicate program success in achieving its primary objective, meriting further program research.
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Affiliation(s)
- Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing Program, The McCaughey VicHealth Centre for Community Wellbeing, University of Melbourne, Australia.
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Hazzard EL, Moreno E, Beall DL, Zidenberg-Cherr S. Factors contributing to a school's decision to apply for the California Instructional School Garden Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2012; 44:379-383. [PMID: 22236495 DOI: 10.1016/j.jneb.2011.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Revised: 07/21/2011] [Accepted: 08/07/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To compare the applicant schools (AS) to non-applicant schools (NAS) residing in the same school districts for the California Instructional School Garden Program and identify barriers to the application process. METHODS A case-control, cross-sectional study design was used to compare resources and school environments. Pearson chi-square and logistic regression were conducted. RESULTS Public schools throughout California participated (n = 1,662). The response rates for AS and NAS were 43.2% and 48.2%, respectively. Applicant schools had greater access to garden coordinators and parent/community volunteers dedicated to school gardens, and they had other sources of funds/grants to support school gardens compared to NAS (P < .001). CONCLUSIONS AND IMPLICATIONS Access to certain garden resources played a significant role in predicting whether schools would decide to participate in the California Instructional School Garden Program.
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Affiliation(s)
- Eric L Hazzard
- Department of Nutrition, University of California-Davis, Davis, CA, USA
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Abstract
This article presents results from a mixed-method evaluation of a structured cooking and gardening program in Australian primary schools, focusing on program impacts on the social and learning environment of the school. In particular, we address the Stephanie Alexander Kitchen Garden Program objective of providing a pleasurable experience that has a positive impact on student engagement, social connections, and confidence within and beyond the school gates. Primary evidence for the research question came from qualitative data collected from students, parents, teachers, volunteers, school principals, and specialist staff through interviews, focus groups, and participant observations. This was supported by analyses of quantitative data on child quality of life, cooperative behaviors, teacher perceptions of the school environment, and school-level educational outcome and absenteeism data. Results showed that some of the program attributes valued most highly by study participants included increased student engagement and confidence, opportunities for experiential and integrated learning, teamwork, building social skills, and connections and links between schools and their communities. In this analysis, quantitative findings failed to support findings from the primary analysis. Limitations as well as benefits of a mixed-methods approach to evaluation of complex community interventions are discussed.
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Davis JN, Ventura EE, Cook LT, Gyllenhammer LE, Gatto NM. LA Sprouts: a gardening, nutrition, and cooking intervention for Latino youth improves diet and reduces obesity. ACTA ACUST UNITED AC 2011; 111:1224-30. [PMID: 21802571 DOI: 10.1016/j.jada.2011.05.009] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 12/17/2010] [Indexed: 11/29/2022]
Abstract
Evidence demonstrates that a gardening and nutrition intervention improves dietary intake in children, although no study has evaluated the effect of this type of intervention on obesity measures. The objective of this pilot study was to develop and test the effects of a 12-week, after-school gardening, nutrition, and cooking program (called LA Sprouts) on dietary intake and obesity risk in Latino fourth- and fifth-grade students in Los Angeles, CA. One hundred four primarily Latino children (mean age 9.8±0.7 years), 52% boys and 59% overweight, completed the program (n=70 controls, n=34 LA Sprouts participants). Weight, height, body mass index, waist circumference, body fat (via bioelectrical impendence), blood pressure, and dietary intake (via food frequency screener) were obtained at baseline and postintervention. LA Sprouts participants received weekly 90-minute, culturally tailored, interactive classes for 12 consecutive weeks during spring 2010 at a nearby community garden, whereas control participants received an abbreviated delayed intervention. Compared to subjects in the control group, LA Sprouts participants had increased dietary fiber intake (+22% vs -12%; P=0.04) and decreased diastolic blood pressure (-5% vs -3%; P=0.04). For the overweight subsample, LA Sprouts participants had a significant change in dietary fiber intake (0% vs -29%; P=0.01), reduction in body mass index (-1% vs +1%; P=0.04) and less weight gain (+1% vs +4%; P=0.03) compared to those in the control group. We conclude that a gardening, nutrition, and cooking intervention is a promising approach to improve dietary intake and attenuate weight gain in Latino children, particularly in those who are overweight.
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Affiliation(s)
- Jaimie N Davis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA.
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Hazzard EL, Moreno E, Beall DL, Zidenberg-Cherr S. Best practices models for implementing, sustaining, and using instructional school gardens in California. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2011; 43:409-413. [PMID: 21906553 DOI: 10.1016/j.jneb.2011.05.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Revised: 03/19/2011] [Accepted: 05/02/2011] [Indexed: 05/31/2023]
Abstract
To ascertain best practices for schools implementing or sustaining instructional school gardens by interviewing key members in 10 schools with exemplary instructional school gardens programs in California. Practices of schools with exemplary instructional school gardens programs were analyzed by constant comparative analysis using qualitative data analysis software. Seven of the 10 schools had people from at least 3 of the following 4 groups: administrators, teachers, parent and community volunteers and garden coordinators. Nine of 10 schools had a part- or full-time garden coordinator. Results demonstrated that a committee committed to instructional school gardens is the most important step towards success.
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Dyment JE, Bell AC. Grounds for movement: green school grounds as sites for promoting physical activity. HEALTH EDUCATION RESEARCH 2008. [PMID: 17956885 DOI: 10.1080/13504620701843426] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
An environmental factor of particular importance to children's physical activity levels appears to be the presence of parks and open space. Thus, in promoting children's health, school grounds merit consideration as a potential setting for intervention. This paper explores how 'green' school grounds, which contain a greater diversity of landscaping and design features, affect the quantity and quality of physical activity among elementary school children. Teachers, parents and administrators associated with 59 schools across Canada completed questionnaires (n = 105). Analysis reveals that through greening, school grounds diversify the play repertoire, creating opportunities for boys and girls of all ages, interests and abilities to be more physically active. Complementing the rule-bound, competitive games supported by asphalt and turf playing fields, green school grounds invite children to jump, climb, dig, lift, rake, build, role play and generally get moving in ways that nurture all aspects of their health and development. Of particular significance is the potential to encourage moderate and light levels of physical activity by increasing the range of enjoyable, non-competitive, open-ended forms of play at school. Seen in this light, green school grounds stand to be an important intervention to be included in school health promotion initiatives.
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Affiliation(s)
- J E Dyment
- Faculty of Education, University of Tasmania, Launceston, Tasmania 7250, Australia.
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Bisset SL, Potvin L, Daniel M, Paquette M. Assessing the impact of the primary school-based nutrition intervention Petits cuistots--parents en réseaux. Canadian Journal of Public Health 2008. [PMID: 18457283 DOI: 10.1007/bf03405455] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study sought to provide an intermediate impact assessment of the nutrition intervention Petits cuistots--parents en réseaux (Little Cooks--Parental Networks) on: 1) knowledge, attitude, capacity and experience with regard to nutrition, diet and cookery, and 2) parental and/or family participation in school. PARTICIPANTS A total of 388 students from grades 5 (participants) and 6 (non-participants). SETTING The evaluation of the nutrition intervention took place in each of the seven participating elementary schools, all of which are located in Montreal's most disadvantaged neighbourhoods. INTERVENTION The program component "Little Cooks" is a nutrition workshop run by community dieticians. Each of the eight annual workshops features a food item and nutrition theme with a recipe for a collective food preparation and tasting experience. Classroom teachers participate to provide classroom management and program support. The "Parental Networks" component of the program invites parents to assist with the nutrition workshop, and offers additional parent and family activities which link to nutrition workshop themes (e.g., dinners or visits to local food producers). OUTCOME The program had some impact on knowledge of the nutrient content of food, food produce and cooking; attitude and experience with tasting of new or less common foods; and perceived cooking capacity. Families with students participating in the program participated more in school activities than did families of students not in the program. CONCLUSIONS Our assessment indicates a potential program impact upon several intermediate impact measures, and in so doing highlights a promising nutrition capacity-promoting intervention.
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Affiliation(s)
- Sherri L Bisset
- Department of Social and Preventive Medicine, University of Montréal, Montréal, QC.
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Alaimo K, Packnett E, Miles RA, Kruger DJ. Fruit and vegetable intake among urban community gardeners. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2008; 40:94-101. [PMID: 18314085 DOI: 10.1016/j.jneb.2006.12.003] [Citation(s) in RCA: 165] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2006] [Revised: 12/05/2006] [Accepted: 12/05/2006] [Indexed: 05/02/2023]
Abstract
OBJECTIVE To determine the association between household participation in a community garden and fruit and vegetable consumption among urban adults. DESIGN Data were analyzed from a cross-sectional random phone survey conducted in 2003. A quota sampling strategy was used to ensure that all census tracts within the city were represented. SETTING Flint, Michigan. PARTICIPANTS 766 adults. VARIABLES MEASURED Fruit and vegetable intake was measured using questionnaire items from the Behavioral Risk Factor Surveillance System. Household participation in a community garden was assessed by asking the respondent if he or she, or any member of the household, had participated in a community garden project in the last year. ANALYSIS Generalized linear models and logistic regression models assessed the association between household participation in a community garden and fruit and vegetable intake, controlling for demographic, neighborhood participation, and health variables. RESULTS Adults with a household member who participated in a community garden consumed fruits and vegetables 1.4 more times per day than those who did not participate, and they were 3.5 times more likely to consume fruits and vegetables at least 5 times daily. CONCLUSIONS AND IMPLICATIONS Household participation in a community garden may improve fruit and vegetable intake among urban adults.
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Affiliation(s)
- Katherine Alaimo
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan 48824, USA.
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Position of the American Dietetic Association, Society for Nutrition Education, and American School Food Service Association: Nutrition services: an essential component of comprehensive school health programs. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2003; 35:57-67. [PMID: 12731558 DOI: 10.1016/s1499-4046(06)60040-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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