Effects of TX Sprouts, A School-Based Cluster Randomized Gardening, Nutrition, and Cooking Intervention, on Dietary Quality

Abstract

Abstract Objectives School gardens have become a common school-based health promotion strategy to enhance dietary behaviors in the US. The goal of this study was to examine the effects of TX Sprouts, a one-year school-based gardening, nutrition, and cooking cluster randomized trial on dietary quality. Methods Eight schools were randomly assigned to TX Sprouts intervention and eight schools to control (i.e., delayed intervention) over three years (2016–2019). The intervention arm received: formation 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; and nine parent lessons. The following outcomes were collected on the children at baseline and post-intervention: height, weight, waist circumference, and body composition via bioelectrical impedance. Dietary intake via two, 24-hour dietary recalls (24hDR) were collected on a subsample. Dietary quality was assessed using the Healthy Eating Index 2015 (HEI-2015). Analytic sample included subjects with complete data. Mixed-effects linear regression models, accounting for the cluster effect, were used to assess changes in outcomes between intervention and control groups. Results Of the 4239 eligible students, 3135 students consented and provided baseline clinical measures. Two 24hDR were collected on a subsample of 440 children at baseline and post-intervention. Children were 54% female with the mean age of 9 years, 60% were Hispanic, and 66% received free and reduced lunch. Change in HEI-2015 total score was not significantly different between intervention and control groups [+2.02 (0.96) vs. 0.98 (1.05); P = 0.46]. The intervention group compared to control group resulted in significant increases, mean change (SE), in HEI-2015 vegetable component scores [+0.18 (0.13) vs. −0.06 (0.12); P = 0.003] and HEI-2015 greens and beans component scores [+0.13 (0.18) vs. −0.32 (0.18); P = 0.02]. Conclusions This is the largest, cluster-randomized trial to examine the effects of a school-based gardening, nutrition, and cooking program on diet quality in primarily low-income Hispanic children. School-based garden programs may serve as promising health promotion strategies in improving vegetable consumption. Funding Sources Supported by National Heart, Lung, and Blood Institute grant R01HL123865.