Abstract
School gardens have become common school-based health promotion strategies to enhance dietary behaviors in the United States. The goal of this study was to examine the effects of TX Sprouts, a one-year school-based gardening, cooking, and nutrition cluster randomized controlled trial, on students’ dietary intake and quality. Eight schools were randomly assigned to the TX Sprouts intervention and eight schools to control (i.e., delayed intervention) over three years (2016–2019). The intervention arm received: formation and training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly in the teaching garden during school hours; and nine parent lessons, taught monthly. Dietary intake data via two 24 h dietary recalls (24 hDR) were collected on a random subsample (n = 468). Dietary quality was calculated using the Healthy Eating Index 2015 (HEI-2015). The intervention group compared to control resulted in a modest increase in protein intake as a percentage of total energy (0.4% vs. −0.3%, p = 0.021) and in HEI-2015 total vegetables component scores (+4% vs. −2%, p = 0.003). When stratified by ethnicity/race, non-Hispanic children had a significant increase in HEI-2015 total vegetable scores in the intervention group compared to the control group (+4% vs. −8%, p = 0.026). Both the intervention and control groups increased added sugar intake; however, to a lesser extent within the intervention group (0.3 vs. 2.6 g/day, p = 0.050). School-based gardening, cooking, and nutrition interventions can result in significant improvements in dietary intake. Further research on ways to scale and sustain nutrition education programs in schools is warranted. The trial is registered at ClinicalTrials.gov (NCT02668744).
Highlights
According to the 2020–2025 Dietary Guidelines for Americans, persons should consume fruits and vegetables as part of a healthy eating pattern to reduce their risk for diet-related chronic diseases, such as cardiovascular disease, type 2 diabetes, some cancers, and obesity [1]
As school garden advocates push for more gardens in schools, they often cite the wealth of direct and indirect benefits that school gardens can have on students, including academic performance, psychosocial factors, dietary intake, mental health, obesity risk factors, and physical activity [11,12,13,14,15,16,17,18,19,20]
Of the 1121 students randomly selected for 24 h dietary recalls (24 hDR), (69%) (n = 738 children; n = 361 intervention group, n = 377 control group) completed both recalls at baseline
Summary
According to the 2020–2025 Dietary Guidelines for Americans, persons should consume fruits and vegetables as part of a healthy eating pattern to reduce their risk for diet-related chronic diseases, such as cardiovascular disease, type 2 diabetes, some cancers, and obesity [1]. Childhood is a critical period during which lifelong eating habits are established, influencing future risk for diet-related chronic diseases [2,3] Despite these recommendations, the vast majority of children in the US continue to consume energydense, nutrient-poor diets [3,4,5,6,7]. A primary limitation of most previous studies is that they did not conduct randomization of either children or schools, increasing the risk for selection bias and systematic differences between study groups [21]. This limits the ability to determine whether causality exists between changes in dietary behaviors and garden-based interventions. The few existing randomized controlled trials (RCTs) have been limited by short duration, intervention intensity and fidelity of implementation, and methods used to assess overall dietary or vegetable intake (e.g., food frequency questionnaires) [14,18,23,24]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
