Nudging children toward healthier food choices: An experiment combining school and home gardens

Dhruba Raj Bhattarai,Puspa Lal Ghimire,Ghassan Baliki,Rachana Manandhar Shrestha,Pepijn Schreinemachers,Tilman Brück,Bhishma P Subedi,Ishwori P Gautam

doi:10.1016/j.gfs.2020.100454

Abstract

School gardens have become a widely used approach to influence children's food knowledge, preferences and choices in low- and high-income countries alike. However, evidence indicates that such programs are more effective at influencing food knowledge and preferences than actual food choices. Such finding may occur because school gardens insufficiently influence the food behavior of parents and because healthy food items are not always available in children's homes. We tested this hypothesis using a one-year cluster randomized controlled trial in Nepal with 15 treatment and 15 control schools and a matched sample of 779 schoolchildren (aged 8–12) and their caregivers. Data were collected before and after the intervention during the 2018–2019 school year. In addition, children's food consumption was monitored using a monthly food logbook. Average treatment effects were quantified with a double-difference estimator. For caregivers, the intervention led to a 26% increase in their food and nutrition knowledge (p < 0.001), a 5% increase in their agricultural knowledge (p = 0.022), a 10% increase in their liking for vegetables (p < 0.001), and a 15% increase in home garden productivity (p = 0.073). For children, the intervention had no discernible effect on food and nutrition knowledge (p = 0.666) but led to a 6% increase in their liking for vegetables (p = 0.070), healthy food practices (p < 0.001), and vegetable consumption (October–December +15%; p = 0.084; January–March +26%; p = 0.017; April–June +26%; p = 0.088). The results therefore indicate both schools and parents matter for nudging children toward healthier food choices.

Highlights

Evidence indicates that it is critically important to develop healthy food preferences and eating habits in children because these can persist into adolescence and adulthood (Birch et al, 2007; Cooke, 2007; Kelder et al, 1994; Wadhera et al, 2015)
It has been reported that children under the age of two in Kathmandu Valley are getting a quarter of their calories from unhealthy snack foods and beverages (Pries et al, 2019), which is indicative of a wider problem of unhealthy eating habits
The results show no effect for the first quarter of the year-long study period (p = 0.620), which is the period before the intervention got started in September

Summary

Introduction

Evidence indicates that it is critically important to develop healthy food preferences and eating habits in children because these can persist into adolescence and adulthood (Birch et al, 2007; Cooke, 2007; Kelder et al, 1994; Wadhera et al, 2015). An eval uation of a school garden program in Belgium found small but signifi cant effects on knowledge and awareness, but no significant effect on vegetable consumption (Huys et al, 2019). These studies show that school garden programs tend to be more effective in improving children’s knowledge, attitudes and preferences than at changing actual food behavior

Methods

Results

Discussion

Conclusion