School-based Food Research Articles

Changes in unhealthy food consumption among vulnerable elementary-aged children in the United States during the COVID-19 pandemic: a serial cross-sectional analysis.

Several studies suggest that during the early pandemic, amidst socioeconomic instability, children from underserved families were more likely to resort to consuming cheaper, lower-quality foods with longer shelf lives. This study investigated the change in unhealthy food consumption across different phases (pre, early, mid) of the COVID-19 pandemic, and whether the strength of association between unhealthy food consumption and household socioeconomic disadvantage (HSED) varied across phases of the pandemic. This study utilized serial cross-sectional data collected from low-income families enrolled in a school-based food co-op, Brighter Bites. Secondary data analysis included 5,384 surveys from families who had complete data: 3422 pre-pandemic, 944 from the early pandemic, and 1,018 mid-pandemic. Outcome measures included sugary food intake and convenience/fast food intake, each of which was operationalized as a scale using pre-validated items from the surveys. HSED was operationalized as a composite of parent employment, parent education, food insecurity, and participation in government programs; responses were categorized into low, medium, and high HSED groups for analysis. We examined the interaction between HSED and time period to explore how HSED and its association with dietary measures changed over the course of the pandemic. A significant linear negative trend, i.e., a decrease in consumption from pre-to-mid-pandemic period was seen in sugary food intake (p < 0.001), but not in convenience food intake. In data pooled across time-periods, both sugary food and convenience/fast food consumption were inversely associated with HSED, and low unhealthy food consumption was observed among high-disadvantage groups. No significant interaction between time period and HSED was observed on either scale. However, the post-regression estimates from the adjusted interaction model showed a significant association between convenience/fast food consumption and HSED in pre- and mid-pandemic periods. The study highlights the nuances of socioeconomic dynamics on the diet behaviors of children from low-income families during a natural disaster.

Impact of a school-based food assistance program on household food insecurity in Greece, 2012–2019: a multi-year evaluation of the DIATROFI program

BackgroundChildhood food insecurity can persist among low socioeconomic areas in high-income countries. Universal Free School Meal (UFSM) programs are designed to respond to this pressing issue. This study aimed to conduct a multi-year evaluation of the DIATROFI Program’s impact on household food insecurity in Greece. MethodsThis study utilized data from 18,716 students (618 kindergarten to high schools), from low socioeconomic areas participating in the school-level UFSM Program DIATROFI between 2012 and 2019. Parents of students completed annual baseline and follow-up paper-based self-completed questionnaires. The primary outcome was household food insecurity, measured using the Food Security Survey Module (FSSM) at both questionnaires, and evaluated through mixed linear and logistic regression models with repeated measurements. FindingsStudents’ median age was 9 years old (Interquartile range (IQR): 6·5, 12·0), 51·6% (n=9,658) were girls, and 82·2% (n=15,382) lived in low/medium socioeconomic affluence households. Households with food insecurity reduced from 51·5% (n=9,630) to 47·6% (n=8,901) after one school year. Food insecurity score declined steadily for four years of consecutive participation, compared to baseline score (one-year b:–0·26; 95% Confidence Interval (CI):–0·30, –0·22, and four-year –1·28; –1·53, –1·03). The likelihood of retaining food insecure status reduced from 17% after one-year participation (Odds Ratio (OR): 0·83; 95% CI: 0·79, 0·87) to 36% after four-year participation (0·64; 0·49, 0·82). The Program’s impact on household food insecurity alleviation was greater among households with low parental education and low socioeconomic affluence. InterpretationThe DIATROFI Program effectively improved household food security during and after the Greek socioeconomic crisis. School-level UFSM programs targeting underprivileged students can improve household food insecurity, with a more pronounced effect with increased years of participation, and among economically disadvantaged households. FundingThe DIATROFI Program was funded through various national and private organizations, including national prefecture authorities, Greek payment authorities, philanthropic/charitable organizations, and private companies.

A school-based food and nutrition education intervention increases nutrition-related knowledge and fruit consumption among primary school children in northern Ghana

BackgroundProviding children with the opportunity to learn about nutrition is critical in helping them establish a healthy lifestyle and eating behaviours that would remain with them till adulthood. We determined the effect of a school-based food and nutrition education (SFNE) intervention on the nutrition-related knowledge, attitudes, dietary habits, physical activity levels and the anthropometric indices (BMI-for-age z scores, %Body fat and waist circumference) of school-age children in northern Ghana.MethodsFollowing a controlled before-and-after study design, we recruited school-age children in primary 4 and 5 from public and private schools and assigned them non-randomly to intervention and control groups (4 schools total). A SFNE intervention called ‘Eat Healthy, Grow Healthy (EHGH)’ was implemented in intervention schools. Components of the intervention included children, teachers, school officials, and the school environment. Nutrition education didactic sessions, active discussions, nutrition games, charades, art work, and physical activity sessions were among the teaching and learning activities implemented. At 0 and 6 months, primary (anthropometry) and secondary (fruit, vegetable, and breakfast consumption) outcomes were obtained.ResultsMean BMI-for-age z-scores did not differ significantly between intervention and control groups (F1,261 = 0.45, P = 0.503, η2 = 0.01). However, significantly greater nutrition-related knowledge scores were recorded in the intervention group than in the control group at post-intervention (M = 6.07 SD = 2.17 vs. M = 5.22 SD = 1.92; p = 0.002). Mean number of days intervention children consumed fruits differed across time (F1, 263 = 33.04, p = 0.002, η2 = 0.04) but not between the control and intervention groups (F1, 263 = 0.28, p = 0.60, η2 = 0.00).ConclusionsThe EHGH intervention had positive effects on the nutrition-related knowledge and the consumption of fruits among children although it did not impact their anthropometric indices.

Refugee youth’s perspective on the role that food insecurity plays in a healthy community: a photovoice project

PurposeFood insecurity is a major public health concern, especially for refugee families. Despite the growing population of refugee families in the USA and the harmful effects on youth’s health and well-being, there are limited qualitative studies exploring food insecurity among US refugee adolescents. The use of community-based participatory research and photovoice can highlight the strength of gathering and sharing underrepresented and disadvantaged group experiences. The purpose of this study was to understand adolescent refugee's food insecurity perspectives and experiences, with a nutrition and food access focus. Three main themes and nine subthemes emerged around the role that food security plays in a healthy, thriving community. The main themes included food must be more accessible in school; importance of food access in one’s community; and food access and creating a vibrant community. Implications regarding how to apply these results with community and school-based food programs are discussed.Design/methodology/approachThis study followed a phenomenological research approach to understand the experiences of refugee youth and what constitutes healthy food access in a community. Data analysis was conducted using Braun and Clarke’s (2006) thematic analysis to ensure that data saturation was met (Guest et al., 2006).FindingsThe thematic analysis of the photovoice methodological approach revealed three main themes and nine subthemes around the role that food security plays in a healthy and thriving community. These themes are as follows: food must be more accessible in school; importance of food access in one’s community; and food access and creating a vibrant community.Research limitations/implicationsFunding resources limited the duration of meeting in which we could meet and discuss the photo’s students were taking. Second, consistent with phenomenological studies, the sample size was small. However, common sample size for studies using a phenomenological approach ranged from 5 to 25 (Creswell et al., 2007), which is in alignment with this study. Next, while participants did receive training in the SHOWeD method, the photography training was limited to only one hour. Despite the limited training, participants felt they had sufficient knowledge and skills to take the necessary pictures.Practical implicationsThis study provides important policy implications for school-based food programs, such as food pantries and free or reduced school meals, and how it plays an important role in refugee youth’s well-being and education. Based on feedback from the study participants, many school-based food programs were considered not available or easily accessible, and that youth and their families were often unaware of programs available to them. This study revealed the important role schools can play in ensuring food security among refugee youth and their families as well as for refugee youth to reach their full potential equitably.Originality/valueThis study used a creative research approach that integrates photovoice as a means to elevate the voices of a marginalized populations. This approach has been identified as one of the most culturally appropriate method when working with refugee children and youth (Pieloch et al., 2016). Second, the study included having multiple meetings, that recruited from previously established partnerships. This form of community building and activism elevates participants voices (Catalani and Minkler, 2009). Finally, this study used a cycle of photography and discussion and held a final public photo exhibition for both the participant’s community and its influential leaders (Catalani and Minkler, 2009; Evans-Agnew and Rosemberg, 2016). The results of this study have important policy implications for schools and communities.

Safe plates in the school space: Investigating compliance of food safety standards among school-based food service providers

Enhancing food safety measures within School-Based Food Service Providers (SBFSPs) is essential to safeguarding the well-being of students and school staff against foodborne risks. This study aims to assess the compliance of SBFSPs in primary and secondary schools with documentation protocols related to Good Manufacturing Practices (GMP), Good Hygiene Practices (GHP), Hazard Analysis and Critical Control Points (HACCP), and the necessary operational permits. We conducted a descriptive-correlational study spanning from April 2020 to March 2022, involving 138 public and private elementary and high schools selected through proportional stratified sampling. Each school underwent an audit using standardized checklists for GMP, GHP, and HACCP. Descriptive statistics, Fleiss Kappa, and Pearson chi-square tests were employed for data analysis. The results indicate that the participating schools do not meet the documentation requirements for GMP/GHP (29.7%), HACCP (2.9%), and operational permits (55.1%). Additionally, the schools received a "Very Poor" rating in terms of food safety compliance, with weighted mean rating scores of 2.45 ± 0.73 (GMP/GHP), 0.09 ± 0.02 (HACCP), and 1.69 ± 0.40 (operational permits). Furthermore, a significant relationship was observed between GMP/GHP and HACCP compliance and the characteristics of SBFSPs such as school kinds, types, places, and categories. The school GMP/GHP and HACCP compliance were also associated to the health permit of SBFSP personnel, authority to operate and manage school, and food handlers training. This study emphasizes the enforcement of compliance to food safety regulations, need to provide schools with adequate facilities and infrastructure, to promote a safe food production and consumption environment. It also underscores the importance of establishing partnerships for support and educating school personnel, especially those involved in food production and consumption, about GMP/GHP and HACCP principles to ensure the safety of meals for students, teachers, and other educational stakeholders. The need for certification of food handler in schools are of paramount importance, thereby advocating for increased food safety education.

Exploring the long-term sustainability of school-based nutrition and food programs: What works, where and why?

Most food and nutrition programs cease within 2 years. Understanding the determinants of program sustainability is crucial to maximise output from funding, whilst allowing sufficient time for program benefits to be achieved. This study applied the Consolidated Framework for Implementation Research (CFIR) to map the barriers and enablers of successful long-term implementation of school-based nutrition and food programs. Qualitative methods with purposive and snowball sampling were used to recruit experts who were identified as being influential in implementing and sustaining long-term (>2 years) school-based food and nutrition programs. Semi-structured interviews with global experts were conducted, transcribed verbatim and coded deductively (by applying the CFIR constructs) and inductively when required. Thematic analysis informed the development of themes. Interviews were conducted with 11 experts including researchers, government employees, and a consultant of an international agency, from seven countries. Forty-eight deductive codes and eight inductive codes identified six main themes: (1) funding and integrity of its source; (2) political landscape; (3) nutrition policies and their monitoring; (4) involvement of community actors; (5) adaptability of the program and (6) effective program evaluation. Themes related mainly to the 'outer setting' domain of the CFIR. The CFIR highlighted pertinent factors that influence the successful long-term implementation of school-based food and nutrition programs. SO WHAT?: The findings suggest that to sustain program implementation beyond its initial funding, relationships across government departments, local organisations and communities, need to be nurtured and prioritised from the outset.

Parasitic Contamination of Street Food Samples From School-Based Food Vendors of Dhaka City, Bangladesh

Street food is an old notion that arose from the need of quick access of light food to satisfy hunger. With the mention of street food in Bangladesh, a picture is visualized which includes open stalls with uncovered food, unawareness of vendors about hygienic practices, lack of safe source of water for cleaning and preparing food, increasing pollution in surrounding environment leading to infestation with various parasites and causing diarrhoeal diseases in people. The aim of the present study was to determine the prevalence of parasites in school-based street foods in Dhaka city. A total of 200 food samples were examined containing three representative types of street foods: tamarind water of snacks (79 samples), sliced fruits (71 samples) and fruit juices (50 samples) using Formal-ether concentration technique. Among them, 164 (82%) samples were contaminated with Entamoeba histolytica, Blastocystis hominis, Cystoisospora belli, Diphyllobothrium latum, Hymenolepis diminuta, Hymenolepis nana, Ascaris lumbricoides, Enterobius vermicularis, Trichuris trichiura and Ancylostoma duodenale. C. belli was the most prevalent (38%), followed by A. lumbricoides (33%) and B. hominis (33%). While comparing the parasite prevalence in three types of street foods, the highest prevalence was observed for C. belli (21.5% in tamarind water of snacks, 6.5% in sliced fruits and 10% in fruit juices) followed by A. lumbricoides, B. hominis and D. latum. There were significant associations (p&lt;0.05) among the different food types with B. hominis, C. belli, D. latum and A. lumbricoides positive samples. The study implicates that parasitic contamination of school-based street foods is alarming and it is urgent to take necessary steps to ensure the food safety. Bangladesh J. Zool. 51(2): 217-229, 2023

Emergency Food Support Preference and Usage During COVID-19: A Neighborhood Study of Low-Income Black Mothers? Use of School-Based Food Distribution and P-EBT.

COVID-19 disrupted families' food supply. Based on in-depth interviews with 45 Black low-income mothers of young children in an underserved Houston, Texas, neighborhood from April 2020 to June 2021, we compared two aid programs-Pandemic Electronic Benefits Transfer cash assistance and in-kind food distributions. We found that mothers preferred cash assistance for boosting existing food strategies, while food distributions presented new challenges for already burdened families. We argue that food assistance interventions can be more successful and equitable by integrating service user context, needs, and preferences. (Am J Public Health. 2023;113(S3):S227-S230. https://doi.org/10.2105/AJPH.2023.307458).

Developing healthy and sustainable school food systems: A collaborative practice in the city of Madrid

Abstract Problem Eating habits and lifestyle during childhood and adolescence are key to achieving an adequate health status in adulthood. Malnutrition, in the forms of overweight and obesity, disproportionately occurs among vulnerable communities. The question is: How can cities develop strategies and policies to stablish and maintain healthy and sustainable school food systems? In Madrid, the Healthy and Sustainable Food Strategy started in 2018-22 with a revised phase 2022-25 for the promotion of healthy and sustainable policies. Within the public nursery system, local NGOs, food and nutrition researchers, the education department and city officials collaborated to develop healthy and sustainable menus and public food procurement. This collaborative practice can be useful to other European cities. Objective To describe the example of Madrid developing collaborative policies (e.g. public food procurement standards) and activities between city administration, civil society and academia (e.g. creation of school based Food Driving Groups) towards healthy and sustainable school food systems. Results We will share two specific sets of results: 1) Creation of school-based Food Driving Groups. 2) Establishment of public food procurement criteria. More results will be presented at the conference. Lessons Regarding school food procurement criteria, it is necessary to improve the knowledge of the different socio-environmental variables of food. The development of school-based Food Driving Groups as a fruitful and sustained collaboration is only possible with the education department leadership.

Nutritional Value of Meals Designed for a School-Based Food Aid Program and Comparison with Similar Commercial Products: An Example of Good Practice from the DIATROFI Program.

Providing meals of high nutritional value should be the principal objective of large-scale school-based food aid programs. This study aimed at highlighting the nutritional value of meals distributed in the school-based food assistance DIATROFI Program by comparing them to their commercially available counterparts. For the purpose of this study, n = 13 DIATROFI meals and n = 50 commercial products from the 2016-2017 school year, and n = 12 DIATROFI meals and n = 40 commercial products from the 2022-2023 school year were selected. The protein, carbohydrate, total sugar, dietary fiber, total fat, sodium/salt content, and fatty acid methyl ester profile of DIATROFI meals were estimated through recipe simulation and national/international food databases, and verified through laboratory analyses while the relevant information was extracted from the label for commercial products. As verified by laboratory analyses and in comparison with food labels, most DIATROFI meals had lower total fat, saturated fatty acid, and sugar content, and most had higher dietary fiber content during both years. Many recipes' nutrient profiles also improved over time. DIATROFI meals present significant advantages over available commercial products. Such tailored-made school meals can prove to be advantageous in terms of nutrition profile compared to commercially available, which have yet to be impacted by food reformulation.

Pulse-Based Nutrition Education Intervention Among High School Students to Enhance Knowledge, Attitudes, and Practices: Pilot for a Formative Survey Study.

Promoting pulse consumption in schools could improve students' healthy food choices. Pulses, described as legumes, are rich in protein and micronutrients and are an important food choice for health and well-being. However, most Canadians consume very little pulse-based food. This pilot study sought to investigate outcomes of a teacher-led, school-based food literacy intervention focused on the Pulses Make Perfect Sense (PMPS) program in 2 high schools in Saskatoon, Saskatchewan. Both high schools were selected using a convenience sampling technique and have similar sociodemographic characteristics. The mean age of students was 16 years. The intervention comprised 7 key themes focused on pulses, which included defining pulses; health and nutritional benefits of pulses; incorporating pulses into meals; the role of pulses in reducing environmental stressors, food insecurity, and malnutrition; product development; taste testing and sensory analysis; and pulses around the world. A self-administered questionnaire was used to assess knowledge, attitudes, practices, and barriers regarding pulse consumption in students at baseline and study end. Teachers were interviewed at the end of the intervention. Descriptive statistics and the nonparametric Mann-Whitney U test were used for analysis. In total, 41 and 32 students participated in the baseline and study-end assessments, respectively. At baseline, the median knowledge score was 9, attitude score was 6, and barrier score was 0. At study end, the median knowledge score was 10, attitude score was 7, and barrier score was 1. A lower score for barriers indicated fewer barriers to pulse consumption. There was a significant difference between baseline and study-end scores in knowledge (P<.05). Barriers to pulse consumption included parents not cooking or consuming pulses at home, participants not liking the taste of pulses, and participants often preferring other food choices over pulses. The teachers indicated that the pulse food-literacy teaching resources were informative, locally available, and easy to use. Despite the improvements in knowledge, attitude, and practice, pulse consumption did not change significantly at the end of the intervention. Future studies with larger samples are needed to determine the impact of PMPS on knowledge, attitude, and practice of high school students.

School-Based Food Pantries & the COVID-19 Pandemic: Pantry Organizers Suggest Both Challenges and Opportunities

ABSTRACT To address food insecurity concerns presented by pandemic school closures, many communities relied on school mobile markets or on-site pantries. However, little scholarship has investigated how these programs adapted to the challenges presented by the pandemic. To address this absence, eleven food bank program coordinators who collectively manage over 200 school pantries were interviewed by phone. Our findings revealed a number of post-pandemic changes in the food distribution system and challenges in coordinating pantry efforts as on-site teacher-organizers shifted to remote learning. These findings suggest potential advantages to sharing best practices from schools who were successful in their crisis response.

How do adolescents classify foods as healthy and unhealthy?: A qualitative inquiry from rural India.

Indian adolescents exhibit obesogenic dietary habits including low intake of fruits and vegetables and increasing consumption of fast food and carbonated beverages. Adolescents' classification of healthy and unhealthy foods is likely to have significant implications for their dietary behaviour, and consequently, their health. However, there is limited evidence about the ways Indian adolescents classify foods as healthy or unhealthy. Hence, this qualitative study was designed to explore how Indian adolescents classify nutritious or non-nutritious food choices. Convenience sampling was used to recruit the study participants from Tikari village in Uttar Pradesh, India. Underpinned by the social constructivist lens, the adolescents were interviewed face-to-face in Hindi. All the interactions were digitally recorded, transcribed verbatim, and translated into English prior to data analysis. Transcribed data were analysed thematically using inductive as well as deductive coding, and subsequently, conceptual themes were extracted. A total of thirty-nine adolescents (twenty boys; nineteen girls) aged 10-19 years participated in this qualitative inquiry. The adolescents classified healthy and unhealthy foods based on the following six themes: (i) Food groups and nutrients; (ii) Health and immunity; (iii) Type of ingredient; (iv) Place and time of food preparation; (v) Packaging; and (vi) Parental influence. These findings can inform school-based food literacy interventions to foster healthy dietary habits and cooking skills among Indian adolescents.

Children's Perspectives on Food Allergy in Schools: A Qualitative Study.

Approximately 7% of children live with food allergy, a condition that requires dietary avoidance to prevent an allergic reaction. In this qualitative study, we aimed to understand food allergy-related experiences, beliefs and learning preferences among children with and without food allergies, to inform a school-based, food allergy education program. Data were analysed thematically. We virtually interviewed children in Kindergarten-Grade 8 in Manitoba, Canada, with (n = 7) and without (n = 9) parent-reported, physician-diagnosed food allergies. We identified three themes: Naive reliance on peers and school staff to assist with food allergy management; Limited food allergy knowledge; and, Recommended food allergy curricula: complementary perspective. Our findings will help inform the development of a school-based, food allergy education program, with a long-term goal of minimizing food allergy-related worries and optimizing safety for children with food allergy. Ongoing, school-based food allergy education is needed.

Indian adolescents’ perceptions of packaged food and food labels – A qualitative inquiry

In the last two decades, India has witnessed a dramatic rise in the consumption of packaged foods, especially among adolescents. Food labelling is often recognised as an instrumental population-based approach which can enable consumers to make informed food choices by providing all the necessary details about the food product on the packaging. In the Indian context, where adolescent obesity and the ensuing non-communicable diseases are escalating, it is crucial to understand adolescents' views on the use of non-nutritious packaged foods and food labels. Therefore, the aim of this qualitative inquiry was to explore Indian adolescents’ perceptions regarding the consumption of packaged food and use of food labels. Convenience sampling was employed to recruit 29 boys and 15 girls (aged 10–19 years) from rural Varanasi, India. Semi-structured, face-to-face interviews were conducted in the local language. Interview recordings were transcribed verbatim and translated to English. Narrative data were subjected to thematic analysis using NVivo software program. The adolescents reported frequent consumption of packaged food like potato chips, biscuits, chocolates, deep-fried Indian snacks both at school and home. Packaged foods were regarded as tasty, safe, and fresh. Brand name, date of expiry and cost were often read by the study respondents. Nevertheless, they reported difficulty in understanding other components of the label (e.g., nutrition information) and they were not aware of the negative impact of consuming unhealthy packaged foods. Nearly all the respondents insisted that food labels should be written in the local language for easy understanding. These emerging findings underscore the need to design school-based food literacy programs for vulnerable Indian adolescents to address obesity and diet-related complications in early adulthood.

Fruit and Vegetable Intake Is Associated with Food Knowledge among Children Aged 9-14 Years in Southwestern Ontario, Canada.

Interventions to improve dietary quality and intake of fruits and vegetables (FV) among Canadian children have had modest success, and it has been suggested that food knowledge could be key to improvement. Programs have been criticized for insufficiently connecting food knowledge with food skills and decision making about dietary intake. The objective of this study was to investigate factors associated with FV consumption by elementary school children, aged 9–14 years, in Ontario, Canada, including food knowledge, socioeconomic status, sociodemographic characteristics, and the food environment. In 2017–2019, a cross-sectional survey was administered to 2443 students at 60 elementary schools across Southwestern Ontario (SWO), Canada. A parent survey was used to validate self-reported sociodemographic variables. The mean intake of FV reported by these participants was 2.6 (SD 1.1) and 2.4 (SD 1.2) servings/day, respectively. A FV intake below WHO guidelines was reported by 40.7% of respondents. Knowledge score, child age, and parent employment status significantly predicted higher reported intake of FV. This study shows that FV intake among this population group is low, and increased intake is associated with higher food knowledge. To encourage healthy eating, school-based food and nutrition programs that incorporate multiple components and emphasize food literacy are needed.

Effect of School-Based Food and Nutrition Education Interventions on the Food Consumption of Adolescents: A Systematic Review and Meta-Analysis.

The school is a favorable environment for the development of interventions to prevent obesity. The objective of this systematic review is to evaluate the effects of school-based food and nutrition education interventions on adolescent food consumption. The literature search was conducted on databases: MEDLINE/PubMed, Embase, Scopus, ERIC, Science Direct, Web of Science, Cochrane, LILACS, and ADOLEC. The following research strategies were focused on: population (adolescents), intervention (food and nutrition education), outcome (food consumption), and study design (clinical trial). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement guidelines were followed and all stages of this review were performed by two researchers and, when necessary, a third researcher resolved discrepancies. Included studies are randomized clinical trials (RCT). A total of 24 articles were included for review and 11 articles in meta-analysis. In the evaluation of the general effects, there was a significant effect (mean difference (MD) for fruit consumption (MD = 0.09, CI 0.05, 0.14) in serving/day; and for vegetables (MD = 0.59, IC 0.15, 1.03) at times/week. In the consumption of FV (fruits and vegetables), there was no significant effect (standardized mean difference (SMD) of interventions in their consumption (SMD = 0.00, 95% C1 −0.11, 0.11). The evidence available in this review and meta-analysis concludes that food and nutrition education interventions in schools presented favorable results in the food consumption of adolescents. Registered on the PROSPERO database (CRD42019116520).

Evaluation of the PhunkyFoods intervention on food literacy and cooking skills of children aged 7–9 years: a cluster randomised controlled trial in Yorkshire Primary Schools UK

BackgroundChildhood obesity rates more than double during primary school in England. Acquiring competent cooking skills is a key part of children’s education that can lead to improved knowledge of a healthy lifestyle and dietary behaviours. Evaluation of the impact of ‘PhunkyFoods’, a school-based food and nutrition education programme, will assess food literacy, cooking skills and dietary behaviour in primary-school children.MethodsA cluster randomised controlled trial will be undertaken in 28 primary schools in North Yorkshire, UK, including a total population of children aged 7–9 years (n = 420). The trial has two arms: (a) the intervention group receiving PhunkyFoods programme (n = 210) and (b) the wait-list control group receiving the usual school curriculum (n = 210). The intervention ‘PhunkyFoods’ will be delivered by Purely Nutrition Ltd. The participating school staff are supported with training, policy development and access to resources to improve the delivery of nutrition education. Children participate through whole school assemblies, classroom activities, and after-school clubs about food preparation, cooking healthy meals and healthy living. Schools, parents and children have access to healthy meal recipes through the PhunkyFoods website. The primary outcomes are differences in food literacy and cooking skills scores between control and intervention arms after 12 months of the intervention and adjusted for baseline values. The secondary outcome is differences in fruit and vegetable intake between the arms after 12 months (adjusted for baseline). Treatment effects will be examined using mixed ANOVA and regression analysis. Primary analyses will adjust for baseline food literacy and cooking skills scores and secondary analysis will adjust for pre-specified baseline school and child level covariates.DiscussionThe PhunkyFoods programme is a flexible menu of options for schools to choose from, making this a highly complex intervention. Following Medical Research Council guidance, research perspectives will focus on effectiveness and theory-based approaches: to what extent the intervention produces the intended outcomes in real-world settings and what works in which circumstances.Trial registrationISRCTN ISRCTN68114155. Prospectively registered on 22 October 2021

A critical comparison of the Indian school food and nutrition guidelines with the WHO-nutrition friendly school initiative and the review of existing implementation scenario.

Background: The school-based food and nutrition guidelines approach has the potential to combat undernutrition, overnutrition and micronutrient deficiencies among children and adolescents and set the foundation for a healthy adult lifestyle. Aim: To critically compare the Nutrition Friendly School Initiative (NFSI) of the World Health Organization (WHO) with the Food Safety and Standards Authority of India (FSSAI) and the Indian Academy of Pediatrics (IAP) guidelines to gauge the strengths and limitations. Additionally, to summarize the existing studies on implementing school food and nutrition guidelines. Methods: Policy documents of the above guidelines were critically evaluated, and narrative analysis was conducted. An electronic search was conducted for full-text research articles published in the English language between January 2007 to September 2021 in Science Direct, PubMed, Web of Science, and SCOPUS databases. Results: Upon critical comparison of the three guidelines, it was found that the NFSI and FSSAI guidelines shared similarities in many components and the FSSAI guidelines, if implemented adequately, could improve the school food environment and combat the triple malnutrition burden in India. After screening the articles based on the eligibility criteria, 11 studies were included in the preparation of the review. Studies reported partial or inadequate implementation and poor compliance with the guidelines or approach. A few studies identified barriers to guideline implementation. Conclusion: Implementation of school food and nutrition guidelines could improve the nutritional outcomes in children and adolescents. To sustain the effective implementation, adequate resources and preparedness are essential in low-and middle-income countries, including India.

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

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.