To examine whether targeted determinants mediated the effects of the HEalth In Adolescents (HEIA) intervention on fruit and vegetable (FV) consumption and explore if these mediating effects were moderated by sex, parental education or weight status.

Cluster-randomised controlled trial.

The HEIA study (2007–2009) was a Norwegian 20-month multi-component school-based intervention to promote healthy weight development. FV consumption and targeted determinants were self-reported at baseline, mid-way (8 months) and post-intervention (20 months).

Adolescents (11–13-year-old) in twenty-five control schools (n 746) and twelve intervention schools (n 375).

At post-intervention, more adolescents in the intervention group compared with the control group had knowledge of the FV recommendations (OR: 1·4, 95 % CI 1·1, 1·9) and reported a decreased availability of vegetables at home (β: –0·1, 95 % CI –0·2, 0·0). Availability/accessibility of FV at home, availability of vegetables at dinner, taste preferences for different types of FV and knowledge of the FV recommendations were positively associated with the consumption of FV. However, none of the post-intervention determinants significantly mediated the intervention effects on FV consumption. Although no moderating influences by sex, parental education or weights status were observed on the mediating effects, exploratory analyses revealed significant moderations in the b-paths.

Since none of the targeted determinants could explain the increase in FV consumption, it remains unclear why the intervention was effective. Reporting on a wide range of mediators and moderators in school-based interventions is needed to reveal the pathways through which intervention effects are achieved.

The purpose of this study was to measure the impact of the Ajyal Salima school intervention on nutrition and physical activity outcomes in children aged 9–11 years.

The study was a 1-year cluster-randomised controlled trial. Ajyal Salima used a multi-component approach including classroom activities, family programme and food service adaptation. Outcomes included daily intake of breakfast, frequency of healthy and unhealthy food consumption, frequency of physical activity, knowledge score and self-efficacy score. Intervention and control groups were compared for all main outcomes and a post-intervention qualitative evaluation assessed strengths and limitations of the intervention components.

Schools in five countries – Lebanon, Jordan, Palestine, Saudi Arabia and Bahrain.

Schools were selected by Ministries of Health and Education within their jurisdictions. Forty-five intervention schools (6052 students) and forty-six control schools (6200 students) were included in the analysis.

The intervention group had a significantly higher odds of consuming breakfast daily (OR 95 % CI = 1·60, 1·35, 1·90), consuming healthy foods (OR 95 % CI = 1·60, 1·39, 1·84) and a decreased odds of consuming unhealthy foods and sweetened beverages (OR, 95 % CI = 0·70, 0·60, 0·81). Additionally, school children in the intervention group, as compared with the control group, were 47 % more likely to exercise outside school hours (OR 95 % CI = 1·47, 1·23, 1·76). Lastly, children in the intervention group had a significantly improved nutritional knowledge score and improved self-efficacy by 1·3 score unit and 1·1 score unit, respectively.

The Ajyal Salima intervention led to significant improvements in dietary and physical activity habits among school children and increased nutritional knowledge scores.

School-based CalFresh Healthy Living (CFHL) (California’s SNAP-Ed) interventions adapted to new learning environments necessitated by COVID-19. We examined the impact of these interventions on student diet and physical activity (PA) outcomes.

Quasi-experimental, two-group, pre-post.

California public schools with ≥50 % of students Free and Reduced Price Meal-eligible (nintervention = 47; ncomparison = 17).

Fourth- and fifth-grade students who completed the online Eating and Activity Tool for Students at pre and post (nintervention = 1087; ncomparison = 846 students).

Intervention students reported a significantly greater increase in consumption frequency of total fruit (by 0·16 times/d; P = 0·032), driven primarily by a greater increase in 100 % fruit juice (by 0·11 times/d; P = 0·007). Intervention students reported a significantly greater increase in total vegetable consumption frequency (by 0·45 times/d; P < 0·001) than comparison students. Specifically, intervention students reported increased, whereas comparison students reported decreased, consumption frequencies for starchy vegetables (0·05 v. −0·10 times/d, P < 0·001), salad/green vegetables (0·01 v. −0·11 times/d, P = 0·005) and beans (0·04 v. −0·03 times/d, P = 0·025). Consumption frequency of other vegetables decreased in both groups (−0·01 v. −0·09 times/d) but decreased more among comparison students (P = 0·048). No differences in pre-post change in PA outcomes were detected.

Findings suggest that despite COVID-19-related challenges necessitating programme modifications, CFHL interventions played a role in protecting student consumption of fruit and vegetables during the 2020–2021 school year. Therefore, it appears that school-based CFHL interventions can be a viable means of safeguarding student nutrition at a time when access to nutritious food and PA opportunities are hindered.

To assess the effects of a school-based intervention on the diets of 7–9-year-olds.

Dietary intake of children in second and fourth grades was assessed with 3d weighed dietary records in autumn 2006 and autumn 2008, before and after a school-based intervention that started in the middle of second grade, and compared with control schools with no intervention. The diet was evaluated by comparison with food-based dietary guidelines (FBDG) and reference values for nutrient intake. The intervention aimed at several determinants of intake: knowledge, awareness, preferences/taste, self-efficacy and parental influence. Nutrition education material was developed for the intervention and implemented in collaboration with teachers. The main focus of the intervention was on fruit and vegetable intake as the children’s intake was far from meeting the FBDG on fruit and vegetables at baseline.

Elementary schools in Reykjavik, Iceland.

Complete dietary records were available for 106 children both at baseline and follow-up.

Total fruit and vegetable intake increased by 47 % in the intervention schools (mean: 61·3 (sd 126·4) g/d) and decreased by 27 % in the control schools (mean: 46·5 (sd 105·3) g/d; P < 0·001). The majority of the children in the intervention schools did still not meet the FBDG on fruits and vegetables at follow-up. Fibre intake increased significantly in the intervention schools, as well as that of potassium, magnesium, β-carotene and vitamin C (borderline).

The school-based intervention in 7–9-year-olds was effective in increasing fruit and vegetable intake, by 47 % increase from baseline, which was mirrored in nutrient intake.

A school-based nutrition information programme was initiated in 1992 in two towns in northern France (Fleurbaix and Laventie, FL) and was followed by a number of community-based interventions. We took the opportunity to measure the outcomes in terms of childhood obesity and overweight over the next 12 years.

Repeated, cross-sectional, school-based survey. For the school years beginning in 1992, 2000, 2002, 2003 and 2004, the height and weight of all 5- to 12-year-old children attending school were measured in FL. In 2004, the same assessments were made in two comparison towns with similar socio-economic characteristics but no intervention.

Fleurbaix and Laventie (intervention towns), Bois-Grenier and Violaines (comparison towns), northern France.

In 2002, 2003 and 2004, respectively 515, 592 and 633 children were measured in FL (participation rate of 95–98 % of all eligible individuals); in the comparison towns, 349 children were measured in the 2004 school year (98 % of the towns’ school population).

After an initial increase, trends in mean BMI and prevalence of overweight started to reverse. Compared with 2002, the age-adjusted OR for overweight in FL was significantly lower in 2003 and 2004 (but for girls only). In the 2004 school year, the overweight prevalence was significantly lower in FL (8·8 %) than in the comparison towns (17·8 %, P < 0·0001).

These data suggest that, over a long period of time, interventions targeting a variety of population groups can have synergistic effects on overweight prevalence. This gives hope that it is possible to reverse trends towards increasing overweight by actions at the community level.

The aim of the present study was to pilot-test a school-based interventiondesigned to increase consumption of whole grains by 4th and 5th gradechildren.

This multi-component school-based pilot intervention utilised aquasi-experimental study design (intervention and comparison schools) thatconsisted of a five-lesson classroom curriculum based on Social CognitiveTheory, school cafeteria menu modifications to increase the availability ofwhole-grain foods and family-oriented activities. Meal observations ofchildren estimated intake of whole grains at lunch. Children and parentscompleted questionnaires to assess changes in knowledge, availability,self-efficacy, usual food choice and role modelling.

Parent/child pairs from two schools in the Minneapolis metropolitan area; 67in the intervention and 83 in the comparison school.

Whole-grain consumption at the lunch meal increased by 1 serving (P < 0·0001) andrefined-grain consumption decreased by 1 serving for children in theintervention school compared with the comparison school post-intervention(P < 0·001).Whole-grain foods were more available in the lunches served to children inthe intervention school compared with the comparison schoolpost-intervention (P <0·0001). The ability to identify whole-grain foods by children inboth schools increased, with a trend towards a greater increase in theintervention school (P =0·06). Parenting scores for scales for role modelling (P < 0·001) and enablingbehaviours (P <0·05) were significantly greater for parents in the interventionschool compared with the comparison school post-intervention.

The multi-component school-based programme implemented in the current studysuccessfully increased the intake of whole-grain foods by children.