Effectiveness of School-based Nutrition Education Programs that Include Environmental Sustainability Components, on Fruit and Vegetable Consumption of 5-12YearOld Children: A Systematic Review.

Abstract

Introduction: This systematic review examined the effectiveness of interventions of school-based nutrition education programs that included environmental sustainability components in addressing fruit and vegetable (F&V) consumption and/or variety among children (aged 5-12 years).

Methods: The systematic search included MEDLINE, CINAHL, ERIC, Global Health, PsychINFO, EMBASE, the Cochrane Library, and 3 clinical trial registries. Searches between January 1, 1987, and February 22, 2022, found 18 eligible studies. The Evidence Project risk-of-bias (RoB) tool was used for quality assessment.

Results: Sixteen studies had moderate-to-high RoB, and 2 had low RoB. Eight studies reported significant increases in F&V consumption and/or variety. Programs that included environmental sustainability experiential components (i.e., gardening, tasting F&Vs, and cooking activities) and were underpinned by a theoretical framework were more likely to report significant outcomes than studies that reported no effects.

Conclusions and implications: This review underscores the benefits of school-based nutrition education programs that incorporate experiential components of environmental sustainability. These findings could support future researchers in designing strategies to improve children's F&V consumption by incorporating the experiential components of environmental sustainability into nutrition programs. In addition, conducting process evaluations to gather teachers' input to overcome common implementation barriers, performing long-term follow-up assessments to monitor behavioral changes over time, and implementing school policies to support these programs could also be beneficial. This review was registered with the International Prospective Register of Systematic Reviews (CRD42020184727).