The impact of a school-based nutrition education intervention on dietary intake and cognitive and attitudinal variables relating to fruits and vegetables
Open accessAbstract
Objective: To assess the impact of a school-based nutrition education intervention aimed at increasing the consumption of fruits and vegetables. Design: The intervention programme increased the provision of fruits and vegetables in schools and provided a range of point-of-purchase marketing materials, newsletters for children and parents, and teacher information. Curriculum materials at age 6–7 and 10–11 years were also developed and utilised. Evaluation was undertaken with groups of younger (aged 6–7 years) and older (aged 10–11 years) children. Methods included 3-day dietary records with interview and cognitive and attitudinal measures at baseline, with follow-up at 9 months, in intervention and control schools. Setting: The work was undertaken in primary schools in Dundee, Scotland. Subjects: Subjects comprised 511 children in two intervention schools with a further 464 children from two schools acting as controls. Results: Children (n= 64) in the intervention schools had an average increase in fruit intake (133±1.9 to 183±17.0 g day-1) that was significantly (P< 0.05) greater than the increase (100±11.7 to 107±14.2 g day-1) estimated in children (n= 65) in control schools. No other changes in food or nutrient intake were detected. Increases in scores for variables relating to knowledge about fruits and vegetables and subjective norms were also greater in the intervention than in the control group, although taste preferences for fruits and vegetables were unchanged. Conclusions: It is concluded that a whole school approach to increasing intakes of fruits and vegetables has a modest but significant effect on cognitive and attitudinal variables and on fruit intake.
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Included interventions consistently addressed foundational nutrition knowledge, including food and nutrient concepts, healthy eating, food groups, daily caloric intake, hydration, obesity-related knowledge, and balanced diet principles.
“Across studies, curriculum content consistently addressed foundational nutrition knowledge, including food and nutrient concepts, healthy eating, food groups, daily caloric intake, hydration, obesity-related knowledge, and balanced diet principles [43, 49, 51, 53–55, 62, 63].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [63]
The Intervention programme section describes curriculum materials focused on fruit-and-vegetable preparation and tasting; the assessment table also covers children’s understanding of healthy foods and healthier choices. This supports the claim’s healthy-eating and food-knowledge elements, but the paper does not document curriculum content on daily caloric intake, hydration, obesity, or balanced-diet principles. Page numbers are not available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredOnly a minority of included interventions modified access to healthier food or drink (two studies) or tackled media-literacy (three studies).
“Only a minority modified access to healthier food or drink (two studies [43, 44]) or tackled media-literacy (three studies [43, 47, 58, 63]) (Supplementary files 2; Table 1 key characteristics of studies included in the review).”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [63]
The Intervention programme section (page unavailable) says the study increased provision of fruits and vegetables in school tuck shops and lunches, supporting its identification as an intervention that modified access. It describes promotional materials and food-preparation activities, but does not establish that the intervention taught media literacy. As a single study, it also cannot substantiate the review-wide counts of two and three studies. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSeveral included interventions extended nutrition content to food processing, food classification, and label-related competencies, including label literacy, nutrition label comprehension, classification of healthy and unhealthy foods, recognition of processed and ultra-processed foods, and understanding of health and environmental implications of food choices.
“Several interventions extended this content to food processing, food classification, and label-related competencies, including label literacy, nutrition label comprehension, classification of healthy and unhealthy foods, recognition of processed and ultra-processed foods, and understanding of the health and environmental implications of food choices [43, 44, 53, 54, 59, 62, 63].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [63]
The Discussion’s Table 2 describes asking children to identify healthy and less healthy foods, sort foods by fruit-and-vegetable content, and choose the healthier of two options. The Intervention programme describes food preparation and tasting, but our copy does not support attributing label literacy, nutrition-label comprehension, recognition of processed or ultra-processed foods, or environmental implications to this intervention. No page numbers are available in the indexed passages. (LLM, conf=0.86)
Experimental — accuracy not yet measuredLessons in included cooking interventions commonly included food safety, basic preparation skills, and working with recipes, with some classes compiling a cookbook from student work.
“Lessons commonly included food safety, basic preparation skills, and working with recipes, with some classes compiling a cookbook from student work [48, 63].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [63]
The Intervention programme section (page not provided) says the curriculum materials focused largely on practical food preparation and tasting, supporting the preparation-skills portion. It does not describe food-safety lessons, working with recipes, or student-made cookbooks, and this single intervention does not establish what lessons commonly included across interventions. (LLM, conf=0.85)
Experimental — accuracy not yet measuredTools such as goal-setting worksheets, self-monitoring logs, and home tasks were used in included interventions to help children monitor and adjust their behaviors over time.
“Tools such as goal-setting worksheets, self-monitoring logs, and home tasks were used to help children monitor and adjust their behaviors over time [52, 56, 63].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [63]
The Intervention programme section (page not provided) says the curriculum used written work and self-monitoring materials, supporting the general point that children had tools for monitoring behavior. It does not identify goal-setting worksheets or home tasks, or say that the materials helped children adjust their behavior over time. The 3-day food diaries described in Assessment of food and nutrient intakes (page not provided) were used for evaluation, not identified as intervention logs. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Meta-regression using region/ethnicity (East Asian vs. other) yielded β = −1.06 (95% CI −2.24 to 0.11; p = 0.15); East Asian trials showed smaller gains in nutritional knowledge, but the difference was not statistically significant.
“Meta-regression using region/ethnicity (East Asian [53–55] vs. other [58, 62, 63]) yielded β = −1.06 (95% CI − 2.24 to 0.11; p = 0.15) [58, 62]; East Asian trials showed smaller gains in nutritional knowledge, but the difference was not statistically significant.”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [63]
The Overview describes a school intervention in Dundee, Scotland, and the Results report higher healthier-choice knowledge scores in the intervention group than in controls. This supports identifying the paper as a non-East Asian trial, but its Statistical analysis describes a within-study comparison, not the attributed East Asian-versus-other meta-regression; the reported coefficient, confidence interval, and p-value are not supported by this paper. (LLM, conf=0.85)
Experimental — accuracy not yet measuredTwo other included studies used media primarily to communicate and reinforce intervention messages through newsletters, school-wide announcements, posters, poster contests, and quizzes, rather than to develop students' critical evaluation of media content.
“In contrast, two other studies used media primarily to communicate and reinforce intervention messages through newsletters, school-wide announcements, posters, poster contests, and quizzes, rather than to develop students’ critical evaluation of media content [44, 63].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [63]
The meta-analysis included studies reporting results based on nutritional knowledge (10 studies) and nutritional behavior (10 studies).
“Includes studies reporting results based on nutritional knowledge (10 studies) [43, 49, 53–55, 57, 58, 61–63] and nutritional behavior (10 studies) [44, 46, 48, 50, 52, 53, 56, 59, 61, 64], as seen in Fig. 1.”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [63]
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Cites
(1980) · Medical Entomology and Zoology · Cited by 25,810 · see citing works
Diet, nutrition and the prevention of chronic diseases
Joint, W. (2002) · Medical Entomology and Zoology · Cited by 4,889 · see citing works
Kushi, L. H., Byers, T., Doyle, C., Bandera, E. V., McCullough, M., Gansler, T., Andrews, K. S., Thun, M. J., & The American Cancer Society 2006 Nutrition and Physical Activity Guidelines Advisory Committee (2006) · CA A Cancer Journal for Clinicians · doi:10.3322/canjclin.56.5.254 · Cited by 1,901 · see citing works
DEVELOPMENT OF FOOD PREFERENCES
Birch, L. L. (1999) · Annual Review of Nutrition · doi:10.1146/annurev.nutr.19.1.41 · Cited by 1,757 · see citing works
Fruit and vegetables, and cardiovascular disease: A review
Ness, A. R., & Powles, J. W. (1997) · International Journal of Epidemiology · doi:10.1093/ije/26.1.1 · Cited by 1,368 · see citing works
Deprivation and Health in Scotland
Tunstall-Pedoe, H. (1993) · Postgraduate Medical Journal · doi:10.1136/pgmj.69.814.665-a · Cited by 1,172 · see citing works
Deprivation and Health in Scotland
Thunhurst, C. (1992) · Journal of Epidemiology & Community Health · doi:10.1136/jech.46.1.87 · Cited by 824 · see citing works
What kind of exposure reduces children's food neophobia?
Birch, L. L., McPhee, L., Shoba, B. C., Pirok, E. W., & Steinberg, L. (1987) · Appetite · doi:10.1016/s0195-6663(87)80011-9 · Cited by 566 · see citing works
The effect of diet on risk of cancer
Key, T. J., Allen, N. E., Spencer, E. A., & Travis, R. C. (2002) · The Lancet · doi:10.1016/s0140-6736(02)09958-0 · Cited by 510 · see citing works
Increasing children's acceptance of vegetables; a randomized trial of parent-led exposure
Wardle, J., Cooke, L. J., Gibson, E. L., Sapochnik, M., Sheiham, A., & Lawson, M. S. (2003) · Appetite · doi:10.1016/s0195-6663(02)00135-6 · Cited by 490 · see citing works
National diet and nutrition survey: young people aged 4 to 18 years
Robinson, S. F. (2001) · Cited by 428 · see citing works
The Influence of Social-Affective Context on the Formation of Children's Food Preferences
Birch, L. L., Zimmerman, S., & Hind, H. (1980) · Child Development · doi:10.2307/1129474 · Cited by 393 · see citing works
McCance and Widdowson's The Composition of Foods
Royal Society of Chemistry (2003) · Nutrition & Food Science · doi:10.1108/nfs.2003.33.6.294.1 · Cited by 367 · see citing works
Implications of childhood obesity for adult health: findings from thousand families cohort study
Wright, C. M., Parker, L., Lamont, D., & Craft, A. W. (2001) · BMJ · doi:10.1136/bmj.323.7324.1280 · Cited by 360 · see citing works
Gimme 5 Fruit, Juice, and Vegetables for Fun and Health: Outcome Evaluation
Baranowski, T., Davis, M. A., Resnicow, K., Baranowski, J. C., Doyle, C., Lin, L. S., Smith, M. J., & Wang, D. T. (2000) · Health Education & Behavior · doi:10.1177/109019810002700109 · Cited by 356 · see citing works
Perry, C. L., Bishop, D., Taylor, G., Murray, D. M., Mays, R. W., Dudovitz, B., Smyth, M., & Story, M. T. (1998) · American Journal of Public Health · doi:10.2105/ajph.88.4.603 · Cited by 339 · see citing works
The Influence of Social-affective Context on the Formation of Children's Food Preferences
Birch, L. L., Zimmerman, S. I., & Hind, H. (1980) · Child Development · doi:10.1111/j.1467-8624.1980.tb02623.x · Cited by 335 · see citing works
Increasing the Fruit and Vegetable Consumption of Fourth-Graders: Results from the High 5 Project
Reynolds, K. D., Franklin, F. A., Binkley, D., Raczynski, J. M., Harrington, K. F., Kirk, K. A., & Person, S. (2000) · Preventive Medicine · doi:10.1006/pmed.1999.0630 · Cited by 271 · see citing works
5 a day for better health: A new research initiative
Havas, S., Heimendinger, J., Reynolds, K. D., Baranowski, T., Nicklas, T. A., Bishop, D. B., Buller, D. B., Sorensen, G., Beresford, S. A. A., Cowan, A., et al. (1994) · Journal of the American Dietetic Association · doi:10.1016/0002-8223(94)92037-0 · Cited by 250 · see citing works
Changing the diet of America's children: What works and why?
Lytle, L. M., & Achterberg, C. (1995) · Journal of Nutrition Education · doi:10.1016/s0022-3182(12)80793-x · Cited by 171 · see citing works
Nicklas, T., Johnson, C. C., Myers, L., Farris, R., & Cunningham, A. (1998) · Journal of School Health · doi:10.1111/j.1746-1561.1998.tb06348.x · Cited by 171 · see citing works
(1991) · Royal Society of Chemistry eBooks · doi:10.1039/9781849732499 · Cited by 166 · see citing works
Milk Products and Eggs: Fourth Supplement to McCance and Widdowson's the Composition of Foods
Holland, B. R., Unwin, I. D., Buss, D. H., McCance, R. A., & Widdowson, E. M. (1989) · Medical Entomology and Zoology · Cited by 154 · see citing works
Vegetables, herbs and spices: fifth supplement to McCance and Widdowson's The Composition of Foods.
Holland, B. R., Unwin, I. D., & Buss, D. H. (1991) · Medical Entomology and Zoology · Cited by 149 · see citing works
(1993) · Royal Society of Chemistry eBooks · doi:10.1039/9781849732611 · Cited by 143 · see citing works
Holland, B. R., BROWN, J. H., & Buss, D. H. (1993) · Cited by 140 · see citing works
(1992) · Royal Society of Chemistry eBooks · doi:10.1039/9781849732482 · Cited by 135 · see citing works
(1995) · Royal Society of Chemistry eBooks · doi:10.1039/9781849732475 · Cited by 118 · see citing works
Johnsen, D. (1992) · Food / Nahrung · doi:10.1002/food.19920360456 · Cited by 111 · see citing works
Cereals and cereal products: third supplement to McCance and Widdowsons the Composition of foods
Holland, B. R., McCance, R. A., Widdowson, E. M., Unwin, I. D., & Buss, D. H. (1988) · Royal Society of Chemistry eBooks · Cited by 108 · see citing works
(1996) · Royal Society of Chemistry eBooks · doi:10.1039/9781849732505 · Cited by 106 · see citing works
(1994) · Royal Society of Chemistry eBooks · doi:10.1039/9781849732604 · Cited by 106 · see citing works
Davies, D. J. (1991) · Nutrition Bulletin · doi:10.1111/j.1467-3010.1991.tb01053.x · Cited by 104 · see citing works
Haenel, H. (1988) · Food / Nahrung · doi:10.1002/food.19880321031 · Cited by 86 · see citing works
McCance, R. A., Widdowson, E. M., Holland, B. R., et al. (1993) · Medical Entomology and Zoology · Cited by 85 · see citing works
An effective procedure for changing food preferences in 5–7-year-old children
Horne, P. J., Lowe, C. F., Fleming, P. F. J., et al. (1995) · Proceedings of The Nutrition Society · doi:10.1079/pns19950013 · Cited by 79 · see citing works
Behnke, U. (1995) · Food / Nahrung · doi:10.1002/food.19950390312 · Cited by 78 · see citing works
BIRCH, G. G. (1997) · Food Chemistry · doi:10.1016/0308-8146(97)90004-2 · Cited by 58 · see citing works
Young, I. S. (1993) · Health Education Journal · doi:10.1177/001789699305200102 · Cited by 47 · see citing works
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Sorted by citations
Langford, R., Bonell, C. P., Jones, H. E., Pouliou, T., Murphy, S. M., Waters, E., Komro, K. A., Gibbs, L. F., Magnus, D., & Campbell, R. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008958.pub2 · Cited by 768 · see citing works
Langford, R., Bonell, C., Jones, H., Pouliou, T., Murphy, S., Waters, E., Komro, K., Gibbs, L., Magnus, D., & Campbell, R. (2015) · BMC Public Health · doi:10.1186/s12889-015-1360-y · Cited by 578 · see citing works
“Anderson 2005 [19] Nutrition UK 6-7 and 10–11 year- olds 8 months Health Promoting Schools framework”
BackgroundHackman, C., & Knowlden, A. (2014) · Adolescent Health, Medicine and Therapeutics · doi:10.2147/ahmt.s56207 · Cited by 132 · see citing works
Somerset, S., & Markwell, K. (2009) · Public Health Nutrition · doi:10.1017/s1368980008003327 · Cited by 130 · see citing works
The Health Promoting Schools Framework: Known Unknowns and an Agenda for Future Research
Langford, R., Bonell, C., Komro, K., Murphy, S., Magnus, D., Waters, E., Gibbs, L., & Campbell, R. (2017) · Health Education & Behavior · doi:10.1177/1090198116673800 · Cited by 130 · see citing works
Prelip, M., Slusser, W., Thai, C. L., Kinsler, J., & Erausquin, J. T. (2011) · Journal of School Health · doi:10.1111/j.1746-1561.2011.00622.x · Cited by 73 · see citing works
Posri, S., Powwattana, A., Lagampan, S., Chongsuwat, R., Boonmanunt, S. W., & Wongkampun, S. (2026) · BMC Public Health · doi:10.1186/s12889-026-27909-w
“A substantial proportion of interventions incorporated experiential and skill-based learning, particularly cooking, food preparation, tasting, and sensory activities [45–48, 50, 52, 56, 59–61, 63].”
Influential
- Authors
- Anderson, A., Porteous, L., Foster, E., Higgins, C., Stead, M., Hetherington, M., Ha, M.-A., & Adamson, A.
- Affiliations
- University of Dundee (GB)
- Newcastle University (GB)
- University of Strathclyde (GB)
- University of Liverpool (GB)
- Venue
- Public Health Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2005-09
- Volume
- 8
- Issue
- 6
- Pages
- 650-656
- ISSN
- 1368-9800 (ISSN-L)
- 1475-2727
- OpenAlex
- W2076681324
- Semantic Scholar
- 85315a8be3f385f7e4f37d0c4fcd2471f602042b
- Cited by
- 192
- References
- 39
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 6 · 2023: 9 · 2022: 9 · 2021: 14 · 2020: 20 · 2019: 9 · 2018: 7 · 2017: 4 · 2016: 9 · 2015: 16 · 2014: 18 · 2013: 7 · 2012: 14
- FWCI
- 2.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Public Health Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (publishedVersion)
- University of Brighton Repository (University of Brighton) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- National Institute for Health and Care Research (PHCS/C4/4/008)
- Food Standards Agency
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- school-based nutrition education, fruit and vegetable intake, dietary intake, children, elementary school students, point-of-purchase marketing, school food provision, nutrition knowledge, subjective norms, taste preference, dietary behavior change, whole-school approach
- MeSH terms
- Child, Female, Food Preferences, Food Services, Fruit, Health Education, Health Promotion, Humans, Health Knowledge, Attitudes, Practice, Male, Schools, Scotland, Students, Vegetables, Diet Records, Nutritional Sciences
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