School-based nutrition education programs
School-based nutrition education programs include educational components such as classroom instruction by teachers, nutrition education curricula, and peer training as well as environmental components such as healthy school menu offerings, classroom snacks, and fruit and vegetable taste tests. Programs also often include other components such as family education and involvement, healthy school culture, and community involvement efforts. Specific components vary by program1. Some states regulate nutrition education programs.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Improved dietary habits
Increased fruit & vegetable consumption
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Reduced sweetened beverage consumption
Improved weight status
What does the research say about effectiveness?
There is some evidence that school-based nutrition education programs increase healthy eating habits for children and adolescents1, 2, 3, 4, 5, 6, including increasing fresh fruit and vegetable consumption4, 5, 6. Additional evidence is needed to confirm effects, especially over the long term3.
Nutrition education interventions that use a whole school approach can increase participants’ consumption of high-fiber foods, healthier snacks, water, milk, and fruits and vegetables, as well as reduce consumption of low-nutrient dense foods, high fat foods, and sugar sweetened beverages (SSBs), and decrease breakfast skipping4. School-based nutrition education programs that include food environment changes and family support have been shown to improve healthy eating attitudes and knowledge, and increase fruit and vegetable consumption3, 5, which can lead to improved weight status, including reduced body mass index (BMI)3. In some cases, school-based nutrition education can reduce BMI for children and adolescents; interventions with longer durations have greater effects6, 7. However, in other instances, participation in school-based nutrition and physical activity education programs does not reduce children’s BMI8.
Educational interventions may be more effective for girls9, 10. Boys appear to respond more effectively to structural interventions9.
The most successful school-based nutrition education interventions are intensive, comprehensive, whole school interventions, that last longer than a year and include changes to promote a healthy school food environment as well as efforts to increase parental or family support1, 4, 9. Research also suggests such interventions be theory-based, incorporated into regular school curriculum and activities, and have support from policy makers and school management1, 6, 9, 11.
An Iowa-based study suggests that adding a parent-oriented social media marketing campaign to school-based nutrition education programs can increase nutrition knowledge and consumption of fruits, vegetables, and low-fat milk12.
Implementation Examples
The National Association of State Boards of Education runs the Obesity Prevention Project which supports states in creating policy tools (such as nutrition education programs) to reduce obesity rates13. Team Nutrition is a U.S. Department of Agriculture program that supports child nutrition programs through training and technical assistance14.
The Shaping Healthy Choices Program (SHCP), developed at the Center for Nutrition in Schools at UC-Davis, is an example of a multi-component intervention that combines nutrition education, family and community support, school food environment improvements, and school wellness policies. SHCP includes school gardens, cooking demonstrations, family newsletters, salad bars featuring regional produce, and school-wide health fairs with educational booths and games15. Cooking with Kids is another example of a hands-on food and nutrition education program that operates in Santa Fe, New Mexico and as a pilot program in Colorado. Cooking with Kids includes a tasting curriculum, recipes, and classroom nutrition lessons with Spanish translations16.
As of 2014, only 35% of school districts require a school nutrition education curriculum for each grade level17.
Implementation Resources
WI DPI-Nutrition - Wisconsin Department of Public Instruction (WI DPI). Team nutrition.
SNA - School Nutrition Association (SNA). Teaching kids about nutrition.
LHC-Rockeymoore 2014 - Rockeymoore M, Moscetti C, Fountain A. Rural childhood obesity prevention toolkit. Leadership for Healthy Communities (LHC), Center for Global Policy Solutions, Robert Wood Johnson Foundation; 2014.
CNS-SHCP guide 2017 - Center for Nutrition in Schools (CNS), University of California-Davis. The Shaping Healthy Choices Program (SHCP) in action: A best practices guide. Second edition; 2017.
Footnotes
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1 Meiklejohn 2016 - Meiklejohn S, Ryan L, Palermo C. A systematic review of the impact of multi-strategy nutrition education programs on health and nutrition of adolescents. Journal of Nutrition Education and Behavior. 2016;48(9):631-646.e1.
2 Wolfenden 2017 - Wolfenden L, Nathan NK, Sutherland R, et al. Strategies for enhancing the implementation of school-based policies or practices targeting risk factors for chronic disease. Cochrane Database of Systematic Reviews. 2017;(11):CD011677.
3 Yip 2016 - Yip C, Gates M, Gates A, Hanning RM. Peer-led nutrition education programs for school-aged youth: A systematic review of the literature. Health Education Research. 2016;31(1):82-97.
4 Wang 2013b - Wang D, Stewart D. The implementation and effectiveness of school-based nutrition promotion programmes using a health-promoting schools approach: A systematic review. Public Health Nutrition. 2013;16(6):1082-1100.
5 Langford 2014 - Langford R, Bonell CP, Jones HE, et al. The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement. Cochrane Database of Systematic Reviews. 2014;(4):CD008958.
6 Silveira 2011 - Silveira JAC, Taddei JAAC, Guerra PH, Nobre MRC. Effectiveness of school-based nutrition education interventions to prevent and reduce excessive weight gain in children and adolescents: A systematic review. Jornal de Pediatria. 2011;87(5):382-392.
7 da Silveira 2013 - da Silveira JAC, Taddei JAAC, Guerra PH, Nobre MRC. The effect of participation in school-based nutrition education interventions on body mass index: A meta-analysis of randomized controlled community trials. Preventive Medicine. 2013;56(3-4):237-243.
8 Guerra 2014 - Guerra PH, Nobre MRC, da Silveira JAC, Taddei JAAC. School-based physical activity and nutritional education interventions on body mass index: A meta-analysis of randomised community trials - Project PANE. Preventive Medicine. 2014;61:81-89.
9 Guerra 2016 - Guerra PH, da Silveira JAC, Salvador EP. Physical activity and nutrition education at the school environment aimed at preventing childhood obesity: Evidence from systematic reviews. Jornal de Pediatria. 2016;92(1):15-23.
10 Kropski 2008 - Kropski JA, Keckley PH, Jensen GL. School-based obesity prevention programs: An evidence-based review. Obesity. 2008;16(5):1009-18.
11 Murimi 2017 - Murimi MW, Kanyi M, Mupfudze T, et al. Factors influencing efficacy of nutrition education interventions: A systematic review. Journal of Nutrition Education and Behavior. 2017;49(2):142-165.e1.
12 Blitstein 2016 - Blitstein JL, Cates SC, Hersey J, et al. Adding a social marketing campaign to a school-based nutrition education program improves children’s dietary intake: A quasi-experimental study. Journal of the Academy of Nutrition and Dietetics. 2016;116(8):1285-1294.
13 NASBE-Student health - National Association of State Boards of Education (NASBE). Student health.
14 USDA-Team nutrition - U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS). Team nutrition.
15 CNS-SHCP - Center for Nutrition in Schools (CNS), University of California-Davis. Shaping Healthy Choices Program (SHCP).
16 CWK-Nutrition ed - Cooking with Kids. Cooking with Kids educates and empowers children and families to make healthy food choices through hands-on learning with fresh, affordable foods.
17 BTG-School nutrition 2014 - Bridging the Gap (BTG) Research Program, Centers for Disease Control and Prevention (CDC). Strategies for creating supportive school nutrition environments. Atlanta, Georgia. 2014.
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