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Page 2
Author, Year, Country, Funding agency
Design, Dominant/Theory Framework*
Sample
Treatment Length
Teaching Strategy/Approach
Coupled with Physical Activity
Coupled with Specially-resourced teachers
Relevant Outcome Categories
Statistical Significance (pvalue/95% CI)
Effect Size (Cohen’sd)
M 1 - M 2/SDpooled
Randomised Controlled Trials
Francis et al. (2010) Trinidad & Tobago, Self-funded [40]
RCT/NR
579 x Grade 6 students
32 weeks
(Curriculum approach) Bloom’s mastery learning model
Gortmaker et al. (1999) USA, Walton Family Foundation [48]
QE/SCT BCT
336 x Grades 4–5 students
2 years
Cross-curricular (Math, science, language, social studies, physical education) coupled with a Social Marketing Approach
√
X
24 hr recall of Daily Dietary Intake
Insufficient data reported for calculation
Mean age: 9.1 yrs
- Energy from fat (%)
.04
- FV consumption (Servings/4184 kJ)
.01
- Vitamin C (mg/4184 kJ)
.01
Govula et al. (2007) USA, NR [30]
QE/NR
33 x Grade 3 students
6 weeks
(Curriculum approach) MyPyramid and Medicine Wheel Nutrition for Native Americans
X
X
Block Kids Fruit/Vegetable recall
- F&V consumption (Servings/per day)
.010
.10
Mean age: NR
Culturally appropriate lessons
- Fruit consumption (Servings/per day)
.519
−0.26
- Vegetable consumption (Servings/per day)
<.001
1.04
Knowledge Questionnaire (% correct)
<.001
Insufficient data
Horne et al. (2004) UK, Horticultural Development Council, Fresh Produce Consortium, ASDA, Co-operative Group, Safeway, Sainsbury, Somerfield, Tesco, Bird’s Eye [31]
QE/SLT
749 x Grades K-6 students
16 weeks
Animation abstraction and contingent reinforcement for F&V consumption
X
X
Consumption based on teacher visual estimates
Mean age: NR
- 5-7 yr/old fruit (%)
<.002
2.12
- 5-7 yr/old vegetable (%)
NR
2.01
- 7-11 yr/old fruit (%)
<.002
2.36
- 7-11 yr/old vegetable (%)
NR
1.51
Liquori et al. (1998) USA, NR [49]
QE/SCT
590 x Grades K-6 students
1 year
Experiential learning (Cooking, environment and community garden)
X
√
Food intake based on teacher visual estimates (%)
Grd K-3
Grd 4–6
Grd K-3
Grd 4-6
<.01
NS
−1.90
−2.03
Mean age: NR
Self report
- Preference for plant food
<.001
<.001
2.51
0.00
- Attitudes
NS
NS
0.59
0.04
- Knowledge
<.05
<.001
1.98
1.94
- Self efficacy in cooking
NS
<.05
0.79
0.70
- Food intentions
<.01
NS
0.63
−0.17
- Paired food choice
<.01
NS
1.58
−0.06
Manios et al. (2002), Greece, Kellogg’s, Greek Ministry of Sport, Greek Ministry of Education [50]
QE/NR
1006 x Grade 1 students
6 years
(Curriculum approach) Literary abstraction
√
√
Parental reporting (Food Diary)
Age range: 5.5-6.5 yrs
- Energy (kJ)
<.05
−0.38
- Total fat (g)
<.05
−0.38
- Protein (g)
<.05
−0.42
- Carbohydrate (g)
NS
−0.23
McAleese & Rankin (2007), USA, NR [36]
QE/NR
99 x Grade 6 students
12 weeks
(Curriculum approach) Nutrition in the Garden
X
X
24 hr recall of Daily Dietary Intake
Mean age: 11.11 yrs
Experiential learning (School garden)
- Fruit (Servings/day)
<.001
1.17
- Vegetables (Servings/day)
<.001
0.92
- Vitamin A (μg/day)
.004
0.20
- Vitamin C (mg/day)
.016
0.49
- Fibre (g/day)
.001
0.56
Morgan et al. (2010) Australia, Hunter Medical Research, Coles [51]
QE/SCT
127 x Grades 5–6 students
10 weeks
(Curriculum approach) Nutrition in the Garden – Modified
X
X
FV knowledge (Gimme 5 Questionnaire)
<.02
Insufficient data reported for calculation
Age range: 11-12 yrs
Experiential learning (School garden)
24 hr recall of Daily Dietary Intake
.22
- Vegetable intake (Servings/day)
.23
- Fruit intake (Servings/day)
Simmons-Morton et al. (1991), USA, HHLBI Grant [52]
QE/SCT
135 x Grades K-4 students)
40 weeks
(Curriculum approach) Behaviour-based Health & Physical Education
√
√
24 hr recall of Daily Dietary Intake
Mean age: NR
(Canteen) New School Lunch
- Analysis of tray lunch (% kcals)
<.05
−0.10
- Analysis of bag lunch (% kcals)
<.05
0.03
Cluster-Controlled Trials
Agozzino et al. (2007), Italy, NR [53]
CT/CogT
570 x students (30 x 4 & 5 grade classes)
40 weeks
(Curriculum approach) Didactic-approach to health education
X
√
24 hr recall of Daily Dietary Intake
Insufficient data reported for calculation
- Breakfast consumption (Sufficient)
<.001
- Meat consumption (Sufficient)
.003
- Fish consumption (Sufficient)
.02
- Pulse consumption (Sufficient)
.003
- Vegetable consumption (Sufficient)
<.001
Amaro et al. (2005), Italy, Amici di Raoul Follereau (AIFO) [54]
CT/NR
241 x students Mean age: 12.4 yrs
24 weeks
Kalèdo Board Game (15-30mins play time p/w)
X
X
Nutritional knowledge (31 items)
<0.05
Insufficient data reported for calculation
BMI (z-score)
NS
Anderson et al. (2005), UK, Food Standards Agency [55]
CT/TPB
129 x Grades 1–6 students
36 weeks
(Curriculum approach) based on experiential learning, video & literary abstraction
X
X
Cognitive & attitudinal (Likert scale)
Mean age: 8.5 yrs
Marketing and canteen provisions
- Diet heart disease knowledge
.001
0.24
- Preference for HFSS foods
.034
−0.32
3-day food diary
- FV consumption (g)
.617
0.07
- Energy (kJ)
.327
0.00
- Sucrose (g)
.578
0.01
Baronowski et al. (2000), USA, NR [32]
CT/SCT
3347 x Grades 4–6 students
12 weeks
(Curriculum approach) Gimme 5
X
X
7-day food record
Mean age: NR
Experiential learning, goal setting & problem solving, contingent reinforcement for F&V consumption
- FV consumption (Servings)
<.05
0.03
- Vegetable consumption(Servings)
<.01
0.00
Questionnaire (Likert scale)
- Self efficacy (Eating FV)
<.10
0.02
- Social norms
<.10
0.00
- Asking behaviour
<.05
0.06
- Knowledge
<.05
0.05
Bere et al. (2006), Norway, Norwegian Research Council [56]
CT/SCT
369 x Grade 6 students
28 weeks
(Curriculum approach) National Curriculum
X
√
24 hr recall of Daily Dietary Intake
Insufficient data reported for calculation
Mean age: 11.3 yrs
Experiential learning (Cooking/Food Prep)
- FV consumption (Servings per day)
.41
Curriculum enjoyment (Likert scale)
.004
Cooke (2011), UK, Medical Research Council National Prevention Research Initiative [57]
CT/mixed
442 x Kindergarten students
2 weeks
Contingent reinforcement for vegetable tasting
X
X
Liking of vegetables (Likert scale)
.001
Insufficient data reported for calculation
Mean age: 6 yrs
Intake of vegetables
.001
Day et al. (2008), Canada, NR [58]
CT/NR
444 x Grades 4–5 students
12 weeks
Integrates classroom learning, environmental change strategies, and a family/community component to promote the consumption of FV
X
X
24 hr recall of Daily Dietary Intake
Mean age: 10.0 yrs
- Fruit consumption (Servings)
<.05
−0.04
- Vegetable consumption (Servings)
NS
−0.05
- F V consumption (Servings)
<.05
−0.06
- Variety of FV consumption (Servings)
<.05
−0.01
Domel et al. (1993) USA, The International Apple Institute [59]
CT/SCT
301 x Grades 4–5 students
6 weeks
“5 a Day - for Better Health”
X
X
24 hr recall of Daily Dietary Intake
- F V consumption (Servings)
NS
0.47
- Fruit consumption (Servings)
.001
0.74
- Juice consumption (Servings)
NS
−0.14
- Vegetable consumption (Servings)
.018
0.28
- Legume consumption (Servings)
NS
0.45
Questionnaire (Likert scale)
- Fruit
.046
0.35
- Vegetables
NS
0.32
FV Knowledge (Multiple choice score)
<.001
0.59
Duncan et al. (2011) New Zealand, Health Research Council NZ [60]
CT/NR
97 x Grades 5–6 students
6 weeks
Curriculum approach with “Healthy Homework” Teaching Resource
√
X
Food Diaries
Insufficient data reported for calculation
Mean age: NR
Experiential learning (Cooking)
- Fruit consumption (Servings/per day)
NS
- Vegetable consumption (Servings/per day)
.016
- Unhealthy food consumption (Servings per/day)
.042
- Unhealthy drink consumption (Servings/per day)
NS
Foster et al. (2008), USA, CDC, US Department of Agriculture/Food and Nutrition Service [61]
CT/NR
1349 x Grades 4–6 students
2 years
The School Nutrition Policy Initiative included the following components: school self-assessment, nutrition education, nutrition policy, social marketing, and parent outreach. Cross-curricular/Integrated learning
√
X
BMI (z score)
.80
Insufficient data reported for calculation
Mean age: 11.2 yrs
Total Energy (kJ/day)
.12
Total Fat (g/day)
.12
FV Consumption (Servings/per day)
.82
Gorely et al. (2009) UK, Great Run, Coca-Cola Company [62]
CT/SCT
589 x students
40 weeks
(Curriculum approach) Physical education lessons and homework tasks
√
X
24 hr recall of Daily Dietary Intake
Insufficient data reported for calculation
Mean age: 8.8 yrs
Fun run event
- FV Consumption (Servings/per day)
NS
Knowledge of healthy lifestyle (MC Test)
NS
Head (1974) USA, Emergency food and Medical Services [63]
CT/NR
4,700 x Grades 5, 7 & 10 students
20 weeks
Cross Curriculum approach in nutrition, reading, math, history, art, music and science
X
X
Knowledge (% correct)
<.05
Insufficient data reported for calculation
Mean age: NR
School lunch (% of plate waste)
<.05
Acceptance of school served food (%)
NS
Hendy et al. (2011) USA, grants from Penn State University [64]
CT/SCT
382 x Grades 1–4 students
12 weeks
Kid’s Choice Program (KCP), contingent reinforcement supported by parental involvement.
√
X
Eating FV first in meals
<.001
Insufficient data reported for calculation
SDT
Choosing low fat and low sugar drinks
<.001
Hoffman et al. (2010) USA, National Institute of Child Health and Human Development [65]
CT/SLT
297 x Kindergarten & Grade 1 students
2 years
Cross-Curricular program included school-wide, classroom, lunchroom, and family components
X
X
Plate Waste Weight
Year 1
Year 2
Year 1
Year 2
- Fruit intake(g)
<.001
<.001
0.86
0.55 -
- Vegetable intake (g)
<.01
NS
0.34
James et al. (2005) UK, GlaxoSmithKline, Aventis, Pfizer, Florence Nightingale Foundation [33]
CT/NR
644 x 2nd-6th Grade students
40 weeks
(Curriculum approach) Reducing SLB consumption
X
√
3-Day Consumption Diary
Mean age: 8.7 yrs
Cross curricular approach in Health, Science, Music and Art
- SLB Consumption (Servings)
0.02
0.83
Kipping (2010), UK, Department of Health [66]
CT/SCT
393 x Grade 5 students
20 weeks
(Curriculum approach) Eat Well Keep Moving program
√
X
24 hr recall of Daily Dietary Intake
Insufficient data reported for calculation
BCT
Mean age: 9.4 yrs
- FV consumption (Servings/per day)
NS
- Snack consumption (Servings/per day)
NS
- HFF consumption (Servings/per day)
NS
- SLB consumption (Servings/per day)
NS
Kristjansdottir et al. (2010) Iceland, The University of Iceland, The Icelandic Centre for Research, Brim Seafood [67]
CT/NR
171 x Grade 2 students
2 years
(Curriculum approach) co developed with teachers and supported by homework, letters to parents and meetings with parents
X
X
Food record by parents
Mean age: NR
- FV consumption (g/day)
<.001
0.93
- Fruit consumption (g/day)
.001
0.62
- Vegetable consumption (g/day)
<.001
1.35
Luepker et al. (1996) USA, National Heart, Lung, and Blood Institute [68]
CT/NR
5106 x Grade 3 students
3 years
(Curriculum Approach) (Child and Adolescent Trial for Cardiovascular Health-CATCH)
√
X
School Lunch Menu Analysis
Mean age: NR
Enhanced PE and classroom health curricula. 28 additional schools received these components plus family education.
- Total energy intake (MJ)
<.001
0.02
24 hr recall of Daily Dietary Intake
- Total energy intake (MJ)
.01
0.07
- Total energy from fat (%)
.001
0.17
Health Behaviour Questionnaire
- Dietary knowledge
<.001
0.25
Mangunkusumo et al. (2007) The Netherlands, Organisation for Health Research and Development [69]
CT/NR
675 x 7th Grade students
12 weeks
Internet-tailored advice followed by dietary counselling
X
√
24 hr recall of Daily Dietary Intake
Insufficient data reported for calculation
Mean age: 10.3 yrs
-Vegetable consumption (g/per day)
NS
- Behavioural determinants
NS
Muth (2008) USA, American Medical Association [70]
CT/SCT
73 x 4th Grade students
12 weeks
(Curriculum approach) (Improving Meals and Physical Activity in Children and Teens (IMPACT)
X
X
Texas School Physical Activity and Nutrition Questionnaire (SPAN)
Insufficient data reported for calculation
Mean age: 9.9 yrs
Train-the-trainer model with HS students trained to teach 4th graders
- FV Consumption (Servings/per day)
.05
- Nutritional knowledge (%)
.01
Panunzio et al. (2007) Italy, NR [71]
CT/NR
471 x 4th Grade students
36 weeks
(Curriculum approach) Teachers vs Nutritionists
X
√
24 hr recall of Daily Dietary Intake
Insufficient data reported for calculation
Mean age: 9.6 yrs
- FV consumption (>1 serving p/day)
<0.01
- Legume consumption (>1 serving p/day)
<0.01
- Chips consumption (>1 serving p/day)
<0.01
- SLB consumption (>1 serving p/day)
<0.01
Parcel et al. (1989) USA, National Heart, Lung, and Blood Institute [72]
CT/SLT
398 x K-4th Grade students
14 weeks
(Curriculum approach) 3 concurrent programs: the New School Lunch, Children’s Active Physical Education (CAPE), and Go For Health classroom instruction.
√
X
Behavioural Capability Questionnaire
Mean age: NR
- Diet behavioural capability (Score)
<.01
0.89
- Diet self-efficacy (Score)
NS
0.15
- Diet behavioural expectations (Score)
<.01
0.73
Self-Reported Behaviour
- Salt use (Daily use)
NS
0.00
- FV consumption (% of total intake)
NS
0.13
Parmer (2009) USA, NR [73]
CT/ELT
115 x 2nd Grade students
28 weeks
(Curriculum approach)
X
X
FV Survey (Likert Scale)
Mean age: 7.3 yrs
Nutrition lessons + school garden
- MyPyramid food groups
NS
0.59
Experiential Learning (Gardening + Food Prep)
- Nutrient–food association
< .001
1.13
- Nutrient–job association
< .001
0.99
- F V identification
< .01
2.03
Researcher Observed Lunch Choices
- Vegetable choice (Servings)
<.01
1.09
- Vegetable consumption (Servings)
<.01
1.41
Perry et al. (1998) USA, National Cancer Institute [74]
CT/SLT
441 x 4- 5th Grade students
40 weeks
The 5-a-Day Power Plus Program
X
X
Researcher Observed Lunch Choices
Insufficient data reported for calculation
Mean age: NR
- behavioural curricula
- FV consumption (Servings)
<.001
- parental involvement/education
- Vitamin A (μg)
.02
- school food service changes
- Vitamin C (mg)
<.001
- industry involvement and support.
24 hr recall of Daily Dietary Intake
- Fruit consumption (Servings)
.02
- Total fat consumption (%/kcal)
.02
- Calcium (mg)
.04
Health Behaviour Questionnaire
- Asking for F V (LIkert Scale)
.03
- Servings of FV (Nominal Scale)
<.001
- Knowledge of servings (Nominal Scale)
<.001
Perry, Mulis et al. (1985), USA, NR [75]
CT/SLT
371 x 3rd-4th Grade students
10 weeks
(Curriculum approach) Hearty Heart and Friends program
X
X
24 hr recall of Daily Dietary Intake
Insufficient data reported for calculation
PBT
Mean age: NR
- Sugared cereal consumption (Less)
<.05
- Green vegetable consumption
<.02
- Fruit consumption
<.01
- Fried food consumption (Less)
<.005
- Added salt consumption (Less)
<.05
Powers et al. (2005), USA. State Cooperative Extension System and State Department of Human Resources [76]
