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Published in: International Journal of Public Health 5/2016

01-06-2016 | Original Article

Promotion of healthy nutrition among students participating in a school food aid program: a randomized trial

Authors: Dina Zota, Archontoula Dalma, Athanassios Petralias, Anastasia Lykou, Christina-Maria Kastorini, Mary Yannakoulia, Pania Karnaki, Katerina Belogianni, Afroditi Veloudaki, Elena Riza, Rhea Malik, Athena Linos

Published in: International Journal of Public Health | Issue 5/2016

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Abstract

Objectives

To evaluate the potential benefits on students’ eating habits, of incorporating healthy nutrition education as part of a school food aid program.

Methods

146 schools participating in the DIATROFI Program in Greece during the 2013–2014 school year were randomly allocated to the environmental intervention (received a healthy daily meal) and the multicomponent intervention (MI) group (in addition to the meal, a healthy nutrition educational program was applied). The analysis, based on 3627 pre–post intervention questionnaire pairs, was stratified for children (ages 4–11 years) and adolescents (ages 12–18 years).

Results

Children participating in the MI group displayed 25 % higher odds of increasing the weekly consumption of milk/yoghurt and fruits, 61 % higher odds of improving BMI from overweight/obese to normal and 2.5 times higher odds of improving from underweight to normal. For adolescents in the MI group, the odds of increasing the consumption of vegetables were 40 % higher. In both intervention groups, approximately one in four overweight/obese adolescents reached normal weight.

Conclusions

Educational programs on healthy nutrition might be considered worth implementing in the framework of school food aid programs.
Literature
go back to reference Antonogeorgos G, Panagiotakos DB, Grigoropoulou D, Papadimitriou A, Anthracopoulos M, Nicolaidou P, Priftis KN (2013) The mediating effect of parents’ educational status on the association between adherence to the Mediterranean diet and childhood obesity: the PANACEA study. Int J Public Health 58:401–408CrossRefPubMed Antonogeorgos G, Panagiotakos DB, Grigoropoulou D, Papadimitriou A, Anthracopoulos M, Nicolaidou P, Priftis KN (2013) The mediating effect of parents’ educational status on the association between adherence to the Mediterranean diet and childhood obesity: the PANACEA study. Int J Public Health 58:401–408CrossRefPubMed
go back to reference Bountziouka V, Bathrellou E, Giotopoulou A, Katsagoni C, Bonou M, Vallianou N, Barbetseas J, Avgerinos PC, Panagiotakos DB (2012) Development, repeatability and validity regarding energy and macronutrient intake of a semi-quantitative food frequency questionnaire: methodological considerations. Nutr Metab Cardiovasc Dis 22:659–667CrossRefPubMed Bountziouka V, Bathrellou E, Giotopoulou A, Katsagoni C, Bonou M, Vallianou N, Barbetseas J, Avgerinos PC, Panagiotakos DB (2012) Development, repeatability and validity regarding energy and macronutrient intake of a semi-quantitative food frequency questionnaire: methodological considerations. Nutr Metab Cardiovasc Dis 22:659–667CrossRefPubMed
go back to reference Busch V, de Leeuw JR, de Harder A, Schrijvers AJ (2013) Changing multiple adolescent health behaviors through school-based interventions: a review of the literature. J Sch Health 83:514–523CrossRefPubMed Busch V, de Leeuw JR, de Harder A, Schrijvers AJ (2013) Changing multiple adolescent health behaviors through school-based interventions: a review of the literature. J Sch Health 83:514–523CrossRefPubMed
go back to reference Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320:1240–1243CrossRefPubMedPubMedCentral Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320:1240–1243CrossRefPubMedPubMedCentral
go back to reference Cole TJ, Flegal KM, Nicholls D, Jackson AA (2007) Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 335:194CrossRefPubMedPubMedCentral Cole TJ, Flegal KM, Nicholls D, Jackson AA (2007) Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 335:194CrossRefPubMedPubMedCentral
go back to reference Coleman-Jensen A, Nord M, Singh A (2013) Household Food Security in the United States in 2012. In: ERR-155. U.S. Department of Agriculture, Economic Research Service Coleman-Jensen A, Nord M, Singh A (2013) Household Food Security in the United States in 2012. In: ERR-155. U.S. Department of Agriculture, Economic Research Service
go back to reference Cook B, Wayne GF, Valentine A, Lessios A, Yeh E (2013) Revisiting the evidence on health and health care disparities among the Roma: a systematic review 2003–2012. Int J Public Health 58:885–911CrossRefPubMed Cook B, Wayne GF, Valentine A, Lessios A, Yeh E (2013) Revisiting the evidence on health and health care disparities among the Roma: a systematic review 2003–2012. Int J Public Health 58:885–911CrossRefPubMed
go back to reference Currie C, Molcho M, Boyce W, Holstein B, Torsheim T, Richter M (2008) Researching health inequalities in adolescents: the development of the Health Behaviour in School-Aged Children (HBSC) family affluence scale. Soc Sci Med 66:1429–1436CrossRefPubMed Currie C, Molcho M, Boyce W, Holstein B, Torsheim T, Richter M (2008) Researching health inequalities in adolescents: the development of the Health Behaviour in School-Aged Children (HBSC) family affluence scale. Soc Sci Med 66:1429–1436CrossRefPubMed
go back to reference Dalma A, Kastorini C-M, Zota D, Veloudaki A, Petralias A, Yannakoulia M, Linos A (2016) Perceptions of parents and children, participating in a school-based feeding program in disadvantaged areas in Greece: a qualitative study. Care Health Dev, Child. doi:10.1111/cch.12315 Dalma A, Kastorini C-M, Zota D, Veloudaki A, Petralias A, Yannakoulia M, Linos A (2016) Perceptions of parents and children, participating in a school-based feeding program in disadvantaged areas in Greece: a qualitative study. Care Health Dev, Child. doi:10.​1111/​cch.​12315
go back to reference Deitchler M, Ballard T, Swindale A, Coates J (2011) Introducing a simple measure of household hunger for cross-cultural use. In: Food and nutrition technical assistance II project, AED, Washington, D.C Deitchler M, Ballard T, Swindale A, Coates J (2011) Introducing a simple measure of household hunger for cross-cultural use. In: Food and nutrition technical assistance II project, AED, Washington, D.C
go back to reference Foltz JL, May AL, Belay B, Nihiser AJ, Dooyema CA, Blanck HM (2012) Population-level intervention strategies and examples for obesity prevention in children. Annu Rev Nutr 32:391–415CrossRefPubMed Foltz JL, May AL, Belay B, Nihiser AJ, Dooyema CA, Blanck HM (2012) Population-level intervention strategies and examples for obesity prevention in children. Annu Rev Nutr 32:391–415CrossRefPubMed
go back to reference Gonzalez-Suarez C, Worley A, Grimmer-Somers K, Dones V (2009) School-based interventions on childhood obesity: a meta-analysis. Am J Prev Med 37:418–427CrossRefPubMed Gonzalez-Suarez C, Worley A, Grimmer-Somers K, Dones V (2009) School-based interventions on childhood obesity: a meta-analysis. Am J Prev Med 37:418–427CrossRefPubMed
go back to reference Ickes MJ, McMullen J, Haider T, Sharma M (2014) Global school-based childhood obesity interventions: a review. Int J Environ Res Public Health 11:8940–8961CrossRefPubMedPubMedCentral Ickes MJ, McMullen J, Haider T, Sharma M (2014) Global school-based childhood obesity interventions: a review. Int J Environ Res Public Health 11:8940–8961CrossRefPubMedPubMedCentral
go back to reference Jacka FN, Kremer PJ, Berk M, de Silva-Sanigorski AM, Moodie M, Leslie ER, Pasco JA, Swinburn BA (2011) A prospective study of diet quality and mental health in adolescents. PLoS One 6:e24805CrossRefPubMedPubMedCentral Jacka FN, Kremer PJ, Berk M, de Silva-Sanigorski AM, Moodie M, Leslie ER, Pasco JA, Swinburn BA (2011) A prospective study of diet quality and mental health in adolescents. PLoS One 6:e24805CrossRefPubMedPubMedCentral
go back to reference Kastorini CM, Lykou A, Yannakoulia M, Petralias A, Riza E, Linos A, On behalf of the DIATROFI Program Research Team (2016) The influence of a school-based intervention program regarding adherence to a healthy diet in children and adolescents of disadvantaged areas in Greece: the DIATROFI Study. J Epidemiol Community Health. doi:10.1136/jech-2015-205680 PubMed Kastorini CM, Lykou A, Yannakoulia M, Petralias A, Riza E, Linos A, On behalf of the DIATROFI Program Research Team (2016) The influence of a school-based intervention program regarding adherence to a healthy diet in children and adolescents of disadvantaged areas in Greece: the DIATROFI Study. J Epidemiol Community Health. doi:10.​1136/​jech-2015-205680 PubMed
go back to reference Khambalia AZ, Dickinson S, Hardy LL, Gill T, Baur LA (2012) A synthesis of existing systematic reviews and meta-analyses of school-based behavioural interventions for controlling and preventing obesity. Obes Rev 13:214–233CrossRefPubMed Khambalia AZ, Dickinson S, Hardy LL, Gill T, Baur LA (2012) A synthesis of existing systematic reviews and meta-analyses of school-based behavioural interventions for controlling and preventing obesity. Obes Rev 13:214–233CrossRefPubMed
go back to reference Kokkevi A, Stavrou M, Kanavou E, Fotiou A (2015) Eating behaviour, physical activity and body weight in adolescents. Series of short reports: adolescents, behaviours & health. University Mental Health Research Institute, Athens Kokkevi A, Stavrou M, Kanavou E, Fotiou A (2015) Eating behaviour, physical activity and body weight in adolescents. Series of short reports: adolescents, behaviours & health. University Mental Health Research Institute, Athens
go back to reference Krolner R, Rasmussen M, Brug J, Klepp KI, Wind M, Due P (2011) Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies. Int J Behav Nutr Phys Act 8:112CrossRefPubMedPubMedCentral Krolner R, Rasmussen M, Brug J, Klepp KI, Wind M, Due P (2011) Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies. Int J Behav Nutr Phys Act 8:112CrossRefPubMedPubMedCentral
go back to reference Lapalme J, Bisset S, Potvin L (2014) Role of context in evaluating neighbourhood interventions promoting positive youth development: a narrative systematic review. Int J Public Health 59:31–42CrossRefPubMed Lapalme J, Bisset S, Potvin L (2014) Role of context in evaluating neighbourhood interventions promoting positive youth development: a narrative systematic review. Int J Public Health 59:31–42CrossRefPubMed
go back to reference Lien N, Haerens L, Te Velde SJ, Mercken L, Klepp KI, Moore L, de Bourdeaudhuij I, Faggiano F, van Lenthe FJ (2014) Exploring subgroup effects by socioeconomic position of three effective school-based dietary interventions: the European TEENAGE project. Int J Public Health 59:493–502PubMed Lien N, Haerens L, Te Velde SJ, Mercken L, Klepp KI, Moore L, de Bourdeaudhuij I, Faggiano F, van Lenthe FJ (2014) Exploring subgroup effects by socioeconomic position of three effective school-based dietary interventions: the European TEENAGE project. Int J Public Health 59:493–502PubMed
go back to reference Livingstone MB (1995) Assessment of food intakes: are we measuring what people eat? Br J Biomed Sci 52:58–67PubMed Livingstone MB (1995) Assessment of food intakes: are we measuring what people eat? Br J Biomed Sci 52:58–67PubMed
go back to reference Lorson BA, Melgar-Quinonez HR, Taylor CA (2009) Correlates of fruit and vegetable intakes in US children. J Am Diet Assoc 109:474–478CrossRefPubMed Lorson BA, Melgar-Quinonez HR, Taylor CA (2009) Correlates of fruit and vegetable intakes in US children. J Am Diet Assoc 109:474–478CrossRefPubMed
go back to reference McAloney K, Graham H, Law C, Platt L, Wardle H, Hall J (2014) Fruit and vegetable consumption and sports participation among UK Youth. Int J Public Health 59:117–121CrossRefPubMed McAloney K, Graham H, Law C, Platt L, Wardle H, Hall J (2014) Fruit and vegetable consumption and sports participation among UK Youth. Int J Public Health 59:117–121CrossRefPubMed
go back to reference Mindell JS, Coombs N, Stamatakis E (2014) Measuring physical activity in children and adolescents for dietary surveys: practicalities, problems and pitfalls. Proc Nutr Soc 73:218–225CrossRefPubMed Mindell JS, Coombs N, Stamatakis E (2014) Measuring physical activity in children and adolescents for dietary surveys: practicalities, problems and pitfalls. Proc Nutr Soc 73:218–225CrossRefPubMed
go back to reference Noel A, Stark P, Redford J, Zukerberg A (2013) Parent and family involvement in education, from the National Household Educations Surveys Program of 2012 (NCES 2013-028). U.S. Department of Education, National Center for Education Statistics, Washington, DC Noel A, Stark P, Redford J, Zukerberg A (2013) Parent and family involvement in education, from the National Household Educations Surveys Program of 2012 (NCES 2013-028). U.S. Department of Education, National Center for Education Statistics, Washington, DC
go back to reference Peltzer K, Pengpid S (2015) Correlates of healthy fruit and vegetable diet in students in low, middle and high income countries. Int J Public Health 60:79–90CrossRefPubMed Peltzer K, Pengpid S (2015) Correlates of healthy fruit and vegetable diet in students in low, middle and high income countries. Int J Public Health 60:79–90CrossRefPubMed
go back to reference Perikkou A, Gavrieli A, Kougioufa MM, Tzirkali M, Yannakoulia M (2013) A novel approach for increasing fruit consumption in children. J Acad Nutr Diet 113:1188–1193CrossRefPubMed Perikkou A, Gavrieli A, Kougioufa MM, Tzirkali M, Yannakoulia M (2013) A novel approach for increasing fruit consumption in children. J Acad Nutr Diet 113:1188–1193CrossRefPubMed
go back to reference Petralias A, Papadimitriou E, Riza E, Karagas RM, Zagouras A, Linos A, On behalf of the DIATROFI Program Research Team (2016) The impact of a school food aid program on household food insecurity. Eur J Public Health. doi:10.1093/eurpub/ckv223 PubMedPubMedCentral Petralias A, Papadimitriou E, Riza E, Karagas RM, Zagouras A, Linos A, On behalf of the DIATROFI Program Research Team (2016) The impact of a school food aid program on household food insecurity. Eur J Public Health. doi:10.​1093/​eurpub/​ckv223 PubMedPubMedCentral
go back to reference Reinaerts E, Crutzen R, Candel M, De Vries NK, De Nooijer J (2008) Increasing fruit and vegetable intake among children: comparing long-term effects of a free distribution and a multicomponent program. Health Educ Res 23:987–996CrossRefPubMed Reinaerts E, Crutzen R, Candel M, De Vries NK, De Nooijer J (2008) Increasing fruit and vegetable intake among children: comparing long-term effects of a free distribution and a multicomponent program. Health Educ Res 23:987–996CrossRefPubMed
go back to reference Shepherd J, Harden A, Rees R, Brunton G, Garcia J, Oliver S, Oakley A (2006) Young people and healthy eating: a systematic review of research on barriers and facilitators. Health Educ Res 21:239–257CrossRefPubMed Shepherd J, Harden A, Rees R, Brunton G, Garcia J, Oliver S, Oakley A (2006) Young people and healthy eating: a systematic review of research on barriers and facilitators. Health Educ Res 21:239–257CrossRefPubMed
go back to reference Silveira JA, Taddei JA, Guerra PH, Nobre MR (2011) Effectiveness of school-based nutrition education interventions to prevent and reduce excessive weight gain in children and adolescents: a systematic review. J Pediatr (Rio J) 87:382–392CrossRef Silveira JA, Taddei JA, Guerra PH, Nobre MR (2011) Effectiveness of school-based nutrition education interventions to prevent and reduce excessive weight gain in children and adolescents: a systematic review. J Pediatr (Rio J) 87:382–392CrossRef
go back to reference St George SM, Wilson DK (2012) A qualitative study for understanding family and peer influences on obesity-related health behaviors in low-income African-American adolescents. Child Obes 8:466–476CrossRefPubMedPubMedCentral St George SM, Wilson DK (2012) A qualitative study for understanding family and peer influences on obesity-related health behaviors in low-income African-American adolescents. Child Obes 8:466–476CrossRefPubMedPubMedCentral
go back to reference Stang J, Story M (2005) Guidelines for adolescent nutrition services. Center for Leadership, Education and Training in Maternal and Child Nutrition, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis Stang J, Story M (2005) Guidelines for adolescent nutrition services. Center for Leadership, Education and Training in Maternal and Child Nutrition, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
go back to reference Story M, Neumark-Sztainer D, French S (2002) Individual and environmental influences on adolescent eating behaviors. J Am Diet Assoc 102:S40–S51CrossRefPubMed Story M, Neumark-Sztainer D, French S (2002) Individual and environmental influences on adolescent eating behaviors. J Am Diet Assoc 102:S40–S51CrossRefPubMed
go back to reference Story M, Kaphingst KM, French S (2006) The role of schools in obesity prevention. Future Child 16:109–142CrossRefPubMed Story M, Kaphingst KM, French S (2006) The role of schools in obesity prevention. Future Child 16:109–142CrossRefPubMed
go back to reference Van Cauwenberghe E, Maes L, Spittaels H, van Lenthe FJ, Brug J, Oppert JM, De Bourdeaudhuij I (2010) Effectiveness of school-based interventions in Europe to promote healthy nutrition in children and adolescents: systematic review of published and ‘grey’ literature. Br J Nutr 103:781–797CrossRefPubMed Van Cauwenberghe E, Maes L, Spittaels H, van Lenthe FJ, Brug J, Oppert JM, De Bourdeaudhuij I (2010) Effectiveness of school-based interventions in Europe to promote healthy nutrition in children and adolescents: systematic review of published and ‘grey’ literature. Br J Nutr 103:781–797CrossRefPubMed
go back to reference Verstraeten R, Roberfroid D, Lachat C, Leroy JL, Holdsworth M, Maes L, Kolsteren PW (2012) Effectiveness of preventive school-based obesity interventions in low- and middle-income countries: a systematic review. Am J Clin Nutr 96:415–438CrossRefPubMed Verstraeten R, Roberfroid D, Lachat C, Leroy JL, Holdsworth M, Maes L, Kolsteren PW (2012) Effectiveness of preventive school-based obesity interventions in low- and middle-income countries: a systematic review. Am J Clin Nutr 96:415–438CrossRefPubMed
go back to reference Yannakoulia M, Lykou A, Kastorini CM, Saranti Papasaranti E, Petralias A, Veloudaki A, Linos A (2015) Socio-economic and lifestyle parameters associated with diet quality of children and adolescents using classification and regression tree analysis: the DIATROFI study. Public Health Nutr, pp 1–9. doi:10.1017/S136898001500110X Yannakoulia M, Lykou A, Kastorini CM, Saranti Papasaranti E, Petralias A, Veloudaki A, Linos A (2015) Socio-economic and lifestyle parameters associated with diet quality of children and adolescents using classification and regression tree analysis: the DIATROFI study. Public Health Nutr, pp 1–9. doi:10.​1017/​S136898001500110​X
Metadata
Title
Promotion of healthy nutrition among students participating in a school food aid program: a randomized trial
Authors
Dina Zota
Archontoula Dalma
Athanassios Petralias
Anastasia Lykou
Christina-Maria Kastorini
Mary Yannakoulia
Pania Karnaki
Katerina Belogianni
Afroditi Veloudaki
Elena Riza
Rhea Malik
Athena Linos
Publication date
01-06-2016
Publisher
Springer International Publishing
Published in
International Journal of Public Health / Issue 5/2016
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI
https://doi.org/10.1007/s00038-016-0813-0

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