Effectiveness of school-based interventions in Europe to promote healthy nutrition in children and adolescents: systematic review of published and ‘grey’ literature

• Published in: British journal of nutrition 2010-03, Vol.103 (6), p.781-797
• Main Authors: Van Cauwenberghe, Eveline, Maes, Lea, Spittaels, Heleen, van Lenthe, Frank J., Brug, Johannes, Oppert, Jean-Michel, De Bourdeaudhuij, Ilse
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Behavior; adolescent nutrition; Adolescent Nutritional Physiological Phenomena; Adolescents; Anthropometry; Biological and medical sciences; Child; Child Behavior; child nutrition; Child Nutritional Physiological Phenomena; Children; Diet; diet-related diseases; disease prevention; eating habits; educational interventions; Effectiveness; Elementary school students; environmental interventions; Europe; Feeding. Feeding behavior; food intake; Food Services; Fruit; Fruits; fruits (food); Fundamental and applied biological sciences. Psychology; Health Education; Health promotion; Health Promotion - methods; Healthy diet; human diseases; Humans; Intervention; literature reviews; Nutrition; nutrition education; Obesity; Obesity - prevention & control; Research Design; school children; School-based interventions; Schools; Secondary school students; socioeconomic status; Socioeconomics; Systematic reviews; Vegetables; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1017/S0007114509993370

The objective of the present review was to summarise the existing European published and ‘grey’ literature on the effectiveness of school-based interventions to promote a healthy diet in children (6–12 years old) and adolescents (13–18 years old). Eight electronic databases, websites and contents of key journals were systematically searched, reference lists were screened, and authors and experts in the field were contacted for studies evaluating school-based interventions promoting a healthy diet and aiming at primary prevention of obesity. The studies were included if they were published between 1 January 1990 and 31 December 2007 and reported effects on dietary behaviour or on anthropometrics. Finally, forty-two studies met the inclusion criteria: twenty-nine in children and thirteen in adolescents. In children, strong evidence of effect was found for multicomponent interventions on fruit and vegetable intakes. Limited evidence of effect was found for educational interventions on behaviour, and for environmental interventions on fruit and vegetable intakes. Interventions that specifically targeted children from lower socio-economic status groups showed limited evidence of effect on behaviour. In adolescents, moderate evidence of effect was found for educational interventions on behaviour and limited evidence of effect for multicomponent programmes on behaviour. In children and adolescents, effects on anthropometrics were often not measured, and therefore evidence was lacking or delivered inconclusive evidence. To conclude, evidence was found for the effectiveness of especially multicomponent interventions promoting a healthy diet in school-aged children in European Union countries on self-reported dietary behaviour. Evidence for effectiveness on anthropometrical obesity-related measures is lacking.