School-based nutrition programs produced a moderate increase in fruit and vegetable consumption: meta and pooling analyses from 7 studies

OBJECTIVE: To evaluate, through study- and individual-level analyses of data from 7 studies, the effectiveness of school-based nutrition interventions on child fruit and vegetable (FV) consumption. DESIGN: To find original studies on school-based nutrition interventions, the authors searched electronic databases from 1990 to 2002. First authors of the 13 eligible studies were contacted to request their data. Data from 7 studies were received for inclusion in this pooled analysis. SETTING: Schools. PARTICIPANTS: 8156 children were matched from pretest to posttest. Participants were primarily elementary school-aged (75.5%) and white (66%), and 50.4% were males. MAIN OUTCOME MEASURES: Net FV difference and net FV relative change (%). ANALYSIS: Data were analyzed at both the study and individual levels. A fitted multivariable fixed-effects model was used to analyze the role of potential covariates on FV intake. Statistical significance was set at alpha = .05. RESULTS: At the individual level, the net difference in FV consumption was 0.45 (95% CI 0.33-0.59) servings; the net relative change was 19% (95% CI 0.15-0.23) servings. CONCLUSIONS AND IMPLICATIONS: School-based nutrition interventions produced a moderate increase in FV intake among children. These results may have implications for chronic disease prevention efforts, including cardiovascular disease and cancer.