Do school-based nutrition interventions improve the eating behavior of school-age children?

Background/objectives: Filipino children aged 6-10 yrs are consuming poor quantities and quality of food based on the 2013 Philippine National Nutrition Survey. During these years healthy eating habits must be formed through family influence. Within this background, a complete package of nutrition intervention-feeding and nutrition classes, was pilot tested in selected schools to determine 1) changes in nutrition attitude and behavior and 2) food intake of schoolchildren after the intervention.

Subjects/methods: A quasi-experimental design was used in the study. School children aged 7-9 yrs enrolled in selected Philippine public elementary schools and their mothers/caregivers were the study participants. Profile and socio-demographic data were collected from each participant at baseline. The nutrition behavior and food intake of children were determined using the modified Child and Diet Evaluation Tool (CADET) and the 24-h food recall form, respectively. Data were analyzed using Stata version 15.

Results: No significant differences in characteristics were found among the 339 child-mother pairs in the 4 study groups. The modified CADET recorded improved mean attitude scores of children ranging from 22 to 24 points at endline in the group receiving both lunch feeding and nutrition education classes (group 3). The perceived better behavior of children was reported by their mothers in terms of increased intake of milk and vegetables and decreased consumption of sugar. These improvements were supported by the actual food intake of children obtained from the 24-h food recall.

Conclusions: Family involvement, particularly of mothers/caregivers, appeared to be an important factor in shaping the children's eating behavior. An intervention package with lunch feeding and nutrition classes resulted in a substantial improvement in children's behavior and actual food intake with increased levels of vegetables and milk while lowering sugar consumption. The adoption of the intervention package in public elementary schools should therefore be pursued.