What are the effects of nutrition education in Dutch primary schools?

A healthy diet is important for children’s growth and development. Children need encouragement and support to adopt healthy eating behaviours. Dutch nutrition education programs such as EU-Schoolfruit (EUS) and Taste Lessons (TL) contribute to this by providing children with fruit, vegetables (FV) (EUS) and nutrition education (TL). However, little is known about which components are most effective. It is hypothesized that children participating in nutrition education programs that implement both environmental and educational components will have greater nutrition knowledge, food literacy and higher FV intakes, compared to children participating in nutrition education programs with one component. This research examines effective components of existing Dutch nutrition education programs for primary school children (n=2250, n=45 schools) aged 9-11 years. Child nutrition knowledge, food literacy and FV intakes will be measured by questionnaire. This quasi-experimental study has three arms: (1) schools that implement EUS, (2) schools that implement EUS + TL and (3) schools that implement no nutrition education. Outcomes will be assessed pre-intervention (baseline), immediately following the intervention (post-intervention), and 6 months post-intervention. The results can contribute to the design of future effective nutrition education programs, which support addressing the problem of childhood obesity.

The study investigates the hypothesis that children who participate in a nutrition education program that implements both an environmental component (EU-Schoolfruit) and an educational component (Taste Lessons) will have more nutrition knowledge, food literacy and a higher fruit and vegetable intake, compared to children who are not provided by both nutrition education and the availability of fruits and vegetables.

Outcomes will be assessed pre-intervention (baseline, T0), immediately following the intervention (post-intervention, approximately 6 months after baseline, T1), and 6 months post-intervention (approximately 12 months after baseline, T2).

The intervention will be implemented in the same period as the EU-Schoolfruit program will be conducted, which will be for a period of 20 weeks (November 2018 – April 2019). Both programs (EU-Schoolfruit and Taste Lessons) will be conducted as usual (see Box 1). The distinction between these groups (EUS, EUTL and control) are divided in a way the effect of the environmental component (the availability of fruits and vegetables) and the educational component (nutrition education) will be measured separately.

Box 1. EU-Schoolfruit and Taste Lessons

EU-Schoolfruit

The EU-Schoolfruit program is a Dutch nationwide nutrition education program for primary schools, developed in 2011 and is about fruits and vegetables. Participating primary schools receive during 20 weeks (November-April) 3 pieces of fruits and vegetables per pupil for free in order to promote fruit and vegetable consumption. Next to the availability of fruit and vegetables, this program provides one lesson per grade (total of 8 lessons) that can be implemented by the teachers. Every year, around 3000 primary schools, out of the total approximate amount of 7000, are participating in this program.

Taste Lessons

Taste Lessons is another Dutch national school-based nutrition education program, developed in 2006 by the Netherlands Nutrition Centre and Wageningen University for grades 1-8 of primary schools. The programme consists of 5 lessons for each grade, discussing various topics in relation to five themes: ‘taste’, ‘nutrition and health’, ‘cooking’, ‘food production’ and ‘consumer skills’. Each lesson consists of several activities including experiments, cooking and tasting. Some lessons include home assignments which children are to complete with their parents. Also tips for extra activities, such as visiting a farmer, are provided. Teachers are able to implement Taste Lessons in a flexible way, during the whole school year. Every year, around 4500 primary schools, out of the total approximate amount of 7000, are participating this program.