<i>Objective</i> : Use a school-based food garden as an instrument to improve healthy dietary consumption, habits, and practices among children from the third to fifth grade in public schools in Chile. <i>Design</i>: Quasi-experimental, six-month intervention with an evaluation of dietary consumption, habits, and practices and use of the school-based food garden among the 3rd to 5th grade students. <i>Setting</i>: Two municipal schools in a low-middle income district in Santiago de Chile; one with a school garden intervention and a control school without a garden. <i>Subjects</i>: 155 third to fifth grade children, 63 in the intervention school and 92 in the control school (average age 10 years old, 58% boys). <i>Results</i>: In the intervened school, there was a significant improvement in the children’s dietary habits, such as peeling and slicing fruit (p < 0.05), making sandwiches (p < 0.05), and increased motivation to cook (p < 0.05). Fruit purchases at the school rose from 4% to 37% (p < 0.05) by the end of the intervention. Interest in growing vegetables or fruits at home increased from 48% to 70% (p < 0.05). The school children at the intervention school significantly increased their knowledge about 16 of 21 garden crops (p < 0.05), expanding the spectrum of the vegetables they can consume. There were no significant changes in the control school. Conclusions: The school-based food garden was effective in achieving change in dietary habits and practices among the third to fifth grade children. The project should be carried out for a longer period of time, so that the changes will be reflected in the students’ food consumption and nutritional status.
Chile has evolved in recent decades from high malnutrition and low obesity rates to the eradication of malnutrition and high prevalence of obesity, especially in children [
The progressive increase in overweight and obesity is more frequent among people of a low socioeconomic level, because as income improves, people purchase food with a high fat, carbohydrate, and salt content, with a marked preference for processed, high-calorie food accompanied by low consumption of fruits and vegetables and a high level of sedentarism [
Although the problem of obesity has existed in Chile since the 1990s, the population still does not consider it an important risk factor in the leading health problems, which are cardiovascular disease, cancer, diabetes, and obesity; nor are there any policies currently in effect to address obesity [
Based on this information, strategies have been proposed to combat childhood obesity by promoting appropriate consumption of healthy food among the population. These strategies have contributed to addressing obesity among children, but they have not had an impact due to the lack of a government policy to ensure the necessary continuity [
This project is part of a line of research on food and nutrition education with an intervention program using educational materials on healthy eating for teachers and preschool, the first-grade and second-grade students and their families. Among the findings is that one of the two pillars for conducting a successful intervention in promoting student health is encouraging healthy lifestyles with participative activities and the use of information and communication technologies (ICT) [
School-based food gardens have been used in several countries, following the three basic Food and Agriculture Organization of the United Nations (FAO) pillars: 1) teaching and promoting basic food security in order to supplement the population’s dietary needs; 2) environmental protection; and 3) teaching students how to use food from the garden to eat a healthy diet and supplement various nutritional needs, which has been highlighted recently by the FAO [
Nicaragua has implemented the “Integral School Nutrition Program, School-based Food Gardens Component”, which seeks to develop cognitive skills by improving dietary diversity through changes in eating and nutrition of children and their families, using the “learn by doing” approach. This program involves several different actors (local governments, schools, civil society organizations, private companies), each of which contributes technical, financial, or organizational resources [
In El Salvador, school-based food gardens have been consolidated as an educational strategy that links together parents, students, and teachers. Those involved participate actively in organizing the gardens, generating “school garden committees”. Products from the gardens are used to make healthy food that has become an important component of school snacks [
In recent years, various international studies have been conducted on this topic, and the findings indicate the importance of using school-based food gardens to educate students about healthy eating. In Idaho, United States, a nutritional study was conducted using school-based food gardens with the aim of improving consumption of fruits and vegetables among adolescents through a 12-week nutritional education program. The program resulted in an increase in the portions of fruit and vegetables consumed by adolescents [
Another experience in the United States showed how school-based food gardens can positively influence eating habits at an early age. Children who participated in a nutritional program with activities in the garden were more likely to choose vegetables for school lunch [
In 2013 the government of Chile, with the Choose to Live Healthily (Elige Vivir Sano) program and the Solidarity and Social Investment Fund (Fondo de Solidaridad e Inversión Social, FOSIS) launched an initiative called “Experience Your Garden”, the objective of which is to promote an integral, outdoor learning space that enables students, teachers, and parents to come into contact with nature. This educational opportunity contributed to generating healthy habits and lifestyles throughout the school community. In 2013, 100 school-based food gardens were implemented, with limited follow-up after installation. No additional school-based food gardens were implemented in 2014, and by 2015 the only gardens functioning were those that had received support from directors or teachers interested in the topic [
This study is based on the use of one of the gardens in the FOSIS “Experience Your Garden” program as an instrument to promote healthy dietary consumption, habits, and practices among third to fifth graders in a municipal school in a district of the Metropolitan Region, compared to a control school.
Quasi-experimental, six-month intervention with an initial and a final evaluation of dietary consumption, habits, and practices and uses of the school-based food garden to encourage healthy eating habits, compared with a control school.
The study was conducted in two urban schools in the Peñalolen district of the Santiago Metropolitan Region. One of the schools (Luis Arrieta Cañas) has a food garden that served as an educational tool for the intervention while the other school (Carlos Fernández Peña), which did not have a garden, was used as the control.
All children from third to fifth grade of two schools were measured, a total of 155 children, including 63 at the intervention school and 92 at the control school (average age 10 years old, 58% boys).
On the basis of 80% power to detect a significant difference (p = 0.05, two-sided), a sample size of 50 students from third to fifth grade for each group was needed to detect an 80 g increase in consumption of fruit and vegetables, which was based on a similar study carried out in Peñalolen [
The control school chosen is in the same district, with similar socioeconomic characteristics as the intervention school, and with a minimum of 50 children in the third to fifth grades. The School Vulnerability Index (Índice de Vulnerabilidad Escolar, IVE), which measures poverty among children attending public schools, was used to evaluate the socioeconomic level. The poverty rate, measured by IVE considering poverty over 40%, was very high for both schools: 83.1% for the intervention school and 84.2% for the control school [
The study included 15 teachers from the intervention school and 17 from the control school, with a special emphasis on the lead teachers of each grade in the intervention school, since they can have a greater impact on changing habits. The study also included educational activities for the parents and guardians of the third to fifth grade students.
Initial and Final EvaluationA survey that was recently validated by the project researchers for evaluating dietary consumption, habits, and practices among students from third to fifth grade was used [
An initial and final anthropometric measurement was obtained of the children’s weight and height at the start and end to describe the group with whom the study was conducted. The measurements were taken using a SECA ROBUSTA 813® electronic scale, Santiago, Chile with 200 kg capacity and a sensitivity of 0.1 kg, and a SECA 213® stadiometer, Santiago, Chile with a maximum height of 205 cm and precision to 0.1 cm. The weight and height measurements as well as the surveys were applied by trained nutritionists from the Institute of Nutrition and Food Technology (INTA) at the University of Chile.
The initial measurements were taken in May 2015. The educational intervention was conducted from June to September and the final measurements were taken in October and November 2015.
The project was approved by the Ethics Committee of INTA at the University of Chile.
To implement a school-based food garden, the methodology used was the one validated by the “Process Mapping: Project Creation and Implementation” project from Brazil [
1) Teachers
The teacher workshops were aimed at providing the initial motivation and covered topics such as how to maintain the school-based food garden and ways to incorporate it into teaching. Specific activities were agreed on for each of the grades, using the school-based food garden as a practical tool for teaching. This process also took into consideration the general curriculum that the teachers were following with their students. Finally, the teachers participated in a cooking workshop to verify the ease and practicality of preparing healthy dishes based on products of the garden, in accordance with the methodology proven in the previous project [
2) Students
The students participated in visits to the school-based food garden and classroom activities, and also received educational materials. There were five workshops to familiarize them the school-based food garden and the food that can be grown in it and to review dietary guidelines. The students learned about appropriate consumption frequency, the variety of food that should be included in their diet and the health benefits of food supplied by the garden for children. The students increased their knowledge about garden crops through picking vegetables in the garden. At the end of the intervention, the children participated in a cooking workshop with their parents designed not only to help them learn about preparing food, but also to enable them to bond with family members in activities linked to healthy eating.
3) Parents
The parents were informed about the project to promote healthy eating from home through consumption of fruit and vegetables, how they can grow vegetables at home, and the benefits of eating them.
The parents participated in the cooking workshop with their children so that they would be able to visualize the ease and practicality of making healthy dishes using products from the garden and how the products can promote a healthy diet among their children.
Continuous variables were expressed as mean ± SD (standard deviation) and 95% confidence intervals (95% CI). Categorical variables were expressed as median or percentages. The difference between the control and intervention groups was calculated using the two-sample mean-comparison test or Pearson’s Chi2 test, depending on the kinds of variables. Each child’s BMI (kg/m2) was calculated using the weight and height data.
The Z-score was calculated using the OMS 2007 algorithm [
The Mann Whitney test was used to analyze whether the intervention produced changes in eating habits and practices, as well as for the questions asked of the control and intervention groups regarding the school-based food garden.
The statistical analyses were performed using STATA 14 software [
Boys n = 90 | Girls n = 65 | Total n = 155 | ||||
---|---|---|---|---|---|---|
Intervened n = 42 | Control n = 48 | Intervened n = 21 | Control n = 44 | Intervened n = 63 | Control n = 92 | |
Grades1 | ||||||
Third n (%) | 13 (30.95) | 15 (31.25) | 3 (14.29) | 13 (29.55) | 16 (25.39) | 28 (30.43) |
Fourth n (%) | 11 (26.19) | 17 (35.42) | 9 (42.86) | 12 (27.27) | 20 (31.74) | 29 (31.52) |
Fifth n (%) | 18 (42.86) | 16 (33.33) | 9 (42.86) | 19 (46.43) | 27 (42.85) | 35 (38.04) |
Age (years)2 mean ± SD | 10.0 ± 1.1 | 9.8 ± 1.3 | 9.9 ± 0.7 | 10.0 ± 1.5 | 10.0 ± 1.0 | 9.9 ± 1.4 |
CI 95% | 9.6 - 10.3 | 9.4 - 10.2 | 9.6 - 10.2 | 9.6 - 10.5 | 9.7 - 10.2 | 9.6 - 10.2 |
Weight (kg)2 mean ± SD | 37.1 ± 10.1 | 39.3 ± 10.1 | 44.6 ± 15.3 | 41.4 ± 16.8 | 39.6 ± 12.5 | 40.3 ± 13.8 |
CI 95% | 34.1 - 40.1 | 36.6 - 42.1 | 37.9 - 51.2 | 36.6 - 46.1 | 36.6 - 42.6 | 37.7 - 43.0 |
Height (m)2 mean ± SD | 137.2 ± 7.4 | 138.7 ± 8.9 | 140.8 ± 10.6 | 139.4 ± 10.9 | 138.2 ± 8.6 | 139.0 ± 10.0 |
CI 95% | 135.0 - 139.3 | 136.2 - 141.1 | 136.3 - 145.4 | 136.3 - 142.4 | 136.3 - 140.5 | 137.1 - 140.9 |
BMI (kg/m2)2 mean ± SD | 19.5 ± 3.9 | 20.2 ± 3.6 | 21.8 ± 4.8 | 20.7 ± 5.3 | 20.3 ± 4.3 | 20.5 ± 4.5 |
CI 95% | 18.3 - 20.6 | 19.2 - 21.2 | 19.8 - 23.9 | 19.2 - 22.2 | 19.2 - 21.3 | 19.6 - 21.3 |
ZBMI score2 mean ± SD | 1.08 ± 1.28 | 1.45 ± 1.23 | 1.52 ± 1.30 | 1.17 ± 1.28 | 1.2 ± 1.3 | 1.32 ± 1.26 |
CI 95% | 0.70 - 1.46 | 1.11 - 1.79 | 0.95 - 2.08 | 0.81 - 1.53 | 0.91 - 1.54 | 1.07 - 1.56 |
Nutritional status1 | ||||||
ZBMI < −1 n(%) | 2 (4.8) | 1 ( 2.1) | 1 ( 4.8) | 3 (6.8) | 3 (4.8) | 4 (4.4) |
−1 ≤ ZBMI ≤ 1 n (%) | 19 (45.2) | 17 (35.4) | 6 (28.6) | 18 (40.9) | 25 (39.7) | 35 (38.0) |
1 < ZBMI ≤ 2 n (%) | 11 (26.2) | 13 (27.1) | 6 (28.6) | 12 (27.3) | 17 (27.0) | 25 (27.2) |
ZBMI > 2 n (%) | 10 (23.8) | 17 (35.4) | 8 (38.1) | 11 (25.0) | 18 (28.6) | 28 (30.4) |
1Pearson Chi2 test (intervened-control, by sex and total): p > 0.4; 2Two-sample mean-comparison test (intervened-control, by sex and total): p > 0.2; SD: standard deviation; CI: confidence interval.
Dietary Practices and Habits | Intervened | Control | p-value1 | |||
---|---|---|---|---|---|---|
Start | 6 months | p-value1 | Start | 6 months | ||
n (%) | n (%) | n (%) | n (%) | |||
You like to cook | ||||||
Yes | 28 (44.4) | 43 (68.3) | 0.0065 | 64 (69.5) | 68 (73.9) | 0.2199 |
No | 26 (41.3) | 17 (26.9) | 22 (23.9) | 13 (14.2) | ||
Don’t know | 9 (14.3) | 3 (4.8) | 6 (6.6) | 11 (11.9) | ||
Prepare salads | ||||||
Never-1 day per week | 32 (50.8) | 34 (53.9) | 0.3471 | 40 (43.4) | 36 (39.1) | 0.6608 |
2 - 3 days per week | 20 (31.8) | 20 (31.8) | 27 (29.4) | 39 (42.4) | ||
4 - 5 days per week | 11 (17.4) | 9 (14.3) | 25 (27.2) | 17 (18.5) | ||
Make a sandwich | ||||||
Never-1 day per week | 29 (46.0) | 12 (19.0) | 0.0037 | 34 (37.0) | 32 (34.8) | 0.9556 |
2 - 3 days per week | 19 (30.2) | 23 (36.5) | 30 (32.6) | 32 (34.8) | ||
4 - 5 days per week | 15 (23.8) | 28 (44.5) | 28 (30.4) | 28 (30.4) | ||
Peel and slice fruit | ||||||
Never-1 day per week | 29 (46.0) | 22 (34.9) | 0.0326 | 41 (44.5) | 33 (35.9) | 0.3609 |
2 - 3 days per week | 17 (27.0) | 14 (22.3) | 23 (25.1) | 35 (38.0) | ||
4 - 5 days per week | 17 (27.0) | 27 (42.8) | 28 (30.4) | 24 (26.1) | ||
Eat fruit in front of friends | ||||||
Never | 22 (34.9) | 16 (25.4) | 0.6129 | 30 (32.6) | 24 (26.1) | 0.0517 |
Sometimes | 27 (42.9) | 31 (49.2) | 50 (54.3) | 43 (46.7) | ||
Always | 14 (22.2) | 16 (25.4) | 12 (13.1) | 25 (27.2) | ||
Food brought from home | ||||||
Fruit | 25 (39.6) | 31 (49.2) | 0.2733 | 42 (45.6) | 48 (52.1) | 0.2888 |
Vegetables | 0 (0) | 0 (0) | 0 (0) | 3 (3.2) | 0.0833 | |
Food purchased at school | ||||||
Fruit | 3 (4.7) | 23 (36.5) | <0.0001 | 3 (3.2) | 4 (4.3) | 0.6547 |
1Mann Whitney test.
From
Childhood obesity has continued to increase in Chile despite various initiatives aimed at reducing it [
School-based food gardens are an excellent tool for changing habits and preferences in terms of healthy eating,
Garden Food | Intervened | Control | p-value1 | |||
---|---|---|---|---|---|---|
Start | 6 months | p-value1 | Start | 6 months | ||
n (%) | n (%) | n (%) | n (%) | |||
Grow vegetables or fruit at home | 18 (28.5) | 23 (36.5) | 0.1967 | 31 (33.7) | 44 (47.8) | 0.0158 |
Grow vegetables or fruit in a food garden | 30 (47.6) | 44 (69.8) | 0.0028 | 52 (56.5) | 47 (51.0) | 0.3841 |
Would grow vegetables or fruit at home | 55 (87.3) | 57 (90.5) | 0.4795 | 75 (81.5) | 84 (91.3) | 0.0290 |
Garden knowledge | 46 (73.0) | 63 (100) | <0.0001 | 39 (42.4) | 59 (64.1) | 0.0003 |
Would grow vegetables or fruit in the school garden | 23 (36.1) | 49 (77.8) | <0.0001 | 12 (13.0) | 22 (23.9) | 0.0124 |
Would like to do something in the school garden | 53 (84.1) | 60 (95.2) | 0.0348 | 72 (78.2) | 84 (91.3) | 0.042 |
1Mann Whitney test.
mainly fruit and vegetables, for children and their families [
Regarding the food that students bring from home, parents do not provide fruit as a snack, and so do not promote consumption of fruits and vegetables among their children. However, after the intervention it was observed that the children prefer to use some of the money they receive from their parents to purchase fruit at school. Different studies have corroborated the enormous importance of active parent participation in the education of their children, and that this constitutes a fundamental pillar for their nutrition, both within and outside the home [
One of the important results of the study was the broadening of the spectrum of vegetables that the children are familiar with and can eat. This reinforces the theory that seeing, touching, planting, cooking, and harvesting food are powerful and positive ways to expose children to vegetables and fruits [
This study’s strength is that it is the first evaluation of an educational school-based food garden intervention in Chile, using a control school. The limitations included its short duration and the relatively small number of students per school (63 in the intervention school and 92 in the control school), which does not allow for generalization of the results. This has been a problem in other studies as well [
Another limitation was the sale of unhealthy food both within and outside the schools. Therefore, this strategy should be complemented by healthy eating rules inside each school, such as healthy spaces and kiosks [
One of the major challenges in the continuity of using gardens to teach children about healthy eating is the lack of ongoing work to sustain them [
This study shows that school gardens are effective educational tools, capable of achieving change in the eating habits and practices of students at municipal schools serving disadvantaged areas. We recommend that school- based food garden projects be operated for longer periods of time so that the changes will be reflected in the students’ food consumption and nutritional status. In addition, new school garden evaluation studies should be conducted in different circumstances, such as in schools outside the metropolitan region, by socioeconomic level, and with other age groups.
This study was funded by FONDECYT Project No. 1140748 in the 2014 Regular Education Competition: “Development, application, and evaluation of a participative healthy eating educational program using information and communication technologies (ICT) for teachers, the 3rd to 5th grade students, and their families”. Principal investigator: Fernando Vio del Río. Co-investigator: Judith Salinas Cubillos. Duration: 3 years.
Diego Vinueza,Lydia Lera,Judith Salinas,Carmen Gloria González,Lorena Barrios,Fernando Vio, (2016) Evaluation of a Nutrition Intervention through a School-Based Food Garden to Improve Dietary Consumption, Habits and Practices in Children from the Third to Fifth Grade in Chile. Food and Nutrition Sciences,07,884-894. doi: 10.4236/fns.2016.710088