Increase Font Size Decrease Font Size View as PDF Print

What are the effects of combining changes to the food environment and nutrition education compared to either of these strategies alone on children’s and adolescent’s dietary intake-related behaviors?

Conclusion

Consistent evidence suggests that combining nutrition education with changes to the school food environment is more effective for improving children’s and adolescents’ dietary intake than making changes to the food environment alone.
 

Grade

I – Strong
Click here for more information about grading.

Evidence Summaries

What is the evidence that supports this conclusion? For more information, click on the Evidence Summary link below.
 
What are the effects of combining changes to the food environment and nutrition education, or either of these components alone, on children’s dietary intake-related behaviors?

Research Recommendations

1. Conduct more research to test the effects of combining nutrition education with changes to the food environment in the United States.

Rationale: Previously conducted studies were carried out in a variety of countries, all of which are considered to have “very high human development” based on the Human Development Index 2010. However, because only one of the studies was conducted in the United States, more research is needed to better understand how these types of interventions work most effectively in US-based school settings and populations.

2. Conduct research to investigate whether different types of food environment changes have differential impacts on dietary intake, or whether additional interventions could be combined with nutrition education and food environment changes to increase the efficacy of these interventions for improving children’s and adolescent’s dietary intake-related behaviors.

Rationale: The studies reviewed tested several different types of changes to the food environment, and it was not clear from the research whether one type of environmental change or specific combinations of changes are better than others for eliciting behavior change. Therefore, more research is needed to better understand the effects of different environmental change strategies on dietary intake. Research is also needed to determine whether combining nutrition education and changes to the food environment with additional intervention components, such as parental or family involvement, cooking or gardening education, or use of digital media/technology, would lead to even greater changes in dietary-intake related outcomes. In addition, more information would be needed to determine which combinations of components lead to the biggest return on investment in terms of improved dietary intake and health.

3. Conduct research in which nutrition education combined with food environment changes is delivered over longer periods of time, at a greater frequency, with greater intensity, or with a longer duration of follow-up.

Rationale: The duration of the studies reviewed ranged widely from 16 days to 2 years. In addition, the frequency and intensity of the interventions tested were not well characterized. Therefore, it is unclear whether there is an optimal “dose” of nutrition education and environmental change for affecting behavior change. Research in this area will allow for better understanding of the dose-response effects and the long-term impacts of these types of interventions on children’s behavior, as well as body weight and other health outcomes.

Search Plan and Results

What were the search parameters and selection criteria used to identify literature to answer this question? For more information, click on the Search Plan and Results link below.
 
What are the effects of combining changes to the food environment and nutrition education compared to either