The effect of nutrition knowledge on food choices and body mass index percentile rankings of elementary school children: Results from an in-school nutrition education program

The prevalence of overweight and obese children has increased dramatically in the United States over the past 20 years and is a symptom of multiple systemic and cultural changes that have significantly influenced alterations in energy intake, energy expenditures, and the energy balance of children across the nation. School-based obesity prevention programs addressing nutrition and healthy eating behaviors within the school environment and cultural context provide a unique opportunity to educate and engage students in healthy food consumption practices. This study evaluated the effectiveness of a three-year elementary school nutrition education program for students in grades kindergarten through fifth using a longitudinal analysis of two separate data sets, a nutrition skills behavior assessment survey of self-reported eating behaviors, and body mass index (BMI) scores derived from height and weight measurements of program participants. Nutrition survey results indicated that students reported making healthier food choices from August 2001 to November 2004, with a significant decrease in reported consumption of fats/oils/sweets and significant increases in reported consumption of milk, meat, vegetables, fruit and grains. BMI results indicated a 7.8% decline in the percentage of students in the "overweight" and "at-risk for overweight" categories between August 2001 and October 2004. The combined results of both measures indicate that the nutrition education program appeared to positively affect eating behaviors and body mass index percentages. Implications of the study and strategies for further research are proposed.