Wisconsin Farm to School Programs: Dietary Outcomes in Elementary Students

Background. High overweight and obesity prevalence has instigated many programs to improve children's health. Farm to School (F2S) is a grassroots-organized program that seeks to improve children's dietary habits, especially fruit and vegetable (FV) consumption, through various educational activities. Long-term goals include reducing obesity prevalence while simultaneously supporting local farmers and bolstering local economies. There is little literature assessing the effectiveness of F2S on achieving these aims. Therefore, this study examines F2S program effects on children's knowledge, attitudes, and behaviors with respect to FV intake and short-term BMI outcomes.;Methods. This study included third- through fifth-grade students from 12 schools participating in F2S programming. In a pre-/post-program year evaluation design, students completed a Knowledge & Attitudes Survey, the Block Kids 2004 Food Frequency Questionnaire, Lunch Tray Photo Observation (LTPO), and BMI z-score measurements. Secondary analysis on LTPO data investigated factors associated with FV waste, and the relationship between total- and FV-energy intake in the school lunch setting.;Results. We found small increases in students' dietary knowledge and attitudes toward eating FV, and indications of increased FV access and consumption in school lunch. Several F2S- or FV item-specific-related factors impacted FV waste in school lunch; most importantly with respect to F2S programming, waste of FV items both liked and not liked did not differ. Increased FV intake in school lunches did not reduce total energy intake, but it did increase the meal's proportion of energy from FV, suggesting calorie rather than volume displacement. Finally, we found no change in BMI z-scores across a single program year for students in F2S programs.;Conclusions. These results suggest that F2S programs have the potential to be an effective strategy that communities may implement to improve children's health and reduce the burden of obesity. However, F2S alone is not likely a sufficient means to improve health and lower obesity rates. Instead, it should take its place among a collection of program, policy, and environmental strategies where a community has interest in supporting overall health through robust local food systems and activities.