Context
Schools can play an important role in supporting a healthy lifestyle by offering nutritious
foods and beverages and providing opportunities for physical activity. A healthy diet
and regular physical activity may reduce the risk of obesity. This manuscript reports
on a Community Guide systematic review examining the effectiveness of interventions
in schools combining school meal or fruit and vegetable snack programs and physical
activity.
Evidence Acquisition
Studies meeting the intervention definition were identified from a literature search
(search period: January 1990–November 2019). Community Guide systematic review methods
were used to assess effectiveness as measured by dietary behavior, physical activity,
and weight changes; analyses were conducted in 2020.
Evidence Synthesis
Interventions (n=24 studies) were considered effective for increasing physical activity (median increase=21.8
minutes/day; interquartile interval= –0.8 to 27.4 minutes/day), modestly increasing
fruit and vegetable intake (median relative increase=12.1%; interquartile interval=
–4.6%, 73.4%), and decreasing the prevalence of overweight and obesity (median decrease=2.5
percentage points; interquartile interval= –8.1, –1.6 percentage points) among elementary
school students through sixth grade. There were not enough studies to determine the
effectiveness of interventions for middle- and high-school students.
Conclusions
School meal or fruit and vegetable snack interventions combined with physical activity
were effective in increasing physical activity, with modest effects for improving
fruit and vegetable consumption and reducing the prevalence of overweight and obesity
among elementary students. These results may inform researchers and school administrators
about healthy eating and physical activity interventions.
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Published online: December 07, 2022
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Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.
