Dietary education in school-based childhood obesity prevention programs.

The purpose of this article was to review school based interventions designed to prevent childhood and adolescent obesity that focused on modifying dietary behavior and were published between 2000 and May 2009. A total of 25 interventions met the criteria. The grade range of these interventions was from K to 12; 13 studies exclusively targeted elementary school, 2 targeted both elementary and middle school, 9 exclusively targeted middle school, and 1 targeted high school. The majority of the interventions focused on both dietary and physical activity behaviors, whereas 8 interventions focused exclusively on dietary behaviors. Approximately one-half of the interventions were based on a behavioral theory. In terms of duration, 13 were longer than 6 mo, 4 were less than 1 mo, and 8 had a duration between 1 and 6 mo. The majority of the interventions were implemented by teachers. In terms of activities, almost all interventions had a curricular component except 2 that distributed free fruit or vegetables. Besides curricular instructions, parental and family involvement was also utilized by several interventions. Environmental and policy changes were used in 7 interventions. For evaluation, the 2 most popular designs were experimental design with random assignment at group level and quasi experimental design, both of which were used by 9 interventions each. In terms of impact on adiposity indices, only 14 interventions measured it and only 6 of those were able to demonstrate significant changes. Recommendations for enhancing the effectiveness of school based dietary education interventions for childhood obesity prevention are presented.