How effective are family-based and institutional nutrition interventions in improving children's diet and health? A systematic review

Black, Andrew P., D'Onise, Katina, McDermott, Robyn, Vally, Hassan, and O'dea, Kerin (2017) How effective are family-based and institutional nutrition interventions in improving children's diet and health? A systematic review. BMC Public Health, 17. 818.

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Background: Effective strategies to improve dietary intake in young children are a priority to reduce the high prevalence of chronic non-communicable diseases in adulthood. This study aimed to assess the impact of family-based and school/preschool nutrition programs on the health of children aged 12 or younger, including the sustainability of these impacts and the relevance to socio-economic inequalities.

Methods: A systematic review of literature published from 1980 to December 2014 was undertaken. Randomised controlled trials involving families with children aged up to 12 years in high income countries were included. The primary outcomes were dietary intake and health status. Results were presented in a narrative synthesis due to the heterogeneity of the interventions and outcomes.

Results: The systematic search and assessment identified 39 eligible studies. 82% of these studies were set in school/preschools. Only one school study assessed the impact of involving parents systematically. The family-based programs which provided simple positive dietary advice to parents and regular follow-up reduced fat intake significantly. School and family-based studies, if designed and implemented well, increased F& V intake, particularly fruit. Effective school-based programs have incorporated role-models including peers, teachers and heroic figures, rewards and increased access to healthy foods. School nutrition programs in disadvantaged communities were as effective as programs in other communities.

Conclusions: Family and school nutrition programs can improve dietary intake, however evidence of the long-term sustainability of these impacts is limited. The modest overall impact of even these successful programs suggest complementary nutrition interventions are needed to build a supportive environment for healthy eating generally.

Item ID: 51527
Item Type: Article (Research - C1)
ISSN: 1471-2458
Keywords: children, nutrition programs, family-based, school/preschool
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This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

Funders: National Health and Medical Research Council (NHMRC), Australian Primary Health Care Research Institute
Projects and Grants: NHMRC program grant no.631947
Date Deposited: 15 Nov 2017 07:35
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3210 Nutrition and dietetics > 321005 Public health nutrition @ 100%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920205 Health Education and Promotion @ 40%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920411 Nutrition @ 60%
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