Middle schoolers exposed to an intensive campaign urging them to eat more fruits and vegetables actually did so, but not enough to improve their overall eating patterns, according to the study published in the July/August issue of Health Education & Behavior.

Children recruited to act as peer leaders, who therefore received the most intense exposure to the program's messages, ate significantly more fruits or vegetables each day. Other students who participated in the program had more modest increases.

"Despite the challenges, it appears that there is a particular need for nutrition intervention for students in the middle grades, and with support, they are able to make healthful changes in their eating behavior," says Amanda S. Birnbaum, Ph.D., M.P.H., of the University of Minnesota.

The study included 16 schools in the Minneapolis/St. Paul metropolitan area. Nearly 4,000 students filled out surveys for the study. Students who were enrolled in the program attended 10 classroom sessions, received three "Parents Packs" designed to encourage healthy eating habits at home and were exposed to environmental interventions like posters, table tents and access to more fruits, vegetables and low-fat snacks.

Students who were not enrolled in the program, but attended the school where the program was being implemented, were exposed only to the environmental components. Students in the control group attended schools where no program was in place.

Peer leaders received special training and helped lead group activities and discussions. They had the biggest increase in fruit and vegetables, with an average of nearly one more serving a day than before the program, researchers found.

"It is possible that the extra instructional time peer leaders received (six hours of in-school training), with additional practice in behavioral skills such as food preparation, goal setting and problem solving, may have increased their self-efficacy or ability to change their diet," Birnbaum says.

Other program participants had an average increase of about half a serving each day. The control students had no increase in fruit or vegetable consumption. The students only incidentally exposed to the program actually had apparent decreases in fruit and vegetable consumption, a finding the researchers were hard-pressed to explain.

"The trend toward decreased fruit and vegetable intake among students exposed only to the school environment interventions was surprising and disturbing," they say. "Perhaps students in intervention schools who did not receive the classroom curriculum felt isolated from the program."

They conclude that when it comes to changing middle school students' eating habits, more is better. Intensive, multi-component interventions, both in schools and at home, are needed to reach these children.

The study was funded with a grant from the National Cancer Institute.

---Health Behavior News Service

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