Background Although school garden programs have been shown to improve dietary behaviors, there has not been a cluster-randomized controlled trial (RCT) conducted to examine the effects of school garden programs on obesity or other health outcomes. The goal of this study was to evaluate the effects of a one-year school-based gardening, nutrition, and cooking intervention (called Texas Sprouts) on dietary intake, obesity outcomes, and blood pressure in elementary school children. Methods This study was a school-based cluster RCT with 16 elementary schools that were randomly assigned to either the Texas Sprouts intervention (n = 8 schools) or to control (delayed intervention, n = 8 schools). The intervention was one school year long (9 months) and consisted of: a) Garden Leadership Committee formation; b) a 0.25-acre outdoor teaching garden; c) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school-year; and d) nine monthly parent lessons. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Child outcomes measured were anthropometrics (i.e., BMI parameters, waist circumference, and body fat percentage via bioelectrical impedance), blood pressure, and dietary intake (i.e., vegetable, fruit, and sugar sweetened beverages) via survey. Data were analyzed with complete cases and with imputations at random. Generalized weighted linear mixed models were used to test the intervention effects and to account for clustering effect of sampling by school. Results A total of 3135 children were enrolled in the study (intervention n = 1412, 45%). Average age was 9.2 years, 64% Hispanic, 47% male, and 69% eligible for free and reduced lunch. The intervention compared to control resulted in increased vegetable intake (+ 0.48 vs. + 0.04 frequency/day, p = 0.02). There were no effects of the intervention compared to control on fruit intake, sugar sweetened beverages, any of the obesity measures or blood pressure. Conclusion While this school-based gardening, nutrition, and cooking program did not reduce obesity markers or blood pressure, it did result in increased vegetable intake. It is possible that a longer and more sustained effect of increased vegetable intake is needed to lead to reductions in obesity markers and blood pressure. Clinical trials number NCT02668744.

Background: The purpose of the Texas!Grow!Eat!Go! (TGEG) study was to assess individual and combined effects of schoolbased gardening and physical activity (PA) interventions on children's eating and PA behaviors and obesity status. Methods: Using a 2 • 2 design, 28 low-income schools in Texas were randomized to 1 of 4 conditions: (1) School Garden intervention (Learn!Grow!Eat!Go! [LGEG]), (2) PA intervention (Walk Across Texas [WAT!]), (3) both Garden and PA intervention (Combined), or (4) neither Garden nor PA intervention (Control). Participants included 1326 third grade students and parents (42% Hispanic; 78% free/reduced lunch). Student and parent data were collected at the beginning and end of the school year. Two different sets of analyses measuring pre-post changes in outcomes within and across conditions were estimated by factorial ANOVAs using mixed models adjusted for demographics. Results: Main effect analyses indicate that relative to children at schools that did not receive LGEG, children at schools that received LGEG, either individually or in combination with WAT!, showed significant increases in Nutrition knowledge, Vegetable preference, and Vegetable tasted (p < 0.001 in all cases). Within-group analyses show that compared to Comparison, children in the WAT! group significantly increased in the amount of time parents and children were active together (p = 0.038). In addition, children in LGEG and WAT! schools significantly decreased BMI percentile (p = 0.042, p = 0.039, respectively), relative to children in Comparison schools. Conclusions: Both the garden and PA interventions independently produced significant changes related to healthy lifestyle behaviors. However, combining the two interventions did not show greater impact than the single interventions, underscoring the need for more research to determine how to better implement comprehensive interventions at schools.

Food insecurity (FI) is adversely associated with physical and mental wellbeing in children. The mechanism underlying this association is assumed to be dietary intake; however, evidence has been mixed. This study examined the relationship between self-reported FI and dietary quality among low-income children. Cross-sectional data were used from TX Sprouts, a school-based cooking, gardening, and nutrition intervention. A sample of 598 children completed two 24-h dietary recalls and a questionnaire including an adapted version of the 5-item Child Food Security Assessment (CFSA). Food security was categorized as food secure or FI based on summed CFSA scores. Dietary quality was assessed using the Health Eating Index-2015 (HEI-2015). Mixed effects linear regression models examined associations between FI and dietary quality. Children were 64% Hispanic, 55% female, and were 9.2 years old on average. Adjusting for sociodemographic characteristics, BMI percentile, and energy intake, FI was associated with lower HEI-2015 total scores (β = −3.17; 95% CI = −5.28, −1.06; p = 0.003). Compared to food secure children, FI children had lower greens and beans (2.3 vs. 1.9, p = 0.016), seafood and plant protein (2.0 vs. 1.6, p = 0.006), and added sugar (7.4 vs. 8.0, p = 0.002) component scores. Interventions targeting low-income and FI children should investigate ways to improve dietary quality.

As lockdown and school closure policies were implemented in response to the coronavirus, the federal government provided funding and relaxed its rules to support emergency food provision, but not guidance on best practices for effectiveness. Accordingly, cities developed a diverse patchwork of emergency feeding programs. This article uses qualitative data to provide insight into emergency food provision developed in five cities to serve children and families. Based on our qualitative analysis, we find that the effectiveness of local approaches appears to depend on: (i) cross‐sector collaboration, (ii) supply chains, and (iii) addressing gaps in service to increased risk populations.