Impact of a Farm-to-School Nutrition and Gardening Intervention for Native American Families from the FRESH Study: A Randomized Wait-List Controlled Trial

Abstract

Establishing healthy eating habits during childhood is critical to prevent chronic diseases that develop in adulthood. Tribally owned Early Childhood and Education (ECE) programs signify fundamental influence in childhood obesity disparities. A strategy to improve diet is the use of school gardens; however, few studies have used rigorous methods to assess diet and health outcomes. The purpose of this manuscript is to describe results from the six-month Food Resource Equity for Sustainable Health (FRESH) study among Native American families. We aimed to recruit 176 families of children attending Osage Nation ECE programs in four communities. Two communities received the intervention and two served as wait-list controls. Outcomes included change in dietary intake, body mass index, health status, systolic blood pressure (adults only), and food insecurity in children and parents. There were 193 children (n = 106 intervention; n = 87 control) and 170 adults (n = 93 intervention; n = 77 control) enrolled. Vegetable intake significantly increased in intervention children compared to controls for squash (p = 0.0007) and beans (p = 0.0002). Willingness to try scores increased for beans in intervention children (p = 0.049) and tomatoes in both groups (p = 0.01). FRESH is the first study to implement a farm-to-school intervention in rural, tribally owned ECEs. Future interventions that target healthy dietary intake among children should incorporate a comprehensive parent component in order to support healthy eating for all household members.

Effectiveness of Gardening-Only, Cooking-Only and Combined Cooking and Gardening Programs in Elementary Schools to Improve Fruit and Vegetable Intake: A Systematic Review

“…The details of each intervention and article are included in Table 1. Nine of these studies included gardening-only interventions [13,[18][19][20][21][22][23][24]50], eight studies included cooking-only interventions [8,[19][20][21][22][23][24][25], and nineteen studies included combined cooking/gardening interventions [15,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]. Out of the nine gardening-only intervention studies (8/9-89% had positive results), seven studies had significant findings for at least one relevant outcome, one study reported positive qualitative findings, and one study did not have any significant results [24].…”

“…The final combined intervention study that assessed this variable looked specifically at group differences in willingness to try tomatoes, carrots, spinach, squash, beans, and peppers. The only significant results were willingness to try tomatoes and beans (p = 0.01 and 0.049) [49].…”

The Center for Indigenous Innovation and Health Equity: The Osage Nation’s Mobile Market

“…During the development of the Farm, Osage Nation partnered with Oklahoma State University Center for Indigenous Health Research and Policy (CIHRP), to implement a farm-to-school program to increase healthy foods among AI children aged 3–5 years. This community-based participatory research (CBPR) study led to significant increases in vegetable consumption among Osage children and trends toward increased food security within the community (Taniguchi et al, 2022). While these efforts are making progress in addressing long-standing issues of healthy food access, tribal members residing in the most remote areas of the Nation are not benefiting equally from the Nation’s investment in food sovereignty.…”

“…Food insecurity is strongly correlated with CVD risk (Blue Bird Jernigan et al, 2017). In the Osage Nation located in northeastern Oklahoma, the prevalence of food insecurity, the limited or uncertain availability of nutritionally adequate and safe foods, is 17% compared with 10% among the United States general population (Taniguchi et al, 2022). In particular, low-income limits people’s ability to purchase healthy foods and increases the likelihood of eating highly caloric fast food.…”

Toward the upscaling of school nutrition programs in Dubai: An exploratory study

“…Several international nutrition-based organizations strongly recommend that schools adapt reliable and comprehensive nutritional program, and promote nutrition education, as well as strengthen school-home-community partnerships (1), to maximize the positive impact on the general health of a community (2,3). This is due to the significant impact of School Nutrition Programs (SNPs) on the eating behaviors, and health and wellbeing of school children (4)(5)(6). SNPs could also impact the intellectual, social, and emotional development of school student, as well as their cognitive function and academic performance (7,8).…”