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The effects of a school-based intervention on the dietary quality of mid-morning snacks in second grade Azorean childrean
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Introduction: Schools appear to be a key place to establish healthy eating habits, since it is where children spend a significant amount of time and consume at least one meal per day. Currently in Portugal, there is no mandatory legislation regarding school mid morning snacks (MMS), allowing the children to bring all typess of foods from home. To improve the dietary and nutritional quality of MMS during the school year 2020/2021, a
school-based nutrition intervention was implemented in all elementary public schools of São Miguel Island.
Aim: To assess the effects of a school-based intervention on the dietary and nutritional
quality of MMS among children attending the second grade.
Methodology: This quasi-experimental study included all elementary public schools
(n=76) with a total of 83 second-grade classes (7- to 8-year-old). The intervention
consisted of food education, through a story book and practical weekly activities for 24
weeks. The effects were evaluated through an assessment of the dietary quality of MMS,
converted into a nutritional traffic-light label: “foods to promote”, “foods to limit” and
“foods to avoid”. To measure children’s nutrient intake an electronic database, including
the Portuguese Food Composition Table, was used to convert the MMS foods into energy
and nutrients. Data on MMS foods were collected at pre- and post-intervention.
Results: A total of 969 participants (50.6% male) were included. An overall improvement
in the dietary and nutritional quality of MMS was observed. Data from post-intervention
showed an increase of healthier MMS – “foods to promote” (+17.7 percentage points) and
a decrease of “foods to avoid” (-19.4 percentage points). Regarding the nutritional quality
of MMS, children presented a decrease in energy intake, protein, total fat, saturated fatty
acids, carbohydrates, mono- and disaccharides, added and free sugars, and fibre
(p<0.001). Overall, the adequacy of the nutritional quality of MMS increased from baseline
to post-intervention.
Conclusions: This school-based intervention improved children’s dietary and nutritional
quality of MMS. Our findings emphasize the importance of food education, consistently,
through its inclusion in the school curriculum, and a multidimensional intervention that
includes the children's home and school, leading to a change of eating habits.
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Childhood Dietary Education Eating Habits Mid-Morning Snacks School-based Intervention