Nutrition: Gardening Interventions to Increase Vegetable Consumption Among Children

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Snapshot

Summary of CPSTF Finding

The Community Preventive Services Task Force (CPSTF) recommends school-based gardening interventions in combination with nutrition education to increase children’s vegetable consumption.

Intervention

Gardening interventions provide children with hands-on experience planting, growing, and harvesting fruits and vegetables in an effort to increase their willingness to consume fruits and vegetables.

Interventions must include at least one of the following:

Outside gardens
Microfarms
Container gardens
Other alternative gardening methods

Interventions may also include nutrition education or a parental component. They may be implemented in early care and education settings, schools, afterschool programs, or communities.

CPSTF Finding and Rationale Statement

Read the full CPSTF Finding and Rationale Statement for details including implementation issues, possible added benefits, potential harms, and evidence gaps.

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What the CPSTF Found

About The Systematic Review

The CPSTF uses recently published systematic reviews to conduct accelerated assessments of interventions that could provide program planners and decision-makers with additional, effective options. The following published review was selected and evaluated by a team of specialists in systematic review methods, and in research, practice, and policy related to obesity, nutrition, and school health:

Savoie-Roskos MR, Wengreen H, Durward C. Increasing fruit and vegetable intake among children and youth through gardening-based interventions: a systematic review. Journal of the Academy of Nutrition and Dietetics 2017;11(2);240-50.

The systematic review included 14 studies that examined gardening interventions conducted with children ages 2 to 18 years (search period January 2005 – October 2015).

The CPSTF finding is based on results from the published review, additional information from the subset of studies, and expert input from team members and the CPSTF.

Context

A healthy diet includes a variety of fruits and vegetables (Dietary Guidelines for Americans 2015-2020 External Web Site Icon ). Most people in the United States, including children and adolescents, do not eat enough fruits and vegetables (CDC, 2017; CDC, 2014). Gardening interventions have been shown to increase children’s preferences for, and willingness to try, new fruits and vegetables (Robinson-O’Brien et al, 2009).

CDC recommends gardening as a strategy to increase fruit and vegetable intake among children (CDC, 2011). Gardening interventions also are included within the Healthy Eating Learning Opportunities component of CDC’s Comprehensive Framework for Addressing the School Nutrition Environment and Services pdf icon [PDF - 2.95 MB] External Web Site Icon .

Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement.

The systematic review included 14 studies.

Consumption of vegetables increased (12 studies) while fruit consumption did not change (10 studies).
Interventions, including nutrition education in addition to gardening activities, were more effective than gardening activities alone.

Summary of Economic Evidence

A systematic review of economic evidence has not been conducted.

Applicability

While additional research is warranted, the CPSTF finding is likely applicable to interventions in elementary and middle school settings in high income countries.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

Are interventions effective in early care and education, afterschool, and community settings?
Are interventions effective when implemented without nutrition education?
Does effectiveness vary by age or school level?
Do children participating in gardening programs act as agents of change by engaging parents in discussion about food and nutrition? Do parents incorporate healthier dietary habits or purchasing practices at home?

Study Characteristics

Interventions were conducted in the United States (10 studies), the United Kingdom (2 studies), Australia (1 study), and Canada (1 study).
Interventions were implemented in schools (8 studies), afterschool settings (2 studies), communities (2 studies), early care and education settings (1 study), and multiple settings (1 study).
Study participants had the following demographic characteristics:
- Mean age of 9.0 years (7 studies)
- 51.5% female (10 studies)
- Black (median 18.0%, 4 studies), Hispanic (median 44.5%, 6 studies), Asian (median 8.0%, 5 studies), White (median 29.6%, 6 studies), and First Nations (100.0%, 1 study)
Intervention characteristics:
- Interventions included nutrition education in addition to gardening activities (7 studies)
- Intervention duration ranged from 2.5 to 18 months, with a median of 4 months

Supporting Materials

Analytic Framework

No content is available for this section.

Summary Evidence Table

A summary evidence table for this Community Guide review is not available because the CPSTF finding is based on the following published systematic review:

Included Studies

The number of studies and publications do not always correspond (e.g., a publication may include several studies or one study may be explained in several publications).

Effectiveness Review

Castro DC, Samuels M, Harman AE. Growing Healthy Kids: a community garden-based obesity prevention program. American Journal of Preventive Medicine 2013;44(3S3):S193-9.

Christian MS, Evans CE, Nykaer C, et al. Evaluation of the impact of a school gardening intervention on children’s fruit and vegetable intake: a randomised controlled trial. International Journal of Behavioral Nutrition and Physical Activity 2014;11:99.

Davis JN, Ventura EE, Cook LT, et al. LA Sprouts: a gardening, nutrition, and cooking intervention for Latino youth improves diet and reduces obesity. Journal of the American Dietetic Association 2011;111:1224-30.

Duncan MJ, Eyre E, Bryant E, et al. The impact of a school-based gardening intervention on intentions and behavior related to fruit and vegetable consumption in children. Journal of Healthy Psychology 2015;20(6):765-73.

Gatto NM, Martinez LC, Spruijt-Metz D, et al. LA sprouts randomized controlled nutrition, cooking and gardening programme reduces obesity and metabolic risk in Hispanic/Latino youth. Pediatric Obesity 2017;12:28-37.

Hanbazaza MA, Triador L, Ball GDC, et al. The impact of school gardening on Cree Children’s knowledge and attitudes toward vegetables and fruit. Canadian Journal of Dietetic Practice and Research 2015;76(3):133-9.

Lautenschlager L, Smith C. Understanding gardening and dietary habits among youth garden program participants using the Theory of Planned Behavior. Appetite 2007;49:122-30.

McAleese JD, Rankin LL. Garden-based nutrition education affects fruit and vegetable consumption in sixth-grade adolescents. Journal of the American Dietetic Association 2007;107:662-5.

Meinen Amy, Friese B, Wright W, et al. Youth gardens increase healthy behaviors in youth children. Journal of Hunger & Environmental Nutrition 2012;7:192-204.

Morgan PJ, Warren JM, Lubans DR, et al. The impact of nutrition education with and without a school garden on knowledge, vegetable intake and preferences and quality of school life among primary-school students. Public Health Nutrition 2010;13(11):1931-40.

Namenek Brouwer RJ, Benjamin Neelon SE. Watch Me Grow: a garden-based pilot intervention to increase vegetable and fruit intake in preschoolers. BMC Public Health 2013;13:363.

Parmer SM, Salisbury-Glennon J, Shannon D, et al. School gardens: an experimental learning approach for a nutrition education program to increase fruit and vegetable knowledge, preference, and consumption among second-grade students. Journal of Nutrition Education and Behavior 2009;41(3):212-7.

Ratcliffe MM, Merrigan KA, Rogers BL, et al. The effects of school garden experiences on middle school-aged students’ knowledge, attitudes, and behaviors associated with vegetable consumption. Health Promotion Practice 2011;12(1):36-43.

Wang MC, Rauzon S, Studen N, et al. Exposure to a comprehensive school intervention increases vegetable consumption. Journal of Adolescent Health 2010;47:74-82.

Search Strategies

Refer to the existing systematic review for information about the search strategy:

Review References

Savoie-Roskos MR, Wengreen H, Durward C. Increasing Fruit and Vegetable Intake among Children and Youth through Gardening-Based Interventions: A Systematic Review. Journal of the Academy of Nutrition and Dietetics 2017;11(2);240-50.

Considerations for Implementation

The following considerations are drawn from studies included in the evidence review, the broader literature, and expert opinion.

Incorporating a parental component could increase intervention effectiveness by encouraging changes in the home environment and providing support and resources to families, such as cooking and nutrition workshops.
While evidence indicates gardening interventions are effective across age groups, it is important to consider children’s ages when developing and implementing gardening interventions to ensure they are age appropriate.
Climate may impact program effectiveness as programs in milder climates have longer growing seasons. Programs in more severe climates may be able to lengthen their programs using other methods such as green houses and hydroponics.
Schools or communities with greater resources, including financial resources and physical space for gardening, are better able to implement gardening interventions than those with fewer resources.
Garden upkeep and maintenance, especially during summer months and school holidays, maybe be a particular challenge for some programs. Hiring a dedicated garden coordinator or providing stipends to teachers implementing gardening programs can help, though dedicated staff are not a requirement for program success.
Previous exposure to gardening may impact program effectiveness, as one study had low retention among students with a prior history of gardening at home.

Crosswalks

Healthy People 2020

Healthy People 2020 includes the following objectives related to this CPSTF recommendation.

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