Effectiveness of school-based nutrition intervention components on fruit and vegetable intake and nutrition knowledge in children aged 4-12 years old: an umbrella review

Context: School-based nutrition interventions can support healthy eating in children. Objective: To identify components of school-based nutrition interventions and synthesize the impact on consumption of fruits and vegetables (FV) and nutrition knowledge (NK) in children aged 4-12 y. Data sources: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and PICOS inclusion criteria, relevant systematic reviews and/or meta-analyses, written in English, published between 2010 and August 2020, across 6 databases were identified. Data extraction: Two reviewers independently performed data extraction and assessed the study quality. Data analysis: The JBI Critical Appraisal Instrument for Systematic Reviews and Research Syntheses was used to assess review quality, and the Grading of Recommendations Assessment, Development, and Evaluation approach was used to rate strength of evidence. Results: From 8 included reviews, 7 intervention components were identified: FV provision, gaming/computer-delivered, curriculum, experiential learning, reward/incentives, nudging, and caregiver involvement. FV provision had the greatest effect on F intake, gaming/computer-delivered on V intake, and curriculum on NK. Conclusion: FV provision and gaming/computer-delivered components showed, overall, some positive effect on FV intake, as did the curriculum component on NK. More evidence evaluating single-component effectiveness that considers the setting and context of nutrition interventions is required to strengthen the evidence base.