Table 3.

An overview of the studies found in the systematic review and included in the meta-analysis.

Author (Year), Country, Funding agency	Design/Dominant Theory Framework*	Sample	Treatment Length	Teaching Strategy/Approach	Relevant Outcome Categories	Statistical Significance (p value/95% CI)
Amaro et al. (2006), Italy, Amici di Raoul Follereau (AIFO)	CT / NR	241 × students Mean age: 12yrs	24 weeks	Kalèdo Board Game (15-30mins play time p/w)	Nutritional knowledge (31 items) BMI (z-score)	<0.05 NS
Anderson et al. (2005), UK, Food Standards Agency	CT / TPB	129 × Grades 1–6 students Mean age: 8yrs	36 weeks	(Curriculum approach) based on experiential learning, video & literary abstraction Marketing and canteen provisions	Cognitive & attitudinal (Likert scale) - Diet heart disease knowledge - Preference for HFSS foods 3-day food diary - FV consumption (g) - Energy (kJ) - Sucrose (g)	0.001 0.034 0.617 0.327 0.578
Auld et al. (1998), USA, Kraft Foods, Inc., USDA Food and Consumer Services Cooperative, National Institute of Health/Centers for Disease Control and Prevention 5 A Day Evaluation Grant, and The Lindsay Trust.	QE / SCT	760 students in grades 2–4. Mean age: NR	16 weekly sessions	(Curriculum approach) Nutrition education sessions	FV knowledge FV consumption -Fruits -Vegetables Plate wastage -Fruits -Vegetables -FV Attitudes to food -School lunches -Wholegrains Self-Efficacy scores	< 0.001 < 0.05 < 0.05 < 0.01 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001
Baronowski et al. (2000), USA, NR.	RCT / SCT	1172 children in grades 3–5. Mean age: NR	6 weeks with 12 sessions	(Curriculum approach) Nutrition education sessions. Videotapes, point of purchase education	Fruit Vegetable and Juice consumption -Vegetables intake -FVJ eaten at weekday lunch -Knowledge of FVJ Fruit and Vegetable self-efficacy	< 0.05 < 0.01 < 0.10 < 0.05 < 0.10
Battjes-Fries et al. (2015), The Netherlands, Ministry of Economic Affairs of the Netherlands.	QE / NR	1183 children aged between 9 and 12 years. Mean age: 9yrs.	10–12 sessions	(Curriculum design) nutrition education Experiential Learning (cooking and tasting food)	Determinants of taste acceptance -Number of foods known -Positive taste -Number of foods tasted -Willingness to taste food Determinants of target behaviours -Knowledge -Awareness -Attitude	< 0.05 NS < 0.05 NS < 0.01 NS NS
Bere et al. (2006), Norway, Norwegian Research Council.	CT / SCT	369 × Grade 6 students Mean age: 11yrs	28 weeks	(Curriculum approach) National Curriculum Experiential learning (Cooking/Food Prep)	24hr recall of Daily Dietary Intake - FV consumption (Servings per day) Curriculum enjoyment (Likert scale)	0.41 0.004
Campbell et al. (Campbell et al., 2012), Canada, the Provincial Health Service Authority (PHSA) and by the Child and Family Research Institute (CFRI).	RCT / NR	873 students in grades 3–7. Mean age NR	21 lessons spanning 1 year	(Curriculum design) nutrition education, peer to peer instruction	Healthy behaviours -Grades K to 3 -Grades 4 to 7 Health knowledge -Grades K to 3 -Grades 4 to 7 Healthy habits -Grades K to 3 -Grades 4 to 7	< 0.001 NS < 0.001 < 0.001 < 0.001 < 0.001
Cooke et al. (2011), UK, Medical Research Council National Prevention Research Initiative	CT / mixed	442 × Kindergarten students Mean age: 6yrs	2 weeks	Contingent reinforcement for vegetable tasting	Liking of vegetables (Likert scale) Intake of vegetables	0.001 0.001
Day et al. (Day et al., 2008), Canada, NR	CT / NR	444 × Grades 4–5 students Mean age: 10yrs	12 weeks	Integrates classroom learning, environmental change strategies, and a family/community component to promote the consumption of FV	24hr recall of Daily Dietary Intake - Fruit consumption (Servings) - Vegetable consumption (Servings) - F V consumption (Servings) - Variety of FV consumption (Servings)	<0.05 NS <0.05 <0.05
Evans et al. (Evans et al., 2010), UK, NR.	Meta-analysis / NR	Trials of children aged 5 to 11 years. Mean age NR	NR	NR	FV schemes -Fruit portions -Vegetable portions	Significant Significant
Fahlman et al. (Fahlman et al., 2008) USA, NR	QE / NR	576 × students Mean age: 12yrs	4 weeks	(Curriculum approach) adapted Health Belief Model	24hr recall of Daily Dietary Intake - Grain consumption (Servings/day) - Fruit consumption(Servings/day) - Vegetable consumption(Servings/day) - Dairy consumption (Servings/day) - Meat consumption (Servings/day) Self-Efficacy (Likert scale) - Eat more FV - Eat less fat - Drink less SLB - Eat healthy at FF restaurants	NS 0.047 0.018 NS NS NS NS NS NS
Francis et al. (Francis et al., 2010) Trinidad & Tobago, Self-funded	RCT / NS	579 × Grade 6 students Mean age: 10yrs	32 weeks	(Curriculum approach) Bloom’s mastery learning model	Children’s Eating Attitude Test-26 (M) Self-Report SLB consumption (Servings/wk) Fried food consumption (Servings/day) HFSS food consumption (<502 kJ/day)	<0.05 NS 0.04 NS
Friel et al. (Friel et al., 1999), Ireland, the Department of Health.	QE / SLT	821 children aged 8–10 years. Mean age NR	20 sessions over 10 weeks	(Curriculum approach) Worksheets, homework tasks. Aerobic exercise regimen.	Food Behaviour Food Preference Food Knowledge	< 0.01 < 0.01 NS
Gatto et al. (Gatto et al., 2017), USA, The NIH and a Community Benefit grant from the Keck School of Medicine.	RCT / Self-Efficacy	375 elementary school students. Mean age: 9yrs	12x weekly sessions of 90 min	School gardening and cooking lessons	FV consumption -Fruit -Vegetables	<0.05 NS
Gibbs et al. (Gibbs et al., 2013), Australia, NR	CT / mixed	764 × Grades 3 to 6: Mean age: NR	2 years	(Curriculum approach) Stephanie Alexander’s Kitchen Garden Program. Experiential (gardening and cooking classes)	Parent-proxy questionnaire - Fruit consumption /d - Vegetable consumption /d	0.11 0.59
Gortmaker et al. (Gortmaker et al., 1999), USA, Walton Family Foundation.	QE / SCT BCT	336 × Grades 4–5 students. Mean age: 9yrs	2 years	Cross-curricular (Math, science, language, social studies, physical education) coupled with a Social Marketing Approach	24 hr recall of Daily Dietary Intake - Energy from fat (%) - FV consumption (Servings/4184 kJ)	0.04 0.01
Govula et al. (Govula et al., 2007), USA, NR	QE / NR	33 × Grade 3 students Mean age: NR	6 weeks	(Curriculum approach) MyPyramid and Medicine Wheel Nutrition for Native Americans Culturally appropriate lessons	Block Kids Fruit/Vegetable recall - F&V consumption (Servings/per day) - Fruit consumption (Servings/per day) - Vegetable consumption (Servings/per day) - Knowledge Questionnaire (% correct)	0.10 0.519 <0.001 <0.001
Horne et al. (Horne et al., 2004) UK, Horticultural Development Council, Fresh Produce Consortium, ASDA, Co-operative Group, Safeway, Sainsbury, Somerfield, Tesco, Bird’s Eye	QE / SLT	749 × Grades K-6 students Mean age: NR	16 weeks	Animation abstraction and contingent reinforcement for F&V consumption	Consumption based on teacher visual estimates − 5–7 yr/old fruit (%) − 5–7 yr/old vegetable (%) − 7–11 yr/old fruit (%) − 7–11 yr/old vegetable (%)	<0.002 NR <0.002 NR
Katz et al. (2011), USA, NR	RCT / NR	1180 × Grades 2–4 students. Mean age: NR	3 months	(Curriculum approach) developed with teachers and supported by homework, letters to parents and information evenings with parents.	Nutrition Knowledge - Food label quiz score Youth and Adolescent Questionnaire Calories (kcal) Carbohydrates (g)	0.04 0.51 0.51
Kipping et al. (2014), UK, UK National Institute for Health Research (NIHR) Public Health Research Programme	RCT / SCT	2121 × Grade 5 students. Mean age: 9yrs	12 months	(Curriculum approach) Active For Life Year 5 intervention. Included teacher training, provision of lesson and child-parent interactive homework plans, all materials required for lessons and homework, and written materials for school newsletters and parents.	A Day in the Life Questionnaire - F&V consumption (no./day)	0.42
Kristjansdottir et al. (2010), Iceland, The University of Iceland, The Icelandic Centre for Research, Brim Seafood	CT / NR	171 × Grade 2 students Mean age: NR	2 years	(Curriculum approach) co developed with teachers and supported by homework, letters to parents and meetings with parents	Food record by parents - FV consumption (g/day) - Fruit consumption (g/day) - Vegetable consumption (g/day)	<0.001 0.001 <0.001
Lakshman et al. (2010), UK, Health Enterprise East, NHS innovations hub for East of England.	RCT / NR	2519 × Grades 5–6 students. Mean age: NR	9 weeks	(Curriculum approach) Healthy eating curriculum + Top Grub card game to be implemented in classroom and at home.	Healthy eating quiz - Knowledge	0.042
Liquori et al. (Liquori et al., 1998) USA, NR.	QE / SCT	590 × Grades K-6 students Mean age: NR	1 year	Experiential learning (Cooking, environment and community garden)	Food intake based on teacher visual estimates (%) Self-report - Preference for plant food - Attitudes - Knowledge - Self efficacy in cooking - Food intentions - Paired food choice	<0.01 <0.001 NS <0.05 NS <0.01 <0.01
Manios et al. (2002), Greece, Kellogg’s, Greek Ministry of Sport, Greek Ministry of Education.	QE / NR	1006 × Grade 1 students Age range: 5.5–6.5yrs Mean age: NR	6 years	(Curriculum approach) Literary abstraction	Parental reporting (Food Diary) - Energy (kJ) - Total fat (g) - Protein (g) - Carbohydrate (g)	<0.05 <0.05 <0.05 NS
McAleese & Rankin (McAleese and Rankin, 2007), USA, NR.	QE / NR	99 × Grade 6 students Mean age: 11yrs	12 weeks	(Curriculum approach) Nutrition in the Garden Experiential learning (School garden)	24hr recall of Daily Dietary Intake - Fruit (Servings/day) - Vegetables (Servings/day) - Vitamin A (µg/day) - Vitamin C (mg/day) - Fibre (g/day)	<0.001 <0.001 0.004 0.016 0.001
Morgan et al. (Morgan et al., 2010) Australia, Hunter Medical Research, Coles.	QE / SCT	127 × Grades 5–6 students Age range: 11-12yrs Mean age: NR	10 weeks	(Curriculum approach) Nutrition in the Garden – Modified Experiential learning (School garden)	FV knowledge (Gimme 5 Questionnaire) 24hr recall of Daily Dietary Intake - Vegetable intake (Servings/day) - Fruit intake (Servings/day)	<0.02 0.22 0.23
Parmer et al. (2009), USA, NR	CT / ELT	115 × 2nd Grade students Mean age: 7yrs	28 weeks	(Curriculum approach) Nutrition lessons + school garden Experiential Learning (Gardening + Food Prep)	FV Survey (Likert Scale) - MyPyramid food groups - Nutrient–food association - Nutrient–job association - F V identification Researcher Observed Lunch Choices - Vegetable choice (Servings) - Vegetable consumption (Servings)	NS < 0.001 < 0.001 < 0.01 <0.01 <0.01
Prelip et al. (Prelip et al., 2012), USA, the Network for a Healthy California through the United States Department of Agriculture.	QE / SCT,TPB	399 × Grades 3–5. Age range: 8-11yrs Mean age: NR	1 year of schooling	(Curriculum approach) National curriculum and teacher training workshops	FV Recall - Fruit intake - Vegetable intake - Fruit availability - Vegetable availability FV Questionnaire - Food grp knowledge - FV related attitudes - FV attitude influence from parent - FV influence from teacher	< 0.01 NS NS NS <. 05 < 0.01 NS < 0.05
Ransley et al. (Ransley et al., 2007), United Kingdom, NR.	QE / NR	3703 × Children Age range: 4 – 6yrs. Mean age 6 yrs	11 months	Provision of fruit and vegetables at school	Fruit intake - At reception age - In year 1 - In year 2 Vegetable portions - At reception age - In year 1 - In year 2 Fruit and vegetable intake - At reception age - In year 1 - In year 2 Energy intake - At reception age - In year 1 - In year 2	95% CI (7mth follow up) 0.2 (0.1–0.4) 0.3 (0.1 – 0.6) 0 (-0.2 – 0.3) −0.2 (-0.5 – 0.1) −0.2 (-0.5–0.2) −0.3 (-0.6 – 0.1) 0.2 (0.3 – 0.1) 0.2 (−0.2 – 0.6) −0.2 (−0.5 – 0.2) −0.03 (-0.25 – 0.19) 0.03 (-0.35 – 0.4) −0.63 (-1.01 – 0.25)
Rosário et al. (2012), Portugal, NR	RCT / SCT, Health Promotion Model	464 × Grades 1–4. Mean age: 8yrs	6 months of lessons	(Curriculum approach) Nutrition lessons	FV Intake - Fruit (grams) - Vegetables (grams) - Fruits and vegetables (grams) - BMI - Weight control	< 0.01 <0.05 < 0.001 < 0.01 < 0.05
Simons-Morton et al. (1991), USA, NHLBI funded	RCT / SCT	Total sample size NR. Children in kindergarten – 4th grade. Mean age NR	3x spring sessions spanning 3 years	(Curriculum approach) Classroom nutrition lessons, Physical activity, School lunches	Nutrient Intake - Energy (kcal) [School 3] - Energy (kcal) [School 4]	Value (95% CI range) 849.3 (816.8 – 881.8) 840.9 (800.7 – 881.1)
Struempler et al. (Struempler et al., 2014), USA, Alabama Cooperative Extension System and the US Department of Education SNAP	QE / Experiential Learning Theory	2477 × third graders. Mean age NR	17 weeks	(Curriculum approach) Nutrition lessons	FV intake - Fruit intake (weekly servings) - Vegetable intake (weekly servings)	< 0.001 < 0.001
van de Gaar et al. (2014), The Netherlands, ZonMw, the Netherlands Organization for Health Research and Development and The Netherlands Organization for Scientific Research (NWO)	RCT / NR	1288 × Grades 2 – 7. Mean age NR	1 year	(Curriculum based) Healthy lifestyle promotion, Physical activity	Sugar sweetened beverage consumption (parent report) - SSB consumed daily (% of cohort) - SSB consumption (Litres) - SSB servings Sugar sweetened beverage consumption (child report) - SSB consumed daily (% of cohort) - SSB consumption (Litres) - SSB servings SSB brought to school	0.79 (0.47 – 1.34) −0.19 (−0.28 - −0.10) −0.54 (-0.82 - −0.26) 1.32 (0.78 – 2.24) 0.04 (-0.10 – 0.19) 0.05 (-0.36 – 0.47) 0.51 (0.36 – 0.72)
Viggiano et al. (2015) Italy, Second University of Naples, Associazione Culturale Kaledo, Regione Campania (Assessorato all’Istruzione), Provincia di Napoli, Provincia di Salerno Assessorato allo Sport, Comune di Cercola (Assessorato all’istruzione) and Fondazione per l’Assistenza all’Infanzia	RCT / NR	3110 × 9–19 year olds. Mean age 13yrs.	20 weeks	Board game based education	Adolescent Food Habit Checklist − 6 month follow up score − 18 month follow up score Nutrition Knowledge Questionnaire − 6 month follow up score − 18 month follow up score Healthy and Unhealthy Diet and Food Questionnaire − 6 month follow up score − 18 month follow up score Food Habits Questionnaire − 6 month follow up score − 18 month follow up score	< 0.001 NS < 0.001 NS < 0.001 NS < 0.001 NS

(N.B. TPB = Theory of Planned Behaviour; SCT = Social Cognitive Theory; SLT = Social Learning Theory; BCT = Behavioural Choice Theory; RCT = Randomised controlled trial; QE = Quasi-experimental; CT = Cluster-controlled trial; NR = Not reported; NS = Not significant; FV = Fruit and vegetable; SLB = Sugar-laden beverages; HFSS = High fat, sugar & salt; HFF = High Fat Food; FF = Fast food, BMI = Body Mass Index).