Long-term effects of the Dutch Schoolgruiten Project--promoting fruit and vegetable consumption among primary-school children.

OBJECTIVES To evaluate the long-term effects of the Schoolgruiten Project, a Dutch primary school-based intervention providing free fruit and vegetables (F&V). In addition, we assessed whether children's appreciation of the project mediated these intervention effects. DESIGN AND METHODS Participating schoolchildren (mean age 9.9 years at baseline) and their parents completed parallel questionnaires at baseline, at 1-year and at 2-year follow-up, including questions on usual F&V intake of the child, potential behavioural determinants, their appreciation of the project and general demographics. Primary outcomes were usual F&V intakes as assessed by parent and child self-reported food frequency measures. Secondary outcome measures were taste preference, knowledge of daily recommendations, availability and accessibility for fruit intake. Multilevel linear regression analyses were used to assess differences at second follow-up adjusted for baseline values between control and intervention groups. SUBJECTS Reports were available for 346 intervention children (148 parents) and 425 control children (287 parents). RESULTS Both child and parent reports indicated that the intervention group had a significantly higher fruit intake at 2-year follow-up (difference, servings/d: 0.15; 95 % CI 0.004, 0.286 for child reports; 0.19; 95 % CI 0.030, 0.340 for parent reports). No significant effects on vegetable intake were observed. Significant positive intervention effects were also found for knowledge of fruit recommendations among boys. Some evidence was found for partial mediation analyses of the effects on fruit intake. CONCLUSION The present study indicates that the Schoolgruiten scheme was effective in increasing children's fruit intake and that appreciation of the project partially mediated this effect.