Farm to elementary school programming increases access to fruits and vegetables and increases their consumption among those with low intake

Objective: To assess the effectiveness of Wisconsin Farm to School (F2S) programs in increasing students' fruit and vegetable (FV) intake.

Design: Quasi-experimental baseline and follow-up assessments: knowledge and attitudes survey, food frequency questionnaire (FFQ), and lunch tray photo observation.

Setting: Wisconsin elementary schools: 1 urban and 8 rural.

Participants: Children, grades 3-5 (n = 1,117; 53% male, 19% non-Caucasian).

Intervention(s): Farm to School programming ranging from Harvest of the Month alone to comprehensive, including school garden, locally sourced produce in school meals, and classroom lessons.

Main outcome measures: Knowledge, attitudes, exposure, liking, willingness; FFQ-derived (total), and photo-derived school lunch FV intake.

Analysis: t tests and mixed modeling to assess baseline differences and academic-year change.

Results: Higher willingness to try FV (+1%; P < .001) and knowledge of nutrition/agriculture (+1%; P < .001) (n = 888), and lunch FV availability (+6% to 17%; P ≤ .001) (n = 4,451 trays), both with increasing prior F2S program exposure and across the year. There was no effect on overall dietary patterns (FFQ; n = 305) but FV consumption increased among those with the lowest intakes (FFQ, baseline very low fruit intake, +135%, P < .001; photos: percentage of trays with no FV consumption for continuing programs decreased 3% to 10%, P ≤ .05).

Conclusions and implications: Farm to School programming improved mediators of FV consumption and decreased the proportion of children with unfavorable FV behaviors at school lunch. Longer-term data are needed to further assess F2S programs.