A Community Guide Systematic Review: School Dietary and Physical Activity Interventions

Context: Schools can play an important role in supporting a healthy lifestyle by offering nutritious foods and beverages and providing opportunities for physical activity. A healthy diet and regular physical activity may reduce the risk of obesity. This manuscript reports on a Community Guide systematic review examining the effectiveness of interventions in schools combining school meal or fruit and vegetable snack programs and physical activity.Evidence Acquisition: Studies meeting the intervention definition were identified from a litera-ture search (search period: January 1990-November 2019). Community Guide systematic review methods were used to assess effectiveness as measured by dietary behavior, physical activity, and weight changes; analyses were conducted in 2020.Evidence Synthesis: Interventions (n=24 studies) were considered effective for increasing physi-cal activity (median increase=21.8 minutes/day; interquartile interval= -0.8 to 27.4 minutes/day), modestly increasing fruit and vegetable intake (median relative increase=12.1%; interquartile inter-val= -4.6%, 73.4%), and decreasing the prevalence of overweight and obesity (median decrease=2.5 percentage points; interquartile interval= -8.1, -1.6 percentage points) among elementary school students through sixth grade. There were not enough studies to determine the effectiveness of inter-ventions for middle-and high-school students.Conclusions: School meal or fruit and vegetable snack interventions combined with physical activity were effective in increasing physical activity, with modest effects for improving fruit and vegetable con-sumption and reducing the prevalence of overweight and obesity among elementary students. These results may inform researchers and school administrators about healthy eating and physical activity interventions. Am J Prev Med 2023;64(3):441-451. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.

Automated summary

Schools can support healthy lifestyles by offering nutritious foods, promoting physical activity, and reducing the risk of obesity. This study found that interventions combining school meal or snack programs with physical activity were effective in increasing physical activity and improving fruit and vegetable intake among elementary school students. These findings provide important information for researchers and school administrators regarding healthy eating and physical activity interventions.