Will European agricultural policy for school fruit and vegetables improve public health? A review of school fruit and vegetable programmes.
BACKGROUND
For the first time, public health, particularly obesity, is being seen as a driver of EU agricultural policy. In 2007, European Ministers of Agriculture were asked to back new proposals for school fruit and vegetable programmes as part of agricultural reforms. In 2008, the European Commission conducted an impact assessment to assess the potential impact of this new proposal on health, agricultural markets, social equality and regional cohesion.


METHODS
A systematic review of the effectiveness of interventions to promote fruit and/or vegetable consumption in children in schools, to inform the EC policy development process.


RESULTS
School schemes are effective at increasing both intake and knowledge. Of the 30 studies included, 70% increased fruits and vegetables (FV) intake, with none decreasing intake. Twenty-three studies had follow-up periods >1 year and provide some evidence that FV schemes can have long-term impacts on consumption. Only one study led to both increased fruit and vegetable intake and reduction in weight. One study showed that school fruit and vegetable schemes can also help to reduce inequalities in diet. Effective school programmes have used a range of approaches and been organized in ways which vary nationally depending on differences in food supply chain and education systems.


CONCLUSIONS
EU agriculture policy for school fruits and vegetables schemes should be an effective approach with both public health and agricultural benefits. Aiming to increase FV intake amongst a new generation of consumers, it will support a range of EU policies including obesity and health inequalities.
de Sa
Joia
J
European Centre for Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK.
Lock
Karen
K
D000293:Adolescent; D000383:Agriculture / Q000331:legislation & jurisprudence*; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D004032:Diet; D005062:European Union; D005260:Female; D005638:Fruit; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008297:Male; D011634:Public Health; D011640:Public Policy; D012574:Schools / Q000458:organization & administration*; D014675:Vegetables