title: Healthier food choices as a result of the revised healthy diet programme Krachtvoer for students of prevocational schools.
abstract: BACKGROUND
  Krachtvoer is a Dutch healthy diet programme for prevocational schools, developed in 2001 and revised for a broader target group in 2007, based on the findings of an evaluation of the first version. The goal of this study was to report on the short- and longer-term total and subgroup effects of the revised programme on students' fruit, fruit juice, breakfast, and snack consumption.
  
  
  METHODS
  Schools were randomized to the experimental condition, teaching the Krachtvoer programme, or to the control condition teaching the regular nutrition lessons. Self-reported consumption of fruit, fruit juice, breakfast and snacks was measured at baseline directly before programme implementation, one to four weeks after finishing programme implementation, and after six months. Mixed linear and logistic regression analyses were conducted.
  
  
  RESULTS
  In total 1117 students of 13 experimental schools and 758 students of 11 control schools participated in the study. Short- and longer-term favourable intervention effects were found on fruit consumption (mean difference between experimental and control group 0.15 servings at both posttests). Regarding fruit juice consumption, only short-term favourable effects were revealed (mean difference between experimental and control group 0.05 glasses). Intervention effects on breakfast intakes were limited. No changes in snack frequency were reported, but students made healthier snack choices as a result of the programme. Some favourable as well as unfavourable effects occurred in subgroups of students.
  
  
  CONCLUSIONS
  The effects on fruit consumption and snack choices justify the current nationwide dissemination of the programme. Achieving changes in breakfast consumption may, however, require other strategies.
authors.affiliation: NUTRIM School for Nutrition, Toxicology, and Metabolism, Department of Health Promotion, Maastricht University Medical Centre+, P,O, Box 616, 6200, MD, Maastricht, The Netherlands. k.bessems@maastrichtuniversity.nl
authors.forename: Kathelijne M H H
authors.initials: KM
authors.lastname: Bessems
authors.forename: Patricia
authors.initials: P
authors.lastname: van Assema
authors.forename: Marloes K
authors.initials: MK
authors.lastname: Martens
authors.forename: Theo G W M
authors.initials: TG
authors.lastname: Paulussen
authors.forename: Lieke G M
authors.initials: LG
authors.lastname: Raaijmakers
authors.forename: Mark
authors.initials: M
authors.lastname: de Rooij
authors.forename: Nanne K
authors.initials: NK
authors.lastname: de Vries
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D001628:Beverages; D062408:Breakfast; D002648:Child; D053198:Child Nutrition Sciences / Q000193:education*; D002755:Choice Behavior; D004032:Diet / Q000523:psychology / Q000592:standards*; D005260:Female; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D008297:Male; D009426:Netherlands; D012572:School Health Services / Q000458:organization & administration*; D012574:Schools; D062410:Snacks; D013334:Students / Q000523:psychology*