title: Introduction of a school fruit program is associated with reduced frequency of consumption of unhealthy snacks.
abstract: BACKGROUND
  A diet high in fruit and vegetables (FV) is inversely related to chronic diseases, and some studies suggest that increasing the intake of FV reduces the intake of unhealthy snacks.
  
  
  OBJECTIVE
  The objectives were to analyze changes in the frequency of consumption of unhealthy snacks (soda, candy, and potato chips) from 2001 to 2008 in Norwegian children, to assess whether being part of a school fruit program reduces the frequency of unhealthy snack consumption, and to explore differences in sex and socioeconomic status.
  
  
  METHODS
  Within the project Fruits and Vegetables Make the Marks, 1488 sixth- and seventh-grade pupils from 27 Norwegian elementary schools completed a questionnaire in 2001, and 1339 sixth- and seventh-grade pupils from the same schools completed the same questionnaire in 2008. In 2001, none of the schools had any organized school fruit program. In 2008, 15 schools participated in a program and 12 did not participate in any program.
  
  
  RESULTS
  From 2001 to 2008, the frequency of unhealthy snack consumption decreased from 6.9 to 4.6 times/wk (P < 0.001). The decrease was largest in the schools that had been included in the national free school fruit program (-2.8 times/wk). The effect of the school fruit programs was significant in reducing the frequency of unhealthy snack consumption in children of parents without higher education (from 7.8 to 4.0 times/wk; P = 0.004).
  
  
  CONCLUSIONS
  The frequency of unhealthy snack consumption decreased from 2001 to 2008 in schoolchildren in Norway. The decrease was most evident among children at schools participating in the national free school fruit program and in children with a low socioeconomic status.
authors.affiliation: University of Agder, Department of Public Health, Sport and Nutrition, Kristiansand, Norway. nina.c.overby@uia.no
authors.forename: Nina Cecilie
authors.initials: NC
authors.lastname: Øverby
authors.forename: Knut-Inge
authors.initials: KI
authors.lastname: Klepp
authors.forename: Elling
authors.initials: E
authors.lastname: Bere
mesh_terms: D002648:Child; D004522:Educational Status; D005260:Female; D005518:Food Preferences; D005522:Food Services; D005638:Fruit; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D009664:Norway; D012572:School Health Services; D012574:Schools; D062410:Snacks; D011795:Surveys and Questionnaires; D014675:Vegetables