title: The influence of a school-based intervention programme regarding adherence to a healthy diet in children and adolescents from disadvantaged areas in Greece: the DIATROFI study.
abstract: To evaluate the effects, via a cohort study, of a food aid and promotion of healthy nutrition programme, implemented in areas of low socioeconomic status (SES) in Greece, on students' diet quality.
  
  
  
  From a total of 162 schools participating in the programme during the 2012-2013 school year, we collected 3941 individually linked questionnaires at baseline and at the end of the intervention, recording sociodemographic characteristics, lifestyle parameters and dietary habits of the students. For the assessment of diet quality, the KIDMED score was computed, along with food frequency consumption data regarding milk, fruits, vegetables and whole grain products. Pre-post intervention values were compared using non-parametric tests. Generalised estimating equations were used to explore the factors that influence changes in dietary habits.
  
  
  
  By the end of the intervention, favourable changes were observed regarding healthy eating; KIDMED increased statistically significantly in adolescent girls (p=0.042), while the consumption frequency of all foods promoted by the intervention, namely, milk, fruits, vegetables and whole grain products, increased for children and adolescents, boys and girls (p≤0.002). Factors indicating lower SES, such as foreign country of birth, lower education level, no income source and high levels of food insecurity, were associated with lower diet quality.
  
  
  
  As low SES groups tend to adopt unhealthier dietary choices, it is of the outmost importance to take action for the promotion of healthy eating, directed especially to these at risk populations. School-based nutritional programmes can be considered as an effective policy measure towards this direction.
authors.affiliation: Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece.
authors.forename: Christina Maria
authors.initials: CM
authors.lastname: Kastorini
authors.affiliation: Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Lykou
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: Mary
authors.initials: M
authors.lastname: Yannakoulia
authors.affiliation: Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece Department of Statistics, Athens University of Economics and Business, Athens, Greece.
authors.forename: Athanassios
authors.initials: A
authors.lastname: Petralias
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Elena
authors.initials: E
authors.lastname: Riza
authors.affiliation: Institute of Preventive Medicine, Environmental & Occupational Health, Prolepsis, Maroussi, Greece Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Athena
authors.initials: A
authors.lastname: Linos
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D000072001:Diet, Healthy; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D012572:School Health Services; D012574:Schools; D035862:Vulnerable Populations
keywords: CHILD HEALTH; HEALTH PROMOTION; NUTRITION; OBESITY; POVERTY