School-Based Strategies to Improve Acceptance of Healthier Foods and Dietary Patterns in High School Students: A Rapid Review

OBJECTIVES: To conduct a rapid review addressing the question: What is the effect of school-based strategies that aim to improve acceptance of healthier foods and dietary patterns in children and adolescents on dietary intake and dietary intake-related behaviors? Results are from randomized controlled trials (RCTs) and are presented for high school students only. METHODS: We conducted a literature search (2000–2020) and dual-screened the results using pre-defined inclusion criteria. Among included studies, the review team extracted data, assessed risk of bias, qualitatively synthesized the evidence to develop conclusion statements, and graded the strength of the evidence. RESULTS: The body of evidence in high school included 18 articles (from 18 RCTs), examining teaching and educational interventions (12 articles), behavioral and environmental interventions (4 articles), and interventions that combined teaching and educational strategies with behavioral and/or environmental strategies (2 articles). Curriculum-based nutrition education tended to improve dietary intake (particularly vegetables), but findings were mixed across studies and food groups. Evidence was insufficient to draw conclusions for other types of educational interventions, those that utilized behavioral and/or environmental strategies, or those that combined educational and behavioral strategies. CONCLUSIONS: Limited evidence from this rapid review suggests curriculum-based nutrition education may improve dietary intake (particularly vegetable intake) in high school adolescents. FUNDING SOURCES: USDA, Food and Nutrition Service, Office of Policy Support, Special Nutrition Research and Analysis Division.