Free Fruits and Veggies in School Can Improve Lifelong Health

Dentistry Today


Providing free fruits and vegetables and limiting sugary drinks in schools could have positive effects on oral and systemic health in the short and long term, potentially reducing mortality, reports the Friedman School of Nutrition Science and Policy at Tufts University

“Standards such as Smart Snacks in School have largely eliminated sugary drinks in US public schools, but potential effects on obesity in children or long-term health are not known,” said senior author Dariush Mozaffarian, MD, DrPH, dean of the school.

“Also, elementary schools in low-income neighborhoods often have free fresh fruits and vegetables programs, but these have not been expanded to other elementary, middle, or high schools, and potential long-term effects have not been evaluated,” Mozaffarian said.

The study used a comparative risk assessment model to estimate the impact that implementing national food policies in elementary, middle, and high schools could have on dietary intake and body mass index in children and what cardiometabolic disease outcomes might be influenced in adulthood.

“As children consume more than one-third of their daily meals and snacks in school, having policies focused on healthy food options in school is important,” said Katherine L. Rosettie, MPH, first and corresponding author of the study.

“What we need to know is how these policies are changing food choice, nutrition, and health,” said Rosettie, who conducted her work as a research scholar at the Friedman School and is now a researcher at the Institute for Health Metrics and Evaluation

The researchers estimated that a provision of free fruits and vegetables would lead to an increase in habitual fruit consumption across school-age children over a period of one to two years: 

  • 17% increase for children in elementary school
  • 22% in middle school
  • 25% in high school

A limitation on sugary drinks would decrease habitual consumption and have a modest effect on body mass index across school-age children, specifically:

  • 27% decrease in consumption and 0.7% decrease in body mass index for children in elementary school
  • 19% and 0.5% in middle school
  • 15% and 0.5% in high school

If such school food policies had been implemented when current adults were children, the researchers estimated that a provision for fruits and vegetables would increase fruit intake of these adults by 19% and vegetable intake by 2% and decrease sugary drink consumption by 24%.

If they had been implemented together, the researchers estimated that the free fruits and vegetables provision and limitation on sugar drinks would prevent more than 22,000 adult deaths per year due to heart disease, diabetes, or stroke, or 3% of total annual cardiometabolic deaths.

Reduced consumption was estimated to have the largest impact, averting more than 14,000 adult deaths per year. And in addition to health outcomes, understanding the dietary and nutritional effects of existing policies also may help estimate the potential impact of their expansion or repeal. 

“Identifying the benefits of school food policies helps to inform how to enhance these programs as well as the potential for harm if they were to be weakened or cut,” said Mozaffarian.

“Our findings suggest that eliminating sugary drinks and providing free fruits and vegetables in schools has small effects on obesity in childhood but real potential for meaningful long-term benefits into adulthood,” Mozaffarian said.   

The study, “Comparative Risk Assessment of School Food Environment Policies and Childhood Diets, Childhood Obesity, and Future Cardiometabolic Mortality in the United States,” was published by PLoS One.

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