Background: To assess the impact of a school-based garden/farm program on nutritional health outcomes among youth who participated in our pilot farm-to-school initiative.

Methods: We modified and administered previously published questionnaires designed to assess self-reported fruit and vegetable taste preferences and fruit and vegetable intakes among 4^th and 5^th grade children in two distinct inner-city Title 1 Elementary Schools located within South Carolina during the 2012/2013 academic school year. Pre- and post-program questionnaire data were collected for 68 intervention group participants and 47 non-intervention group participants.

Results: Findings suggest that youth participation in farm-to-school experiential learning activities such as school-based gardening/farming is associated with improved fruit and vegetable taste preferences as well as intakes, which are important implications for public health nutrition policy and practice.

Conclusions: Future research is needed to further explore the impact of farm-to-school experiential learning activities on youth nutritional health outcomes.

Farm-to-school; Fruits; Vegetables; Food systems; Youth

Low fruit and vegetable intake among youth is a major public health problem in the United States (U.S.) as 22.3% of U.S. children and adolescents fail to meet minimum national fruit and vegetable intake recommendations [1-5]. These data are particularly troubling because inadequate fruit and vegetable intake in childhood is associated with obesity and co-morbid diseases and conditions in childhood and obese children are more likely than their non-obese peers to become obese adults [2,6-18]. In partial response to the childhood obesity crisis in the U.S., the Child Nutrition and WIC Reauthorization Act of 2004 was created, requiring that publicly-funded education agencies develop wellness policies that include nutrition guidelines for foods provided to youth on school campuses [7,19]. The development of the Child Nutrition and WIC Reauthorization Act of 2004 was important as researchers and practitioners alike suggest that schools are key venues for the implementation of public health programs, policies, and initiatives that promote general wellness and seek to prevent and control obesity among youth [20,21]. Not only is school a place where children and adolescents spend the first two decades of their lives [22,23], but it is also a place where they consume about half of their daily kilocalories from school meals and snacks [23-26].

To facilitate building positive relationships between youth and healthful foods such as fruits and vegetables, schools may incorporate some form of healthful food taste education into their school nutrition environments such that students are at the center of the educational activity [5,27,28]. Examples of student-focused, healthful food taste education activities include learning basic cooking skills, taste-testing fresh fruits and vegetables, and growing produce in a school garden/ farm setting [27]. School-based garden/farm initiatives, in particular, can provide ample healthful food taste education opportunities for youth and these initiatives have been gaining ground in the nutrition community as research has shown that youth who are exposed can develop positive taste preferences for fresh, local produce among other health-related outcomes [1,3,12,27]. For example, Evans et al., found that youth who participated in school gardening/farming activities had increased food-related knowledge, which, as suggested by Evans et al. could be a precursor for change in food-related selfefficacy and outcome expectations [11]. Other researchers have found similar results but have also determined that the youth who participated in school gardening/farming activities shifted their taste preferences toward fresh fruits and vegetables [1,5,6,17]. Moreover, and importantly, several researchers have recently demonstrated that youth who participated in school gardening/farming programs increased their actual consumption of fruits and vegetables along with other healthful foods [10,12,29,30]. The purpose of the current study was to assess the impact of a school-based garden/farm program on nutritional health outcomes among youth who participated in our pilot farm-to-school initiative. To achieve this objective, we modified and administered previously published questionnaires designed to assess youth self-reported fruit and vegetable taste preferences and fruit and vegetable intakes to 4th and 5th grade children during the 2012/2013 academic school year who attended two distinct inner-city Title 1 Elementary Schools located within South Carolina, United States (U.S.).

Demographic characteristic data for participants with complete pre- and post-test data (N = 115; 68 intervention group participants and 47 non-intervention group participants) are presented in Table 1. Twenty-two girls (47.8%) and 24 boys (52.2%) were in the nonintervention group and 32 girls (47.1%) and 36 boys (52.9%) were in the intervention group. All participants in the non-intervention group were in the 5^th grade, while approximately half of the participants in the non-intervention group were in the fourth grade and the other half were in the fifth grade.

Data pertaining to participants’ preference and willingness to taste a new fruit/vegetable in community, home, and school environments are reported in Table 2. Data revealed that students in the non-intervention group were more likely to try a new fruit at school compared to students in the non-intervention group, from pre- to post-test controlling for gender and grade level. No statistically significant differences were observed for preference and willingness to taste a new vegetable between students in the intervention and nonintervention groups, however. Interestingly, boys were less likely than girls to report “liking fruits a lot” when controlling for intervention, time, and grade level.

Data pertaining to participants’ preference for the six fruits and 14 vegetables evaluated are reported in Table 3a & b. Data revealed that there were no statistically significant intervention effects for fruit and vegetable preference. However, students in the intervention group were more likely to “like” cauliflower than students in the nonintervention group, controlling for sex and grade level. Moreover, compared to girls, boys were less likely to “like” cabbage, cucumbers, and squash, controlling for grade level. Data pertaining to participants’ fruit and vegetable consumption for the six fruits and 14 vegetables evaluated are reported in Table 4a & b. Data revealed that statistically significant increases for fruit and vegetable consumption among students in the intervention group occurred for both cantaloupe and peppers.

To assess the impact of a school-based garden/farm program on nutritional health outcomes among youth who participated in our pilot farm-to-school initiative, we modified and administered previously published questionnaires designed to assess youth selfreported fruit and vegetable taste preferences and intakes to 4^th and 5^th grade children during the 2012/2013 academic school year who attended one of two inner-city Title 1 Elementary Schools located within South Carolina, United States (U.S.). Study findings, while modest, suggest that participation in the school-based garden/farm program was associated with positive taste preference for a variety of fruits and vegetables as well as increased fruit and vegetable intakes among youth - results that are consistent with those from previous researchers.

For example, Morris and Zidenberg-Cherr conducted research at three schools from a local school district in Davis, California and found that students who were exposed to nutrition education and a gardening curriculum showed greater preferences for fruits and vegetables as well as increased nutrition knowledge compared to students who were in the control group, even at 6-months post intervention [1]. Similarly, Somerset et al. conducted a 12-month school-based garden intervention trial with 4^th to 7^th grade students enrolled in a state primary school within a low socioeconomic area of Brisbane, Australia. These researchers found that the intervention led to improvements in students’ abilities to not only identify vegetables and fruits, but to prepare them for consumption [15]. Furthermore, in a 12-week quasi-experimental, garden-based intervention with predominately Latino 4^th and 5^th grade students in Los Angeles, Gatto et al. assessed student motivations and preferences for fruits and vegetables [6]. In this study, researchers found that vegetable and fruit preferences as well as self-efficacy increased among participating youth compared to non-participating youth from pre- to postintervention.

Heim et al. conducted a U.S. based 12-week pilot intervention with 4^th to 6^th grade youth attending a YMCA summer camp. In this study, youth were exposed to one of three groups: (1) a school gardening and nutrition education group, (2) a nutrition education only group, or (3) a control or unexposed group. These researchers found that youth who were exposed to both school gardening and nutrition education conditions were more willing to taste a variety of unfamiliar fruits and vegetables, compared to youth who were only exposed to nutrition education or who were not exposed to either condition [3]. Similarly, Morgan et al. conducted a 10-week intervention trial with 5^th and 6^th grade students enrolled in two primary schools in the Hunter Region of New South Wales, Australia [16]. These researchers found that of the three study groups, youth who participated in garden-enhanced nutrition education were more willing to taste new fruits and vegetables and reported positive taste references compared to youth who participated in non-gardenenhanced nutrition education.

In addition to improving knowledge, preferences, and self-efficacy for fruits and vegetables, researchers have also found that schoolbased garden/farm programs can increase students’ overall intake of fruits and vegetables. For example, McAleese and Rankin conducted a 12-week study on 6^th grade students at three different elementary schools in southeast Idaho. These researchers found that students who participated in nutrition education and gardening activities significantly increased their intakes of fruits and vegetables as well as selected nutrients such as vitamin A, vitamin C and fiber [12]. Evans et al. measured the effects of different levels of exposure to a multiplecomponent, garden-based intervention on students from five middle schools in ethnically diverse communities in Austin, Texas. These researchers found that students who were exposed to the multiplecomponent school garden intervention reported increased intakes of fruits and vegetables and related self-efficacy and knowledge and decreased preference for unhealthy foods or foods that did not meet the USDA’s newly reformed nutrition standards [11,31-34].

A recent joint initiative released by Michelle Obama, the Surgeon General, and the Department of Health and Human Services on January 28^th, 2010 called for healthier school environments, improved dietary and physical behaviors at home, and community engagement efforts to improve the health of our nation’s youth [30,35]. To support this initiative, President Obama issued a memorandum calling for the establishment of a federal task force to combat the childhood obesity epidemic specifically [30,36]. In 2008, the Institute of Medicine Committee on Childhood Obesity Prevention Actions for Local Governments cited the implementation of youth-gardens in communities as a promising and innovative way to promote the consumption of fruits and vegetables and prevent childhood obesity [37]. For example, as explained in Ratcliffe M’s Polytheoretical Model for Food and Garden-Based Education, school-based garden programs provide a real-world context for learning that is distinguishable from other hands-on learning activities [38]. This model suggests that food and garden-based education programs directly affect relationships between students and health-promoting and environmentally responsible behaviors. Moreover, as Story et al. noted, school gardens act as outdoor “learning laboratories” that offer multiple opportunities for students to gain food systemrelated knowledge, skills, and abilities as well as serving as a setting for positive youth development [23]. School gardens/farms can improve a school’s physical and social learning environments [38-40] as they visually reinforce learning and can positively influence social norms around eating [38,40]. In summary, our findings combined with those from previous researchers suggest that school garden/farm programs can improve nutritional health outcomes by shifting youth taste preferences toward fresh, local fruits and vegetables and by increasing actual fruit and vegetable intakes.