A healthy‐lifestyles intervention improves children's diet quality in rural America

The objective of this study was to examine the impact of the CHANGE (Creating Healthy, Active and Nurturing Growing‐up Environments) study, a randomized, controlled, community‐based obesity prevention intervention in rural America, on the diets of participating elementary students (grades 1–6). Children's diets (n = 432) were assessed using the 2007 Block Food Screener in 8 rural schools and communities in California, Kentucky, Mississippi, and South Carolina. Changes in dietary intake were analyzed using mixed‐model analysis of variance, with schools included as a random effect nested within condition. At the end of one year, students in the intervention schools consumed significantly more vegetables (0.08cups/1000 kcal per day; p=0.03) and combined fruits and vegetables (0.22cups/1000 kcal per day; p=0.01) compared to students in control schools. Results were adjusted for corresponding baseline value, sex, age, grade, race/ethnicity, and state. Students enrolled in CHANGE Study intervention schools also showed a reduction in the average daily dietary glycemic index (GI −1.22; p=0.02). There were no significant differences in students’ consumption of whole grains, legumes, dairy, potatoes, saturated fat, added sugars, or dietary fiber. The CHANGE Study improved rural students’ diet quality, and was particularly promising as an intervention to support vegetable consumption.