Over the years, children in America have consistently consumed fewer than the recommended servings of fruit and vegetables [Centers for Disease Control (CDC), 1996a; Cullen et al., 2001; Domel et al., 1993b; Krebs-Smith et al., 1996; Subar et al., 1995]. Instead, they are consuming high fat, caloric-dense, nutrient-poor foods. As a result, the number of overweight children has increased to record numbers (Blumenthal et al., 2002; CDC, 1996a). The prevalence of Type II diabetes in children is also on the rise (St.-Onge et al., 2003).
The consumption of fruit and vegetables is vital to the health of children (Bazzano et al., 2002; Cullen et al., 2002; Djousse et al., 2004; Domel et al., 1993b; Kirby et al., 1995; Liu et al., 2000; Ness and Powles, 1997). Fruit and vegetable consumption decreases the risk for numerous diseases and health problems (Bazzano et al., 2002; Djousse et al., 2004; Liu et al., 2000). Including fruit and vegetables consistently in a diet can also assist with weight control (Lin and Morrison, 2002). This may be a result of fruit and vegetables being nutrient-dense and generally low in calories.
Low-income populations tend to consume even fewer fruit and vegetables and are at greater risk of being overweight and obese (Morton and Guthrie, 1999; Treiman et al., 1996; Wang, 2001). Often, fruit and vegetables are not available in the homes of low-income families because of areas of food deserts (areas without a proper grocery store) combined with the expense and perishable nature of fresh foods (Goodman, 2009; Treiman et al., 1996; Wang, 2001). Low-income families also report eating at fast food restaurants more frequently (Kirby et al., 1995). Research has reported many low-income families suffer from food insecurity, which is associated with a reduced variety and availability of fruit and vegetables at home (Dave et al., 2010; Kaiser et al., 2003; Matheson et al., 2002).
Additionally, research has suggested demographics influence risk levels for obesity and Type II diabetes. In the United States, the prevalence of overweight people and obesity is greatest among the low-income groups (Morton and Guthrie, 1999; Wang, 2001). Cullen et al. (2002) found Hispanic children on average consumed fewer fruit and vegetables per day compared with non-Hispanic white children. Male Hispanics and the youngest and oldest age groups among Hispanics have reported the lowest intakes of fruit and vegetable servings per week (Subar et al., 1995). Furthermore, Hispanics are more likely to have a high body mass index compared with non-Hispanic whites (American Heart Association, 2011; Wang, 2001). Hispanic parents also report significantly fewer “meal planning practices” (such as making a menu before shopping) than non-Hispanic white parents (Cullen et al., 2002).
Early childhood is a critical period for developing obesity (Law, 2001). The number of overweight children aged 6 to 17 has increased by almost 200% in the last 30 years and those numbers continue to rise in America (Blumenthal et al., 2002; CDC, 1996b; Jolliffe, 2004; Law, 2001; St.-Onge et al., 2003; Wang, 2001; Weisberg, 2002). About 30% of children aged 6 to 19 years old are overweight (St.-Onge et al., 2003; Wang, 2001). According to the 2005–2008 National Health and Nutrition Examination Survey, only 31% of adult Americans are at a healthy weight, indicating many children are at risk for becoming overweight as adults [National Center for Health Statistics (NCHS), 2011]. Overweight individuals and the incidence of obesity has increased so rapidly both worldwide and within the United States that physicians are now calling it an epidemic and believe that it will soon pass smoking as the leading cause of preventable death within the United States (Blumenthal et al., 2002; Hesketh and Campbell, 2010; Weisberg, 2002). Diseases that result from being overweight or obese are believed to be responsible for ≈300,000 deaths per year in the United States and have been estimated to cost in excess of $200 billion annually for medical expenses and lost productivity (CDC, 1996b; NCHS, 2011; Weisberg, 2002).
Food preferences and dietary habits are established during childhood (Carter, 2002; Kirby et al., 1995). Therefore, interventions need to be targeted toward young children while they are forming their lifelong habits. Preference for and positive attitudes about fruit and vegetables have been major predictors of fruit and vegetable consumption (Cullen et al., 2002; Domel et al., 1993b; Reniscow et al., 1997). Since many chronic diseases begin in childhood and carry over into adulthood and dietary preferences are learned while children are young, strategies should be aimed at younger children to improve their preferences and attitudes toward fruit and vegetables (Baranowski et al., 1997). Strategies aimed at younger children tend to have better long-term results than strategies focused on adolescents (Carter, 2002).
There are many ways teachers can teach nutrition. School-based nutrition education increases nutritional knowledge and can influence positive attitude change toward healthy eating in most grade levels (Contento et al., 1992). School gardens are a way to teach students using hands-on activities that are fun and teach skills at the same time. Gardening provides hands-on activities through the actual growing, harvesting, and preparation of vegetables. Gardening and related activities improve attitudes about, preferences for, and willingness to taste new fruit and vegetables (Lineberger and Zajicek, 2000; Morris et al., 2001).
The objective of the current study was to evaluate the impact of a health education through gardening program on children’s knowledge about nutrition and the attitudes they have toward fruit and vegetables.
American Heart Association2011Overweight in Children. 12 Mar. 2012. <http://www.heart.org/HEARTORG/GettingHealthy/Overweight-in-Children_UCM_304054_Article.jsp>
BaranowskiT.SmithM.HearnM.LinL.BaranowskiJ.DoyleC.ReniscowK.WangD.1997Patterns in children’s fruit and vegetable consumption by meal and day of the weekJ. Amer. Coll. Nutr.16216223
BazzanoL.HeJ.OgdenL.LoriaC.VupputuriS.MyersL.WheltonP.2002Fruit and vegetable intake and risk of cardiovascular disease in US adults: The first national health and nutrition examination survey epidemiologic follow-up studyAmer. J. Clin. Nutr.769399
Byrd-BredbennerC.MarecicM.L.BernsteinJ.1993Development of a nutrition education curriculum for head start childrenJ. Nutr. Educ.25134139
Centers for Disease Control1996aSummary of CDC’s guidelines for school health programs to promote lifelong healthy eatingJ. Nutr. Educ.294546
CullenK.W.BaranowskiT.OwensE.de MoorC.RittenberryL.OlveraN.ResnicowK.2002Ethnic differences in social correlates of dietHealth Educ. Res.17718
CullenK.W.BaranowskiT.RittenberryL.CosartC.HerbertD.de MoorC.2001Child-reported family and peer influences on fruit, juice and vegetable consumption: Reliability and validity measuresHealth Educ. Res.16187200
DaveJ.M.EvansA.E.PfeifferK.A.WatkinsK.W.SaundersR.P.2010Correlates of availability and accessibility of fruits and vegetables in homes of low-income Hispanic familiesHealth Educ. Res.2597108
DjousseL.ArnettD.CoonH.ProvinceM.MooreL.EllisonC.2004Fruit and vegetable consumption and LDL cholesterol: The National Heart, Lung, and Blood Institute Family Heart StudyAmer. J. Clin. Nutr.79213217
DomelS.B.BaranowskiT.DavisH.LeonardS.RileyP.BaranowskiJ.1993aMeasuring fruit and vegetable preferences among fourth- and fifth-grade studentsPrev. Med.22866879
DomelS.B.BaranowskiT.DavisH.ThompsonW.LeonardS.RileyP.BaranowskiJ.DudovitzB.SmythM.1993bDevelopment and evaluation of a school intervention to increase fruit and vegetable consumption among fourth and fifth grade studentsJ. Nutr. Educ.25345349
GallM.D.BorgW.R.GallJ.P.2006Educational research: An introduction. 8th ed. Allyn and Bacon White Plains NY
GenzerS.SeagravesR.WhittleseyL.RobinsonC.W.KochS.2001Junior Master Gardener Level 1 Golden Ray: Health and nutrition from the garden. Newman Publishing Bryan TX
GoodmanD.2009Place and Space in Alternative Food Networks: Connecting Production and Consumption. 12 Mar. 2012. <http://www.kcl.ac.uk/content/1/c6/03/95/42/GoodmanWP21.pdf>
HeskethK.D.CampbellK.J.2010Interventions to prevent obesity in 0-5 year olds: An updated systematic review of the literatureObesity (Silver Spring)18S27S35
HowisonD.NiedermyerF.ShortridgeR.1988Field testing a fifth-grade nutrition education program designed to change food-selection behaviorJ. Nutr. Educ.208286
KaiserL.L.Melgar-QuinonezH.TownsendM.S.NicholsonY.FujiiM.L.MartinA.C.LampC.L.2003Food insecurity and food supplies in Latino households with young childrenJ. Nutr. Educ. Behav.35148153
KirbyS.D.BaranowskiT.ReynoldsK.D.TaylorG.BrinkleyD.1995Children’s fruit and vegetable intake: Socioeconomic, adult-child, regional, and urban-rural influencesJ. Nutr. Educ.27261271
KochS.WaliczekT.M.ZajicekJ.M.2006The effect of a summer gardening program on the nutritional knowledge, attitudes, and behaviors of childrenHortTechnology16620625
Krebs-SmithS.M.CookD.A.SubarA.F.ClevelandL.FridayJ.KahleL.L.1996Fruit and vegetable intakes of children and adolescents in the United StatesArch. Pediatr. Adolesc. Med.1508186
LawC.2001Adult obesity and growth in childhood: Children who grow rapidly during childhood are more likely to be obese as adultsBMJ32313201321
LawatschD.E.1990A comparison of two teaching strategies on nutrition knowledge, attitudes and food behavior of preschool childrenJ. Nutr. Educ.22117123
LinebergerS.ZajicekJ.M.2000School gardens: Can a hands-on teaching tool affect students’ attitudes and behaviors regarding fruit and vegetables?HortTechnology102327
LiuS.MansonJ.LeeI.ColeS.HennekensC.WillettW.BuringJ.2000Fruit and vegetable intake and risk of cardiovascular disease: The Woman’s Health StudyAmer. J. Clin. Nutr.72922928
MathesonD.M.VaradyJ.VaradyA.KillenJ.D.2002Household food insecurity and nutritional status of Hispanic children in the fifth gradeAmer. J. Clin. Nutr.76210217
MorrisJ.L.NeustadterA.Zidenberg-CherrS.2002Garden-enhanced nutrition curriculum improves fourth-grade school children’s knowledge of nutrition and preferences for some vegetablesJ. Amer. Dietetic Assn.1029193
MortonJ.F.GuthrieJ.F.1999Diet related knowledge, attitudes, and practices of low income households with childrenJ. Early Educ. Family Rev.62633
National Center for Health Statistics2011Healthy People 2010: Final Review. 9 Feb. 2012. <http://www.cdc.gov/nchs/data/hpdata2010/hp2010_final_review.pdf>
SeagravesR.L.WhittleseyL.KlemmerC.RobinsonC.W.HallG.GenzerS.S.LewisC.GrahmannS.2005Junior Master Gardener: Level 1 teacher/leader guide. Texas A&M Agr. Commun. College Station TX
St.-OngeM.KellerK.L.HeymsfieldS.B.2003Changes in childhood food consumption patterns: A cause for concern in light of increasing body weightsAmer. J. Clin. Nutr.7810681073
SubarA.HeimendingerJ.PattersonB.Krebs-SmithS.PivonkaE.KesslerR.1995Fruit and vegetable intake in the United States: The baseline survey of the five a day for better health programAmer. J. Health Promot.9352360
TreimanK.FreimuthV.DamronD.LasswellA.AnlikerJ.HavasS.LangenbergP.FeldmanR.1996Attitudes and behaviors related to fruits and vegetables among low-income women in the WIC programJ. Nutr. Educ.28149156
U.S. Census Bureau2000U.S. Census Bureau. 12 Mar. 2012. <http://www.census.gov/>
WangY.2001Cross national comparison of childhood obesity: The epidemic and the relationship between obesity and socioeconomic statusIntl. J. Epidemiol.3011291136