Please note our website will be undergoing maintenance on Tuesday, May 28, 2024. e-Commerce transactions and new registrations will be temporarily unavailable during this time. We apologize for any inconvenience this may cause.

The Impact of Canadian School Food Programs on Children’s Nutrition and Health: A Systematic Review

Publication: Canadian Journal of Dietetic Practice and Research
15 November 2018


The quality of children’s diets has declined over the past few decades, giving rise to a variety of health-related consequences. In response to this trend, school food programs have become an increasingly effective method to support nutrition and lifelong healthy eating habits. This systematic review synthesizes current academic literature pertaining to school nutrition programs in Canada to identify existing interventions and their impacts on children’s nutritional knowledge, dietary behaviour, and food intake. The review was conducted through a search of the following databases: ERIC, Education Source, CINAHL, PubMed, SagePub, SCOPUS, EMBASE, and CBCA. Information extracted from the articles included the program objectives, intervention design and components, research evaluation, and primary outcomes. A total of 11 articles evaluating Canadian school nutrition programs were identified. The programs incorporated a variety of intervention components including policy, education, family and community involvement, and/or food provision. These multi-component interventions were positively associated with children’s development of nutrition knowledge, dietary behaviour changes, and intake of healthy foods; however, barriers associated with intervention duration, intensity, and availability of resources may have influenced the extent to which these programs impacted children’s diets and overall health.


La qualité de l’alimentation des enfants s’est détériorée au cours des dernières décennies, causant l’augmentation d’une variété de conséquences sur la santé. En guise de réponse à cette tendance, les programmes d’alimentation dans les écoles constituent désormais des méthodes de plus en plus efficaces pour favoriser un apport nutritionnel adéquat et créer de saines habitudes alimentaires qui dureront toute la vie. Cette revue systématique résume les recherches universitaires actuelles menées sur les programmes d’alimentation dans les écoles du Canada afin de relever les interventions existantes et leurs effets sur les connaissances nutritionnelles, les comportements alimentaires et l’apport alimentaire des enfants. La revue a été réalisée grâce à des recherches effectuées dans les bases de données suivantes : ERIC, Education Source, CINAHL, PubMed, SagePub, SCOPUS, EMBASE et CBCA. L’information tirée des articles comprend les objectifs des programmes, la méthodologie et les composantes des interventions, l’évaluation de la recherche et les objectifs principaux. Un total de 11 articles évaluant les programmes d’alimentation dans les écoles du Canada ont été trouvés. Les programmes intégraient une variété d’éléments d’intervention tels que des politiques, de l’éducation, l’implication des familles et de la collectivité, et des mesures en matière d’offre alimentaire. Ces interventions à composantes multiples étaient positivement associées au développement des connaissances nutritionnelles, à des changements de comportement alimentaire et à un apport en aliments sains chez les enfants. Cependant, des obstacles associés à la durée et à l’intensité de l’intervention et à la disponibilité des ressources peuvent avoir influencé la portée de l’effet de ces programmes sur l’alimentation des enfants et sur leur santé globale.

Get full access to this article

View all available purchase options and get full access to this article.

Financial support: PC received graduate trainee support from the Children’s Health Research Institute through funding from the Children’s Health Foundation. No other funding or financial support.
Conflict of interest: The authors declare that they have no competing interests.


Taylor JP, Evers S, and McKenna M. Determinants of healthy eating in children and youth. Can J Public Health. 2005 Jul–Aug;96:S20–6.
Minaker L and Hammond D. Low frequency of fruit and vegetable consumption among Canadian youth: findings from the 2012/2013 Youth Smoking Survey. J Sch Health. 2016 Feb;86(2):135–42.
Garriguet D. Overview of Canadians’ eating habits. Ottawa, ON: Statistics Canada; 2006. 47 p.
Martorell R. The nature of child malnutrition and its long-term implications. Food Nutr Bull. 1999 Sep;20(3):288–92.
Peirson L, Fitzpatrick-Lewis D, Morrison K, Ciliska D, Kenny M, Usman Ali M, et al. Prevention of overweight and obesity in children and youth: a systematic review and meta-analysis. Can Med Assoc J. 2015 Jan;3(1):23–33.
Calle EE and Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004 Aug;4(8):579–91.
Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL, Kumanyika S, et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation. 2005 Apr;111(15):1999–2012.
Dietz WH. Overweight in childhood and adolescence. N Engl J Med. 2004 Feb;350(9):855–7.
Benton D. Micronutrient status, cognition and behavioral problems in childhood. Eur J Nutr. 2008 Aug;47(Suppl. 3):38–50.
Pollitt E, Golub M, Gorman K, Grantham-McGregor S, Levitsky D, Schurch B, et al. A reconceptualization of the effects of undernutrition on children’s biological, psychosocial, and behavioral development and commentaries. Soc Policy Rep. 1996 Jan;10(5):1–32.
Rao TSS, Asha MR, Ramesh BN, and Rao KSJ. Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008 Apr;50(2):77–82.
Fung C, Kuhle S, Lu C, Purcell M, Schwartz M, Storey K, et al. From “best practice” to “next practice”: the effectiveness of school-based health promotion in improving healthy eating and physical activity and preventing childhood obesity. Int J Behav Nutr Phys Act. 2012 Mar;9(1):27.
He M, Beynon C, Sangster Bouck M, St Onge R, Stewart S, Khoshaba L, et al. Impact evaluation of the Northern Fruit and Vegetable Pilot programme—a cluster-randomised controlled trial. Public Health Nutr. 2009 Nov;12(11):2199–208.
Drapeau V, Savard M, Gallant A, Nadeau L, and Gagnon J. The effectiveness of a school-based nutrition intervention on children’s fruit, vegetables, and dairy product intake. J Sch Health. 2016 May;86(5):353–62.
Dalen JE and Devries S. Diets to prevent coronary heart disease 1957–2013: what have we learned? Am J Med. 2014 May;127(5):364–9.
WHO. Diet, nutrition and the prevention of chronic diseases. World Health Organization Technical Report Series No. 916; Geneva: WHO, 2002.
Schardt C, Adams MB, Owens T, Keitz S, and Fontelo P. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak. 2007 Jun;7:16.
Miller LMS and Cassady DL. The effects of nutrition knowledge on food label use. A review of the literature. Appetite. 2015 Sep;92:207–16.
Baranowski T, Cullen KW, and Baranowski J. Psychosocial correlates of dietary intake: advancing dietary intervention. Annu Rev Nutr. 1999 Feb;19(1):17–40.
Department of Education. Food and nutrition policy for New Brunswick schools. No. 14-700-005; Fredericton: Government of New Brunswick, 1991.
Moher D, Liberati A, Tetzlaff J, and Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 Jul;6(7):e1000097.
Zingg W, Castro-Sanchez E, Secci FV, Edwards R, Drumright LN, Sevdalis N, et al. Innovative tools for quality assessment: integrated quality criteria for review of multiple study designs (ICROMS). Public Health. 2016 Apr;133:19–37.
Gates M, Hanning RM, Gates A, Isogai A, Tsuji LJS, and Metatawabin J. A pilot comprehensive school nutrition program improves knowledge and intentions for intake of milk and milk alternatives among youth in a remote first nation. J Nutr Educ Behav. 2013 Sep;45(5):455–9.
Veugelers PJ and Fitzgerald AL. Effectiveness of school programs in preventing childhood obesity: a multilevel comparison. Am J Public Health. 2005 Mar;95(3):432–5.
Saksvig BI, Gittelsohn J, Harris SB, Hanley AJG, Valente TW, and Zinman B. A pilot school-based healthy eating and physical activity intervention improves diet, food knowledge, and self-efficacy for Native Canadian children. J Nutr. 2005 Oct;135(10):2392–8.
Bisset SL, Potvin L, Daniel M, and Paquette M. Assessing the impact of the primary school-based nutrition intervention Petits cuistots—parents en réseaux. Can J Public Health. 2008 Mar;99(2):107–13.
Hanbazaza MA, Triador L, Ball GDC, and Farmer A. The impact of school gardening on Cree children’s knowledge and attitudes toward vegetables and fruit. Can J Diet Pract Res. 2015 Sep;76(3):133–9.
Day M, Strange K, McKay H, and Naylor P. Action schools! BC—healthy eating: effects of a whole-school model to modifying eating behaviours of elementary school children. Can J Public Health. 2008 Jul;99(4):328–31.
Traidor L, Farmer A, Maximova K, Willows N, and Kootenay J. A school gardening and healthy snack program increased Aboriginal First Nations children’s preferences toward vegetables and fruit. J Nutr Educ Behav. 2015 Mar;47(2):176–80.
He M, Beynon CE, Gritke JL, Henderson ML, Kurtz JM, Sangster Bouck M, et al. Children’s perceptions of the Northern Fruit and Vegetable Program in Ontario, Canada. J Nutr Educ Behav. 2012 Nov;44(6):592–6.
Gates M, Hanning RM, Gates A, McCarthy DD, and Tsuji LJS. Assessing the impact of pilot school snack programs on milk and alternatives intake in 2 remote First Nation communities in Northern Ontario, Canada. J Sch Health. 2013 Feb;83(2):69–76.
Sahay TB, Ashbury FD, Roberts M, and Rootman I. Effective components for nutrition interventions: a review and application of the literature. Health Promot Pract. 2006 Oct;7(4):418–27.
Aloia CR, Shockey TA, Nahar VK, and Knight KB. Pertinence of the recent school-based nutrition interventions targeting fruit and vegetable consumption in the United States: a systematic review. Health Promot Perspect. 2016 Mar;6(1):1–9.
Morris JL and Zidenberg-Cherr S. Garden-enhanced nutrition curriculum improves fourth-grade school children’s knowledge of nutrition and preferences for some vegetables. J Am Diet Assoc. 2002 Jan;102(1):91–3.
Reinaerts E, de Nooijer J, Candel M, and de Vries N. Increasing children’s fruit and vegetable consumption: distribution or a multicomponent programme? Public Health Nutr. 2007 Sep;10(9):939–47.
Knai C, Pomerleau J, Lock K, and McKee M. Getting children to eat more fruit and vegetables: a systematic review. Prev Med. 2006 Feb;42:85–95.
Godin KM, Kirkpatrick SI, Hanning RM, Stapleton J, and Leatherdale SC. Examining guidelines for school-based breakfast programs in Canada: a systematic review of the grey literature. Can J Diet Pract Res. 2017 Jun;78:92–100.

Supplementary Material

File (cjdpr-2018-037suppla.docx)
File (cjdpr-2018-037supplb.docx)

Information & Authors


Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 80Number 2June 2019
Pages: 79 - 86


Version of record online: 15 November 2018



Paige Colley MSc
Health and Rehabilitation Sciences, Western University, London, ON
Bronia Myer
Medical Sciences and Psychology, Western University, London, ON
Jamie Seabrook PhD
School of Food and Nutritional Sciences, Brescia University College at Western University, London, ON
Department of Paediatrics and Epidemiology & Biostatistics, Western University, London, ON
Jason Gilliland PhD
Department of Geography, Health Studies, Paediatrics, and Epidemiology & Biostatistics, Western University, London, ON

Metrics & Citations


Other Metrics


Cite As

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

Cited by

1. Applicability of the Socioecological Model for Understanding and Reducing Consumption of Ultra-Processed Foods in Canada
2. Examining Elementary School Children’s Knowledge about Food and Nutrition in Southwestern Ontario, Canada

View Options

Get Access

Login options

Check if you access through your login credentials or your institution to get full access on this article.


Click on the button below to subscribe to Canadian Journal of Dietetic Practice and Research

Purchase options

Purchase this article to get full access to it.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options


View PDF

Full Text

View Full Text





Share Options


Share the article link

Share on social media