Effects of school-based interventions on Food and Nutrition Literacy (FNLIT) in primary-school-age children: a systematic review.

This study systematically reviewed the evidence on interventions seeking to improve food and nutrition literacy (FNLIT) functional, interactive, and critical skills in primary school-aged children. Electronic databases, including PubMed/MEDLINE, SCOPUS, Web of Science, Cochrane, Pro-Quest, and Google Scholar were systematically searched. Randomized and non-randomized controlled trials, pre/post-test, and case-control designs were included. The primary outcomes were three levels of FNLIT: functional, interactive, and critical. All citations, full-text articles, and abstract data were screened by two independent reviewers. Any conflicts were then resolved through discussion. The quality of the included studies was individually evaluated using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Two reviewers extracted data from the included studies, and a descriptive analysis was performed.The quality of all eligible studies (n=19) was rated as moderate/weak. A wide variety of skill-building activities were introduced by programs, including recipe skills/food preparation, food label literacy, food tasting, gardening harvesting, and supporting cultural practices and ethnic foods. Only four studies measured food literacy (food label literacy) via a valid measure. Most interventions focused on the functional level of food literacy, except for two programs (one scored weak, and one scored moderate). In most of the studies, delivery of intervention content was facilitated by teachers (n=15).Promising interventions were tailored to the needs and interests of students, incorporated into the existing curriculum, and facilitated by teachers. The successful intervention strategies led to improvements in functional, partly interactive, and critical skills. Future interventions should focus, holistically, on all aspects of food and nutrition literacy, especially interactive and critical skills.