Public Health Nutrition: 22(1), 28–34 doi:10.

1017/S1368980018002586

The effects of a nutrition education curriculum on improving

young children’s fruit and vegetable preferences and nutrition
and health knowledge
Sara A Schmitt1,*, Lindsey M Bryant1, Irem Korucu1, Lisa Kirkham2, Bhagyashree Katare3
and Tamara Benjamin4
1
Human Development and Family Studies, Purdue University, 1202 W. State Street, West Lafayette, IN 47907,
USA: 2Evaluation and Learning Research Center, College of Education, Purdue University, West Lafayette, IN, USA:
3
Agricultural Economics, Purdue University, West Lafayette, IN, USA: 4Horticulture and Landscape Architecture,
West Lafayette, IN, USA

Submitted 6 February 2018: Final revision received 15 August 2018: Accepted 3 September 2018: First published online 22 October 2018

Abstract
Objective: The main objective of the present study was to develop and evaluate a
nutrition education curriculum to enhance young children’s dietary behaviours
and nutrition and health knowledge.
Design: A randomized controlled design was utilized. The intervention was
designed to improve children’s nutrition and health knowledge and preferences
for fruits and vegetables through classroom lessons and activities, including direct
instruction and tastings (implemented twice per week for 6 weeks).
Setting: The study took place in elementary schools in a Midwestern US state.
Subjects: One hundred and thirty-one 2nd grade children from ten classrooms (n
82 intervention, n 49 control) participated.
Results: Multiple regression analyses that adjusted SE for clustering by classroom
were used to test hypotheses. Children in the intervention condition demonstrated
significantly higher scores on the nutrition and health survey ( β = 0·47, P = 0·001)
and showed greater preferences for fruits and vegetables at post-test than the
control group ( β = 0·19, P = 0·003).
Conclusions: Findings suggest that a short, 6-week intervention that aligns with Keywords
educational standards has the ability to significantly enhance children’s outcomes Nutrition education
and thus may be a more feasible option for teachers to incorporate into their Dietary behaviours
classrooms than what is currently available. School intervention

Childhood obesity is considered a serious public health consume almost no servings of fruits or vegetables each
concern in the USA. In the last 30 years, childhood day(5). Consumption of fruits and vegetables may be low
obesity has tripled, and recent data suggest that one in in the USA because many children do not establish
six American children is obese and one in three is preferences for healthy foods early in life(6). Food pre-
overweight or obese(1). This dramatic increase in child- ferences develop in early childhood(6) and preferences
hood overweight and obesity can be attributed to a for fruits and vegetables have been positively linked with
number of factors, including individual child-level fac- intake(6–8) and inversely associated with risk of obesity in
tors. Children’s dietary behaviours and their knowledge children(7). Thus, targeting preferences in young children
of nutrition-related information have been identified as may be a promising approach for promoting consump-
primary mechanisms for weight gain. For instance, con- tion of fruits and vegetables and reducing risk for over-
sumption of foods high in saturated fat and sugary bev- weight and obesity. Although the home environment is a
erages is related to paediatric weight gain(2). In contrast, critical context for establishing young children’s food
fruit and vegetable intake in childhood is associated with preferences and for promoting fruit and vegetable
lower risk of being overweight and obese(3). Unfortu- consumption, parents may unintentionally decrease
nately, most children in the USA do not meet current children’s preferences for fruits and vegetables by deci-
dietary recommendations of at least four servings of fruits sions concerning food availability(9). However, repeated
and vegetables per day(4), and in fact many children exposure to healthy foods, even outside the home (e.g.

*Corresponding author: Email saraschmitt@purdue.edu © The Authors 2018

Nutrition education curriculum effects 29
at school), can lead to improvements in children’s pre- Methods
ferences and willingness to consume these foods(9,10).
Nutrition-related knowledge has also been identified as Study design and procedures
a mechanism for healthy weight in childhood, as this In the current study we employed a cluster randomized
knowledge helps shape children’s dietary preferences and controlled design. Using convenience sampling methods,
choices(11,12). When children have an understanding of the three elementary schools in a Midwestern US state were
benefits of including fruits and vegetables in their diets, recruited to participate in the study during the summer of
they are more likely to choose and consume these 2016. In the autumn of 2016, teachers and children from
foods(13). Schools can serve as a primary context for the all 2nd grade classrooms in the three schools were
development of healthy dietary behaviours and nutrition- recruited to participate in the study. Teachers were
related knowledge, and although evidence is mixed, pre- recruited through an email with an informational letter
vious research has found that these domains can be describing study procedures. Teachers then provided
improved through school-based interventions(14–18). For written consent if they were willing to participate. Children
example, results from one study indicated that 2nd and 3rd were recruited to participate in the study through an
graders who participated in a nutrition education pro- informational letter sent to their parents describing study
gramme delivered in elementary schools demonstrated procedures. Parents then provided written consent if they
greater improvements in dietary behaviours and nutrition were willing to allow their child to participate. Parents of
knowledge than children in a control group(17); however, 131 children returned consent forms and were included in
in that study, nutrition educators, not classroom teachers, the study sample. Children were, on average, 8 years old
implemented the intervention. Other studies have found (53 % female) and were primarily Caucasian (90 %),
that programmes focused on school-based gardens may with other races/ethnicities including 1 % Asian, 3 %
be effective in promoting dietary behaviours and knowl- African American, 2 % Hispanic, 1 % mixed race and 3 %
edge(16), yet many schools do not have the space, unknown. Children’s parents had education levels ranging
resources or expertise to implement such programmes. from some high school to a graduate degree, with an
Despite the importance of developing healthy dietary average level of education of a bachelor’s degree.
behaviours and nutrition and health knowledge for chil- Following parent consent procedures, all participating
dren’s outcomes and the fact that some nutrition education children completed pre-test assessments, including a short
programmes have been effective in elementary schools, survey on nutrition and health knowledge and a direct
few teachers incorporate nutrition education into their assessment of fruit and vegetable preferences adminis-
curricula(19). In a recent study, elementary-school teachers tered by their teachers. Teachers were trained to admin-
identified several reasons for not incorporating nutrition ister the assessment in a standardized fashion and were
education into their classrooms, including a lack of suit- told not to add any language beyond what was provided
able curriculum where lessons were feasible, easy to in the assessment script to avoid the introduction of any
implement and short, and a lack of time to incorporate a bias. After completion of pre-test assessments, all 2nd
stand-alone curriculum that did not align with required grade classrooms (n 10) were randomly assigned within
education standards(20). Teachers in that study reported a school to be intervention or business-as-usual control
preference for a curriculum that could be easily integrated classrooms (school 1: one intervention, one control
into curricula from other subject areas (e.g. health, sci- classroom; school 2: one intervention, one control class-
ence) that included approximately ten sessions per year. room; school 3: three intervention, three control class-
Thus, the objective of the current study was to develop rooms; children: eighty-two in intervention classrooms,
and evaluate a short (6-week) and feasible nutrition edu- forty-nine in control classrooms). Children in intervention
cation curriculum that aligned with the National Health classrooms were not significantly different from children in
Education Standards designed to enhance children’s diet- control classrooms according to age, gender, parent edu-
ary behaviours and nutrition and health knowledge. Much cation, ethnicity or pre-test assessments.
of the previous research exploring the utility of school- Teachers in intervention classrooms participated in a 2 h
based interventions, such as school gardens, has utilized training session conducted by project staff either at their
non-experimental or quasi-experimental designs, limiting respective schools or at the research university where the
the validity and generalizability of study findings(21); thus project investigators were housed. Training consisted of a
in the current study we employed a rigorous randomized review of the curriculum day-by-day, including an outline
controlled design to evaluate the curriculum. It was of all activities. As a support, teachers received an inter-
hypothesized that children who participated in the curri- vention manual with all materials required to teach
culum would exhibit greater improvements in a direct the programme, including class copies of all handouts.
assessment of fruit and vegetable preferences and a Teachers also received a $US 100 gift card to
nutrition and health knowledge survey relative to children purchase fruits and vegetables necessary for food tastings.
in a control group. For consistency, questions regarding the programme or
30 SA Schmitt et al.
implementation were directed to project staff that con- developed, they were aligned to the National Health
ducted training. Education Standards. This enabled teachers to cover topics
Following training, teachers in intervention classrooms required by the state while using the nutrition lessons. In
implemented a 6-week curriculum (two lessons per week) addition to direct instruction on nutrition and health, a
that was designed to promote children’s nutrition knowl- variety of age-appropriate activities were implemented
edge and fruit and vegetable preferences. Children in the throughout the programme including trivia, food tastings,
control classrooms received no intervention and teachers projects and games.
carried on activities as usual. To establish fidelity of Week 1 focused on the overarching questions, ‘What
implementation, intervention teachers completed a brief does it mean to be healthy?’ and ‘What does it mean to eat
evaluation at the end of each week’s instruction that healthy?’ The MyPlate framework was highlighted. As a
included questions related to curriculum delivery. An culminating activity for day 2, students labelled a blank
example item included: ‘How many lessons did you teach copy of the MyPlate diagram after learning the compo-
this week?’ Items also included frequency questions, such nents of healthy meals during both lessons of week 1.
as ‘How often did you deliver the lessons as was inten- Week 2 emphasized the question, ‘Why is it important to
ded?’ These items were rated on a 4-point scale eat a variety of foods from all food groups?’ The concept of
(1 = ‘rarely’, 4 = ‘always’). Following intervention imple- nutrients was introduced and the book, Two-Bite Club,
mentation, all participating children completed post-test was read. The primary goal of the Two-Bite Club book is
assessments that were identical to pre-test assessments. All to encourage children to try at least ‘two bites’ of foods,
study activities were reviewed and approved by the and following this first reading children were challenged
institutional review board at a research university through to try two bites of new foods as they were introduced
an expedited review process. throughout the rest of the nutrition curriculum. Week 3
focused on the questions, ‘What should I eat less of and
why?’ and ‘What can I eat instead?’ This week was focused
Intervention on teaching children strategies for replacing sweet or salty
The nutrition education curriculum used in the interven- snacks with healthy choices. Week 3 also introduced the
tion was designed to improve children’s nutrition and Put a Rainbow on Your Plate framework that was incor-
health knowledge and preferences for fruits and vege- porated throughout the rest of the curriculum. Put a
tables. This intervention was grounded in Social Cognitive Rainbow on Your Plate encourages children to eat foods
Theory(22), which emphasizes environmental inputs that that are a variety of colours. In week 3, children learned
contribute to children’s self-efficacy around dietary beha- the nutritional benefits of red foods while sampling a
viours. As Bandura notes, from a social cognitive per- variety of red fruits and vegetables. Week 4 focused on the
spective, in order for school-based health promotion final question to be emphasized throughout the remainder
programmes to be effective, children must be equipped of the programme: ‘Why should we eat fruits and vege-
with the beliefs and skills needed to change their beha- tables?’ During this week, children learned the nutritional
viours(23). Our curriculum provides children with age- benefits of orange foods and sampled fruits and vege-
appropriate background information on nutrition and tables that are orange. The final project was also intro-
health that is intended to change their belief systems duced to children this week. The final project served as an
around the benefits of eating healthy foods. Further, our assessment of children’s understanding of key concepts
curriculum gives children opportunities to develop the introduced throughout the curriculum. The curriculum
skills necessary to make healthy choices and try a variety provided each class a choice from one of three projects: (i)
of foods they may not have been exposed to before. Thus, children creating ‘Eat the Rainbow’ posters to be placed in
our curriculum is in line with a Social Cognitive Theory the school cafeteria; (ii) children developing video com-
approach. mercials for various fruits and vegetables to be played on
The curriculum was developed during the summer of the school news; or (iii) children holding a farmers’ market
2016 in collaboration with three 3rd grade teachers. (with pretend or real foods) to ‘sell’ to students in other
Recruiting 3rd grade teachers was deliberate as we did not grades or to school adults. Each project required children
want to cut into our research pool of 2nd grade teachers, to report on the nutritional benefits of fruits and vege-
and 3rd grade teachers begin their teaching year with tables. Weeks 5 and 6 focused on the continuing theme of
‘ending’ 2nd grade students. Thus, they would understand ‘Why should we eat fruits and vegetables?’ and empha-
the developmental stage of 2nd graders and be equipped sized the nutritional value and tasting of green and blue/
to develop the curriculum. During a full-day workshop, purple foods, respectively. The final projects were pre-
the research team and teachers developed a 6-week cur- sented in week 6.
riculum, consisting of lessons implemented twice per Overall, intervention implementation fidelity was high.
week. The lessons were developed based on four existing On average, over the course of 6 weeks, teachers reported
programmes: MyPlate for grades 1–2 and 3–4, Two-Bite delivering two lessons per week (mean 2·00 (SD 0·11)) that
Club, and Put a Rainbow on Your Plate. As lessons were lasted approximately 15–20 min each, which was the
Nutrition education curriculum effects 31
targeted duration and dosage. Teachers also indicated that, particular fruit or vegetable, they asked ‘What is your
on average, they implemented the lessons as intended opinion of this [food]?’ Children were asked to respond
(mean 3·65 (SD 0·42); 4-point scale). Finally, teachers with ‘I like it’ (score of 2), ‘I don’t like it’ (score of 1) or ‘I’ve
reported that children were engaged in and enjoyed the never tried it’ (score of 0). Scores across all fruits and
lessons (mean 3·56 (SD 0·46) and mean 3·57 (SD 0·58), vegetables were summed, with a total range in scores from
respectively; 4-point scale). 0 to 82. The internal consistency for this outcome measure
was 0·90.
Measurement instruments
Parents completed a demographic survey including
items related to children’s age, gender and ethnicity, as Analytic procedures
well as their own education level. Two child-level Data analyses were conducted using the statistical soft-
assessments were used in the present study to test the ware package Stata version 13.0. All outcome data were
efficacy of the intervention. The first assessment was analysed for normality using skewness and kurtosis
developed by the research team to align with nutrition checks. Preliminary analyses, including t tests, were con-
and health content provided in the intervention. ducted to explore differences in outcome scores between
This survey consisted of fifteen questions. Sample the intervention and control children. Data were multi-
items included: ‘What contains the most vitamin A level, with randomization occurring at the classroom level
per serving?’ (response options: 1 = ‘oranges’, 2 = ‘can- and child-level data being the unit of analysis. Intraclass
taloupe’) and ‘What you eat can make a difference in correlations representing classroom variance in outcomes
your chances of getting heart diseases or cancer’ were 0·51 for the nutrition and health knowledge survey
(response options: 1 = ‘true’, 2 = ‘false’). Children and 0·02 for the food preferences assessment. To account
received a score of 1 for each correct response and 0 for for this variance, multiple regression analyses that used the
each incorrect response, with a possible range in scores generalized Huber–White sandwich estimator to adjust SE
from 0 to 15. The internal consistency (Cronbach’s α) errors for non-independence (clustering by classroom)
for this outcome measure was 0·79. were conducted. Separate models were run for each out-
The second assessment was a direct measure of chil- come. Models included the following covariates: pre-test
dren’s fruit and vegetable preferences that was modified scores, age, gender, ethnicity and parent education. Sta-
from an assessment used in previous research(2). Teachers tistical significance was determined using an α level of
administered this measure to participating children. Dur- 0·05. There were very few missing data (<1 % for nutrition
ing this assessment, teachers showed children forty-one and health knowledge, <2 % for food preferences); how-
coloured pictures of a variety of fruits and vegetables. ever, full information maximum likelihood was employed
While teachers were showing children a picture of a to handle missing data.

Table 1 Descriptive characteristics of the full sample and intervention and control groups of elementary-school children
participating in the nutrition education curriculum intervention in a Midwestern US state, autumn 2016

Full sample (n 131) Intervention group (n 82) Control group (n 49)

Mean or % SD Mean or % SD Mean or % SD t†

Age (months) 94·56 8·64 95·04 10·35 93·79 4·62 t(125) = − 0·79
Parent education‡ 4·64 0·91 4·65 0·85 4·63 1·02 t(125) = − 0·12
T1 Food pref 39·38 13·21 38·96 12·34 40·06 14·61 t(126) = 0·46
T2 Food pref 45·90 13·88 47·57 12·71 43·08 15·39 t(127) = − 1·79(*)
T1 Health 6·53 1·89 6·71 2·15 6·24 1·33 t(126) = − 1·36
T2 Health 9·35 3·33 10·60 3·04 7·21 2·66 t(128) = − 6·42***
Gender (%) t(127) = 0·29
Male 46·51 – 46·34 – 44·90 – –
Female 53·49 – 51·22 – 55·10 – –
Race t(125) = − 1·28
Asian/Pacific Islander 1·57 – 0·00 – 4·26 – –
Back/African American 2·37 – 2·50 – 2·13 – –
Hispanic American 1·57 – 1·25 – 2·13 – –
White/Caucasian 92·92 – 95·0 – 89·36 – –
Multiracial 1·57 – 1·25 – 2·13 – –

T1, pre-test assessment; Food pref, food preferences; T2, post-test assessment; Health, nutrition and health knowledge.
* P < 0·10, ***P < 0·001.
( )

†t Tests comparing intervention and control groups.

‡1 = 8th grade or less, 2 = some high school, 3 = General Educational Development, 4 = high school diploma, 5 = some college,
6 = associate’s degree, 7 = bachelor’s degree, 8 = master’s degree, 9 = doctoral/postgraduate degree.
32 SA Schmitt et al.
(1)
Results recent years . In the current study, we chose to focus on
designing an intervention that targeted children’s dietary
Descriptive statistics and correlations are presented in behaviours (i.e. food preferences) and nutrition-related
Tables 1 and 2. Intervention participation was marginally knowledge because of evidence suggesting that both have
correlated with food preferences at post-test and sig- can a substantial impact on sustained behavioural change
nificantly related to the nutrition and health survey. regarding consumption of healthy foods(7,11,12). For
Skewness and kurtosis analyses indicated normal dis- example, in a review, Blanchette and Brug noted that taste
tributions for both outcomes. Results from analyses preferences are the among most critical determinants of
revealed that when controlling for the pre-test nutrition children’s consumption of fruits and vegetables. Knowl-
and health survey score, age, gender, ethnicity and parent edge of recommended fruit and vegetable intakes was also
education, children in the intervention condition demon- identified as a key determinant of behaviour change(24). As
strated significantly higher scores on the nutrition and such, we developed a short and feasible nutrition educa-
health survey compared with children in the control tion curriculum that aligns with the National Health Edu-
condition ( β = 0·47, P = 0·001). Similarly, results suggested cation Standards. Social Cognitive Theory was used as a
that when controlling for the pre-test fruit and vegetable basis for our intervention design; the intent was to equip
preferences, age, gender, ethnicity and parent education, children with the necessary skills and beliefs to effect
children who received the intervention showed greater actual behavioural changes(23). For example, by providing
preferences for fruits and vegetables at post-test than children with nutrition and health knowledge in a fun and
children who did not receive the intervention ( β = 0·19, engaging manner, the goal was to facilitate a sense of self-
P = 0·003). See Table 3 for a summary of results and effect efficacy for making healthy choices. Our findings indi-
sizes. cated that just two, 15–20 min lessons per week for
6 weeks were enjoyable for children and feasible for
teachers. Further, participation in these lessons effected
Discussion positive change in both targeted outcomes (food pre-
ferences and nutrition and health knowledge).
The aim of the current study was to develop and evaluate The findings with regard to nutrition education are in
a feasible nutrition education curriculum designed to line with other school-based and nutrition-focused inter-
enhance children’s dietary behaviours and nutrition and ventions(14–18). For instance, in one study of similar dura-
health knowledge. As expected, results from a randomized tion, 5th grade children who participated in a nutrition
controlled trial indicated that 2nd grade children who education programme at school showed significantly
participated in the curriculum demonstrated greater greater gains in nutrition knowledge relative to a control
improvements in their fruit and vegetable preferences and group(14). Similarly, in another study, 2nd and 3rd grade
nutrition and health knowledge relative to children in a children exposed to six weekly nutrition education lessons
control group. These findings suggest that a relatively demonstrated greater improvements in nutrition knowl-
short, 6-week intervention that aligns with educational edge compared with children in a control condition(17).
standards has the ability to significantly enhance children’s There have been few school-based and nutrition-focused
outcomes and thus may be a more feasible option for interventions that have been effective for promoting chil-
teachers to incorporate into their classrooms than what is dren’s fruit and vegetable preferences. For example, in a
currently available. multicomponent, school-based intervention study,
Childhood obesity, and related health problems, has although there were intervention effects on nutrition
become a significant public health issue in the USA in knowledge and vegetable identification, there were no

Table 2 Correlation matrix for all study variables (n 131)

Variable 1 2 3 4 5 6 7 8 9
1. Age† –
2. Gender − 0·02 –
3. Ethnicity − 0·01 − 0·01 –
4. Parent education‡ − 0·05 0·00 0·21* –
5. Condition 0·07 − 0·03 0·11 0·01 –
6. T1 Food pref − 0·08 − 0·13 − 0·09 − 0·24** 0·04 –
7. T2 Food pref − 0·01 − 0·06 − 0·13 − 0·09 0·16(*) 0·49*** –
8. T1 Health 0·08 − 0·07 0·07 − 0·01 0·12 0·19* 0·04 –
9. T2 Health 0·04 0·04 0·16(*) 0·08 0·49*** − 0·01 0·19* 0·22* –

T1, pre-test assessment; Food pref, food preferences; T2, post-test assessment; Health, nutrition and health knowledge.
* P < 0·10, *P < 0·05, **P < 0·01, ***P < 0·001.
( )

†Child age measured in months.

‡1 = 8th grade or less, 2 = some high school, 3 = General Educational Development, 4 = high school diploma, 5 = some college, 6 = associate’s degree,
7 = bachelor’s degree, 8 = master’s degree, 9 = doctoral/postgraduate degree.
Nutrition education curriculum effects 33
Table 3 Effects of the nutrition education curriculum intervention in a Midwestern US state on elementary-school children’s food preferences
and nutrition and health knowledge, autumn 2016

Food preferences Nutrition and health knowledge

B SE β Hedge’s g B SE β Hedge’s g
Age 0·03 0·04 0·02 − 0·00 0·03 − 0·00
Parent education 0·65 0·65 0·04 0·18 0·19 0·05
Gender 0·34 1·35 0·01 0·42 0·35 0·06
Ethnicity − 3·16* 1·27 − 0·12 0·57 0·71 0·09
Pre-test score 0·52*** 0·10 0·50 0·29* 0·12 0·16
Condition 5·28** 1·54 0·19 0·39 3·19** 1·21 0·47 1·11

*P < 0·05, **P < 0·01, ***P <0·001.

significant effects on children’s food preferences(18). The meet this particular standard in addition to meeting health
majority of school-based interventions that have been education standards.
effective in improving food preferences include a garden Although the current study has a number of strengths
component. Morris and Zidenberg-Cherr found that (e.g. randomized controlled design), limitations must be
although a nutrition education curriculum did produce noted. First, our sample size was relatively small and
favourable effects on food preferences for 4th grade chil- homogeneous. It will be critical for future research to
dren, effects were greater and sustained when garden replicate our findings with larger and more diverse sam-
activities were included(25). Although garden-based inter- ples. Second, our targeted outcomes were limited to direct
ventions have promise for improving food preferences, assessment of food preferences and child report of nutri-
they may not be feasible for many schools. Gardens can tion and health knowledge. Although both of these out-
be expensive to build and time-consuming to maintain, comes have been associated with consumption in
and some schools may not have the resources or space for previous research(1,11,12), future research evaluating the
this endeavour. Thus, one goal of the current study was to curriculum would benefit from the inclusion of pre- and
include other activities that may promote nutrition post-test assessments of fruit and vegetable consumption.
knowledge and food preferences that did not include a Finally, although the short-term intervention was found to
garden component. effective, we did not have a long-term follow-up to assess
One key ingredient of our curriculum that may have the extent to which the effects were maintained. It is
facilitated positive effects on both dietary behaviours and possible that the intensity of the intervention was not
nutrition and health knowledge is the inclusion of tastings. enough to lead to sustained behaviour change. Future
For young children, nutrition education may not always be research should test whether a more holistic approach to
enough to effect actual change in children’s dietary beha- curriculum that more fully integrates nutrition into all areas
viours; however, exposure to healthy fruits and vegetables of education (e.g. health, maths, science, arts) would lead
with tastings has been shown to promote preferences for to even stronger effects in the short and long term.
these foods(26). As part of our nutrition education curricu- Despite these limitations, our study supports the inclu-
lum, children were exposed to and tasted a variety of fruits sion and effectiveness of a nutrition education programme
and vegetables that were introduced in fun and engaging for promoting young children’s fruit and vegetable pre-
ways. For example, in week 2, children were introduced to ferences and nutrition and health knowledge. Preferences
the Two-Bite Club via a storybook reading that encourages for and knowledge of fruits and vegetables predict chil-
children to try at least two bites of new foods, just like the dren’s consumption of healthy foods(1,11). Thus, exposing
characters in the Two-Bite Club book. Then, children were children to healthy foods and providing an education on
given new foods to taste (e.g. pomegranate, butternut the value of these foods early in life may help prevent the
squash, okra). This inclusion of tastings along with nutrition onset of overweight and obesity, laying the foundation for
education may be critical for promoting healthy dietary lifelong health and well-being.
behaviours in young children. It will be important for future
research to test this hypothesis. Acknowledgements
An additional strength of the present study is the
potential for the curriculum to be integrated into other Financial support: This study was supported by a grant
content domains. Although the curriculum primarily tar- from the Indiana State Department of Agriculture, Speci-
gets nutritional components of the National Health Edu- alty Crop Block Grant Program (EDS #A337-15-SCBG-14-
cation Standards, it could also meet some of the National 006). The funder had no role in the design, analysis or
Health Science Standards. For example, one of the foci of writing of this article. Conflict of interest: None. Author-
the ‘Science in Personal and Social Perspectives’ standard ship: S.A.S. designed the study, recruited participants,
is personal health. Teachers could use the curriculum to collected data, trained teachers, analysed the data and led
34 SA Schmitt et al.
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the data and assisted in manuscript preparation. I.K. education for school-aged children. J Nutr Educ 27,
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