TX Sprouts: A School-Based Cluster Randomized Gardening, Nutrition, and Cooking Intervention: Effects on Obesity, Blood Pressure and Diet

Abstract Objectives To assess the effects of a one-year school-based gardening, nutrition, and cooking cluster randomized controlled trial, called TX Sprouts, on dietary intake, obesity markers, and blood pressure. Methods Sixteen schools were randomly assigned to either the TX Sprouts intervention (n = 8 school) or to delayed intervention (n = 8 schools). The intervention arm received: formation/training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly during school hours; and nine parent lessons. The delayed intervention received the same protocol one year later. Primary child outcomes were measured at baseline and after one school year included: changes in dietary intake (fruit and vegetables servings via screener), height, weight, waist circumference, body composition, and blood pressure. Ten multiple imputations and generalized linear mixed models with schools as the random cluster were used to assess differences in changes in primary outcomes between intervention and control groups. Results Of the 4239 eligible students, 3135 (74%) of students consented and completed baseline clinical measures and child surveys. Participants were 47.4% male and average age was 9.2 years. Approximately 64% were Hispanic, and 69% were economically disadvantaged with attendance to TX Sprouts lessons was 95% of the intervention children. Ninety-one % of children completed both pre and post measures. Intervention group compared to control group resulted in increases, mean change (SE), in vegetable intake [+0.33(0.13) vs. 0.03(0.11) serv/d; P = 0.003]. There was a significant race/ethnicity by sex interaction (P = 0.01) for diastolic blood pressure, with Hispanic males in the intervention group compared to Hispanic males in the control group having reductions in diastolic blood pressure [−2.5(1.0) vs. +0.8(1.10) Hg/mm; P = 0.021). There was no effect of the intervention on any of the obesity parameters. Conclusions The TX Sprouts intervention targets the school nutrition environment, and may provide a sustainable approach to increase vegetable intake and reduce blood pressure in low-income, primarily Hispanic children. Funding Sources NIH/NHLBI (1R01HL123865, 2015-2020), Whole Kids Foundation, Home Depot, Sprouts Healthy Communities Foundation.