School gardening programs offer affordable and accessible fruits and vegetables (FV), teach children how to grow, cook, and enjoy FV, and show promising effects on reducing obesity and related diseases in low-income Hispanics. Lack of access to healthy and affordable food is a significant factor contributing to elevated rates of obesity and metabolic risk factors among low-income Hispanics. There is a growing national and grassroots movement to support gardening efforts to make healthy foods more affordable and accessible and to make intake more sustainable for low-income families. However, few experimental studies have evaluated the impact of garden-based interventions on obesity and related metabolic disorders. We recently completed an NIH R21 grant, which was a randomized controlled trial (RCT) to test the effects of a gardening, nutrition, and cooking program in 375 low-income Hispanic students living in Los Angeles. Preliminary results from this study show that intervention compared to the control students have reductions in BMI parameters and waist circumference, increases in daily intake of dietary fiber and vegetables, and improved lipid profiles. We want to expand and replicate this study by: a) using a cluster randomized school design; b) implementing the program during school hours; c) increasing sample size; d) lengthening the intervention period to one school year; e) collecting comprehensive metabolic measurements on the child; f) enhancing family workshops; g) collecting more parental data; and h) developing and evaluating sustainability strategies. Thus, the overall goal of this project is to test the effects of a large school-based gardening, nutrition, and cooking RCT (called Sprouts) on dietary intake, dietary-related behaviors, obesity, and related metabolic disorders in low-income Hispanic youth and their families in Central Texas. Sixteen elementary schools will be randomized to either: 1) Sprouts intervention or 2) Control (delayed intervention). At each intervention school, we will build edible gardens; form and train Garden Leadership Coalitions (GLCs); teach 20 Sprouts in-school lessons to the students; and teach nine family-based Sprouts lessons throughout school year. The following measures will be obtained for students at baseline and post-intervention: height, weight, BMI, waist circumference, body composition (via bioimpedance), blood pressure, glucose, insulin, and lipids (via voluntary fasting blood draws), dietary intake, and related psychosocial behaviors (e.g., preference/motivation/self-efficacy to eat FV). We will also measure anthropometrics, dietary intake, and related dietary psychosocial variables on the parents at baseline and post-intervention. After the intervention year, we will provide a series of training workshops and resources to the GLCs and schoolteachers to sustain the Sprouts program in subsequent years. We will measure the sustainability employed by each school by process logs/surveys, structured interviews, and school observations. The findings could provide a successful, sustainable model for garden- based school programs that decrease the obesity and metabolic diseases impacting Hispanic populations.
Growing evidence shows that gardening projects can make healthy foods more affordable and accessible and intake more sustainable for low-income families, thereby potentially decreasing obesity and related metabolic disorders. However, this has not yet been tested in a large-scale school-based setting. Findings from this project could provide a successful and sustainable model for garden-based obesity prevention and treatment programs disseminated in school settings across the nation.