| Reynolds et al. 200011 | Randomised controlled trial | Elementary schools, Birmingham, USA | 28 schools; 1698 4th grade students, mean age 8.7 years; 50% female; 83% European-American; 16% African-American;1% other | 7-week intervention; (High 5); Group 1: immediate intervention (classroom component, parent component, food service component); Group 2: delayed intervention | Delayed intervention | Diet and psychosocial variables | 1, 2 years | Medium risk of bias | Intervention students consumed more fruit and vegetables after 1 year (mean, 95% CI) 3.96 servings (3.51 to 4.44) than controls 2.28 (1.92 to 2.66) (p<0.0001) and 2 years follow-up intervention 3.20 (2.89 to 3.52) versus control 2.21 (1.94 to 2.49) (p<0.0001) | Intervention resulted in increases in fruit and vegetable consumption that was greater in higher income (mean difference after 1 year 2.4 portions per day, p<0.0001) than in lower income children (mean difference 1.3 portions per day, p<0.0003) |
| Friel et al. 199912 | Comparative quasi-experimental study | Primary schools, Ireland | Eight primary schools, 821 Irish school children aged 8–10 years | 10-week intervention (NEAPS) aiming to build awareness of healthy eating and regular exercise | Control schools | Children’s knowledge, behaviours and preferences of healthy foodstuffs | 3 months | High risk of bias | Intervention children’s consumption of fruit and vegetables increased and salty food decreased | The NEAPS programme was less effective in pupils in disadvantaged areas (f = 5.606, p<0.018) |
| Reinaerts et al. 200713 | Controlled clinical trial | Primary schools, the Netherlands | 12 primary schools, approx. 939 children aged 4–12 years | 9-month intervention aimed to (1) increase children daily fruit and vegetable consumption or (2) create supportive environments. Group (1) free fruit and vegetable distribution; Group (2) multicomponent programme | Delayed intervention | Fruit, vegetables and fruit juice consumption | 12 months | High risk of bias | Fruit and vegetable consumption increased in groups 1 and 2 | In the free fruit and vegetable group (group 1), 24-h fruit juice and vegetable consumption increased more in “non-native” children (beta coefficient = 1.30, p<0.01) than in ‘native’ children (beta coefficient = 0.24, p<0.05) |
| Winkleby et al. 199714 | Cluster randomised controlled trial | Community education classes, USA | 24 community classes; 242 adults with low literacy | 6-week intervention (SNAP) targeting low fat eating followed by 12-week maintenance phase; Group 1 SNAP intervention; Group 2 general nutrition (GN) intervention | Control (GN) classes | Nutrition knowledge, nutrition attitudes, % calories from fat | 30 weeks | Low risk of bias | 60% of SNAP groups met the goal of consuming 30% of dietary energy from fat at follow-up compared with 34% of GN group | The group with better educated participants (Group 2) achieved 34% of dietary goals compared with group 3 who had the highest non-US-born and non-English speakers, which achieved 60% of dietary goals |
| Calfas et al. 200215 | Randomised controlled trial | Primary care providers, San Diego, USA | 10 providers, 173 adults, mean age 37.5 years (SD 8.4); 69% female; 71.7% Caucasian, 11.6% Asian-American/Pacific Islander, 8.1% Hispanic, 4.0% African-American, 1.7% multiracial, 2.9% other | 4-month intervention (PACE+ for adults); computerised assessment and goal setting; then randomised to four groups: Group1 mail only; Group 2 infrequent phone and mail; Group 3 frequent phone and mail; Group 4 control | No intervention | Self-report of: five target behaviours (moderate and vigorous physical activity, stage of change, dietary fat, fruit/vegetable intake, overeating behaviours) | 4 months | Low risk of bias | No difference between groups; those who set dietary goals had reduced pre–post dietary fat consumption (−1.05 versus −0.07 servings per day, p<0.002) and increased fruit and vegetable consumption (+1.66 versus +0.34 servings per day, p<0.001) compared with those who did not | Greater attrition among the ethnic minority participants than among the Caucasian participants (p<0.04) |
| Kristal et al. 199916 | Randomised controlled trial | Health care clinics, Atlanta, Birmingham, Miami, USA | Three clinical centres, 1702 participants, mean age 60.2 years (SD 6.6), 100% women, 60% white, 9% Hispanic, 31% black | 12-month intervention; Group 1: dietary intervention (aiming to reduce fat intake to 20% energy, increase fruit and vegetables and reduce saturated fat) | Control group | Total dietary fat; fat-related dietary habits; food purchasing patterns | 6 months | Medium risk of bias | Difference in consumption of added fat between the intervention and control group was −8.9 g/day in blacks and −12.0/day in whites (p<0.05) | Intervention effects were significantly larger among blacks compared with whites for poultry and fish but smaller for added fat, dairy food and baked goods |