Background: School children are at great risk of nutrition-related chronic diseases. Their eating pattern in
school is influenced by the availability of food served within the school environment. The purpose of this
paper was to determine the effectiveness of a canteen-based food nutrition intervention, designed according
to the theory of planned behaviour, on the knowledge, perception and choices of healthy food among primary
schoolchildren.
Methods: This was a prospective intervention study using a two-group design. Six school canteens from the
ninety-eight primary schools were randomly allocated to an intervention group or a control group. All the
food handlers in the intervention group were given a twelve-week training course in food nutrition. On the
completion of the course, 293 Standard Six students from these schools, were interviewed with a nutritional
questionnaire on food in their school canteens. The training programme for the intervention group and the
questionnaire for the students were developed and validated for the study, and a power calculation made for
the sample size of students.
Results: The students in both groups were homogeneous in gender and body mass. The mean body mass
index (BMI) was 19.26 (SD: 0.38) and 19.47 (SD: 0.39) for the intervention and the control group respectively.
There were more schoolchildren in the intervention group who purchased foods in school canteens (p 0.0036)
of milk and milk products (p 0.034), and white rice (p
The aim of this study was to evaluate the impact of Food Nutrition Intervention (FNI) for
improving food handlers’ knowledge and serving of competitive food in the primary school
canteens. We randomized 16 out of 98 primary schools into intervention and control groups
using a multistage sampling method. The training programme for the intervention group and
questionnaires for evaluating knowledge were developed. On-site observations were done to
document all competitive foods served in school canteens. Out of the 79 food handlers who
participated in this study, 33 (41.8%) were in the intervention group and 46 (58.2%) were
in the control group. The majority of food handlers were female, Malay, had education at
middle levels, and at middle-aged. The commonest food category served was carbohydrate
(75%), high-fat foods (34.4%) and food not recommended for sale (34.4%). Knowledge about
healthy food choice in the intervention group at 6 weeks and 12 weeks post intervention were
significantly higher than at baseline. The intervention group also demonstrated significantly
better knowledge composite score at 6 weeks and 12 weeks following intervention. These
improvements were also observed between intervention and control regardless of time. By
six weeks, the number of vegetable menu served significantly increased in the intervention
(p=0.040) and by 12 weeks, the number of milk and milk products served also significantly
increased (p=0.015) as compared to the control group. Thus, the provision of FNI was
associated with significantly improved healthy food knowledge amongst food handlers, the
serving of vegetables and milk or milk products in school canteens.