The Norwegian School Fruit Programme: evaluating paid vs. no-cost subscriptions

Background. This study reports the effect of providing Norwegian school children with free fruit or vegetables every school day and the effect of an existing fee-based School Fruit Programme. Methods. Seventh grade pupils and their parents completed questionnaires at baseline (autumn 2001) and at follow-up (spring 2002). Nine schools participated in the School Fruit Programme for free (Free fruit), nine schools took part at standard conditions (Paid fruit), and 20 schools did not take part in the subscription programme (No fruit). A total of 795 7th graders (11 or 12 years old at baseline) participated both at baseline and at follow-up. Results. At follow-up, pupils attending the Free fruit schools had significantly higher intake of fruit and vegetables at school than the pupils at the Paid fruit and No fruit schools (P < 0.001, mean intakes were 1.1, 0.4 and 0.2 portions, respectively). Subscribers at the Paid fruit schools had significantly higher intake than the non-subscribers at the same schools. Conclusions. Providing a free piece of fruit or a vegetable is an effective strategy to increase school childrenʹs fruit and vegetable intake. The existing School Fruit Programme appears to increase the intake among the subscribers, but thereby also tends to increase an existing difference in consumption patterns among subscribers and non-subscribers.