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Promotion of healthy nutrition among students participating in a school food aid program: a randomized trial



To evaluate the potential benefits on students’ eating habits, of incorporating healthy nutrition education as part of a school food aid program.


146 schools participating in the DIATROFI Program in Greece during the 2013–2014 school year were randomly allocated to the environmental intervention (received a healthy daily meal) and the multicomponent intervention (MI) group (in addition to the meal, a healthy nutrition educational program was applied). The analysis, based on 3627 pre–post intervention questionnaire pairs, was stratified for children (ages 4–11 years) and adolescents (ages 12–18 years).


Children participating in the MI group displayed 25 % higher odds of increasing the weekly consumption of milk/yoghurt and fruits, 61 % higher odds of improving BMI from overweight/obese to normal and 2.5 times higher odds of improving from underweight to normal. For adolescents in the MI group, the odds of increasing the consumption of vegetables were 40 % higher. In both intervention groups, approximately one in four overweight/obese adolescents reached normal weight.


Educational programs on healthy nutrition might be considered worth implementing in the framework of school food aid programs.

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Over 100 volunteers participated in the DIATROFI Program and deserve our sincere thanks.

The Food Aid and Promotion of Healthy Nutrition Program—DIATROFI ( is implemented by the Institute of Preventive Medicine, Environmental and Occupational Health, Prolepsis, and has been approved and conducted under the auspices of the Greek Ministry of Education and Religious Affairs. The DIATROFI Program was funded by the Stavros Niarchos Foundation.

The DIATROFI Program research team (in alphabetical order): Belogianni Katerina, MSc; Dalma Archontoula, MSc; Giannikou Dafni MSc; Gioti Natalia, BSc; Haviaris Anna Maria, MSc; Karagas R Margaret, PhD; Karnaki Pania, MA; Kastorini Christina Maria, PhD; Linos Athena, MD, MPH, PhD; Linos Constantinos, BSc; Lykou Anastasia, PhD; Mitraka Kallis, MA; Pantazopoulou Anastasia, MD, PhD; Papadimitriou Eleni, MD, PhD; Peppas Manolis, BSc; Petralias Athanassios, PhD; Riza Elena, PhD; Saranti Papasaranti Eirini, MSc; Spyridis Ioannis, MSc; Veloudaki Afroditi, MA; Yannakoulia Mary, PhD; Zota Dina, MSc.

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Corresponding author

Correspondence to Athena Linos.

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The DIATROFI Program was funded by the Stavros Niarchos Foundation and has been approved and runs under the auspices of the Greek Ministry of Education and Religious Affairs.

Conflict of interest


Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The DIATROFI Program was conducted under the auspices of the Greek Ministry of Education and Religious Affairs. All questionnaires collected were anonymous.

Informed consent

Informed consent was obtained from all individual participants.

Additional information

On behalf of the DIATROFI Program Research Team: The members are listed in the Acknowledgments section.

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Zota, D., Dalma, A., Petralias, A. et al. Promotion of healthy nutrition among students participating in a school food aid program: a randomized trial. Int J Public Health 61, 583–592 (2016).

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  • School food aid program
  • Dietary habits
  • Children
  • School
  • Educational intervention