Assessing the Role of a School-Based Nutrition Program in Reducing Obesity Risk Among Children From Low-Income Neighbourhoods in Toronto: A Research Protocol

Abstract

Introduction: Childhood obesity is a significant public health concern in Canada, particularly in low-income, highly populated neighbourhoods with limited access to affordable, nutritious food. Given the considerable time children spend in school, educational institutions are well-positioned to provide healthy food alternatives for those from low-income communities. The objective of this pilot study is to evaluate the feasibility of a school-based nutrition program in low-income Toronto neighbourhoods and examine its preliminary effects on BMI. The study will assess secondary outcomes, including dietary quality and nutritional literacy, while controlling for baseline physical activity levels and household food security as covariates.

Methods: Forty children aged 4 to 13 will be randomly recruited from a single elementary public school. Participants will be randomly assigned to intervention and control groups: 10 boys and 10 girls will receive the intervention, and 10 boys and 10 girls will be controls. Within each group, one child from each age will be selected. The intervention group will receive a school-based nutrition program for eight months, consisting of daily breakfast and snack meals aligned with the 2020 Ontario Student Nutrition Program Guidelines. Controls will continue their usual diet. BMI will be measured at baseline and eight months, then compared between intervention and control groups using independent-sample t-tests and analysis of covariance (ANCOVA), and within individuals pre- and post-intervention using paired t-tests.

Anticipated Results: Children who receive the school-based nutrition program are predicted to have lower BMI scores after eight months compared to those who do not. The intervention group is expected to show a reduction in BMI from baseline measurements.

Discussion: This study will pilot a school-based nutrition program to evaluate its feasibility, acceptability, and preliminary effects on childhood obesity in low-income neighbourhoods in Toronto. The primary purpose is to refine the intervention procedures to inform a future, large-scale randomized control trial.

Conclusion: The findings from this study will inform policymakers and educators about the viability and potential impact of school-based nutrition programs, providing the evidence to support the design of a future randomized controlled trial assessing the effectiveness of school-based nutrition programs.