A program on food aid and promotion of healthy nutrition in schools of underprivileged areas in Greece

Program on Food Aid and Promotion of Healthy Nutrition – DIATROFI

A large-scale initiative implemented in schools of underprivileged areas across Greece incorporating food aid, health promotion and research

This is a guest blog post written by Athena Linos (MD, MPH, PhD), on behalf of the DIATROFI Program Research Team. Professor Linos is Chair of the Department of Hygiene, Epidemiology and Medical Statistics of the National and Kapodistrian University of Athens and President of the Institute of Preventive Medicine, Environmental & Occupational Health “Prolepsis” in Athens, Greece. You can contact her at a.linos@prolepsis.gr.

Students participating in the DIATROFI Program

In response to Greece’s recent economic crisis, Prolepsis Institute implements a large-scale school based nutrition Program entitled “Food Aid and Promotion of Healthy Nutrition Program-DIATROFI” in disadvantaged areas across Greece.^1-5 The DIATROFI Program is privately funded with founding donor the Stavros Niarchos Foundation, and the contribution of numerous additional donors and crowd funding.

The Program provides students attending selected schools in low socioeconomic areas with a free healthy meal and promotes healthy eating through educational activities. Note that Greek public schools do not provide meals for students in any income bracket. Over twelve million meals have been distributed to more than 90,000 students and 530 schools since the Program began in 2012. To our knowledge, DIATROFI is the largest school nutrition program implemented in the recent history of Greece.

Typical meal (whole wheat sandwich with vegetables and roasted chicken fillet and apple; includes also fresh milk) and booklet on healthy nutrition

 Indicative educational material; booklet and card game on healthy nutrition

All students of participating schools receive the free meal so as to avoid stigmatization. Meals daily include wholegrain bakery products with vegetables, roasted chicken fillet, medium-hard cheese and/or boiled egg, combined with a fresh fruit and white milk or yoghurt. Meals are high in protein and healthy oils (exclusive use of virgin/extra virgin olive oil), contain no preservatives, trans-fatty acids, sweetened drinks or processed meat. The fresh meals, which differ on daily and weekly basis, are prepared and distributed daily, via refrigerated vans, and scheduled to be consumed during the first school break (around 10 a.m.). Continuous monitoring of the process is conducted in schools and suppliers via unannounced visits and microbiological and physicochemical laboratory tests. Besides the meal, health promotion activities for students and their families take place including diverse materials and activities for each target group (students of different ages, parents, and teachers).

Typical meal; whole wheat sandwich with vegetables and medium-hard cheese, orange, apple and fresh milk

 Indicative educational material; puzzle “Captain health and his delicious alliance”

A rigorous data collection, research, and evaluation component is a central part of this Program, in hopes that the evidence collected will inform future research, policy and practice.  Indicatively, by the end of the 2014-2015 school year, 122,400 validated questionnaires had been collected and 375 focus groups and personal interviews had been conducted. The positive effects of the Program have been recorded in outcomes such as food insecurity reduction, BMI improvement, adherence to the Mediterranean diet, changes in food consumption frequencies, improvement in health related quality of life and educational outcomes.

The DIATROFI Program is the first school feeding program of this magnitude in Greece, incorporating food aid, health promotion and research. Moreover, to our knowledge, it is the first program that systematically measures the effects of healthy school nutrition among underprivileged students in a developed country.

The Program has been welcomed by the school community across the country. Currently, over 2,090 schools with 260,000 students (approximately 20% of the total student population in Greece) have applied for the 2015-2016 school year, although the available financial resources allow less than 10% of them to participate. Therefore, we continuously pursuit additional funding for the continuation and extension of the Program.

Students participating in the DIATROFI Program

Please click here to access the list of references and the acknowledgements for this postTo To read our recently published paper on this programme, click here!