A School-Based Five-Month Gardening Intervention Improves Vegetable Intake, BMI, and Nutrition Knowledge in Primary School Children: A Controlled Quasi-Experimental Trial

<b>Background/Objectives</b>: Childhood obesity rates in Jordan have reached alarming levels, with 28% of school-age children classified as overweight or obese. School-based gardening interventions show promise for promoting healthy eating behaviors, yet limited research exists in Middle Eastern contexts. This study evaluated the effectiveness of a five-month school-based vegetable gardening and nutrition education intervention on anthropometric measures, dietary intake, and knowledge, attitudes, and practices (KAP) regarding vegetable consumption among Jordanian primary school children. <b>Methods</b>: A quasi-experimental controlled trial was conducted with 216 students (ages 10-12 years) from two demographically matched schools in Amman, Jordan. The intervention group (<i>n</i> = 121) participated in weekly one-hour gardening sessions combined with nutrition education and vegetable tasting activities over five months, while the control group (<i>n</i> = 95) continued the standard curriculum. Outcomes measured at baseline and post-intervention included anthropometric assessments, dietary intake via 24 h recalls, and vegetable-related KAP using a validated questionnaire. Data were analyzed using paired <i>t</i>-tests and repeated measures ANCOVA. <b>Results</b>: The intervention group demonstrated significant improvements in body composition, including reductions in BMI (-1.57 kg/m²), weight (-1.88 kg), and BMI z-score (-0.37), while controls showed minimal increases. Vegetable intake showed significant time × group interaction (<i>p</i>-value = 0.003), with a non-significant increase in the intervention group (2.7 to 2.9 times/day) and a non-significant decrease in the controls (2.5 to 2.4 times/day). Dietary quality improved, including increased fiber intake (+2.36 g/day) and reduced saturated fat consumption (-9.24 g/day). Nutrition knowledge scores increased substantially in the intervention group (+22.31 points) compared to controls (+1.75 points; <i>p</i>-value ≤ 0.001). However, attitudes and practices toward vegetable consumption showed no significant changes. <b>Conclusions</b>: This intervention effectively improved body composition, dietary quality, and nutrition knowledge among Jordanian primary school children. These findings provide evidence for implementing culturally adapted school gardening programs as childhood obesity prevention interventions in Middle Eastern settings, though future programs should incorporate family engagement strategies to enhance behavioral sustainability.