A high fruit intake may reduce the risk of asthma. The English National School Fruit Scheme was introduced in the East Midlands region of the UK in June 2003 and in the Eastern region in September 2004. Questionnaires were distributed to children aged 4-6 yrs in schools in May 2003. This was repeated in May 2004 when those in the East Midlands had received free fruit for 1 yr and those in the Eastern region had not. Responses were obtained in 2004 for 4,971 (53%) and 5,770 (54%) children in the intervention and control regions, respectively. Despite an increase in fruit consumption in the intervention compared with the control region between 2003 and 2004, there was no difference between the two regions in the prevalence or severity of asthma symptoms after 1 yr of fruit supplementation (odds ratio for wheeze in the past 12 months in intervention compared with control region 1.00, 95% confidence interval 0.88-1.14). Providing free fruit at school for 1 yr does not have any immediate effect on prevalence or severity of asthma in young children, although these data do not refute the hypothesis that a higher increase in fruit intake improves measures of asthma control.