Background
Many children worldwide do not eat recommended amounts of vegetables. Disliking vegetables is a key factor associated with low intake.
Objective
This umbrella review synthesized systematic reviews to determine the effectiveness of sensory and behavioral strategies to facilitate liking of vegetables (primary outcome) in young children up to 5 y of age, as key predictors of vegetable intake (secondary outcome).
Methods
Nine databases were searched up to May 2019 (updated in September 2020). Two reviewers independently conducted study screening and selection, data extraction, and assessment of methodological quality using AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews). Eleven reviews (n = 1 rated strong quality, n = 4 moderate quality, n = 6 low/critically low quality) examining 85 primary studies met the review criteria: systematic reviews and meta-analyses of primary studies (any quantitative design) that examined sensory or behavioral strategies on vegetable liking or intake (outcomes reported separately for children ≤5 y). Strategy effectiveness was synthesized into 3 categories based on evidence strength: 1) promising (large and consistent body of moderate quality evidence), 2) emerging (small to moderate body of mixed consistency and quality evidence), and 3) limited (small body of limited consistency and quality evidence).
Results
Promising evidence was identified for repeated exposure to a single or a variety of vegetables. Emerging evidence was identified for several strategies that increase familiarity with vegetable flavors (e.g., via exposure in utero and through breast milk, and a “vegetable first” approach to complementary feeding) and/or willingness to try vegetables (e.g., via parental role modeling, nonfood rewards, and vegetable-based story books).
Conclusions
Current evidence supports incorporation of tailored advice into guideline documents for parents and carers to repeatedly expose their children to a variety of vegetables to increase vegetable intake. Ongoing robust research on strategies to facilitate children's liking of vegetables is warranted to strengthen the evidence base underpinning advice for parents and health professionals.
Objective: To measure the effectiveness of a new sensory education program for Australian primary (elementary) schoolchildren (Vegetable Education Resource to Increase Children's Acceptance and Liking [VERTICAL]) designed to increase vegetable enjoyment and positively predispose to vegetable consumption. Methods: Pretest and posttest (collected 2 weeks after intervention) survey data (n = 299) on cognitive, attitudinal, and behavioral factors associated with vegetable consumption were compared between the intervention (which followed VERTICAL, a program consisting of five 1-hour teacher-led interventions) and control students (aged 8−12 years) from Sydney primary schools. Results: The VERTICAL intervention increased knowledge about vegetables and the senses (P = .002), the ability to verbalize sensations (P < .001), vegetable acceptance (P = .007), and willingness to try vegetables (P = .05). Middle primary students gained more positive attitudes toward vegetable consumption (P = .009). Moreover, VERTICAL had no effect on food neophobia, perceived norms of teacher and peers, emotions, behavioral intentions, and vegetables tried. Conclusions and Implications: Behavioral change was achieved through VERTICAL in a short intervention, supporting further development and validation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.