Interventions for increasing fruit and vegetable consumption in children aged five years and under

Hodder, Rebecca K; Stacey, Fiona; Wyse, Rebecca; O’Brien, Kate; Clinton‐McHarg, Tara; Tzelepis, Flora; Nathan, Nicole; James, Erica L.; Bartlem, Kate; Sutherland, Rachel; Robson, Emma; Yoong, Sze Lin; Wolfenden, Luke

doi:10.1002/14651858.cd008552.pub3

Cited by 38 publications

(35 citation statements)

References 529 publications

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“…Although consumption of fruit has been associated with a reduced risk of obesity and chronic disease [1][2][3][4][5][6], better psychological well-being [1,[7][8][9], and improved gut health [1,10], intake fails to meet dietary recommendations among all but the youngest children in the US [11,12]. Considering the growing evidence of an association between greater fruit and vegetable consumption during childhood and reduced chronic diseases in adulthood [13][14][15][16], both short-and long-term implications of programs that successfully increase fruit intake among children are likely to be significant. However, public health initiatives should not only address deficits in nutrition knowledge [17,18], but also enduring challenges with regard to the access to and affordability of fresh, high-quality fruits-particularly among low-income children [6,[19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Child Consumption of Whole Fruit and Fruit Juice Following Six Months of Exposure to a Pediatric Fruit and Vegetable Prescription Program

Saxe-Custack

LaChance²,

Hanna‐Attisha³

2019

Nutrients

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Public health recommendations suggest limiting child consumption of fruit juice in favor of whole fruit due to juice's high sugar content, lack of fruit fiber, and potential for excess intake. However, replacing juice with whole fruit may be particularly challenging for low-income and minority children, who report the highest intake of 100% juice. To address access and affordability challenges among low-income children, researchers partnered with pediatricians in an urban food desert community, to introduce a fruit and vegetable prescription program (FVPP) that provided a $15 prescription for fresh produce to every child during each office visit. Participating vendors included a farmers' market and local mobile market. This study assessed changes in daily consumption of total fruit and whole fruit among 108 pediatric patients following six months of exposure to the FVPP. Child-reported mean daily intake of whole fruit increased significantly from the baseline to the 6-month follow-up (p = 0.03): 44% of children reported an increased intake of at least 1 4 cup per day, and 30% reported an increased intake of at least 1 2 cup per day. Changes in total fruit intake (including fruit juice) were not significant. Results suggest a pediatric FVPP may have meaningful impacts on children's dietary behaviors, particularly with regard to the intake of whole fruits.

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Section: Introductionmentioning

confidence: 99%

Child Consumption of Whole Fruit and Fruit Juice Following Six Months of Exposure to a Pediatric Fruit and Vegetable Prescription Program

Saxe-Custack

LaChance²,

Hanna‐Attisha³

2019

Nutrients

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“…As a result, providers have the opportunity to educate individuals about the importance of proper nutrition and the connection between food and health [22,23]. Pediatricians, who often follow children from infancy to young adulthood, are uniquely positioned to influence lifelong dietary behaviors [24,25,26]. With mounting evidence that higher fruit and vegetable consumption during childhood is associated with reductions in chronic diseases in adulthood [5,24,27,28], both the immediate and long-term implications of fruit and vegetable prescription programs for pediatric patients could be substantial.…”

Section: Introductionmentioning

confidence: 99%

Fruit and Vegetable Prescriptions for Pediatric Patients Living in Flint, Michigan: A Cross-Sectional Study of Food Security and Dietary Patterns at Baseline

Saxe-Custack

LaChance²,

Hanna‐Attisha³

et al. 2019

Nutrients

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Though fruit and vegetable consumption is essential for disease prevention and health maintenance, intake among children fails to meet dietary recommendations. Limited access to and the affordability of fresh produce, particularly among low-income youth, are barriers to adequate intake. To address these challenges, researchers and pediatricians in Flint, Michigan, expanded a successful fruit and vegetable prescription program that provides one $15 prescription for fresh fruits and vegetables to every child at every office visit. Vendors include the downtown farmers’ market and a local mobile market. This study describes baseline characteristics, dietary patterns, food access, and food security among 261 caregiver–child dyads enrolled August 2018–March 2019. The child-reported mean daily intake of vegetables (0.72 cups ± 0.77), dairy products (1.33 cups ± 1.22), and whole grains (0.51 ounces ± 0.49) were well below recommendations. Furthermore, 53% of children and 49% of caregivers who completed the food security module indicated low or very low food security. However, there were no statistically significant differences in the child consumption of fruits and vegetables between households that reported high versus low food security (p > 0.05). Results validate and raise deep concerns about poor dietary patterns and food insecurity issues facing Flint children, many of whom continue to battle with an ongoing drinking water crisis. Additional poverty-mitigating efforts, such as fruit and vegetable prescription programs, are necessary to address these gaps.

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“…Several interventions have been conducted to better understand what increases children's vegetable intake among children below 5 years (14,15) . However, interventions focusing on increasing vegetable intake among children in childcare settings are limited.…”

mentioning

confidence: 99%

“…However, interventions focusing on increasing vegetable intake among children in childcare settings are limited. The latest review of interventions for increasing fruit and vegetable consumption targeting children up to 5 years found little consistent evidence across studies (15) . In addition, multicomponent studies were more successful in increasing vegetable consumption than single-exposure strategies (14) .…”

mentioning

confidence: 99%

Effects of a kindergarten intervention on vegetables served and staff’s food-related practices: results of a cluster randomised controlled trial – the BRA study

Himberg-Sundet

Kristiansen

Andersen

et al. 2020

Public Health Nutr.

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Objective:The aim of the current study was to evaluate the effect on frequency, variety and amount of vegetables served and staff’s food-related practices in the multicomponent BRA intervention.Design:Cluster randomised controlled trial, conducted between Spring 2015 and Spring 2016. For allocation of the kindergartens, a stratified block randomisation was used. Data were collected in three ways: (i) a questionnaire for pedagogical leaders assessing the variety and frequency of vegetables served, including staff’s food-related practices assumed to be related to vegetable intake; (ii) a questionnaire for kindergarten assistants assessing staff’s food-related practices; (iii) a 5-d weighted vegetable diary assessing amount of vegetables served in a department.Setting:The target group for this study was public and private kindergartens in the counties of Vestfold and Buskerud, Norway.Participants:A total of seventy-three kindergartens participated.Results:At follow-up I, the amount of vegetables served increased by approximately 20 g per person per day (P = 0·002), and the variety in served vegetables increased by one-and-a-half kind per month (P = 0·014) in the intervention group compared to the control group. No effects on the frequency of vegetables served or on staff’s food-related practices were found.Conclusions:The BRA intervention was successful in increasing the amount and variety of vegetables served within intervention kindergartens. Further research is needed to understand the mechanisms that can affect the staff’s food-related practices.

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Interventions for increasing fruit and vegetable consumption in children aged five years and under

Cited by 38 publications

References 529 publications

Child Consumption of Whole Fruit and Fruit Juice Following Six Months of Exposure to a Pediatric Fruit and Vegetable Prescription Program

Child Consumption of Whole Fruit and Fruit Juice Following Six Months of Exposure to a Pediatric Fruit and Vegetable Prescription Program

Fruit and Vegetable Prescriptions for Pediatric Patients Living in Flint, Michigan: A Cross-Sectional Study of Food Security and Dietary Patterns at Baseline

Effects of a kindergarten intervention on vegetables served and staff’s food-related practices: results of a cluster randomised controlled trial – the BRA study

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