“Kids Choice” School lunch program increases children's fruit and vegetable acceptance

Hendy, Helen M.; Williams, Keith E.; Camise, Thomas S.

doi:10.1016/j.appet.2005.07.006

Cited by 98 publications

(88 citation statements)

References 51 publications

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“…Any reward (stickers, small toys) can be a potential positive reinforcer for behaviour such as tasting a vegetable. Two studies have shown that children's intake or rated liking of vegetables increases when the children are offered a reward (14,15) . However, one study has found that reward is no more effective than simply asking the child to taste a small amount the vegetable (14) .…”

mentioning

confidence: 99%

Rewards can be used effectively with repeated exposure to increase liking of vegetables in 4–6-year-old children

Corsini

Slater

Harrison

et al. 2011

Public Health Nutr.

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Objective: To examine whether parents offering a sticker reward to their child to taste a vegetable the child does not currently consume is associated with improvements in children's liking and consumption of the vegetable. Design: A randomized controlled trial evaluated the effectiveness of exposure only (EO) and exposure plus reward (E1R), relative to a control group, on children's liking and consumption of a target vegetable. Assessments were conducted at baseline and 2 weeks from baseline (post-intervention). Follow-up assessments were conducted at 4 weeks and 3 months from baseline. Setting: The study took place in Adelaide, South Australia. Participants were selfselected in response to local media advertisements seeking to recruit parents finding it difficult to get their children to eat vegetables. Subjects: Participants were 185 children (110 boys, seventy-five girls) aged 4-6 years and their primary caregiver/parent (172 mothers, thirteen fathers). Results: The E1R group was able to achieve more days of taste exposure. Both EO and E1R increased liking at post-intervention compared with control and no further change occurred over the follow-up period. All groups increased their intake of the target vegetable at post-intervention. Target vegetable consumption continued to increase significantly over the follow-up period for E1R and control but not for EO. Conclusions: The findings provide support for the effectiveness of using a sticker reward with a repeated exposure strategy. In particular, such rewards can facilitate the actual tastings necessary to change liking.

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mentioning

confidence: 99%

Rewards can be used effectively with repeated exposure to increase liking of vegetables in 4–6-year-old children

Corsini

Slater

Harrison

et al. 2011

Public Health Nutr.

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“…All 3 of these studies were conducted in elementary schools. 20,22,33 Therefore, it is unknown whether the results would be different if rewards were used in older age groups.…”

Section: Discussionmentioning

confidence: 99%

“…20,22 This suggests that the rewards would have to be ongoing to obtain persistent improvement in fruit and/or vegetable consumption.…”

Section: Discussionmentioning

confidence: 99%

“…Preference ratings for vegetable (continued) elementary school students were given tokens for eating at least one-eighth cup of fruits and/or vegetables at lunch for 6 weeks. 20 These tokens could be exchanged for prizes at the end of each week. Consumption of fruits and/or vegetables increased with token reinforcement, as measured by direct visualization (P < 0.001, no absolute values provided).…”

Section: Behavior Modificationmentioning

confidence: 99%

“…Nine studies were performed in elementary schools, [19][20][21][22][23][24][25][26][27] 3 in high schools/secondary schools, [28][29][30] and 1 in middle school. 31 Two studies included grades kindergarten through 8, 32,33 and 1 study included grades kindergarten through 12.…”

Section: Simple Interventions To Improve School Nutritionmentioning

confidence: 99%

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Simple interventions to improve healthy eating behaviors in the school cafeteria

Kessler

2016

Nutr Rev

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The National School Lunch Program in the United States provides an important opportunity to improve nutrition for the 30 million children who participate every school day. The purpose of this narrative review is to present and evaluate simple, evidence-based strategies to improve healthy eating behaviors at school. Healthy eating behaviors are defined as increased selection/consumption of fruits and/or vegetables, increased selection of nutrient-dense foods, or decreased selection of low-nutrient, energy-dense foods. Data were collected from sales records, 24-hour food recalls, direct observation, and estimation of plate waste. The review is limited to simple, discrete interventions that are easy to implement. Sixteen original, peerreviewed articles are included. Interventions are divided into 5 categories: modification of choice, behavior modification, marketing strategies, time-efficiency strategies, and fruit slicing. All interventions resulted in improved eating behaviors, but not all interventions are applicable or feasible in all settings. Because these studies were performed prior to the implementation of the new federally mandated school meal standards, it is unknown if these interventions would yield similar results if repeated now.

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Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health

Philipsborn

Stratil

Burns

et al. 2019

Cochrane Database of Systematic Reviews

155

136

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BackgroundFrequent consumption of excess amounts of sugar‐sweetened beverages (SSB) is a risk factor for obesity, type 2 diabetes, cardiovascular disease and dental caries. Environmental interventions, i.e. interventions that alter the physical or social environment in which individuals make beverage choices, have been advocated as a means to reduce the consumption of SSB.ObjectivesTo assess the effects of environmental interventions (excluding taxation) on the consumption of sugar‐sweetened beverages and sugar‐sweetened milk, diet‐related anthropometric measures and health outcomes, and on any reported unintended consequences or adverse outcomes.Search methodsWe searched 11 general, specialist and regional databases from inception to 24 January 2018. We also searched trial registers, reference lists and citations, scanned websites of relevant organisations, and contacted study authors.Selection criteriaWe included studies on interventions implemented at an environmental level, reporting effects on direct or indirect measures of SSB intake, diet‐related anthropometric measures and health outcomes, or any reported adverse outcome. We included randomised controlled trials (RCTs), non‐randomised controlled trials (NRCTs), controlled before‐after (CBA) and interrupted‐time‐series (ITS) studies, implemented in real‐world settings with a combined length of intervention and follow‐up of at least 12 weeks and at least 20 individuals in each of the intervention and control groups. We excluded studies in which participants were administered SSB as part of clinical trials, and multicomponent interventions which did not report SSB‐specific outcome data. We excluded studies on the taxation of SSB, as these are the subject of a separate Cochrane Review.Data collection and analysisTwo review authors independently screened studies for inclusion, extracted data and assessed the risks of bias of included studies. We classified interventions according to the NOURISHING framework, and synthesised results narratively and conducted meta‐analyses for two outcomes relating to two intervention types. We assessed our confidence in the certainty of effect estimates with the GRADE framework as very low, low, moderate or high, and presented ‘Summary of findings’ tables.Main resultsWe identified 14,488 unique records, and assessed 1030 in full text for eligibility. We found 58 studies meeting our inclusion criteria, including 22 RCTs, 3 NRCTs, 14 CBA studies, and 19 ITS studies, with a total of 1,180,096 participants. The median length of follow‐up was 10 months. The studies included children, teenagers and adults, and were implemented in a variety of settings, including schools, retailing and food service establishments. We judged most studies to be at high or unclear risk of bias in at least one domain, and most studies used non‐randomised designs. The studies examine a broad range of interventions, and we present results for these separately.Labelling interventions (8 studies): We found moderate‐certainty evidence that traffic‐light labelli...

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“Kids Choice” School lunch program increases children's fruit and vegetable acceptance

Cited by 98 publications

References 51 publications

Rewards can be used effectively with repeated exposure to increase liking of vegetables in 4–6-year-old children

Rewards can be used effectively with repeated exposure to increase liking of vegetables in 4–6-year-old children

Simple interventions to improve healthy eating behaviors in the school cafeteria

Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health

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