Positive impact of a pre-school-based nutritional intervention on children's fruit and vegetable intake: results of a cluster-randomized trial

Abstract

Objective: To assess the short-term impact of a nutritional intervention aimed at reducing childhood overweight in German pre-school children. Design: Using a cluster-randomized study design with waiting-list controls, we tested a 6-month intervention administered once weekly by a nutrition expert consisting of joint meal preparation and activities for children and parents such as tasting and preparing nutritious, fresh foods. At baseline, 6 and 12 months, a parent-completed questionnaire assessed fruit and vegetable intakes (primary outcomes) and water and sugared drinks consumption (secondary outcomes). Direct measurement assessed BMI, skinfold thickness and waist-to-height-ratio. An intention-to-treat analysis used random-effects panel regression models to assess the intervention effect, adjusted for each child's age, gender, immigrant background and maternal education. Setting: Eighteen pre-schools from three south German regions. Subjects: Healthy children aged 3-6 years. Results: Three hundred and seventy-seven (80 %) eligible pre-school children participated in the study. Of these, 348 provided sufficient data for analysis. The sample mean age was 4?26 (SD 0?78) years; the majority (53?2 %) were boys. Children's fruit and vegetable intakes increased significantly (P , 0?001 and P , 0?05, respectively); no significant changes in the consumption of water, sugared drinks or anthropometric measurements were noted. Conclusions: Nutritional interventions in pre-schools have the potential to change eating behaviours in young children, which in the long term might reduce risk for developing overweight.

Scottish Primary School Children Who Consume Greater Levels of Fruit and Vegetables Have Improved Health Markers

“…Similar results revealed that waist circumference [73], hip circumference, WHtR and WHR [66] were all negatively associated with increased F & V intake. These effects were not previously reported in studies where these parameters were measured for example in young women aged 18 -28 years [74] or in preschool children 3-6 years old [69]. However, increased in WC, WHR and WHtR was observed with increased fruit intake which was not expected.…”

Current Trends in Childhood Obesity Research

“…Eight publications reported primary outcomes, of which all indicated significantly positive effects on physical activity and/or diet, but findings regarding BMI were mixed: two found decreases [37,38], two found no impact [39,40], and the remaining did not report anthropometric outcomes [41][42][43][44]. For example, the Romp & Chomp intervention in Australia included health education combined with changes to family day care environments and found a decrease in screen time and increase in active play but did not report anthropometric outcomes [41].…”

The impact of fruit and vegetable intake on weight management

“…Based on the inform a tion avail able, 10 studies were considered to have low risk of bias (Chen et al , 2010(Chen et al , , 2011Gow et al , 2010;Kennedy et al , 2009;Kim et al , 2010;LaChausse, 2012;Luszczynska and Haynes, 2009;Østbye et al , 2012;Rosenkranz et al , 2010;Zask et al , 2012), nine had moder ate risk (Bayer et al , 2009;De Bock et al , 2012;Gentile et al , 2009;Gephart and Loman, 2013;Haire-Joshu et al , 2008;Hoffman et al , 2011;NeumarkSztainer et al , 2009;Siegel et al , 2010;van Wier et al , 2009), and six had high risk (Branscum et al , 2013;Foster et al , 2008;French et al , 2010;Spiegel and Foulk, 2006;Taylor et al , 2007;Warren et al , 2003). Nine studies repor ted random iz a tion by a computer, random number tables, or permuted blocks.…”

“…Nineteen of 25 studies repor ted posit ive effects on increas ing fruit and/or veget able consump tion (Bayer et al , 2009;Branscum et al , 2013;Chen et al , 2010Chen et al , , 2011De Bock et al , 2012;French et al , 2010;Gentile et al , 2009;Gephart and Loman, 2013;Haire-Joshu et al , 2008;Hoffman et al , 2011;Kennedy et al , 2009;Kim et al , 2010;LaChausse, 2012;Luszczynska and Haynes, 2009;Østbye et al , 2012;Spiegel and Foulk, 2006;Taylor et al , 2007;Warren et al , 2003;Zask et al , 2012), while five revealed no FV effects (Gow et al , 2010;Neumark-Sztainer et al , 2009;Rosenkranz et al , 2010;Siegel et al , 2010;van Wier et al , 2009). One study detected decreased FV consump tion (Foster et al , 2008).…”

“…Of the 17 chil dren or adoles cent inter ven tions, 70.6% ( n = 12) repor ted posit ive effects on FV consump tion in chil dren (Bayer et al , 2009;Branscum et al , 2013;Chen et al , 2010;De Bock et al , 2012;Gentile et al , 2009;Gephart and Loman, 2013;Hoffman et al , 2011;Spiegel and Foulk, 2006;Taylor et al , 2007;Warren et al , 2003;Zask et al , 2012). Of the 14 inter ven tions with adults, 57.1% ( n = 8) repor ted posit ive effects in adults (French et al , 2010;Gentile et al , 2009;Haire-Joshu et al , 2008;Kennedy et al , 2009;Kim et al , 2010;LaChausse, 2012;Luszczynska and Haynes, 2009;Østbye et al , 2012).…”