Reducing Young Schoolchildren’s Intake of Sugar-Rich Food and Drinks: Study Protocol and Intervention Design for “Are You Too Sweet?” A Multicomponent 3.5-Month Cluster Randomised Family-Based Intervention Study

Abstract

A high consumption of sugar-rich discretionary food and drinks has several health implications, which have been traced from childhood into adulthood. Parents act as primary mediators shaping children’s dietary habits, and interventions that engage parents have shown to result in positive outcomes. Further, collaboration with local school health nurses and dentists provides an effective structural frame to support behaviour change and anchor new initiatives. The multicomponent 3.5-month cluster randomised family-focused intervention “Are you too Sweet?” aims to evaluate the effectiveness of communicating new Danish guidelines for sugar-rich discretionary food and drinks for school starters (5–7 years). This paper describes the development, outcomes and process evaluation of the intervention that includes three main components: extended dialogue during a school health nurse consultation, a box with home-use materials, and a social media platform to facilitate interaction among participants. Children (n = 160) and their parents were scheduled for a baseline interview at six different schools. The intervention was developed to increase self-efficacy, knowledge about guidelines, observational learning and reduce impediments for behavioural change. The desired primary outcome was a reduction in intake of sugar-rich food measured through a 7-day dietary record. The results contribute to the evidence on effective health promotion strategies.

Knowledge and Practices Regarding Oral Hygiene Among School Children: A Survey Based Study

“…16,17 In this study the uses of the fruits, biscuits, lemonade and coca cola, sugar, tea and chew gum was found to be frequent while use of the honey was very lower. Similar findings were made by Mishra A. et al 18 in their research, which showed that youngsters consumed more sugar on a daily basis from cakes, creams, sweets, and candies than from fruits. Two factors may be used to explain this rise in the consumption of carbohydrates: first, they are readily available to the general public in the form of processed food, and children are drawn to them by their appealing look and marketing.…”

“…Children fill up on sweets and other sugary foods when they aren't eating during their free time. 18,20 In this study betel nut use was high but it was not found habitual. However, According to a cross-sectional survey conducted in Taiwan, 50% of primary school children in indigenous areas have chewing tobacco, including 30.1% who chew habitually 21 .…”

“…Two factors may be used to explain this rise in the consumption of carbohydrates: first, they are readily available to the general public in the form of processed food, and children are drawn to them by their appealing look and marketing. 18,19 The parents' jobs might be another factor in their excessive consumption of packaged foods and sugary drinks. Kids who have both parents employed, rely mostly on prepared foods since they are quick and simple to prepare.…”

Comparison of Discretionary Food and Drink Intake Based on a Short Web-Based Sugar-Rich Food Screener and a Validated Web-Based 7-Day Dietary Record

“…At the beginning of the intervention study 160 families signed up. The details of the study have been described in the study protocol [ 15 ]. In total, 95 children, i.e., the intervention group of project “Are you to sweet” were included in this study.…”

Development of a Food Frequency Questionnaire for Assessing Habitual Intake of Free Sugar Among Children in Saudi Arabia

“…Another area of concern is that dietary behaviors in childhood may persist into adulthood (18). As such, intervention studies have been devoted to investigate how to promote healthy food choices and dietary habits and limit FS intake effectively among children (19)(20)(21). In Saudi Arabia and the Middle East, data regarding intake of FS are lacking.…”