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2011, Journal of the American Dietetic Association
Despite the health benefits, vegetable intake in youth remains below recommended levels. The purpose of our study was to compare two methods for increasing vegetable consumption. It was hypothesized that participants randomized to both the exposure-only and the pairing condition would increase their vegetable consumption and increase the variety of vegetables consumed. A total of 78 Mexican-American middle school-aged children from a charter school in Houston, TX, were randomized to a pairing condition (nϭ40) or an exposure-only condition (nϭ38) during the Spring 2009 semester. Children in the pairing condition were provided a preferred taste (peanut butter) paired with vegetables weekly at school during a nutrition class for 4 months. Children in the exposureonly condition received vegetables weekly during a nutrition class that covered the same material as the pairing condition. After 4 months, the pairing condition participants demonstrated significant increases in vegetable consumption (Fϭ13.40, PϽ0.001) as well as variety of vegetables eaten (Fϭ13.69, PϽ0.001) when compared to those in the exposure-only condition. The findings of this study suggest that the pairing of vegetables with a preferred taste, such as peanut butter, may be an effective technique in increasing consumption, especially in children who report being resistant to eating vegetables.
Journal of Adolescent Health, 2010
The current epidemic of childhood overweight has launched a variety of school-based efforts to address the issue. This study reports on the first two years of a three year evaluation of one school district's comprehensive intervention to transform school foodservices and dining experiences, offer cooking and gardening programs, and integrate nutrition and food systems concepts into the academic curriculum.
Food Quality and Preference, 2012
This study investigated effects on vegetable liking and intake gained from exposing children to snack vegetables of different liking levels. In total, 345 9-11-year-old children participated. The intervention consisted of two exposure periods. First, children were either exposed to a neutrally liked vegetable (cauliflower), a mixture of a neutrally liked and a liked (sugar snap peas) vegetable, or a mixture of a neutrally liked and a disliked (celery) vegetable. In the second, period all children were served all vegetables. Intake of individual vegetables was measured daily. Liking was assessed before and after exposures and at a subsequent follow-up. Liking for most vegetables decreased during the exposure periods but tended to recover somewhat during follow-up. Intake of all vegetables was either stable or decreased during the intervention, no increases were observed. Intake levels depended on type of vegetable servings: When served with a liked vegetable, children consumed more of a neutrally liked vegetable than when served alone (p = 0.0005) or together with a disliked vegetable (p = 0.005). .dk (A. Olsen).
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Maternal & Child Nutrition, 2013
Salud pública de México, 2014
To characterize the current consumption of fruits and vegetables based on the international recommendations, as well as its relationship to certain variables of interest in Mexican children aged 6 to 12 years. Adherence to the international recommendations for the consumption of fruits and vegetables was estimated based on data from the 2012 National Health and Nutrition Survey (Ensanut 2012). Logistic regression models were developed. Only 34.4% of children met the recommendations. Their age (years) (OR:074; p< 0.01) and the fact that they lived in the Central (OR:2.48; p< 0.01) or Southern (OR:2.66; p< 0.01) regions of Mexico or in Mexico City (OR:2.37; p< 0.01) versus the Northern region were significantly associated with adherence. An interaction was observed between the educational level of the head of the family and his or her kinship with the child. Only 3 out of every 10 Mexican children meet the recommendations; therefore, the implementation of a public policy w...
Journal of the Academy of Nutrition and Dietetics, 2019
Background Intake of vegetables in children remains low. Objective To compare taste exposure (TE), nutrition education (NE) and TEþNE together on intake of an unfamiliar vegetable (mooli/daikon radish) in preschool-aged children. Design Children attending 11 preschools in England were randomly assigned by clusters to four intervention conditions using a 2Â2 factorial design: TE, NE, TEþNE, and no intervention (control). Participants Two hundred nineteen children aged 2 to 5 years participated from September 2016 to June 2017. Intervention The intervention period was 10 weeks preceded and followed by measurements of raw mooli intake as a snack. Preschools were randomized to receive weekly TE at snack time (n¼62 children); NE (n¼68) using the PhunkyFoods program; TEþNE (n¼55) received both weekly taste exposures at snack and lessons from the PhunkyFoods program; and the control condition (n¼34), received NE after the final follow-up measurement. Main outcome measures Individual measured intakes of mooli at Week 1 (baseline), Week 12 (postintervention), and Week 24 and Week 36 (follow-ups). Statistical analysis Differences in intakes were analyzed by cluster. Logistic regressions were conducted to examine odds ratios for intake patterns. Results Data from 140 children with complete mooli intake assessments were analyzed. TE increased intake from 4.7AE1.4 g to 17.0AE2.0 g and this was maintained at both follow-ups. Children assigned to the NE conditions were more likely to eat some of the mooli than children who were not in the NE conditions (odds ratio 6.43, 95% CI 1.5 to 27.8). Combining TE and NE produced no additional benefit to intake beyond TE alone. Conclusions Taste exposures encouraged children to eat more of the unfamiliar vegetable, whereas nutrition education encouraged children who were noneaters to try the vegetable. Both approaches were effective and can be used to produce different outcomes.
Preventive Medicine, 2000
This study evaluated the effects of a school-based dietary intervention program to increase fruit and vegetable consumption among fourth-graders. Twenty-eight elementary schools were randomized to an immediate intervention condition or to a delayed intervention control condition. Measures of diet and psychosocial variables were collected at base line and 1 and 2 years post-baseline. The intervention included classroom, parent, and cafeteria components. Mean daily consumption of fruit and vegetables was higher for the intervention children compared with controls at Follow-up 1 (X(t) = 3.96, X(c) = 2.28) and at Follow-up 2 (X(t) = 3.20, X(c) = 2.21). Macro- and micronutrient changes favoring the intervention children were also observed at both Follow-up 1 and Follow-up 2. Mean daily consumption of fruit and vegetables was higher for intervention parents compared with controls at Follow-up 1 (X(t) = 4.23,X(c) = 3.94) but not at Follow-up 2. Strong effects were found for the High 5 intervention on fruit and vegetable consumption, on macro- and micro-nutrients, and on psychosocial variables. Future work is needed to enhance the intervention effects on parents&amp;amp;#39; consumption and to test the effectiveness of the intervention when delivered by classroom teachers.
International Journal of Child Health and Nutrition, 2013
Introduction: Less than 15% of the 4 to 8-year old children consume the recommended servings of fruit and vegetables (FV). Early years of life play an important role in establishing healthy eating habits. School is an appropriate setting for healthy eating habits interventions. The purpose of this systematic review is evaluation of school-based interventions to improve FV consumption in elementary school students. Methods: In this systematic review, we performed a search in several databases such as PubMed, Web of Science, Education Resources Information Center (ERIC), Science Direct and Google Scholar. Studies published between January 2005 and December 2012 were included. In examining the studies, we focused on design, strategies and outcomes of the interventions. Results: Eleven studies met the inclusion criteria. Interventions in these three classifications (gardening and education, educational programs and providing FV) have positive effects on children's FV intake. Multi-component education is more effective than other cases in children willingness for FV consumption. Gardening strategies: participating in handson gardening experiences, engaging in gardening challenges and preparing a party by student's garden products. Educational strategies: nutrition education classes, electronic learning by using the popular cartoon characters and child actors as symbolic role models and strategies to improve family awareness like series of newsletters for parents and homework tasks for parents and children. Providing strategies: providing fee-based or free FV at school. Conclusion: Long-term multi-component (gardening, education and providing FV) interventions with the application of behavioral change theories and models are effective to reach the expected results.
Health Education Research, 2000
Children's fruit, juice and vegetable (FJV) and Children's fruit, juice and vegetable (FJV) and fat intakes do not meet recommended national fat intakes do not meet recommended guidelines. guidelines (Patterson et al., 1990; Devaney et al., Since personal factors account for only a small 1993; Domel et al., 1994), and are risk factors for percentage of the variability in children's FJV the development of chronic diseases (US Departconsumption, social and environmental influment of Health and Human Services, 1988). Less ences were explored via focus group discussions than 20% of youth eat the recommended goal of with Grade 4-6 African-, Euro-and Mexican-5 servings per day and mean intakes of 1.5-2.5 American students and parents. Questions servings of FJV per day have been reported for included the effects of social influences, availab-US children (Murphy et al., 1990; Domel et al., ility and accessibility on children's FJV and 1994). Similar data on low-fat food consumption low-fat food choices. Few ethnic differences are not available. were noted. A variety of low-fat items and fresh Since there is a belief that child lifestyle FJV (not cut-up) were available at home; older behaviors are likely to become adult lifestyle children were expected to prepare their own. behaviors (Kelder et al., 1994) and that behaviors Eating out occurred at least twice a week; FJV are more malleable among children (Singer et al., were not usual restaurant choices. Students 1995), dietary behavior change programs for chilreported some modeling by parents (more dren are needed. Understanding the influences mothers) and friends (usually at lunch). Negaon children's diet will lead to more effective tive peer responses for eating vegetables were intervention programs (Baranowski, 1997). reported. Parents were concerned with children Eating FJV and low-fat foods must be undereating too much junk food and not enough FJV, stood in the context of relevant behavioral theory. recognized the outside influences their children Social Cognitive Theory and its principle of recipreceived about food, and reported several rocal determinism propose that behavior, the envirmethods to encourage children to eat FJV. onment and personal factors interact in constant Recommendations for future interventions are reciprocal relationships (Bandura, 1986). Two proposed. recently published studies (Domel et al., 1996; Resnicow et al., 1997a) revealed that among a battery of social cognitive personal characteristics, Children's Nutrition Research Center, Department of including self-efficacy (the confidence one has to Pediatrics, Baylor College of Medicine, 1100 Bates, perform a specific task), FJV preferences and Houston, TX 77030, 1 Department of Behavioral Science, outcome expectations, only FJV preferences was University of Texas M. D. Anderson Cancer Center, the dominant predictor of children's FJV consump-Houston, TX 77030 and
Appetite
Children's vegetable consumption in the UK remains lower than national recommendations, presenting potential longterm health risks. It is known that repeated exposure promotes intake of novel vegetables and that offering children variety and choice can also encourage intake. The current study aimed to compare the impact of offering variety over simple repeated exposure as a strategy for increasing preschool children's vegetable consumption. Children (N=95) aged 24 to 55 months were recruited through participating nurseries and assigned to receive repeated exposure (RE) to a single vegetable snack or a mixed snack consisting of five different vegetables (variety: V). A minimum of 5 (maximium 6) exposures were given for both RE and V conditions. Pre and post-intervention intake measures of both the RE and V snacks were taken for each child. Follow up measures took place 1 month post-intervention (n=40). Vegetable intake increased significantly from pre to post intervention for snacks congruent to the condition to which children were assigned. Magnitude of change was smaller for the variety condition. Follow up data revealed that snack intake remained significantly higher than baseline 1 month post-intervention (p<0.001). In agreement with previous work this study confirmed that repeated exposure was effective in promoting children's vegetable intake but there was no additional benefit of variety in this context. It may be that for moderately familiar vegetables, serving them alone encourages intake and for this age group, avoids contamination fears or effects of neophobia.
The Journal of school health, 2017
Vegetable consumption is a challenging behavioral target; consumption rates are below recommended levels and when interventions produce improvements, increases in vegetable consumption are typically a fraction of the change in fruit consumption. We describe vegetable consumption within Ohio school meals and examine how fruit selection, the more popular item, impacts vegetable consumption. Fruit and vegetable waste was collected on 11,250 trays from 17 elementary and 16 middle/high schools, using the quarter-waste visualization method. One in 4 students ate at least a one-fourth of a cup of vegetables with their school lunch. Consumption was the highest (30.8%) in elementary school buildings with a majority of regular priced meals. Fruit selection was associated with vegetable consumption (p < .001). Middle/high school students who consumed a fruit were 88% more likely to consume a vegetable as oppose to waste it (95% CI: 1.45-2.42). Fruit selection was also associated with not se...
Appetite, 2003
Despite considerable epidemiological evidence of the health benefits of a diet high in fruit and vegetables, consumption in pre-school children remains well below recommended levels. This study evaluated the effectiveness of an exposure-based intervention, carried out by parents in the home, in increasing children's liking for a previously disliked vegetable. 156 parents of 2 -6 year old children were randomly assigned to Exposure, Information or Control groups after a pre-intervention taste test at which a 'target' vegetable was selected. Parents in the Exposure group gave their child a taste of this vegetable daily for 14 days, parents in the Information group were given nutritional advice and a leaflet, and parents in the Control group received no further intervention. All participants took part in a post-intervention taste test. Greater increases in liking, ranking and consumption of the 'target' vegetable from pre-to post-intervention occurred in the Exposure group than in either of the other two groups. Only the Exposure group showed significant increases across all three outcomes. It can be concluded that a parent-led, exposure-based intervention involving daily tasting of a vegetable holds promise for improving children's acceptance of vegetables. These findings suggest a parental advice strategy which could be disseminated directly to parents or by health professionals. q
ACR North American Advances, 2012
Appetite, 2015
Children's vegetable consumption is still far below that recommended, and stimulating their intake is a challenge for caregivers. The objective of this study was to investigate whether choice-offering is an effective strategy to increase children's vegetable intake in an in-home situation. Seventy children (mean age 3.7; SD 1) randomly assigned to a choice or a no-choice condition, were exposed 12 times to six familiar target vegetables at home during dinner. In the choice group, two selected vegetables were offered each time, whereas the no-choice group only received one vegetable. Vegetable intake was measured by weighing children's plates before and after dinner. A mixed linear model with age, gender, and baseline vegetable liking as covariates was used to compare intake between the choice and the no-choice group. Mixed linear model analysis yielded estimated means for vegetable intake of 48.5g +/- 30 in the no-choice group and 57.7 g +/- 31 for the choice group (P = ...
Public Health Nutrition
Objective: To examine demographic and dietary correlates of consumption of a variety of fruits and vegetables (FV) among Texas adolescents. Different types of FV are needed for adequate dietary intake of vitamins and phytochemicals for proper development and functioning throughout the lifespan. Design: Cross-sectional analysis from the Texas Surveillance of Physical Activity and Nutrition (Texas SPAN) data comparing consumption of a variety of fruit and vegetables by gender, race/ethnicity, and region (Texas-Mexico border/non-border). Setting: Middle, high schools in Texas Participants: 8th, 11th grade Texas adolescents (n=9,056 representing N=659,288) mean age 14.8 years. Results: Within this sample, mean fruit and vegetable variety scores (0-7) ranged from 2.47-2.65. Boys consumed a significantly greater variety of fruit than girls (m=1.12 compared to 1.04). Adolescents in non-border regions consumed a greater variety of vegetables and FV compared to those in border regions. FV va...
Journal of the Academy of Nutrition and Dietetics, 2012
URING THE LAST 2 DECADES, OBESITY RATES among children in the United States have reached alarming levels, 1 recently prompting the formation of the first-ever federal task force to address this epidemic. 2 Pediatric obesity is associated with an increased occurrence of childhood cardiovascular disease risk factors, type 2 diabetes mellitus, asthma, and psychological or psychiatric problems, 3-5 and is likely to persist into adulthood. 6,7 Substantial racial and ethnic disparities in obesity prevalence exist among US children and adolescents, with prevalence higher among Mexican-American adolescents than in their non-Hispanic white counterparts. 1 In Los Angeles, CA, the prevalence of obesity in children varies markedly by ethnic/racial group, with adolescent Latinos having among the highest rates (27% in 2007). 8 Low intakes of dietary fiber, specifically fruits and vegetables (FV), coupled with high consumption of refined grains and added sugar 9-11 have previously been shown to be linked to obesity and related disorders in Latino youth age 8 to 18 years in Los Angeles, providing a rationale for targeting specific dietary components in nutrition interventions. Dietary habits and food preferences are shaped when children are young, 12 and children's tastes for vegetables are strong predictors of vegetable consumption. 13,14 Studies sug
Annals of Nutrition and Metabolism, 2013
There has been an urgency to initiate chronic disease prevention interventions to mitigate the substantial health consequences Key insights Diet is a key factor that can influence the prevalence of chronic diseases such as cardiovascular disease, diabetes, obesity, and cancers. Amongst dietary influences, fruit and vegetable intake plays a strategic role in modulating the etiology and prevention of these disorders. This, however, is affected by a complex web of sociobiological factors, including genetics, family eating habits, education, and immediate environment. Current knowledge The preferences and habits for fruit and vegetable intake are formed in early life, suggesting that any attempts to intervene in this process should make children the primary target. Several parameters may influence fruit and vegetable intake, including family dietary habits, the neighborhood food environment, and biological variables. The challenge, however, lies in implementing effective interventions to increase fruit and vegetable intake in the context of these sociobiological factors. To date, many of the individual and family-based interventions have not been successful. Practical implications The use of highly innovative approaches may provide effective means of changing dietary behaviors early in life. Incorporating internet programs and video games alongside social activity programs have yielded promising results so far in increasing fruit and vegetable consumption amongst school-aged children. However, several challenges remain, namely, how to maintain
How children rate vegetables may be influenced by the preparation method. The primary objective of this study was for first grade students to be involved in a cooking demonstration and to taste and rate vegetables raw and cooked. First grade children of two classes (N= 52: 18 boys and 34 girls (approximately half Hispanic) that had assented and had signed parental consent participated in the study. The degree of liking a particular vegetable was recorded by the students using a hedonic scale of five commonly eaten vegetables tasted first raw (pre-demonstration) and then cooked (post-demonstration). A food habit questionnaire was filled out by parents to evaluate their mealtime practices and beliefs about their child's eating habits. Paired sample t-tests revealed significant differences in preferences for vegetables in their raw and cooked states. Several mealtime characteristics were significantly associated with children's vegetable preferences. Parents who reported being ...
Current Developments in Nutrition, 2020
Background Cooking interventions have been linked to reductions in obesity and improvements in dietary intake in children. Objective To assess whether child cooking involvement (CCI) was associated with fruit intake (FI), vegetable intake (VI), vegetable preference (VP), and vegetable exposure (VE) in children participating in the Texas, Grow! Eat! Go! (TGEG) randomized controlled trial. Methods Baseline data from TGEG included 1,231 3rd grade students and their parents. Conducted in 28 low-income, primarily Hispanic schools across Texas, TGEG schools were assigned to: (1) Coordinated School Health (CSH) only (control group), (2) CSH plus gardening and nutrition intervention (Learn! Grow! Eat! Go! or LGEG group), (3) CSH plus physical activity intervention (Walk Across Texas or WAT group), and (4) CSH plus LGEG plus WAT (combined group). Height, weight, dietary intake, VE, VP, and CCI were collected at baseline and post-intervention. Linear regressions were used to assess the relati...
The international journal of behavioral nutrition and physical activity, 2011
Background: Fruit and vegetable (FV) intake in children in the Netherlands is much lower than recommended. Recurrent appraisal of intake levels is important for detecting changes in intake over time and to inform future interventions and policies. The aim of the present study was to investigate differences in fruit and vegetable intake, and whether these could be explained by differences in potential determinants of FV intake in 11-year-old Dutch schoolchildren, by comparing two school samples assessed in 2003 and 2009. Methods: For 1105 children of the Pro Children study in 2003 and 577 children of the Pro Greens study in 2009 complete data on intake and behavioural determinants were available. The self-administered questionnaire included questions on children's ethnicity, usual fruit and vegetable intake, mother's educational level, and important potential determinants of fruit and vegetable intake. Multiple regression analysis was applied to test for differences in intake and determinants between study samples. Mediation analyses were used to investigate whether the potential mediators explained the differences in intake between the two samples. Results: In 2009, more children complied with the World Health Organization recommendation of 400 g fruit and vegetables per day (17.0%) than in 2003 (11.8%, p = 0.004). Fruit consumption was significantly higher in the sample of 2009 than in the sample of 2003 (difference = 23.8 (95%CI: 8.1; 39.5) grams/day). This difference was mainly explained by a difference in the parental demand regarding their child's intake (23.6%), followed by the child's knowledge of the fruit recommendation (14.2%) and parental facilitation of consumption (18.5%). Vegetable intake was lower in the 2009 sample than in the 2003 sample (12.3 (95%CI -21.0; -3.6). This difference could not be explained by the assessed mediators.
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