Abstract
Childhood eating behaviours can track into adulthood. Therefore, programmes that support early healthy eating, including school-based nutrition education programmes, are important. Although school-based programmes may be beneficial in improving nutrition knowledge, impact on actual fruit and vegetable (FV) intake is generally limited as FV intake is also influenced by the home environment. The current study includes secondary analyses of data from an evaluation study on Dutch nutrition education and examined the role of caregivers’ health promotion behaviours (HPB) in influencing healthy eating behaviours in primary school children (n = 1460, aged 7–12 years) and whether caregivers’ HPB contribute to programme effectiveness. Children’s nutrition knowledge, FV intake and caregivers’ HPB (FV/sugar-sweetened beverages/sweets provision to take to school, cooking together and talking about healthy food at home) were measured by child-reported questionnaires at baseline, during, and 6 months post-programme. Results indicated that caregivers’ HPB was positively associated with children’s healthy eating behaviours and that programme effectiveness was highest in those in the lower HPB subcategory. In conclusion, children with less encouragement to eat healthily at home potentially benefit more from school-based nutrition education programmes than children receiving more encouragement. This highlights the important role of the home environment in supporting healthy eating behaviour in children.
Highlights
It is important to optimise eating patterns in early life since eating behaviours that develop during childhood are likely to track into adulthood [1]
The current study aimed to address the following research questions: (1) what is the association between active health promotion behaviour of caregivers within the home environment and children’s fruit and vegetable (FV) consumption and nutrition knowledge? and (2) what is the contribution of active health promotion behaviour of caregivers to the effects of nutrition education programmes on children’s FV intake?
In line with the results of ‘helping with cooking’, more than half of the children reported they sometimes talk about healthy food with their caregivers at home (54%), and the ‘yes’ and ‘no’ answers for this item were relatively equal indicated by the children
Summary
It is important to optimise eating patterns in early life since eating behaviours that develop during childhood are likely to track into adulthood [1]. Higher fruit and vegetable (FV) intake as a component of healthy eating habits helps to lower the risk for obesity, cardiovascular disease and certain types of cancer [2]. Nutrition education programmes targeting children are expedient, with the promotion of FV intake through nutrition and health policies recommended [3]. Schools are an ideal setting for the promotion of healthy eating since children from various socioeconomic backgrounds can be reached [4]. Worldwide many schoolbased nutrition education programmes are developed and evaluated. A systematic review by Evans et al (2012) found that such school-based interventions only moderately improve children’s fruit intake (mean improvement of 0.24 portions, 95% CI: 0.05, 0.43 portions) and often fail to increase children’s vegetable intake (mean improvement of 0.07 portions, 95% CI: −0.03, 0.16 portions) [5]
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