Does Lowering Fat Intake in Children's Diets Result in Increasing Fruit and Vegetable Intake?: Data from the Child and Adolescent Trial for Cardiovascular Health (CATCH)

Abstract

LEARNING OUTCOME: To describe the impact of CATCH on fruit and vegetable intake among the children in the trial. The Dietary Guidelines for Americans recommends 5 to 9 servings of fruits and vegetables daily for those over 2 years of age. Many school based programs that target fat, saturated fat, and sodium also suggest increasing fruit and vegetable consumption. Whether this message was sufficient to effect a change in fruit and vegetable consumption was examined in a secondary analysis of the Child and Adolescent Trial for Cardiovascular Health (CATCH), a school-based intervention aimed at reducing cardiovascular risk in a cohort of elementary-school children in California, Louisiana, Minnesota and Texas between 1991 and 1994. The nutrition interventions targeted fat, saturated fat, and sodium. Intervention students were exposed to forty-seven 40-minute nutrition lessons and 15 family education packets, which included, but were not specific to, increasing fruit and vegetable consumption. Two of the 30 food service guidelines promoted fruits and vegetables. A subsample of 1186 CATCH students who completed a 24-hour recall both in 3rd grade (baseline) and 5th grade (follow-up) were included in the analysis. School-specific recipe and vendor product information was integrated into the recalls where appropriate. Servings of fruits and vegetables consumed by each child were calculated based on total grams of food; all edible sources of plant tissues were included. There was no difference in the number of servings consumed in 5th grade of fruits and vegetables (2.13 and 1.91, respectively) compared to 3rd grade (2.12 and 1.99, respectively). In both grades, vegetable intake was less than the recommended level. Also, there was no significant difference in fruit or vegetable intake between control and intervention students over time. Only one site, Texas, showed an increase in fruit intake among children receiving the intervention as compared to those who did not; there was no difference in vegetable intake. Although the CATCH intervention lowered fat and saturated fat intake, it did not alter fruit and vegetable consumption. We conclude that both dose and specificity of an intervention appear necessary to achieve behavior change. Our findings suggest that effective nutrition messages should be behavior specific and targeted around specific foods or food groups if they are to be expected to achieve dietary changes.