Effects of a Nutrition Education Program on Intake of Fruits and Vegetables in a Population of Predominantly Hispanic Students in Kindergarten Through Second Grade

Abstract

Objective: To assess the effectiveness of home-based maternal nutrition counseling during the first year of life on the Healthy Eating Index (HEI) of preschool-age children. Design, Setting and Participants: A randomized trial in which 500 mothers and newborns recruited at a maternity hospital in Sao Leopoldo, Brazil, were assigned to an intervention or control groups. Intervention: Dietary counseling was provided during 10 home visits during the first year of life by trained fieldworkers who provided instruction on the Ten Steps for Healthy Feeding Children from birth to 2 years of age (Brazilian Ministry of Health/World Health Organization). OutcomeMeasures andAnalysis: The dietary intake of 345 children was assessed at 3 to 4 years of age, using two 24-hour food recalls on nonconsecutive days. Diet quality was determined with the HEI. c Tests were used to calculate the relative risks between the intervention and HEI. Results: Of the 345 children examined at 3 to 4 years of age, the prevalence of ‘‘poor’’ diet in the intervention group was lower compared with that of the control group (relative risk, 0.30; 95% confidence interval, 0.13-0.71). Moreover, the HEI scores, according to dietary components, were significantly greater in the intervention group for vegetables (P 1⁄4 .005), fruits (P 1⁄4 .010), and variety (P 1⁄4 .018). Conclusions and Implications: Dietary counseling during the first year of life was associated with higher HEI when children were 3 to 4 years of age. This project is funded by the National Council of Scientific and Technological Development–Brazil and Capes Foundation, Ministry of Education (proc. number 2080/09-5).