Abstract
Dietary behavior change is difficult to accurately measure in a low-income youth population. Objective tools to measure fruit and vegetable consumption without relying on self-report present the opportunity to do this with less respondent burden and bias. A promising tool for quantifying fruit and vegetable consumption via proxy is skin carotenoids as measured by reflection spectroscopy through a device called the Veggie Meter®. To assess whether the Veggie Meter® is able to detect changes in skin carotenoids as a proxy for fruit and vegetable consumption in a low-income school setting, skin carotenoid measurements were collected at three time points, along with student level demographics, anthropometric measurements, and nutrition knowledge. A secondary goal of this study was to refine the protocol to be used based on researcher observations. Repeated measures analysis of variance with Bonferroni correction for multiple comparisons indicate that there was a significant difference in VM scores over the course of the study (F(2, 68) = 6.63, p = 0.002), with an increase in skin carotenoids from Fall 2018 to Spring 2019 (p = 0.005). This increase was sustained over the summer months when measured in Fall 2019. Changes to the protocol included the addition of a hand cleaning step and using the non-dominant ring finger for data collection. With these refinements, the results demonstrate that the Veggie Meter® is usable as a non-invasive tool for measuring fruit and vegetable consumption in a population that is traditionally difficult to assess.
Highlights
This suggests that the Veggie Meter® is sensitive to changes in intake that occur as a result of school-based nutrition education
While dietary intake was only assessed by proxy using the Veggie Meter®, this was by design, as the Veggie Meter® has been previously validated against several different criteria [43], and it was critical to determine if it can be successfully implemented in lowincome schools despite the logistical challenges that accompany working in this setting
Meter® is an appropriate tool for measuring change in fruit and vegetable consumption by proxy in the school setting, especially in a low-income school setting [24,25,26]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. The causes of childhood obesity are multifaceted with poor dietary intake remaining a key contributor. Over the past 20 years, overweight and obesity in children has risen at an alarming rate [1]. Based on serial NHANES surveys from 1999 to 2016, the estimated overall diet quality of US youth showed modest improvement, but more than half of youth still had poor-quality diets [2,3]
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