Abstract

A high consumption of sugar-rich discretionary food and drinks has several health implications, which have been traced from childhood into adulthood. Parents act as primary mediators shaping children’s dietary habits, and interventions that engage parents have shown to result in positive outcomes. Further, collaboration with local school health nurses and dentists provides an effective structural frame to support behaviour change and anchor new initiatives. The multicomponent 3.5-month cluster randomised family-focused intervention “Are you too Sweet?” aims to evaluate the effectiveness of communicating new Danish guidelines for sugar-rich discretionary food and drinks for school starters (5–7 years). This paper describes the development, outcomes and process evaluation of the intervention that includes three main components: extended dialogue during a school health nurse consultation, a box with home-use materials, and a social media platform to facilitate interaction among participants. Children (n = 160) and their parents were scheduled for a baseline interview at six different schools. The intervention was developed to increase self-efficacy, knowledge about guidelines, observational learning and reduce impediments for behavioural change. The desired primary outcome was a reduction in intake of sugar-rich food measured through a 7-day dietary record. The results contribute to the evidence on effective health promotion strategies.

Highlights

  • A high intake of sugar-rich food and sugar-sweetened beverages (SSB) in children has several health implications

  • This paper describes the development of the components and the study protocol of the multicomponent family-based “real-life” cluster-randomised intervention “Are you to Sweet?” evaluating the feasibility and effectiveness of different strategies for changing the family sugar culture and reducing the intake of sugar-rich discretionary food and drinks among young schoolchildren aged 5–7 years

  • Calculations determined that 76 participants will be needed in both intervention and control groups to detect a 25% reduction in the intake of sugar-rich discretionary foods at a power of

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Summary

Introduction

A high intake of sugar-rich food and sugar-sweetened beverages (SSB) in children has several health implications. A Swedish cross-sectional study among adults suggested that the higher the intake of added sugar in the diet, the more likely it is that the intake of micronutrients will be compromised [7]. Studies from both Denmark and Norway have shown lower intake of dietary fibre, vitamin E, vitamin D, and iron in children with the highest sugar intake compared with children with the lowest intake [8,9]. Public Health 2020, 17, 9580; doi:10.3390/ijerph17249580 www.mdpi.com/journal/ijerph

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