Results from an experimental trial at a Head Start center to evaluate two meal service approaches to increase fruit and vegetable intake of preschool aged children

Lisa J Harnack,J Michael Oakes,Simone A French,Farhiyah M Farah,Gretchen L Taylor,Sarah A Rydell

doi:10.1186/1479-5868-9-51

Abstract

BackgroundStrategies to increase fruit and vegetable consumption of preschool aged children are needed.ObjectivesEvaluate the independent effects of the following meal service strategies on intake of fruits and vegetables of preschool children: 1.) Serving fruits and vegetables in advance of other menu items as part of traditional family style meal service; and 2.) Serving meals portioned and plated by providers.MethodsFifty-three preschool aged children completed a randomized crossover experiment conducted at a Head Start center in Minneapolis, MN. Over a six week trial period each of the experimental meal service strategies (serving fruits and vegetable first and serving meals portioned by providers) was implemented during lunch service for two one-week periods. Two one-week control periods (traditional family style meal service with all menu items served at once) were also included over the six week trial period. Childrens lunch intake was observed as a measure of food and nutrient intake during each experimental condition.ResultsFruit intake was significantly higher (p<0.01) when fruits and vegetables were served in advance of other meal items (0.40 servings/meal) compared to the traditional family style meal service control condition when they were served in tandem with other menu items (0.32 servings/meal). Intakes of some nutrients found in fruits (vitamin A and folate) were concomitantly higher. In contrast, fruit and vegetable intakes were significantly lower and energy intake significantly higher during the provider portioned compared with control condition.ConclusionsServing fruits in advance of other meal items may be a low cost easy to implement strategy for increasing fruit intake in young children. However, serving vegetables first does not appear to increase vegetable intake. Results provide support for current recommendations for traditional family style meal service in preschool settings.

Highlights

Strategies to increase fruit and vegetable consumption of preschool aged children are needed
Fruit and vegetable consumption is below recommended levels for a notable proportion of preschool-aged children in the United States, with 31.5% and 80.3% consuming less than recommended amounts of fruits and vegetables respectively [1]
Children’s tendency to prefer the taste of more energy dense foods such as tater tots and chicken fingers over less energy dense foods such as fruits and non-starchy vegetables may result in the selfselection of meals that lead to over-consumption of energy

Summary

Introduction

Strategies to increase fruit and vegetable consumption of preschool aged children are needed. Encouraging consumption of these types of foods may be difficult when they are served alongside foods that contain sweet, fatty, or salty flavors. Traditional family style meal service is the recommended approach to serving meals in preschool settings [5,6,7,8]. Using this approach, all foods on the menu are served at the same time in serving bowls that are passed around the table, and children self-serve the amounts they desire. There are a number of potential advantages to traditional family-style meal service including allowing children the opportunity to self-regulate consumption (match food selection with hunger level). Children’s tendency to prefer the taste of more energy dense foods such as tater tots and chicken fingers over less energy dense foods such as fruits and non-starchy vegetables may result in the selfselection of meals that lead to over-consumption of energy

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