Intake In Preschool Children Research Articles

Longitudinal associations between food parenting practices and dietary intake in preschool children: The ToyBox Study

IntroductionFood Parenting Practices (FPPs) include the practices parents use in the act of feeding their children, which may further influence their health. ObjectivesTo assess associations between changes in FPPs (permissiveness, food availability, guided choices, water encouragement, rules and limits and the use of food as reward) over 1 year and dietary intake (water, energy-dense/nutrient-poor and nutrient-dense foods) at follow-up in 4- to 6-year-old preschool-aged children. MethodsLongitudinal data from the control group of the ToyBox study, a cluster-randomized controlled intervention study, was used (NCT02116296). Multilevel ordinal logistic regression analyses including FPP as the independent variables and dietary intake as outcome. ResultsNine hundred sixty-four parent-child dyads (50.5% boys and 95.0% mothers) were included. Limited changes on the use of FPPs were observed over time. Nevertheless, in boys, often having F&V at home was associated with higher F&V consumption (OR = 6.92 [1.58; 30.38]), and increasing home availability of F&V was directly associated with higher water consumption (OR = 7.62 [1.63; 35.62]). Also, not having sweets or salty snacks available at home was associated with lower consumption of desserts (OR = 4.34 [1.75; 10.75]). In girls, having F&V availability was associated with higher F&V consumption (OR = 6.72 [1.52; 29.70]) and lower salty snack consumption (OR = 3.26 [1.50; 7.10]) and never having soft drinks at home was associated with lower consumption of sweets (OR = 7.89 [6.32; 9.86]). Also, never being permissive about soft drink consumption was associated with lower soft drink consumption (OR = 4.09 [2.44; 6.85]). ConclusionUsing favorable FPPs and avoiding the negative ones is prospectively associated with healthier dietary intake, especially of F&V, and less intake of soft drinks, desserts, and salty snacks.

Effects of Cucurbita Moschata squash (Butternut) seed paste in improving zinc and iron status in children attending Early Childhood Development centres in Limpopo province, South Africa.

Cucurbita moschata (Butternut squash) seeds are a rich source of nutrition containing nutrients including iron, zinc, copper, calcium, potassium, and phosphorus. The aim of this study was to determine if Cucurbita Moschata squash seed paste improves zinc and iron status, anthropometric status, and dietary intake in preschool children. A pretest-posttest control group trial using cluster randomisation was conducted over 6 months. Four preschools were randomly assigned to receive 100 g of intervention or 100 g of a placebo as the control to enhance iron and zinc status. A total of 276 preschool children were recruited from eight government registered Early Childhood Development centres in Limpopo province, South Africa. The control group consumed Cucurbita moschata flesh twice-weekly, while the intervention group consumed Cucurbita moschata seed paste twice-weekly during a six-month period. Iron (serum iron, transferrin, transferrin saturation, ferritin) and zinc (serum zinc) status and anthropometric indices such as weight, height and mid upper arm circumference for children were evaluated at baseline and the endpoint. Iron and zinc-rich food consumption was measured using a 24-hour dietary recall and food record during the study, and dietary intake was estimated using a food frequency questionnaire which was conducted at the beginning and endpoint. The intervention group significantly improved in the mean serum iron 0.23 μg/dL (95% CI: 0.11;0.33); ferritin 0.21μg/dL (95% CI: 0.13;0.39), transferrin saturation 0.33% (0.23;0.74) and zinc 0.16 μmol/dl (95% CI: 0.13;0.25) at the end of the study. In addition, the intervention group exhibited greater mean weight for age of 0.13 z-score (95% CI: 0.28; 0.34) and weight for height of 0.04 z-score (95% CI: 0.12,0.05), as well as the consumption of iron (p < 0,001), zinc (p < 0,001), and vitamin C (p < 0.001). At the end of the trial, fiber (p < 0.001), riboflavin (p = 0.001), vitamin B6 (p < 0.001), and vitamin B12 (p < 0.001) were significantly higher in the control group. Thus, the inclusion of intervention in the diet of children in an impoverished area of South Africa improved the iron and zinc status of these children. This supplement could be a cost effective and sustainable approach to improve nutrient status in rural South Africa. Trial registration: Pan African Clinical Trial Registry (PACTR202308740458863).

Dietary Sodium and Potassium Intake: Data from the Mexican National Health and Nutrition Survey 2016.

Population studies have demonstrated an association between sodium and potassium intake and blood pressure levels and lipids. The aim of this study was to describe the dietary intake and contribution of sodium and potassium to the Mexican diet, and to describe its association with nutrition status and clinical characteristics. We analyzed a national survey with 4219 participants. Dietary information was obtained with a 24-h recall. Foods and beverages were classified according to level of processing. The mean intake (mg/d) of Na was 1512 in preschool children, 2844 in school-age children, 3743 in adolescents, and 3132 in adults. The mean intake (mg/d) of K was 1616 in preschool children, 2256 in school-age children, 2967 in adolescents, and 3401 in adults. Processed and ultra-processed foods (UPF) contribute 49% of Na intake in preschool children, 50% in school-age children, 47% in adolescents, and 39% in adults. Adults with high Na intake had lower serum concentrations of cholesterol, HDL-c, and LDL-c. A significant proportion of the Mexican population has a high intake of Na (64–82%) and low K (58–73%). Strategies to reduce Na and increase K intake need to reduce the possibility of having high BP and serum lipid disturbances.

Promoting vegetable intake in preschool children: Independent and combined effects of portion size and flavor enhancement

This study investigated the independent and combined effects on preschool children's vegetable intake of serving a larger portion of vegetables and enhancing their flavor. In a crossover design, lunch was served in childcare centers once a week for four weeks to 67 children aged 3–5 y (26 boys, 41 girls). The meal consisted of two familiar vegetables (broccoli and corn) served with fish sticks, rice, ketchup, applesauce, and milk. Across the four meals, we varied the portion of vegetables (60 or 120 g total weight, served as equal weights of broccoli and corn) and served them either plain or enhanced (6.6% light butter and 0.5% salt by weight). All meals were consumed ad libitum and were weighed to determine intake. Doubling the portion of vegetables led to greater consumption of both broccoli and corn (both p < 0.0001) and increased meal vegetable intake by 68% (mean ± SEM 21 ± 3 g). Enhancing vegetables with butter and salt, however, did not influence their intake (p = 0.13), nor did flavor enhancement modify the effect of portion size on intake (p = 0.10). Intake of other meal components did not change when the vegetable portion was doubled (p = 0.57); thus, for the entire meal, the increase in vegetable consumption led to a 5% increase in energy intake (13 ± 5 kcal; p = 0.02). Ratings indicated that children had similar liking for the plain and enhanced versions of each vegetable (both p > 0.31). All versions of vegetables were well-liked, as indicated by ≥ 76% of the children rating them as “yummy” or “just okay”. Serving a larger portion of vegetables at a meal was an effective strategy to promote vegetable intake in children, but when well-liked vegetables were served, adding butter and salt was not necessary to increase consumption.

Examining Chile's unique food marketing policy: TV advertising and dietary intake in preschool children, a pre- and post- policy study

Examining Chile's unique food marketing policy: TV advertising and dietary intake in preschool children, a pre- and post- policy study

Rural and Urban Differences in Household Food Insecurity and Diet Diversity of Preschool Children (PSC) in Occidental Mindoro

Objective. Rural and urban differences affect food availability, accessibility, and sustainability; thus, it has a greatimpact on household food security and dietary diversity. The relationship between the human environment andother factors threatens different domains of food systems resulting in food security. The objective of this study isto determine significant differences between the prevalence of household food security and diet diversity betweenurban and rural communities in Occidental Mindoro. Specifically, to determine the pattern of usual food intake ofpreschool children between rural and urban communities&#x0D; Methods. This study utilized a comparative, cross-sectional, analytic study design in order to determine theprevalence of each variable of interest in the two study areas. Radimer-Cornell Tool was utilized to assess the foodsecurity status of the household while the FAO-Dietary Diversity Score Questionnaire was used to the diversityof diet among PSC. A total of 480 (rural: n=240; urban: n=240) preschool children were recruited to participatein this study. Ratio and proportion using the point and interval estimate were used to determine the prevalencein different areas, meanwhile, chi-square of homogeneity was used to determine significant difference in the twoareas under study.&#x0D; Results. Food insecurity in rural communities was found to be at 56.25% (95% CI: 49.97% to 62.53%) while theprevalence in urban communities was 45.83% (95% CI: 39.53% to 52.14%). There was a significant differencein the prevalence of household food insecurity between rural and urban communities (p=0.0224). Meanwhile,the prevalence of less dietary diversity among preschool children in rural communities was 37.08% (95%: 30.97%to 43.19%) and 26.25% (CI: 20.68% to 31.82%) for urban communities. There was a significant differencein prevalence of low dietary diversity score among preschool children between rural and urban communities(p=0.0107).&#x0D; Conclusion. There were significant differences in terms of household food insecurity and less diverse dietbetween two community settings. Higher prevalence in rural areas signifies that there is a need to prioritize thesevulnerable communities in terms of hunger mitigation and nutrition programs. A combination of milk-rice-meat-fishwas observed in the diet of preschool children for both communities however, higher prevalence of less dietarydiversity was detected among rural communities.

Examining Chile's unique food marketing policy: TV advertising and dietary intake in preschool children, a pre- and post- policy study.

The Chilean government implemented the first phase of a comprehensive marketing policy in 2016, restricting child-directed marketing of products high in energy, total sugars, sodium or saturated fat (hereafter "high-in"). To examine the role that high-in TV food advertising had in the effect of the policy on consumption of high-in products between 2016 and 2017. Dietary data were obtained from 24-hour diet recall measured in 2016 (n = 940) and 2017 (n = 853), pre- and post-policy, from a cohort of 4 to 6 years children. Television use was linked to analyses of food advertisements to derive individual-level estimates of exposure to advertising. A multilevel mediation analysis examined direct and indirect effects of the policy through advertising exposure. Children's high-in food consumption and advertising exposure declined significantly from 2016 to 2017 (P < .01). Consumption changes were not significantly mediated by changes in advertising exposure, which might suggest other elements of the Chilean Law potentially driving decreases in consumption to a greater extent than TV ads. Preschoolers' exposure to high-in advertising and consumption of high-in products decreased post-policy. Further research is needed to understand how marketing changes will relate to dietary changes after full implementation of the law and in the long term.

Promoting Vegetable Intake in Preschool Children: Does Enhancing the Taste of Vegetables Influence the Portion Size Effect?

Abstract Objectives To meet dietary guidelines, effective strategies are needed to encourage children to eat a greater proportion of their diet from vegetables. We tested whether serving a larger portion, enhancing the taste with small amounts of butter and salt, or combining these strategies would increase vegetable intake at a meal for preschool children. Methods Using a crossover design in childcare centers, we served lunch once a week for four weeks to 67 children aged 3–5 y (61% girls; 16% with overweight or obesity). The meal consisted of two familiar vegetables (broccoli and corn) along with fish sticks, rice, ketchup, applesauce, and milk. Across the four meals, we varied the portion of vegetables (60 or 120 g total weight) and served them either plain or enhanced (0.5% salt and 6.6% light butter by weight). The other items in the meal were not varied. All meals were consumed ad libitum and weighed to determine intake. At the end of the study, children rated their liking for the foods and parents completed questionnaires about their child's eating behavior. Results Doubling the portions of vegetables led to greater consumption of both broccoli and corn (P &amp;lt; 0.0001) and increased total vegetable intake by 68% (mean ± SEM 21 ± 3 g). Enhancing vegetables with butter and salt, however, did not influence their intake (P = 0.13) nor modify the effect of larger portions on their intake (P = 0.10). Serving more vegetables did not affect intake of the other meal components (P = 0.57), thus meal energy intake increased by 13 ± 5 kcal (5%; P = 0.02). Ratings indicated that children had similar liking for the plain and enhanced versions of both broccoli (P = 0.31) and corn (P = 0.97). Although 73% of children rated one or both plain vegetables as yummy or just okay, they ranked their preference for the other foods in the meal higher than for the vegetables (P &amp;lt; 0.0001). Children differed in their response to larger portions of vegetables: those with higher scores for food fussiness and parental pressure to eat had smaller increases in vegetable intake when portions were doubled (both P &amp;lt; 0.03). Conclusions Serving larger portions of vegetables at a meal was an effective strategy to promote vegetable intake in children. When familiar, well-liked vegetables were served, adding butter and salt was not necessary to increase vegetable consumption. Funding Sources National Institute of Diabetes and Digestive and Kidney Diseases.

Dietary Contributors to Food Group Intake in Preschool Children Attending Family Childcare Homes

Abstract Objectives To identify and describe the food sources that contribute to food group intake in preschool children attending family childcare homes (FCCH) in Rhode Island and to examine differences by provider ethnicity. Methods Baseline data (n = 120 FCCH and n = 370 children) from Healthy Start, an ongoing cluster-randomized trial, were used. Information about foods and beverages consumed by the children was collected using the Dietary Observation in Child Care. The Nutrition Data System for Research food group classification was used to define food groups, sources and servings. The contribution of food sources to major food groups was calculated using ratio of means. Differences in mean ratios between Latino and non-Latino providers were tested with ANOVA and ANCOVA (P &amp;lt; 0.05) and Bonferroni adjustments were made for multiple comparisons. Results The analysis included 120 FCCH providers, all female, 68% were Latino, mean age of 48.9 ± 9.0 years; and 370 preschool children, 57% were Latino, mean age of 3.4 ± 0.9 years. Across FCCH, juice contributed the highest proportion to the fruits consumed (0.85 ± 0.24), and most vegetables consumed were non-starchy (0.61 ± 0.34). Nearly, three-fourths of dairy was low-fat (0.71 ± 0.30) and most milk/yogurt was unsweetened (0.85 ± 0.20). Three fourths of the grain servings consumed were refined (0.75 ± 0.22). The majority of the fats were vegetable oils (0.89 ± 0.20), and syrup/honey/jelly contributed more than half (0.50 ± 0.41) to the total sweets consumed. Children in non-Latino vs Latino FCCH consumed a significantly higher proportion of nuts and seeds (0.21 ± 0.34 vs 0.05 ± 0.13) and animal fats (0.37 ± 0.36 vs 0.11 ± 0.20). Similarly, children attending non-Latino FCCH ate a significantly higher proportion of non-starchy vegetables (0.82 ± 0.24 vs 0.52 ± 0.34), but a significantly lower proportion of legumes (0.05 ± 0.19 vs 0.33 ± 0.31) compared to Latino FCCH. Conclusions FCCH providers should be encouraged to include more whole fruits and whole grains. Differences between the foods consumed in FCCH according to the ethnicity of the provider, highlights the importance of considering cultural differences when developing tailored interventions to improve children's dietary intake at these settings. Funding Sources National Institutes of Health- National Heart, Lung, Blood Institute, National Institutes of Health.

Evaluation of iron intake in preschool children in a setting with high anemia burden.

BackgroundIron deficiency anemia affects millions of children worldwide. Iron intake assessments can inform targeted interventions.MethodsThis cross-sectional study describes diet and hemoglobin levels of children 1–5 y of age in a resource-limited setting in the Dominican Republic. The study team performed meal observations and measurements, dietary questionnaires, and point-of-care hemoglobin testing.ResultsIron intake and bioavailability were low, with liberal estimates indicating that not more than 40% of subjects consumed the recommended daily allowance for iron. Forty of 80 children had anemia, with 23% demonstrating moderate or severe anemia.ConclusionsPoor observed iron intake likely contributes to the high prevalence of anemia in this population.

Drivers and barriers of water intake in preschool children in a one-year longitudinal field study in Poland

AbstractBackgroundMany children consume too little water and too many sugar-sweetened beverages (SSBs), with potential negative consequences for health. Sustainably increasing water intake is therefore relevant, however challenging.ObjectiveExplore drivers of and barriers to water intake during a one-year field study aiming to increase plain water consumption using Installation Theory in Polish preschool children.MethodCaregivers of children (3–6 yrs) completed questionnaires on the child's preference for water and SSBs, water drinking habit strength (Self-Report Habit Index, range 1 (low)-5 (high habit)), and barriers to drinking water, at baseline and after one year. Children were first allocated to one of three interventions: CONTROL: no intervention; INFO: online coaching sessions on water health benefits (3 weeks); INFO + W: similar coaching sessions and home water delivery (3 weeks). After 3 months, half of INFO and INFO + W subjects were exposed to an online discussion forum (3 weeks) (+ SOCIAL); the other half received no further intervention (-SOCIAL).Results334 children (age: 4.4 ± 1.2 yrs; 50% female) completed the study. At baseline,72% attended kindergarten, among which 48% had access to water during the day. Drinking water during class was not allowed for 41%. The proportion of children who liked or loved water increased from 28% at baseline to 67% after one year. Conversely, that of children who liked or loved SSBs decreased from 58% at baseline to 45% after one year. The increase in preference for water was greater in groups who initially received INFO + W compared to CONTROL (p = 0.004). The mean drinking water habit score increased from 2.3 at baseline to 3.0 across all groups with a larger increase in INFO + W + SOCIAL (+ 28%) compared to CONTROL (+ 16%) (p = 0.001). At baseline, the strongest barriers to drinking water were (1) Drinking large amounts of other beverages (72%), (2) A preference for other beverages such as SSBs (71%), (3) Not being aware that they should drink more water (61%), and (4) Not being used to drinking water or water having no taste (both 55%).Most barriers strongly decreased over the course of the study with no specific effect of the interventions.ConclusionAn intervention aiming to increase water in pre-school children was able to modulate the preference for water, habit to drink water, and barriers to drinking water in preschool children with unhealthy drinking habits. Providing information and facilitating access to water were the most important contributors to improving healthy hydration habits.

Colour as a cue to eat: Effects of plate colour on snack intake in pre-school children

Environmental cues, such as the colour of food and dishware, have been shown to influence food and drink consumption in adult populations. This proof of concept study investigated whether plate colour could be utilised as a strategy to reduce intake of high energy density (HED) snacks and increase intake of low energy density (LED) snacks in pre-school children. In a between and within-subjects design, children were randomly assigned to either a control group (no colour message) or intervention group (received a colour message: red = stop, green = go) and were provided a snack at nursery on three occasions on differently coloured plates (red, green, white), for each snack type (HED, LED). Snack intake, colour preference, colour association, and anthropometrics were recorded for each child. The results showed that there was no effect of group (control vs intervention) on HED (p = 0.540) and LED intake (p = 0.575). No effect of plate colour on HED (p = 0.147) or LED snack intake (p = 0.505) was evident. Combining red and green plates for a chromatic versus achromatic comparison showed that there was no significant effect of chromatic plate on HED (p = 0.0503) and LED (p = 0.347) intakes. Despite receiving a brief learning intervention, the use of plate colour was found in the present study to be an ineffective strategy to control snack food intake in pre-school aged children. Rather, we suggest that food intake in young children may best be predicted by portion size, energy density and eating behaviour traits.

Access With Education Improves Fruit and Vegetable Intake in Preschool Children

ObjectiveTo compare effects of interventions aimed at increasing fruit and vegetable (FV) intake in children. DesignPre-post comparison and intervention study with randomly grouped classrooms. SettingHead Start classrooms. ParticipantsTwo hundred nine Head Start children. InterventionsTreatment A (n = 61) and treatment B (n = 82) children received high-carotenoid FVs for 8 weeks. Treatment B children also received weekly FV education, and their caregivers received FV information and recipes. The comparison group (n = 66) received neither FVs nor education. Main Outcome MeasureCarotenoid values in Raman units. AnalysisMultilevel mixed models, ANCOVA, and post hoc analysis were used. ResultsMultilevel mixed models with the group as fixed effect and classrooms within group as a random effect; ANCOVA showed that the only significant variable affecting the score was the group main effect. The intraclass correlation coefficient was 0.037; the Raman unit scores of treatment B were significantly higher than those of treatment A (P = .02) or comparison group (P < .001). However, there was no significant difference between treatment A and comparison (P = .10; Cohen D = .71). Conclusions and ImplicationsThe results suggested that providing education where FVs are offered may help increase consumption. Measurement of carotenoids in family members who received FVs plus education, as well as replication of this model in different locations and ages of children should be investigated in future research.

Portion size has sustained effects over 5 days in preschool children: a randomized trial

Although short-term studies have found that serving larger portions of food increases intake in preschool children, it is unknown whether this portion size effect persists over a longer period or whether energy intake is moderated through self-regulation. We tested whether the portion size effect is sustained in preschool children across 5 consecutive days, a period thought to be sufficient for regulatory systems to respond to the overconsumption of energy. With the use of a crossover design, over 2 periods we served the same 5 daily menus to 46 children aged 3-5 y in their childcare centers. In 1 period, all foods and milk were served in baseline portions, and in the other period, all portions were increased by 50%. The served items were weighed to determine intake. Increasing the portion size of all foods and milk by 50% increased daily consumption: weighed intake increased by a mean ± SEM of 143±21 g/d (16%) and energy intake increased by 167±22 kcal/d (18%; both P<0.0001). The trajectories of intake by weight and energy across the 5-day period were linear and the slopes did not differ between portion conditions (both P>0.13), indicating that there were sustained increases in intake from larger portions without compensatory changes over time. Children differed in their response to increased portions: those with higher weight status, lower ratings for satiety responsiveness, or higher ratings for food responsiveness had greater increases in intake from larger portions (all P<0.03). This demonstration that preschool children failed to adjust their intake during prolonged exposure to larger portions challenges the suggestion that their self-regulatory behavior is sufficient to counter perturbations in energy intake. Furthermore, overconsumption from large portions may play a role in the development of overweight and obesity, as the magnitude of the effect was greater in children of higher weight status. This trial was registered at www.clinicaltrials.gov as NCT02963987.

Parenting styles and the dietary intake of pre-school children: a systematic review

Parenting styles and the dietary intake of pre-school children: a systematic review

Brazilian preschool children attending day care centers show an inadequate micronutrient intake through 24-h duplicate diet

Inadequate micronutrient intake in childhood harms growth and development, and it is related to increased rates of morbidity and mortality. The aim of this study is to evaluate the dietary intake and prevalence of inadequate micronutrient intake in preschool children (1–4 years old) attending two-day care centers. To assess children’s dietary micronutrient intake, 24-h duplicate diets (n = 64) were collected for one week-day, including everything the children ate and drank both at home and in kindergarten. Anthropometric measurements were carried out to evaluate the children’s nutritional status. The micronutrients copper, iron, calcium, magnesium, selenium, zinc, potassium, sodium, and manganese were determined by inductively coupled plasma mass spectrometry or graphite furnace atomic absorption spectrometry. Calcium and selenium were found with high inadequate intake rates: 50% and 42%, respectively, for children aged 1–3 years old, and 93% and 90% for children aged 4 years. Potassium was consumed in very low amounts, 13% and 5% of children aged 1–3 and 4 years old, respectively, achieved the adequate intake for the nutrient. Sodium intakes were excessive: 23% of the 1–3-year old and 42% of the 4-year-old children, respectively, had an intake higher than the tolerable upper levels. Regarding the nutritional status, overweight and obesity prevalence was 17%. Therefore, considering the damaging health effects for children of micronutrient deficiency and overweight and obesity status, it is necessary that government authorities be aware and update public policies and educational programs in order to promote healthy eating habits in early childhood.

Variations in Palatability and Portion Size of Vegetables on Meal Intake of Preschool Children

Variations in Palatability and Portion Size of Vegetables on Meal Intake of Preschool Children

The effects of repeated exposure and variety on vegetable intake in pre-school children

Children's vegetable consumption in the UK remains lower than national recommendations, presenting potential long-term health risks. It is known that repeated exposure promotes intake of novel vegetables and that offering children variety and choice can also encourage intake. The current study aimed to compare the impact of offering variety over simple repeated exposure as a strategy for increasing pre-school children's vegetable consumption. Children (N = 95) aged 24–55 months were recruited through participating nurseries and assigned to receive repeated exposure (RE) to a single vegetable snack or a mixed snack consisting of five different vegetables (variety: V). A minimum of 5 (maximum 6) exposures were given for both RE and V conditions. Pre and post-intervention intake measures of both the RE and V snacks were taken for each child. Follow up measures took place 1 month post-intervention (n = 40). Vegetable intake increased significantly from pre to post intervention for snacks congruent to the condition to which children were assigned. Magnitude of change was smaller for the variety condition. Follow up data revealed that snack intake remained significantly higher than baseline 1 month post-intervention (p < 0.001). In agreement with previous work this study confirmed that repeated exposure was effective in promoting children's vegetable intake but there was no additional benefit of variety in this context. It may be that for moderately familiar vegetables, serving them alone encourages intake and for this age group, avoids contamination fears or effects of neophobia.

Systematic review and meta-analysis of strategies to increase vegetable consumption in preschool children aged 2–5 years

BackgroundMost children do not meet daily recommendations for fruit and vegetable intake, and consumption of vegetables remains especially low. Eating habits track from childhood to adulthood hence establishing liking and intake of vegetables is important. ObjectiveTo identify the most successful strategies to enhance vegetable intake in preschool children aged 2–5 years. DesignThe research was a systematic review and a meta-analysis of published studies. A comprehensive search strategy was performed using key databases such as Medline, Embase, PsychINFO, EBSCO and CENTRAL. Articles published between 2005–January 2016, specifically with measured vegetable consumption were included. Results30 articles and 44 intervention arms were identified for inclusion (n = 4017). Nine dominant intervention strategies emerged to promote vegetable intake in preschool children. These included; choice, pairing (stealth), education, food service, modelling, reward, taste exposure, variety and visual presentation. The meta-analysis revealed that interventions implementing repeated taste exposure had better pooled effects than those which did not. Intake increased with number of taste exposures and intake was greater when vegetables offered were in their plain form rather than paired with a flavor, dip or added energy (e.g. oil). Moreover, intake of vegetables which were unfamiliar/disliked increased more than those which were familiar/liked. ConclusionsRepeated taste exposure is a simple technique that could be implemented in childcare settings and at home by parents. Health policy could specifically target the use of novel and disliked vegetables in childcare settings with emphasis on a minimum 8–10 exposures.The systematic review protocol was registered on the PROSPERO (number: CRD42016033984).

Is frequency of family meals associated with fruit and vegetable intake among preschoolers? A logistic regression analysis.

The present study aimed to examine the associations between frequency of family meals and low fruit and vegetable intake in preschool children. Promoting healthy nutrition early in life is recommended for combating childhood obesity. Frequency of family meals is associated with fruit and vegetable intake in school-age children and adolescents; the relationship in young children is less clear. We completed a secondary analysis using data from the Early Childhood Longitudinal Study-Birth Cohort. Participants included children, born in the year 2001, to mothers who were >15 years old (n = 8 950). Data were extracted from structured parent interviews during the year prior to kindergarten. We used hierarchical logistic regression to describe the relationships between frequency of family meals and low fruit and vegetable intake. Frequency of family meals was associated with low fruit and vegetable intake. The odds of low fruit and vegetable intake were greater for preschoolers who shared less than three evening family meals per week (odds ratio = 1.5, β = 0.376, P < 0.001) than preschoolers who shared the evening meal with family every night. Fruit and vegetable intake is related to frequency of family meals in preschool-age children. Educating parents about the potential benefits of frequent shared meals may lead to a higher fruit and vegetable consumption among preschoolers. Future studies should address other factors that likely contribute to eating patterns during the preschool years.