- Title
- Interventions for increasing fruit and vegetable consumption in children aged five years and under (review)
- Creator
- Hodder, Rebecca K.; O'Brien, Kate M.; Robson, Emma; Yoong, Sze Lin; Wolfenden, Luke; Stacey, Fiona G.; Wyse, Rebecca J.; Clinton-McHarg, Tara; Tzelepis, Flora; James, Erica L.; Bartlem, Kate M.; Nathan, Nicole K.; Sutherland, Rachel
- Relation
- Cochrane Database of Systematic Reviews Vol. 2018, Issue 5, no. CD008552
- Publisher Link
- http://dx.doi.org/10.1002/14651858.CD008552.pub4
- Publisher
- John Wiley & Sons
- Resource Type
- journal article
- Date
- 2018
- Description
- Background: Insufficient consumption of fruits and vegetables in childhood increases the risk of future non-communicable diseases, including cardiovascular disease. Interventions to increase consumption of fruit and vegetables, such as those focused on specific child-feeding strategies and parent nutrition education interventions in early childhood may therefore be an effective strategy in reducing this disease burden. Objectives: To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. Search methods: We searched CENTRAL, MEDLINE, Embase and two clinical trials registries to identify eligible trials on 25 January 2018. We searched Proquest Dissertations and Theses in November 2017. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included studies to identify further potentially relevant trials. Selection criteria: We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. Data collection and analysis: Two review authors independently extracted data and assessed the risks of bias of included studies; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. Main results: We included 63 trials with 178 trial arms and 11,698 participants. Thirty-nine trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Fourteen trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Nine studies examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. One study examined the effect of a nutrition education intervention delivered to children in increasing child fruit and vegetable intake. We judged 14 of the 63 included trials as free from high risks of bias across all domains; performance, detection and attrition bias were the most common domains judged at high risk of bias for the remaining studies. There is very low quality evidence that child-feeding practices versus no intervention may have a small positive effect on child vegetable consumption equivalent to an increase of 3.50 g as-desired consumption of vegetables (SMD 0.33, 95% CI 0.13 to 0.54; participants = 1741; studies = 13). Multicomponent interventions versus no intervention may have a very small effect on child consumption of fruit and vegetables (SMD 0.35, 95% CI 0.04 to 0.66; participants = 2009; studies = 5; low-quality evidence).
- Subject
- eating; feeding behaviour; fruit; vegetables; conditioning (psychology); house calls; randomized controlled trials as topic; reward; child
- Identifier
- http://hdl.handle.net/1959.13/1386925
- Identifier
- uon:32487
- Identifier
- ISSN:1469-493X
- Language
- eng
- Full Text
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