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The purpose of this study was to evaluate the effect of parent education on increasing parental awareness of vegetable servings needed by preschool children, lowering barriers to increase vegetable consumption in their children's diets, increasing confidence in their ability to increase vegetables in their children's meals, and promoting parent-child interaction to increase vegetable consumption by preschool children. The study was conducted with parents enrolled in the Kid-co Head Start program in Albany and Corvallis. The study protocol consisted of an experimental (n=10 parents) and control (n=4 parents) group. Parents in the experimental group attended a family night event about vegetables on February 13th of 2003. This event was followed by an in-school activity and a delivery of reinforcement material about vegetables, one week after family night event took place. Parents in the control group attended a family night event about healthy snacking on February 13th of 2003. Parents from both groups participated in a follow-up phone interview. A high proportion of participants (75%) of the control group were Hispanics. In the experimental group, 70% were whites and 30% were Hispanics. Levels of education of participants of both groups ranged from 6 years of school up to college degrees. Findings revealed vegetable availability in participants' homes. Fresh vegetable availability in control and experimental group combined ranged from 2 to 7 types of vegetables, before the intervention, and 2 to 5 types after the intervention. Seventy one percent of participants of combined experimental and control groups had frozen vegetables and 85.7% had canned vegetables (before and after the intervention). Daily vegetable consumption was reported by 64.3% of the parents from both experimental and control groups combined. A high proportion of parents (71.4%) from combined experimental and control groups reported that their children eat vegetables every day. Dinner, lunch and snacks are meals in which children eat most vegetables. No significant difference was found about parents' awareness of the daily recommended number of vegetable servings needed by young children between experimental and control group. Similarly, no significant difference was found in experimental group responses before and after the intervention. Findings before the intervention indicate that 50% of participants in the experimental group didn't know the recommendation needed by young children. After the intervention 10% of participants responded that they didn't know the recommendation. No significant difference was found about parents' confidence in their ability to increase vegetables in their children's diets between control and experimental groups responses (before and after the intervention). Similarly, no significant difference was found in experimental group responses before and after the intervention. However, high levels of confidence were reported in both groups. Before the intervention, 75% and 50% of parents in the control and experimental group respectively, reported they felt "very confident." After the intervention, 75% and 40% of parents in the control and experimental group respectively, reported they still felt "very confident." Before the intervention most participants in both groups reported they have barriers to increase the amount of vegetables in their children's diets at least sometimes. The barrier "My child doesn't like vegetables" was reported by 60% of parents in the experimental group and by 100% in the control group, at least sometimes. "Too much time to prepare vegetables" was reported by 25% and 10% of participants in the control and experimental group, respectively. Fifty percent of parents in the control group indicated they have lack of preparation skills, while only 10% of parents in the experimental group reported the same barrier. None of participants in the control group considered "cost of vegetables" a barrier. However, 50% in the experimental group reported the barrier "cost of vegetables." I can't get satisfactory vegetables" was reported by 25% and by 40% of participants in the control and experimental group, respectively. After the intervention, 25% and 30% of parents in the control and experimental group reported that "Nothing" is consider a barrier. However, "My child doesn't like vegetables" was a barrier for 50% of parents in the control group and 10% in the experimental group. Not enough time and energy to cook were barriers reported by 30% and 20% of participants in the experimental group only. Lack of preparation skills was reported by 25% of participants in the control group and by 10% in the experimental group. Only 20% of parents in the experimental group tried the vegetable recipes provided in the handouts. However, 90% of parents in the experimental group reported they tried to give more vegetables to their child since the family event. Ninety percent of parents reported preparing vegetables with their children. Letting their children choose a vegetable in the store was another parent-child interaction activity practiced by 60% of parents from the experimental group. All parents from the experimental group agreed that our educational material helped them to interact with their children. Ninety percent of parents agreed it helped to save money and 70% agreed it helped to prepare more vegetables for their child. Forty percent of parents reported that their child ate more vegetables after the family event.
Multi-sensory nutrition education interventions aimed at promoting children's preferences for vegetables have the potential to positively impact children's intake of essential micronutrients and phytochemicals. We implemented our intervention in Western Massachusetts Head Start preschool classrooms, as part of Massachusetts Farm Fresh research project. Social cognitive theory, early childhood developmental milestones, and the play approach to learning provided the framework. During the 4-week intervention, eight vegetables were matched by appearance and growing process to create vegetable pairs (green bean-sugar snap pea, broccoli-cauliflower, beet-radish, and carrot-parsnip). Each week, two animal puppets introduced the children in the classroom to the vegetable pairs by highlighting the vegetable's color, shape, texture, and growth process. Complete baseline and follow-up consumption data were available for 60 three to five year old children. Total mean consumption (g) increased pre-post intervention (pre: 14.75 + 1.38 vs. post: 17.83 + 2.05 g) (p= 0.06). Specifically, mean consumption (g) increased for peas (pre: 1.32 + 0.26 vs. post: 2.03 + 0.36 g) (p=0.04), parsnips (pre: 1.31 + 0.24 vs. post: 2.06 + 0.35 g) (p=0.04), and for the high-sugar content vegetables (pre: 7.41 + 0.82 vs. post: 9.75 +1.14 g) (p=0.02). Mean consumption of the red and white colored vegetables respectively were (pre: 2.66 + 0.41 vs. post: 3.68 + 0.54 g) (p=0.07) and (pre: 2.81 + 0.46 vs. post: 3.93 + 0.61) (p=0.08). Findings suggest that a puppet based nutrition education intervention highlighting the sensory attributes has the potential to increase young children's consumption of vegetables.
A counting book which uses images of fruits and vegetables to illustrate numbers from one to one hundred and which also includes an explanation of how to do potato printing.
Globally, the food system and the relationship of the individual to that system, continues to change and grow in complexity. Eating is an everyday event that is part of everyone’s lives. There are many commentaries on the nature of these changes to what, where and how we eat and their socio-cultural, environmental, educational, economic and health consequences. Among this discussion, the term "food literacy" has emerged to acknowledge the broad role food and eating play in our lives and the empowerment that comes from meeting food needs well. In this book, contributors from Australia, China, United Kingdom and North America provide a review of international research on food literacy and how this can be applied in schools, health care settings and public education and communication at the individual, group and population level. These varying perspectives will give the reader an introduction to this emerging concept. The book gathers current insights and provides a platform for discussion to further understanding and application in this field. It stimulates the reader to conceptualise what food literacy means to their practice and to critically review its potential contribution to a range of outcomes.
Looking at and listening to picture and story books is a ubiquitous activity, frequently enjoyed by many young children and their parents. Well before children can read for themselves they are able to learn from books. Looking at and listening to books increases children’s general knowledge, understanding about the world and promotes language acquisition. This collection of papers demonstrates the breadth of information pre-reading children learn from books and increases our understanding of the social and cognitive mechanisms that support this learning. Our hope is that this Research Topic/eBook will be useful for researchers as well as educational practitioners and parents who are interested in optimizing children’s learning.
The prevalence of overweight and related health problems is increasing globally. Low vegetable intake and failing to self-regulate energy intake (i.e., eat in the absence of hunger) increase the risk of developing overweight. Interventions promoting healthy eating behaviors from an early age are needed as food preferences and related dietary habits are shaped in the first two years of life, and track into adulthood. The aim of this thesis was to investigate whether vegetable intake and liking of babies and toddlers can be improved, and whether self-regulation of energy intake is present. To this end, the effect of repeated exposure to vegetables on children’s vegetable intake and liking from the first bites of solid food (age 4-6 months), until the age of 24 months was investigated. Eating in the absence of hunger was studied in the same children at the age of 18- and 24 months. The components studied in this thesis were part of an overarching randomized controlled trial, Baby’s First Bites, which tested interventions on the what and how in complementary feeding. Chapter 2 described in detail the rationale and the design of this trial including a repeated vegetable-exposure (what) and sensitive-feeding (how) intervention. In Chapter 3 we evaluated the effects of the vegetable-exposure and sensitive-feeding intervention in terms of child health outcomes and maternal feeding behavior (outside of the scope of this thesis) at child ages 18 and 24 months. Chapter 4 described the intervention in more detail and evaluated the effects of the intervention on infant’s vegetable intake, liking and variety of vegetables consumed during the first weeks of complementary feeding and at the age of 12 months. We found no added effects of repeated exposure to vegetables (combined with consultation sessions to promote repeated exposure until the age of 16 months), as compared to exposure to fruits and a sweet vegetable (carrot) (combined with the sensitive feeding intervention or general contact in the control condition) on infants vegetable intake. This was neither the case directly after the feeding schedule, nor at the ages of 12, 18 and 24 months. It is noteworthy, however, that vegetable intake was on average high at these ages in the full sample: approx. 86 grams, 87 grams and 77 grams respectively. At the age of 12 months a higher variety in vegetable intake was associated with higher absolute vegetable intake (chapter 4), suggesting that consuming a higher variety of different types of vegetables contribute to increasing absolute vegetable intake. In addition, children who ate a higher variety of vegetables also had parents (or at least mothers) eating a larger variety of vegetables (chapter 4). This suggests an effect of parent modelling which has been proven to be an effective method to increase vegetable intake in children. Of the other modifying factors we assessed, only food neophobia was associated with absolute vegetable intake. Food neophobic children ate less vegetables (chapter 4). We did not find differences in child self-regulation of energy intake and BMI-z between conditions (chapter 3). Chapter 5 described an eating in the absence of hunger (EAH) experiment that was designed and conducted within the BFB RCT. We found that children as young as 18 months displayed this behavior. The majority (90%) of children consumed palatable finger foods despite just having eaten a meal. Secondly, we found that EAH at 18 months predicted EAH at 24 months. Furthermore, unexpectedly, a positive association was found between satiety of the child (as estimated by the mother) and the energy intake of finger foods (i.e. higher satiety scores were associated with increased intake of finger foods). Finally, a child’s enjoyment of food was positively associated with the intake of finger foods. This thesis demonstrates that repeated exposure does have an added benefit in infants and toddlers who already have sufficient vegetable intake, as intake was relatively high in the full sample. The control condition in the trial may have been a positive control as no guidelines or restrictions were given on vegetable exposure after the feeding schedule, which could have led to (a high) vegetable exposure in the period thereafter. We did demonstrate that repeated exposure is effective in increasing liking of vegetables. If increased vegetable liking persists over time, perhaps this will also translate to increased intake in the long run. Moreover, we found that food neophobia and variety in vegetable intake play a role in determining vegetable intake. These factors may be taken into account in future studies by targeting groups who may still benefit from early repeated exposure to vegetables (e.g., children with a one-sided diet or food neophobia). Moreover, we showed that eating in the absence of hunger occurs within the first two years of life. Our findings suggest the importance of the eating environment in which parents and caregivers can play an important part in the prevention of overeating. The contemporary living environment seems to revolve around easy access and convenient foods, it is therefore important to create awareness that toddlers are sensitive to the eating environment and to stimulate healthy eating behavior at a young age. Factors that play a key role in this are 1) targeting vegetable intake, 2) self-regulation of energy intake, 3) the context in which food is offered and 4) the type of food that is offered. To further enhance diet quality and consequently health of toddlers it is important to stimulate a multidisciplinary approach in which researchers, parents and caregivers, daycare centers, community and the government collaborate in finding ways to enhance healthy eating behavior of young children to prevent overweight and obesity and to promote health.
Considering the detrimental environmental impact of current food systems, and the concerns raised about their sustainability, there is an urgent need to promote diets that are healthy and have low environmental impacts. These diets also need to be socio-culturally acceptable and economically accessible for all. Acknowledging the existence of diverging views on the concepts of sustainable diets and healthy diets, countries have requested guidance from the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) on what constitutes sustainable healthy diets. These guiding principles take a holistic approach to diets; they consider international nutrition recommendations; the environmental cost of food production and consumption; and the adaptability to local social, cultural and economic contexts. This publication aims to support the efforts of countries as they work to transform food systems to deliver on sustainable healthy diets, contributing to the achievement of the SDGs at country level, especially Goals 1 (No Poverty), 2 (Zero Hunger), 3 (Good Health and Well-Being), 4 (Quality Education), 5 (Gender Equality) and 12 (Responsible Consumption and Production) and 13 (Climate Action).
Problem: Obesity among preschool-aged children is a major public health concern as obese children are more likely to be obese as adults, and obesity is a risk factor for many chronic diseases. Diets high in fruits and vegetables (FV) may decrease the risk of many chronic diseases as well as contribute to obesity prevention. However, many preschool-aged children in the US are not meeting recommended intakes of FV. Therefore, the purpose of this study is to examine previous interventions conducted to increase FV consumption among preschool-aged children. Methods: The search for published articles was conducted using PubMed through the Weill Cornell Medical College library. The search terms "fruit AND vegetable AND consumption AND intervention" with specific filters were used to find studies that had been conducted on preschool-aged children, had full-text versions available online, were published in English, and were of rigorous design. Results: Thirty-four articles resulted, but only 12 were eligible to be included and further examined in this paper. Conclusions: The studies showed promising results for interventions conducted among preschool-aged children to increase the consumption of FV at least in the short-term. One common theme of many of the interventions was repeated exposure to and tastes of FV. Increased fruit consumption was typically achieved through less rigorous strategies, which may be due to children's natural taste preference for sweet food items. Further, many of the interventions involved multiple components.
Despite the numerous health benefits associated with the consumption of fruits and vegetables, the majority of children in the United States fall short of meeting federal recommendations. Since childhood health behaviors track into adulthood, interventions aimed at increasing fruit and vegetable consumption during childhood can maximize well being throughout the lifecycle. Study findings indicate a positive relationship between children's involvement in at-home meal preparation and overall diet quality, including an increase in fruit and vegetable consumption. However, with only one third of children currently assisting with meal preparation two or more times a week, a large opportunity for growth remains available. The purpose of this project is to increase children's fruit and vegetable consumption by encouraging parents to prepare nutrient-dense meals featuring fruits and vegetables with their child. This will be accomplished through the creation of "Raised on Veggies," a nutrition blog that includes nutrition education and provides parents with nutrient-dense recipes featuring fruits and vegetables to cook with their child. "Raised on Veggies" provides the knowledge and tools necessary to help parents increase their child's fruit and vegetable intake and set the stage for a lifetime of healthy eating habits.
Using novel intervention and assessment techniques, fruit and vegetable access plus nutrition education significantly improved carotenoid levels among children compared to those who received access only or neither access or education. This study demonstrated a relationship between self-reported fruit and vegetable intake and quantitative BioPhotonicTM Scanner scores. Scanner scores were increased in both the access and the access with education clusters. Additionally, the self-reported intakes of fruits and vegetables were reported to have increased in both the children as well as their parents. This intake increase was most notable between the access with education cluster versus the control cluster, although significance was also noted between the access cluster and the control cluster as shown in ANOVA testing. This approach of providing fruits and vegetables to low resourced families helps to demonstrate the importance of education supplementing the provisions of fruits and vegetables. Subjects who were provided with information on how to prepare and use such provisions appeared more inclined to utilize the items, resulting in an increased carotenoid level as evidenced by said scan score results. Results of this study will be useful to demonstrate the importance of education along with produce provisions for those in need. Taste testing, hands-on experiential learning, recipe and newsletter type educational information was shown to change the behavior and consumption in this group of Head Start families receiving such interventions.