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Creating action plans in a serious video game increases and maintains child fruit-vegetable intake: a randomized controlled trial.

ABSTRACT: Child fruit and vegetable intake is below recommended levels, increasing risk for chronic disease. Interventions to influence fruit and vegetable intake among youth have had mixed effects. Innovative, theory-driven interventions are needed. Goal setting, enhanced by implementation intentions (i.e., plans tightly connected to a behavioral goal), may offer a solution. Action plans state "how" a goal will be achieved, while coping plans identify a potential barrier and corresponding solution. The research reported here evaluated the short- and long-term effects of goal setting enhanced with implementation intentions on child fruit and vegetable intake in a 10-episode, theoretically-grounded serious videogame promoting fruit and vegetables. This is one of the first studies to test the efficacy of implementation intentions on the dietary intake of healthy children.A four-group randomized design with three data collection periods (baseline, immediate post-intervention, 3 months post-intervention) was employed. Groups varied on whether children created an implementation intention (none, action, coping, both) as part of goal setting. Participants were 4th and 5th grade children (~9-11 years old) and one parent. An a priori power analysis indicated this would provide >80% power to detect a small effect (Cohen's d?=?0.17). Children played a 10-episode online videogame; parents received 10 electronic newsletters and access to a parent-only website. The primary outcome was child fruit and vegetable intake, assessed via three, dietitian-assisted telephone recalls at each data collection period. The primary analysis was conducted using a repeated measures analysis of covariance with a mixed model procedure. Secondary analyses examined intervention effects on fruit and vegetables separately.Four hundred parent/child dyads were recruited. A significant group-by-time interaction for fruit and vegetable intake (p?

SUBMITTER: Thompson D

PROVIDER: S-EPMC4372224 | biostudies-literature | 2015 Mar

REPOSITORIES: biostudies-literature

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Creating action plans in a serious video game increases and maintains child fruit-vegetable intake: a randomized controlled trial.

Thompson Debbe D Bhatt Riddhi R Vazquez Isabel I Cullen Karen W KW Baranowski Janice J Baranowski Tom T Liu Yan Y

The international journal of behavioral nutrition and physical activity 20150318

<h4>Background</h4>Child fruit and vegetable intake is below recommended levels, increasing risk for chronic disease. Interventions to influence fruit and vegetable intake among youth have had mixed effects. Innovative, theory-driven interventions are needed. Goal setting, enhanced by implementation intentions (i.e., plans tightly connected to a behavioral goal), may offer a solution. Action plans state "how" a goal will be achieved, while coping plans identify a potential barrier and correspond ...[more]

PMID: 25890060

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Project description:Background and objectivesHigher fruit and vegetable intake is associated with lower cardiovascular and all-cause mortality in the general population. It is unclear whether this association occurs in patients on hemodialysis, in whom high fruit and vegetable intake is generally discouraged because of a potential risk of hyperkalemia. We aimed to evaluate the association between fruit and vegetable intake and mortality in hemodialysis.Design, setting, participants, & measurementsFruit and vegetable intake was ascertained by the Global Allergy and Asthma European Network food frequency questionnaire within the Dietary Intake, Death and Hospitalization in Adults with ESKD Treated with Hemodialysis study, a multinational cohort study of 9757 adults on hemodialysis, of whom 8078 (83%) had analyzable dietary data. Adjusted Cox regression analyses clustered by country were conducted to evaluate the association between tertiles of fruit and vegetable intake with all-cause, cardiovascular, and noncardiovascular mortality. Estimates were calculated as hazard ratios with 95% confidence intervals (95% CIs).ResultsDuring a median follow up of 2.7 years (18,586 person-years), there were 2082 deaths (954 cardiovascular). The median (interquartile range) number of servings of fruit and vegetables was 8 (4-14) per week; only 4% of the study population consumed at least four servings per day as recommended in the general population. Compared with the lowest tertile of servings per week (0-5.5, median 2), the adjusted hazard ratios for the middle (5.6-10, median 8) and highest (>10, median 17) tertiles were 0.90 (95% CI, 0.81 to 1.00) and 0.80 (95% CI, 0.71 to 0.91) for all-cause mortality, 0.88 (95% CI, 0.76 to 1.02) and 0.77 (95% CI, 0.66 to 0.91) for noncardiovascular mortality and 0.95 (95% CI, 0.81 to 1.11) and 0.84 (95% CI, 0.70 to 1.00) for cardiovascular mortality, respectively.ConclusionsFruit and vegetable intake in the hemodialysis population is low and a higher consumption is associated with lower all-cause and noncardiovascular death.

Project description:BackgroundAlthough intake of fruits and vegetables seemed to have a protective effect on bone metabolism, its effect on fractures remains uncertain.MethodsA systematic review of randomized controlled trials (RCTs) and cohort studies (PROSPERO: CRD42016041462) was performed. RCTs and cohort studies that evaluated the combined intake of fruits and vegetables in men and women aged over 50 years were included. We considered fractures as a primary outcome measure. Changes in bone markers were considered as secondary outcomes. The search strategy included the following descriptors: fruit, vegetables, vegetable products, bone and bones, bone fractures, postmenopausal osteoporosis, and osteoporosis. PubMed, Embase, and Cochrane Library were the databases used. The appraisal of the studies was performed by two independent reviewers, and discussed and agreed upon by both examiners. The data extracted from the RCTs and cohort studies were summarized separately. The risks of fractures were combined across studies using random models. Bone resorption marker (CTx) was summarized with standardized mean differences. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to evaluate the strength of recommendations.ResultsOf the 1,192 studies screened, 13 articles were included in the systematic review and 10 were included in the pooled analysis (6 cohort studies and 4 RCTs). The six cohort studies included in the meta-analysis included a population of 225,062. The pooled hazard ratio (HR) (95% confidence interval (CI)) of the hip in five studies was 0.92 (0.87, 0.98). Its heterogeneity was moderate (I2 = 55.7%, p = 0.060), GRADE (⊕⊕⊕O). Two cohort studies evaluated the risk of any fracture; the HR was 0.90 (95% CI: 0.86-0.96), with aheterogeneity of 24.9% (p = 0.249, GRADE (⊕⊕⊕O)). There was no association between the bone resorption marker CTx and 3 months of fruit and vegetable intake evaluated by four RCTs, GRADE (⊕⊕O O).ConclusionThere was an association between the increase of at least one serving of fruits and vegetables per day and decreases in the risk of fractures. The level of evidence for this association is moderate.

Project description:The role of a properly balanced diet in the prevention and treatment of mental disorders has been suggested, while vegetables and fruits have a high content of nutrients that may be of importance in the case of depressive disorders. The aim of the study was to conduct a systematic review of the observational studies analyzing association between fruit and vegetable intake and mental health in adults. The search adhered to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and the review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42019138148). A search for peer-reviewed observational studies published until June 2019 was performed in PubMed and Web of Science databases, followed by an additional manual search for publications conducted via analyzing the references of the found studies. With respect to the intake of fruit and/or vegetable, studies that assessed the intake of fruits and/or vegetables, or their processed products (e.g., juices), as a measure expressed in grams or as the number of portions were included. Those studies that assessed the general dietary patterns were not included in the present analysis. With respect to mental health, studies that assessed all the aspects of mental health in both healthy participants and subjects with physical health problems were included, but those conducted in groups of patients with intellectual disabilities, dementia, and eating disorders were excluded. To assess bias, the Newcastle-Ottawa Scale (NOS) was applied. A total of 5911 studies were independently extracted by 2 researchers and verified if they met the inclusion criteria using a 2-stage procedure (based on the title, based on the abstract). After reviewing the full text, a total of 61 studies were selected. A narrative synthesis of the findings from the included studies was performed, which was structured around the type of outcome. The studies included mainly focused on depression and depressive symptoms, but also other characteristics ranging from general and mental well-being, quality of life, sleep quality, life satisfaction, flourishing, mood, self-efficacy, curiosity, creativity, optimism, self-esteem, stress, nervousness, or happiness, to anxiety, minor psychiatric disorders, distress, or attempted suicide, were analyzed. The most prominent results indicated that high total intake of fruits and vegetables, and some of their specific subgroups including berries, citrus, and green leafy vegetables, may promote higher levels of optimism and self-efficacy, as well as reduce the level of psychological distress, ambiguity, and cancer fatalism, and protect against depressive symptoms. However, it must be indicated that the studies included were conducted using various methodologies and in different populations, so their results were not always sufficiently comparable, which is a limitation. Taken together, it can be concluded that fruits and/or vegetables, and some of their specific subgroups, as well as processed fruits and vegetables, seems to have a positive influence on mental health, as stated in the vast majority of the included studies. Therefore, the general recommendation to consume at least 5 portions of fruit and vegetables a day may be beneficial also for mental health.

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Creating action plans in a serious video game increases and maintains child fruit-vegetable intake: a randomized controlled trial.

Publications

Creating action plans in a serious video game increases and maintains child fruit-vegetable intake: a randomized controlled trial.

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