Interventions for increasing fruit and vegetable consumption in children aged five years and under.
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ABSTRACT:
SUBMITTER: Hodder RK
PROVIDER: S-EPMC6491117 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC6373580 | biostudies-literature
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| S-EPMC6837849 | biostudies-literature
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| S-EPMC7273132 | biostudies-literature
Project description:Fruits and vegetables are an essential part of the human diet, but many people do not consume the recommended serves to prevent cardiovascular disease and cancer. In this research, we evaluate the cost-effectiveness of interventions to promote fruit and vegetable consumption to determine which interventions are good value for money, and by how much current strategies can reduce the population disease burden.In a review of published literature, we identified 23 interventions for promoting fruit and vegetable intake in the healthy adult population that have sufficient evidence for cost-effectiveness analysis. For each intervention, we model the health impacts in disability-adjusted life years (DALYs), the costs of intervention and the potential cost-savings from averting disease treatment, to determine cost-effectiveness of each intervention over the lifetime of the population, from an Australian health sector perspective. Interventions that rely on dietary counselling, telephone contact, worksite promotion or other methods to encourage change in dietary behaviour are not highly effective or cost-effective. Only five out of 23 interventions are less than an A$50,000 per disability-adjusted life year cost-effectiveness threshold, and even the most effective intervention can avert only 5% of the disease burden attributed to insufficient fruit and vegetable intake.We recommend more investment in evaluating interventions that address the whole population, such as changing policies influencing price or availability of fruits and vegetables, to see if these approaches can provide more effective and cost-effective incentives for improving fruit and vegetable intake.
| S-EPMC2994753 | biostudies-other
Project description:Dairy product consumption is important during childhood, as dairy products provide nutrients to support growth and development. However, a high proportion of children globally are not meeting recommended daily intakes, which may have long-term health implications. Accumulating evidence suggests that interventions aimed at instilling healthy lifestyle habits are most effective when initiated during the preschool years. Therefore, the purpose of the review was to identify the characteristics of effective dairy and/or calcium interventions targeting preschool-aged children. A systematic literature review identified 14 intervention studies published between 1998?2018 addressing dairy/calcium intakes in the preschool population (1.5 to 5 years). Intervention reporting was assessed using intervention intensity, behavior change techniques and Workgroup for Intervention Development and Evaluation Research (WIDER), with the quality of studies evaluated using risk of bias and Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Five of the 14 studies included in the review reported significant improvements in children's dairy (4/5) or calcium (1/5) intake. Characteristics that may enable intervention effectiveness include the delivery of interventions in one setting (preschool facility), using specific behavior change techniques (environmental restructuring and teach to use prompts/cues), and targeting both parent and child. Overall, the interventions assessed demonstrated variable success and highlighted the need for developing effective interventions designed to increase dairy and/or calcium intakes in preschool-aged children.
| S-EPMC6521222 | biostudies-literature
Project description:BackgroundThe overarching objective was to examine the effectiveness of intervention strategies to promote fruit and vegetable consumption. To do this, systematic review evidence regarding the effects of intervention strategies was synthesized; organized, where appropriate, by the setting in which the strategies were implemented. Additionally, we sought to describe gaps in the review of evidence; that is, where evidence regarding the effectiveness of recommended policy actions had not been systematically synthesised.MethodsWe undertook a systematic search of electronic databases and the grey literature to identify systematic reviews describing the effects of any intervention strategy targeting fruit and/or vegetable intake in children or adults of any age.ResultsThe effects of 32 intervention strategies were synthesised from the 19 included reviews. The strategies were mapped across all three broad domains of the NOURISHING framework (i.e. food environment, food system and behaviour change communication), but covered just 14 of the framework's 65 sub-policy areas. There was evidence supporting the effectiveness of 19 of the 32 intervention strategies. The findings of the umbrella review suggest that intervention strategies implemented within schools, childcare services, homes, workplaces and primary care can be effective, as can eHealth strategies, mass media campaigns, household food production strategies and fiscal interventions.ConclusionsA range of effective strategy options are available for policy makers and practitioners interested in improving fruit and/or vegetable intake. However, the effects of many strategies - particularly those targeting agricultural production practices, the supply chain and the broader food system - have not been reported in systematic reviews. Primary studies assessing the effects of these strategies, and the inclusion of such studies in systematic reviews, are needed to better inform national and international efforts to improve public health nutrition.Trial registrationThe review protocol was deposited in a publicly available Open Science framework prior to execution of the search strategy. https://osf.io/unj7x/.
| S-EPMC7798190 | biostudies-literature
Project description:Fruit and vegetable (FV) based intervention studies can be effective in increasing short term FV consumption. However, the longer term efficacy of such interventions is still unclear. The aim of the current study was to examine the maintenance of change in FV consumption 18-months after cessation of a FV intervention and to examine the effect of participating in a FV intervention on barriers to FV consumption.A follow-up of a randomised controlled FV trial in 83 older adults (habitually consuming ?2 portions/day) was conducted. At baseline, participants were assigned to continue consuming ?2 portions FV/day or consume ?5 portions FV/day for 16-weeks. We assessed FV intake and barriers to FV consumption at baseline, end of intervention and 18-months post-intervention.At 18-months, mean FV intakes in both groups were greater than baseline. The 5 portions/day group continued to show greater increases in FV consumption at 18-months than the 2 portions/day group (p?<?0.01). At 18-months, both groups reported greater liking (p?<?0.01) and ease in consuming FV (p?=?0.001) while difficulties with consuming FV decreased (p?<?0.001). The 2 portions/day group reported greater awareness of FV recommendations at 18-months (p?<?0.001).Participating in a FV intervention can lead to longer-term positive changes in FV consumption regardless of original group allocation.Clinical Trials.gov NCT00858728 .
| S-EPMC4683738 | biostudies-literature
Project description:We evaluated the relation of fruit and vegetable consumption, including specific fruits and vegetables, with incident breast cancer characterized by menopausal status, hormone receptor status and molecular subtypes. Fruit and vegetable consumption, cumulatively averaged across repeated, validated questionnaires, was examined in relation to risk of invasive breast cancer among 182,145 women initially aged 27-59 years in the Nurses' Health Study (NHS, 1980-2012) and NHSII (1991-2013). Cox proportional hazards regression, adjusted for known risk factors, was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) and assessed tumors by hormone receptor status and molecular subtypes. We prospectively documented 10,911 invasive breast cancer cases. Greater intake of total fruits and vegetables, especially cruciferous and yellow/orange vegetables, was associated with significantly lower breast cancer risk (>5.5 vs. ?2.5 servings/day HR = 0.89, 95% CI = 0.83-0.96; ptrend = 0.006). Intake of total vegetables was especially associated with lower risk of estrogen receptor negative tumors (HR per 2 additional servings/day as a continuous variable = 0.84, 95%CI = 0.77-0.93; pheterogeneity = 0.02). Among molecular subtypes, higher intake of total fruits and vegetables (HR per 2 additional servings/day as a continuous variable) was most strongly associated with lower risk of human epidermal growth factor receptor 2 (HER2)-enriched (HR = 0.79, 95%CI = 0.67-0.93), basal-like (HR = 0.84, 95%CI = 0.72-0.97) and luminal A (HR = 0.94, 95%CI = 0.89-0.99), but not with luminal B tumors (pheterogeneity = 0.03). In conclusion, our findings support that higher intake of fruits and vegetables, and specifically cruciferous and yellow/orange vegetables, may reduce the risk of breast cancer, especially those that are more likely to be aggressive tumors.
| S-EPMC6440478 | biostudies-literature
Project description:BackgroundIdentifying dietary factors that determine insulin sensitivity and secretion in children entering puberty may provide valuable information for the early prevention of type 2 diabetes.ObjectivesWe assessed whether macronutrients and food groups are longitudinally associated with insulin sensitivity and secretion over a 2-y period in children with a family history of obesity, and whether associations differ by level of adiposity.MethodsData were derived from the Quebec Adipose and Lifestyle Investigation in Youth (QUALITY) Study, an ongoing prospective cohort including 630 children recruited at ages 8-10 y, with ≥1 obese parent, and followed 2 y later (n = 564). The intake of macronutrients and foods was assessed at baseline using three 24-h dietary recalls. At age 10-12 y, insulin sensitivity was assessed by the Matsuda Insulin Sensitivity Index (ISI) and the homeostatic model assessment of insulin resistance. Insulin secretion was assessed by the ratio of the area under the curve of insulin to the area under the curve of glucose at 30 min and at 120 min of an oral-glucose-tolerance test. Multivariable linear regression models were fitted for each dietary factor while adjusting for age, sex, puberty, physical activity, screen time, total energy intake, and percentage of body fat; and interaction terms between dietary factors and percentage of body fat were tested.ResultsSaturated fat intake was associated with a 1.95% lower (95% CI: -3.74%, -0.16%) Matsuda ISI, whereas vegetable and fruit intake was associated with a 2.35% higher (95% CI: 0.18%, 4.52%) Matsuda ISI 2 y later. The association of saturated fat intake with insulin sensitivity was most deleterious among children with a higher percentage of body fat (P-interaction = 0.023). Other than fiber intake, no longitudinal associations between dietary intake and insulin secretion were found.ConclusionsLowering saturated fat and increasing vegetable and fruit intakes during childhood may improve insulin sensitivity as children enter puberty. This study was registered at www.clinicaltrials.gov as NCT03356262.
| S-EPMC6533243 | biostudies-literature
Project description:ObjectiveTo identify currently available evidence on fruit and vegetable consumption in association with frailty by conducting a systematic review of the literature and to summarise and critically evaluate it.DesignSystematic review.SettingFour electronic databases (Embase, MEDLINE, CINAHL and PsycINFO) were systematically searched in August 2017 for observational cohort studies providing cross-sectional or prospective associations between fruit and vegetable consumption and frailty risks. Additional studies were searched by manually reviewing the reference lists of the included studies and related review papers and conducting forward citation tracking of the included studies. The methodological quality of prospective studies was assessed using the Newcastle-Ottawa scale.ParticipantsCommunity-dwelling general populations.ResultsA total of 6251 studies were identified, of which five prospective studies with follow-up periods of 2-10.5 years and two cross-sectional studies were included. Among the five prospective studies, three had adequate methodological quality. Because of different measurements and statistical methodologies, a meta-analysis was not possible. The two studies of good quality showed that fruit and vegetable consumption was mostly associated with lower risk of incident frailty. The other study as a sub-analysis retrospectively examined baseline fruit and vegetable consumption of those who developed frailty and those who did not at follow-up and showed no significant associations.ConclusionsAlthough good quality studies on this topic are scarce, there is some suggestion that higher fruit and vegetable consumption may be associated with lower frailty risk. More high quality research is needed.
| S-EPMC6182506 | biostudies-literature