Objective: To test the efficacy of three nutrition education strategies on the intake of different vegetables in preschool children. Design: This is an experimental study conducted in four Portuguese preschools. The intervention consisted of 20-min educational sessions, once a week, for 5 weeks, with one of the following randomised educational strategies: Portuguese Food Wheel Guide (control), digital game, storybook, storybook and reward (stickers). All groups had repeated exposure to vegetables in all sessions. A pre- and post-test were conducted to determine vegetable intake, and a 6-month follow-up was realised. Setting: Preschools of Leiria district, Portugal. Participants: A sample of 162 children aged 3 to 6 years. All eligible children attending the preschools were invited to participate. Results: All interventions tested were effective in increasing vegetable consumption both in the short and medium term, without statistically significant differences, compared to the control group. Stickers were more effective in the short term than in the medium term. Conclusions: The nutritional education strategies associated with repeated exposure tested in this study were effective in promoting vegetable consumption in preschool children. The use of stickers may be a valid strategy to promote the consumption of vegetables less recognised by children.

Background Vegetable consumption is particularly low in childhood and is one of the main concerns about diet in this age range. Vegetable consumption is associated with better cardiovascular health and the prevention of other chronic non-communicable diseases. Therefore, it is important to find strategies to promote vegetable consumption at early ages, since eating habits established in childhood tend to persist into adulthood. The purpose of this study is to evaluate the impact of using a digital game on knowledge about vegetables and his consumption, in preschool children. Methods This is an experimental study conducted in a Portuguese preschool, with children from 3 to 6 years (n = 39). A pre- and post-test were conducted to determine vegetable intake (carrot, lettuce, cucumber, tomato and purple cabbage) and knowledge about vegetables. The intervention consisted of 20-minutes educational sessions with the digital game Veggies4myHeart, once a week for five weeks. A 6-month follow-up was realized. Results There was a statistically significant increase in the consumption of all vegetables from the pre- test to the post-test. Intake at follow-up was higher than pre-test for the five vegetables and the intake of cucumber and tomato was higher in the follow-up than in post-test. In the knowledge assessment, a higher number of correct answers were obtained in the post-test. Conclusions The use of the digital game ‘Veggies4myHeart’ had a positive impact on the consumption and knowledge about vegetables in preschool children. The use of digital games could be a useful tool for conducting nutrition education with preschool children.

Several factors can influence children’s food choices and preferences. Food and nutrition education at school can therefore be the key to improving children’s nutrition knowledge, and consequently their eating behavior. To this end, several strategies seem effective, and the current difficulty lies in choosing the best methodology to implement. To determine which intervention has the greatest impact on preschool children’s nutrition knowledge about vegetables: serious game, children’s story, children’s story associated with stickers, or food wheel. This experimental study had the participation of 162 children, aged between 3 to 6 years, attending four public school institutions in the district of Leiria, Portugal. To increase children’s nutrition knowledge about vegetables, four interventions were carried out: digital game, children’s story, children’s story associated with stickers, and a food wheel. To assess the recognition of foods, identification of vegetables, and the functions of five vegetables (lettuce, tomato, carrot, cucumber, and red cabbage), two instruments were applied at three different times (at the start, conclusion, and 6 months after the intervention). The collected data were analyzed using IBM SPSS software. There was an increase in nutrition knowledge both post-intervention and 6 months follow-up, compared to the initial moment. This increase was statistically significant (p <0.001) when evaluated overall. The intervention with the digital game “Veggies4myheart”, compared to the children’s story associated with stickers, proved to be more effective in increasing nutrition knowledge related to the vegetable's functions, 6 months after the intervention (p = 0.028). The four interventions were effective to promote nutrition knowledge about vegetables in preschool children. The interventions with the digital game or with the child’s story with stickers seem to be the most appropriate to increase knowledge about vegetable functions.

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