Improvement in Fruit and Vegetable Consumption Associated with More Favorable Energy Density and Nutrient and Food Group Intake, but not Kilocalories

Abstract

Background Children generally do not consume adequate fruit and vegetables. Eating more fruit and vegetables may improve energy density and overall diet quality. Objective To investigate whether improvements in fruit and vegetable consumption were associated with improvements in energy density, total calories, and dietary components related to fruits and vegetables. Design Secondary analyses of dietary data from a successful 4-group randomized controlled trial promoting fruit and vegetables. Data were collected at baseline, immediately after gameplay, and 3 months post-intervention. Participants/setting Pre-adolescent child/parent dyads (n=400) were recruited. Eligibility criteria were 4th or 5th grade child (approximately 9–11 years old) with internet access and a parent willing to participate in the intervention. Complete dietary data were collected on 387 of the 400 participants. The videogame was available online on a secure, password-protected website. Main outcome measures Dietary intake was assessed with three unannounced dietary recalls collected at each data collection period via telephone by trained staff using NDSR 2009. Energy density, fruit and vegetable, nutrient, and food consumption were calculated. Statistical analysis performed A 4 (group) × 3 (time) repeated measures analysis of covariance with mixed–effect linear models was used. Covariates included child’s gender, race/ethnicity, and total energy intake as well as parent’s age and household education. Energy was excluded as a covariate in the energy density and energy models. Results Significant changes occurred in energy density. A significant interaction (group × time) was observed (F (6,515) = 2.40, P<0.05) in energy density from food only, while a significant time effect was observed for energy density from all foods and beverages (F (2,388) = 13.75, P<0.0001). Desirable changes were also observed in fruit and vegetable-related dietary components. Conclusions Increasing fruit and vegetable consumption significantly improved energy density and diet quality in pre-adolescent children.

Effects of the Rango Cards game intervention on food consumption, nutritional knowledge and self-efficacy in the adoption of healthy eating practices of high school students: a cluster randomised controlled trial

“…The meters directly impact health levels, energy and time available to play the match. Fruit and vegetable consumption is a health marker associated with diet quality and improved total energy density (47) . Thus, several educational strategies using games for health promotion seek to expand nutritional knowledge of the topic (33,48,49) .…”

Dietary intake in the early years and its relationship to BMI in a bi-ethnic group: the Born in Bradford 1000 study

“…Although children eating fruit and vegetables on more than five occasions per day is encouraging, we should not confuse this result with five portions per day since the quantity eaten is not included in our analysis. Even so, five times per day is beneficial because this should displace other unhealthier foods at this young age (37)(38)(39)(40) . We acknowledge that looking at dietary patterns (e.g.…”

Incorporating Behavioral Techniques into a Serious Videogame for Children

“…34 The Action group also reported favorable changes in energy density and key nutrients. 50 Children selected a variety of Fs and Vs as their favorites (Tables 4 and 5). The most frequently selected Fs and Vs were strawberries (84.0%) and corn (92.0%); the least favorite were papaya (4.0%) and kale (1.5%).…”