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.