Preliminary results from a multi component kindergarten- based intervention to promote healthy diet in toddlers. A cluster randomized trial.

摘要

Background: Concern has arisen due to the lack of diversity in children's diet with corresponding low intake of fruit and vegetables and high intakes of unhealthy processed food which may be a factor in the rising prevalence of obesity. One reason for the lack of diversity may be food neophobia. The primary aim of the "Food for preschoolers"-intervention was to reduce levels of food neophobia in toddlers, aged 2 years, and promote healthy feeding practices among kindergarten staff and parents. The purpose of this presentation is to present effect of the intervention on dietary intake. Methods: Food for toddlers is a cluster randomized trial. Eighteen randomly selected kindergartens located in two counties in Norway with enrolled children born in 2012 participated. The kindergartens were randomly assigned to the intervention or control groups. A 9-week multi-component intervention was implemented, with four main elements: 1) kindergarten staff implemented a pedagogical tool (Sapere method) in daily sessions to promote willingness to try new food; 2) kindergarten staff prepared and served the toddlers a cooked lunch; 3) kindergarten staff were encouraged to follow 10 meal principles on modeling, responsive feeding, repeated exposure; and 4) parents were encouraged to apply relevant feeding practices. The control group continued their usual practices. Dietary intake was assessed with food frequency questions. A sum score of healthy food; milk, water, fruits (2 items), berries (2 items), vegetables (4 items), potatoes, fish and seafood (3 items), whole grain bread (2 items) and oat meal porridge was calculated. Frequency for each item ranged from 0-10 times per week yielding a possible sum score range from 0-170. Results: Data was analyzed by a multilevel linear mixed model with the sum score as the dependent variable. The model was adjusted for gender and parental education. The model was adjusted for kindergarten as a random effect. There was no significant difference in the healthy food sum score after the intervention (Intervention group: 56.5 (SD: 1.9) vs. control group: 60.4 (2.4), p = 0.219). Conclusion: Our results suggest that there was no intervention effect on child dietary intake measured just after the intervention. There is an ongoing data collection at age four, two years after the intervention to measure possible long term effect. Further analyses are needed to understand why there was no effect on child diet.