Increasing fruit and vegetable consumption in preschoolers in child care centers: Final results of the 5 a Day Preschool Power Plus study

Purpose: To develop and test a childcare center-based program to encourage consumption of fruits and vegetables (f&v), including eight “target” f&v, through repeated exposure and f&v experiences. Presently, only 16% of American children eat 5 f&v servings daily. Methods: Twenty childcare centers were matched on enrollment and randomly assigned to intervention or comparison group. The 26-week intervention included: 1) food service changes, 2) classroom curricula, including weekly f& v cooking and tasting, and 3) parent events supporting consumption at home. Trained observers recorded children's lunch and snack consumption at baseline and follow-up. Results: At follow-up, adjusting for baseline values, the intervention group ate significantly more vegetables than controls at lunch (0.54 vs. 0.36 servings, p=.005) and more total f&v (1.7 vs. 1.3 servings, p=.06) and dietary fiber (1.8g vs. 1.1g, p=.03) at snack. Surprisingly, there was no difference in consumption of targeted f&v. Combining mean f&v consumption at lunch and snack, the intervention sites' total was 3.2 servings versus 2.7 for controls, a difference of 1/2 serving (p=.08). Stratifying the data by baseline BMI status, f&v consumption at snack was much greater in the intervention group for those above the 85th percentile than in controls (1.8 vs. 1.0 servings, p=.006), a difference not seen at lunch or for those below the 85th percentile. Based on self-report, intervention parents significantly increased at home servings of f&v (p=.03) and target f&v (p=.0001). Conclusion: The intervention successfully increased vegetable consumption and exposure to f&v in the daycare setting and was well received.