Life-style intervention among low SES preschoolers: A randomized controlled trial

BACKGROUND: This study aimed to determine the impact of the "Nutrition Enrichment and Healthy Living Model" (NEHLM by the JDC) on diet quality, nutrition knowledge, eating behaviors and dental health in low socioeconomic status (LSES) kindergarten children. METHODS: A randomized controlled trial conducted in a single town, where 258 preschoolers (aged 4-7y) and their mothers were randomly assigned either to the intervention group (n=184; nutrition, physical activity and dental hygiene classes for both children and parents), or to the control group (n=74; physical activity classes only). All interventions were performed by professional personnel. Family data were obtained by parental interviews and children's pre- and post- data were obtained by games and observations. Statistical analysis included use of t or ÷2 tests, and Generalized Estimating Equations models. RESULTS: Of the 258 children enrolled 238 children (94.8%) had complete baseline data and 220 completed the intervention period (87.6%). Children in the intervention group improved their nutritional knowledge by 38.9% from baseline (p<0.001). In addition in this arm, there was a 45.4% increase in the variety of the foods consumed (p<0.001), a 37.9% increase in daily fruit and vegetables consumption (p=0.001), 44.0% increase in habitual water drinking (p=0.02) and 31.4% decrease in sweet drink consumption (0.05). Improvements in dental hygiene were also seen in the intervention group but no differences were found in BMI scores between the groups. CONCLUSIONS: NEHLM delivered by trained professionals resulted in significant positive changes in both nutrition and dental hygiene knowledge and health behaviors in LSES preschool children.