Interventions for increasing fruit and vegetable consumption in children aged five years and under

Area of Science:

• Pediatric Nutrition
• Public Health Interventions
• Systematic Review Methodology

Background:

• Insufficient fruit and vegetable consumption in early childhood elevates the risk of future chronic diseases, including cardiovascular disease.
• Establishing healthy dietary patterns in young children is crucial for long-term health outcomes.

Purpose of the Study:

• To evaluate the effectiveness, cost-effectiveness, and adverse events of interventions aimed at increasing fruit and vegetable intake in children aged five years and under.
• To synthesize evidence from randomized controlled trials on pediatric dietary interventions.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs), including cluster-RCTs and cross-over trials, was conducted.
• Searches were performed across multiple databases (Cochrane CENTRAL, MEDLINE, Embase) and trial registers.
• Data extraction and risk of bias assessments were performed independently by two reviewers, with a third resolving disagreements.

Main Results:

• Fifty-five trials involving 11,108 participants were included.
• Child-feeding practice interventions showed a small, statistically significant increase in vegetable consumption (SMD 0.38), but with very low-quality evidence.
• Parent nutrition education and multicomponent interventions did not demonstrate significant short-term effects on fruit and vegetable consumption.

Conclusions:

• Current evidence on interventions to increase children's fruit and vegetable intake is sparse and of very low quality.
• Child-feeding practices may offer a slight benefit, but effect sizes are small and long-term impacts are unknown.
• Future research with rigorous methodologies is essential to improve understanding and develop effective interventions.