A Randomized Controlled Trial Evaluating the FIT Game's Efficacy in Increasing Fruit and Vegetable Consumption

Area of Science:

• Pediatric Nutrition
• Behavioral Science
• Public Health Interventions

Background:

• Low fruit and vegetable (FV) consumption is prevalent in children.
• Incentive-based interventions can be costly and may reduce intrinsic motivation.

Purpose of the Study:

• To evaluate the FIT Game, a no-cost intervention using virtual incentives to increase children's FV consumption.
• To assess the intervention's impact on FV intake and biomarkers, and its long-term effects on intrinsic motivation.

Main Methods:

• Randomized controlled trial in four elementary schools with the FIT Game (n=881) or a control condition (n=978).
• Intervention involved daily comic-book episodes promoting collective vegetable-eating goals.
• Measured FV consumption via photo estimates and skin carotenoid concentrations at baseline, post-intervention, and 3-month follow-up.

Main Results:

• FIT Game participants showed significant increases in vegetable (d=0.41) and fruit (d=0.39) consumption, and skin carotenoids (d=0.66) post-intervention.
• These gains were maintained at 3-month follow-up for vegetables (d=0.21) and carotenoids (d=0.53).
• No negative impact on intrinsic motivation was observed.

Conclusions:

• The FIT Game effectively and sustainably increases children's FV consumption using virtual incentives.
• This intervention offers a cost-effective and non-detrimental approach to improving pediatric nutrition.
• The program's success highlights the potential of gamified, cooperative strategies in school-based health initiatives.