{"id":94362,"date":"2023-08-23T12:11:42","date_gmt":"2023-08-23T10:11:42","guid":{"rendered":"https:\/\/aprifel-pp.mentalworks.biz\/?post_type=article_revue&p=94362"},"modified":"2023-08-23T12:45:14","modified_gmt":"2023-08-23T10:45:14","slug":"computer-games-and-availability-what-works-in-increasing-childrens-consumption-of-fruits-and-vegetables-in-school","status":"publish","type":"article_revue","link":"https:\/\/aprifel-pp.mentalworks.biz\/en\/global-fv-newsletter-article\/computer-games-and-availability-what-works-in-increasing-childrens-consumption-of-fruits-and-vegetables-in-school\/","title":{"rendered":"Computer games and availability: what works in increasing children\u2019s consumption of fruits and vegetables in school?"},"content":{"rendered":"\n
\"\"<\/figure>\n\n\n\n

Schools are powerful environments<\/strong> for the development <\/strong>of children, and eating behavior<\/strong> is no exception: children from all socio-economic backgrounds mingle in school and can eat up to three meals a day in school (Dudiey et al., 2015<\/a>, Grosso et al., 2013<\/a>). Therefore, schools provide an effective setting for educating children about food and nutrition,<\/strong> with school-based nutrition programs<\/strong> having an important impact on child eating behavior and nutrition knowledge<\/strong> (Murimi et al., 2018<\/a>; Methner et al., 2017<\/a>; Keihner et al., 2017<\/a>). Successful school programs, such as providing healthy foods <\/strong>in a familiar way to children, can result in children making healthier food choices<\/strong> and steer away from energy-dense foods that are high in added fat and sugars<\/strong>. This is crucial since these foods can contribute to an energy imbalance that contributes to weight gain and potentially obesity (WHO, 2021)<\/a>, which in turn is significantly associated with adverse school outcome<\/strong>s (Falkner et al., 2001<\/a>; Datar et al., 2004<\/a>).<\/p>\n\n\n\n

Given the importance of school-based interventions, many of them have been developed<\/strong> and evaluated in the past few decades (Methner et al., 2017<\/a>; Keihner et al., 2017<\/a>). A recent review (Verdonschot et al., 2023) has examined what strategies have shown a more positive impact on fruit and vegetable intake and nutrition knowledge.<\/strong><\/p>\n\n\n\n

Providing fruits and vegetables in school is the most effective strategy to increase fruit intake<\/h2>\n\n\n\n

Many intervention<\/strong>s have been implemented to increase children\u2019s fruit and vegetable consumption. <\/strong>Some of them provide fruits and vegetables directly<\/strong>, such as free or subsidized distribution at lunchtime<\/strong> or in small retailers close to the school<\/strong> or providing healthy foods or beverages in the classroom <\/strong>(Evans et al., 2012<\/a>). Some of the interventions are indirect, focusing on increasing the availability of fruits and vegetables in cafeterias<\/strong> or vending machines without providing it directly (Micha et al., 2018<\/a>).<\/p>\n\n\n\n

These interventions were especially effective in increasing fruit consumption<\/strong>, with positive effects in 5 studies with over 10.166 participants in total (Moore and Tapper, 2008<\/a>; Bere et al., 2010<\/a>; Fogarty et al., 2007<\/a>; Eriksen et al., 2003<\/a>; Ashfield-Watt et al., 2009<\/a>). Concerning vegetable consumption, some studies showed positive effects,<\/strong> with one showing an increase of 20.7g\/day (Tak et al., 2007<\/a>), yet other studies showed negative effects (Bere et al., 2010,<\/a> Eriksen et al., 2003<\/a>).<\/p>\n\n\n\n

Online games and activities to increase children\u2019s vegetable intake<\/strong><\/h2>\n\n\n\n

As children spend more and more time on the internet, researchers are profiting from this means to try to educate children in nutrition and healthy eating in an entertaining way.<\/strong> To do so, different strategies have been used, including online questionnaires with feedback <\/strong>(Evans et al., 2012), online resources to be accessed by students at home or at school <\/strong>(Dudiey et al., 2015<\/a>), or educational games<\/strong> (Silveira et al., 2011<\/a>). One example is the game \u201cSquire\u2019s Quest!<\/strong>\u201d, which includes challenges to eat more fruits, 100% fruit juice, and vegetables, as well as virtual cooking sessions to teach them healthy recipes (Baranowski et al., 2003<\/a>)
And it works: using online games and activities increased the quantity of vegetables that children consumed<\/strong>, based on multiple studies with a total sample size of 2211 (Baranowski et al., 2003<\/a>; Mangunkusumo et al., 2007<\/a>; Amaro et al., 2006<\/a>). The effect on fruit consumption was not that clear, showing mixed effects. The game \u201cSquire\u2019s Quest!\u201d was particularly effective in increasing fruits and vegetables consumption<\/strong>, with children who participated in the program increasing their consumption one serving more than children who did not participate.<\/strong><\/p>\n\n\n\n

Multiple interventions simultaneously are more effective than individual strategies alone<\/h2>\n\n\n\n

Increasing availability of fruits and vegetables in school<\/strong>, as well as creating online games and activities<\/strong> effectively increase the amount of fruit and vegetables that children eat at school and even at home.<\/strong> Yet why stop at one strategy when you can implement more of them at the same time? Indeed, joining forces and applying more than one strategy<\/strong> at the same time has proven to be the most effective way of increasing fruit and vegetable consumption in children (Van Cauwenberghe et al., 2010<\/a>; Evans et al., 2012<\/a>; Murimi et al., 2018<\/a>). Specifically, the most effective are combinations of (1) education components, targeting school children directly<\/strong>; (2) environmental components, targeting the school environment, including the school canteen and school staff but not students; <\/strong>and (3) parental and family components, which involve parents to reinforce the school intervention.<\/strong><\/p>\n\n\n\n

Reviews such as the one in hand (Verdonschot et al., 2023<\/a>), shedding some light on how effective individual components<\/strong>, as well as reviews researching effectiveness of multiple component interventions <\/strong>(Evans et al., 2012<\/a>; Micha et al., 2018<\/a>), allow the development of public policies armed with science-based evidence<\/strong>. Indeed, a toolkit was developed in 2016 by the Joint Research Center (the European Commission\u2019s in-house science service; Mak et al., 2016<\/a>) providing schools with recommendations on how to increase fruit and vegetable consumption.<\/strong> It is the analysis of these interventions<\/strong> that direct the development of public policies towards the most effective action levers,<\/strong> allowing schools to promote fruit and vegetable consumption more effectively.<\/strong><\/p>\n\n\n\n

Based on <\/strong>: Verdonschot, Angeliek, et al. “Effectiveness of school-based nutrition intervention components on fruit and vegetable intake and nutrition knowledge in children aged 4\u201312 years old: an umbrella review.” Nutrition Reviews 81.3 (2023): 304-321.<\/p>\n\n\n\n

\n
\n <\/i>\n Key messages<\/strong>\n <\/div>\n
    \n
  • Providing fruits and vegetables in school is the most effective strategy to increase fruit intake.<\/li>\n
  • Online games and activities are effective as a means to increase children\u2019s vegetable intake. <\/li>\n
  • Multiple interventions simultaneously are more effective than individual strategies alone.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n\n\n
    \n
    \n <\/i>\n Methodology<\/strong>\n <\/div>\n
    <\/ul>\n
  • 8 reviews between 2011 and 2020 were included (2 systematic, 5 systematic with meta-analysis, 1 meta-analysis), which report 33 primary studies<\/li>\n
  • Effect on FV consumption of 7 intervention components was assessed: FV provision, gaming, curriculum, experiential learning, rewards\/incentives, nudging, and caregiver involvement <\/li>\n
  • Limitations: <\/li>\n
  • (1)\tnot many studies could be included, since many used multiple-component programs.<\/li>\n

    (2)\tthe primary studies used by the reviews were generally rated as \u201clow quality\u201d in terms of methodology, meaning that their confidence that the estimate of the effect is not different from the true effect is limited. <\/p>\n<\/div>\n<\/div>\n\n\n\n

    \n
    \n <\/i>\n References<\/strong>\n <\/div>\n
    \n
    \n <\/i>\n Amaro, Salvatore, et al. “Kaledo, a new educational board-game, gives nutritional rudiments and encourages healthy eating in children: a pilot cluster randomized trial.” European journal of pediatrics 165 (2006): 630-635.<\/span>\n <\/div>\n
    \n <\/i>\n Ashfield-Watt, Pauline AL, Elizabeth A. Stewart, and Judi A. Scheffer. “A pilot study of the effect of providing daily free fruit to primary-school children in Auckland, New Zealand.” Public health nutrition 12.5 (2009): 693-701<\/span>\n <\/div>\n
    \n <\/i>\n Baranowski, Tom, et al. “Squire\u2019s Quest!: Dietary outcome evaluation of a multimedia game.” American journal of preventive medicine 24.1 (2003): 52-61<\/span>\n <\/div>\n
    \n <\/i>\n Bere, Elling, Marit Hilsen, and Knut-Inge Klepp. “Effect of the nationwide free school fruit scheme in Norway.” British Journal of Nutrition 104.4 (2010): 589-594.<\/span>\n <\/div>\n
    \n <\/i>\n Datar A, Sturm R. Childhood overweight and elementary school outcomes. in J Obes. 2004,30:1449-1460.<\/span>\n <\/div>\n
    \n <\/i>\n Dudiey OA, Cotton WG, Peralta LR. Teaching approaches and strategies that promote healthy eating in primary schud children: a systematic review and meta-analysis. Int \/ Behov Nutr Phys Act. 2015:12:1-26.<\/span>\n <\/div>\n
    \n <\/i>\n Eriksen, Karen, et al. “Effect of a fruit and vegetable subscription in Danish schools.” Public health nutrition 6.1 (2003): 57-63.<\/span>\n <\/div>\n
    \n <\/i>\n Evans, Charlotte EL, et al. “Systematic review and meta-analysis of school-based interventions to improve daily fruit and vegetable intake in children aged 5 to 12 y.” The American journal of clinical nutrition 96.4 (2012): 889-901.<\/span>\n <\/div>\n
    \n <\/i>\n Falkner NH, Neumark-Stainer D, Story M, et al. Sodal, educational, and psychological correlates of weight status in adolescents. Obes Res. 2001:932-42.<\/span>\n <\/div>\n
    \n <\/i>\n Fogarty, A. W., et al. “Does participation in a population-based dietary intervention scheme have a lasting impact on fruit intake in young children?.” International Journal of Epidemiology 36.5 (2007): 1080-1085.<\/span>\n <\/div>\n
    \n <\/i>\n Grosso G, Mistretta A, Turconi G, et al. Nutrition knowledge and other determinants of food intake and lifestyle habits in children and young adolescents living In a rural area of Sicily, South haly. Pubic Health Nutr. 2013:1611827- 1836.<\/span>\n <\/div>\n
    \n <\/i>\n Keihner A, Rosen N, Wakimoto P, et al. Impact of California Childrer’s Power Play! Campaign on fruit and vegetable intake and physical activity amang fourth-and fifth-grade students. Am J Health Promar. 2017 31-189-191<\/span>\n <\/div>\n
    \n <\/i>\n Mak, T., Storcksdieck Genannt Bonsmann, S., Louro Caldeira, S. and Wollgast, J., How to promote fruit and vegetable consumption in schools: a toolkit, EUR 27946, Publications Office of the European Union, Luxembourg, 2016, ISBN 978-92-79-58781-8 (pdf),978-92-79-58780-1 (print),978-92-79-75168-4 (ePub), doi:10.2788\/33817 (online),10.2788\/678338 (print),10.2788\/81120 (ePub), JRC100990<\/span>\n <\/div>\n
    \n <\/i>\n Mangunkusumo, R. T., Brug, J., de Koning, H. J., van der Lei, J., & Raat, H. (2007). School-based internet-tailored fruit and vegetable education combined with brief counselling increases children’s awareness of intake levels. Public health nutrition, 10(3), 273-279.<\/span>\n <\/div>\n
    \n <\/i>\n Methner 5, Maschkowski G, Hartmann M. The European School Fruit Scheme: impact on children’s fruit and vegetable consumption in North Rhine Westphalla. Germany, Public Health Nut. 2017:20542-548.<\/span>\n <\/div>\n
    \n <\/i>\n Micha, Renata, et al. “Effectiveness of school food environment policies on children\u2019s dietary behaviors: A systematic review and meta-analysis.” PloS one 13.3 (2018): e0194555.<\/span>\n <\/div>\n
    \n <\/i>\n Moore, Laurence, and Katy Tapper. “The impact of school fruit tuck shops and school food policies on children\u2019s fruit consumption: a cluster randomised trial of schools in deprived areas.” Journal of epidemiology & community health 62.10 (2008): 926-931.<\/span>\n <\/div>\n
    \n <\/i>\n Murimi, Mary W., et al. “Factors that contribute to effective nutrition education interventions in children: a systematic review.” Nutrition reviews 76.8 (2018): 553-580.<\/span>\n <\/div>\n
    \n <\/i>\n Silveira, J. A., Taddei, J. A., Guerra, P. H., & Nobre, M. R. (2011). Effectiveness of school-based nutrition education interventions to prevent and reduce excessive weight gain in children and adolescents: a systematic review. Jornal de pediatria, 87, 382-392<\/span>\n <\/div>\n
    \n <\/i>\n Tak, Nannah I., Saskia J. Te Velde, and Johannes Brug. “Ethnic differences in 1-year follow-up effect of the Dutch Schoolgruiten Project\u2013promoting fruit and vegetable consumption among primary-school children.” Public health nutrition 10.12 (2007): 1497-1507.<\/span>\n <\/div>\n
    \n <\/i>\n Van Cauwenberghe, Eveline, et al. “Effectiveness of school-based interventions in Europe to promote healthy nutrition in children and adolescents: systematic review of published and \u2018grey\u2019literature.” British journal of nutrition 103.6 (2010): 781-797.<\/span>\n <\/div>\n
    \n <\/i>\n Verdonschot, Angeliek, et al. “Effectiveness of school-based nutrition intervention components on fruit and vegetable intake and nutrition knowledge in children aged 4\u201312 years old: an umbrella review.” Nutrition Reviews 81.3 (2023): 304-321.<\/span>\n <\/div>\n
    \n <\/i>\n World Health Organization. Obesity and overweight. 2021. Available at: hmps:\/\/ www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight. Accessed October 12, 2021.<\/span>\n <\/div>\n <\/div>\n<\/div>\n","protected":false},"template":"","class_list":["post-94362","article_revue","type-article_revue","status-publish","hentry"],"acf":{"auteur":"","source":"","revue":[{"ID":94237,"post_author":"25","post_date":"2023-08-23 12:11:05","post_date_gmt":"2023-08-23 10:11:05","post_content":"\n
    \"\"<\/figure>\n\n\n\n

    While the health benefits of fruit and vegetables<\/strong> are well-known for children<\/strong>, their intake <\/strong>remains insufficient <\/strong>among this population. A growing number of interventions are designed to promote their intake as this stage of life may be an optimal time for dietary interventions<\/strong>. Numerous reviews and scientific studies assessed the impact of those interventions and initiatives on children in various settings.<\/p>\n\n\n\n

    The Global Fruit and Veg Newsletter of this month presents three articles to determine interventions and initiatives that could effectively increase fruit and vegetable consumption in children<\/strong>.<\/p>\n\n\n\n

    The first review has examined which strategies <\/strong>have shown a positive impact on fruit and vegetables intake<\/strong> and nutrition knowledge<\/strong> in children <\/strong>aged between 4-12 years old<\/strong>. According to this work, providing fruit and vegetables in school is the most effective strategy<\/strong> to increase fruit intake<\/strong> in children, whereas online games<\/strong> and activities (for example, challenges to eat more fruit and vegetables, virtual cooking sessions...) could increase vegetable intake<\/strong>. Yet, this review confirms a generally observed result : implementing multiple interventions simultaneously<\/strong> is more effective<\/strong> than individual strategies alone.<\/p>\n\n\n\n

    The second review systematically identified published randomized controlled trials (RCTs) evaluating childcare- or preschool-based interventions<\/strong> designed to increase objectively measured intake of fruit<\/strong>, vegetables<\/strong>, or both <\/strong>in US preschool children<\/strong> (aged 2-5 years). The most consistent evidence <\/strong>observed is that inclusion of nutrition education components, if interactive, was consistently effective at improving fruit and vegetables intake<\/strong>, while manipulating the feeding environment without directly educating children<\/strong>, produced inconsistent results<\/strong>.<\/p>\n\n\n\n

    The third article determined the associations between family socio-economic status<\/strong> and children\u2019s<\/strong> fruit and vegetables consumption<\/strong> wether it was mediated by parental role-modeling and food availability. The results showed that parental educational level<\/strong> is a stronger predictor of children\u2019s fruit and vegetables consumption<\/strong> than relative family income in Finland. This association <\/strong>was mediated <\/strong>by parental role modelling<\/strong>, higher availability of fruit and vegetables<\/strong> and lower availability of sugary food and drink<\/strong>.<\/p>\n\n\n\n

    These three articles show that there is a wide range of interventions<\/strong> proposed to promote fruit and vegetables among children<\/strong>, the effectiveness <\/strong>of which varies <\/strong>according to several factors<\/strong>, including age group, food environment and parental feeding practices. They emphasize that there is no single approach<\/strong> to ahcieve higher F&V but rather several strategies which shouldbe adapted to local situations.<\/p>\n\n\n\n\n","post_title":"Effective interventions to increase fruit and vegetables consumption in children","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"effective-interventions-to-increase-fruit-and-vegetables-consumption-in-children","to_ping":"","pinged":"","post_modified":"2024-10-24 17:28:20","post_modified_gmt":"2024-10-24 15:28:20","post_content_filtered":"","post_parent":0,"guid":"https:\/\/aprifel-pp.mentalworks.biz\/?post_type=revue&p=94237","menu_order":30,"post_type":"revue","post_mime_type":"","comment_count":"0","filter":"raw"}],"position":"1","references":""},"yoast_head":"\nComputer games and availability<\/title>\n<meta name=\"description\" content=\"Schools provide an effective setting for educating children about food and nutrition, 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