US children don’t eat enough fruits, vegetables and whole grains. A study published in the journal of the Academy of Nutrition and Dietetics shows that intervention programmes may be able to increase fruit and vegetable intake in low-income, rural areas where a disproportionately higher risk of overweight and obesity habits among children persists.
To evaluate students’ diet quality at the beginning and after the study, researchers designed the CHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments) study, a two-year randomised, controlled, community- and school-based intervention to prevent unhealthy weight gain among rural school-aged children. The team wanted to test its hypothesis that students exposed to the study would improve their diet quality due to healthier food environments.
Eight communities in rural California, Kentucky, Mississippi, and South Carolina participated in the study between 2007 and 2009. Two communities in each state were randomly assigned to either an intervention or control group. Students in the intervention sample were given daily access to healthier school foods and weekly educational curriculum which incorporated the goals of the Shape Up Somerville model: at least five servings of fruits and vegetables; no more than two hours of television or other screen time; and at least one hour of physical activity.
The mean age of the 1,230 participating students was 8.6 and about 85–95% of the students were nonwhite. A baseline analysis revealed that students in CHANGE schools ate similar amounts of fruits, vegetables, whole grains, dairy, potatoes/potato products, saturated fats, and sugar as students in control schools.
As a result of the intervention, food consumption of students in CHANGE schools was significantly different than students in the control schools. The students in the intervention group ate 0.22 cups more combined fruits and vegetables per 1,000 kcal than the control group and had significantly lower glycemic index.
“The outcome of the CHANGE study provides evidence that a multi-component intervention targeting low-income children living in rural communities in America can improve their diet quality. Overall, students consumed significantly more vegetables and combined fruits and vegetables after exposure to the CHANGE study intervention compared with students in control schools and communities,” concluded lead author Juliana Cohen, Department of Nutrition, Harvard School of Public Health.