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Title: Improvement in fruit and vegetable consumption associated with more favorable energy density and nutrient and food group intake, but not kilocalories

Author
item Thompson, Deborah - Debbe
item FERRY, JR, ROBERT - University Of Tennessee
item CULLEN, KAREN - Children'S Nutrition Research Center (CNRC)
item LIU, YAN - Children'S Nutrition Research Center (CNRC)

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/2/2016
Publication Date: 6/14/2016
Publication URL: https://handle.nal.usda.gov/10113/62754
Citation: Thompson, D.J., Ferry, Jr, R.J., Cullen, K.W., Liu, Y. 2016. Improvement in fruit and vegetable consumption associated with more favorable energy density and nutrient and food group intake, but not kilocalories. Journal of the Academy of Nutrition and Dietetics. doi: 10.1016/j.jand.2016.05.002.

Interpretive Summary: Children generally do not consume adequate amounts of fruits and vegetables (F/V). Eating more F/V can improve energy density and overall diet quality. The goal of this study was to examine dietary data from a successful study that promoted F/V to 4th and 5th graders. Favorable changes were seen in energy density and F/V related dietary components, particularly among children who created action plans as part of goal setting. Increasing F/V consumption improved energy density and diet quality in preadolescent children. Encouraging preadolescent children to set goals and create action plans may be an effective approach to increasing F/V consumption among preadolescent children.

Technical Abstract: Children generally do not consume adequate amounts of fruits and vegetables (F/V). Eating more F/V can improve energy density and overall diet quality. Our aim was to investigate whether improvements in F/V consumption were associated with improvements in energy density, total calories, and dietary components related to F/V. We performed secondary analyses of dietary data from a successful four-group randomized controlled trial promoting F/V. Data were collected at baseline, immediately after gameplay, and 3 months post intervention. Preadolescent child-parent dyads (n=400) were recruited. Eligibility criteria were 4th- or 5th-grade child (approximately 9 to 11 years old) with Internet access and a parent willing to participate in the intervention. Complete dietary data were collected on 387 of the 400 child participants. The videogame was available online on a secure, password-protected website. Dietary intake was assessed with three unannounced dietary recalls collected at each data-collection period via telephone by trained staff using Nutrition Data System for Research software. Energy density and F/V, nutrient, and food consumption were calculated. A 4×3 (group by time) repeated measures analysis of covariance with mixed-effect linear models was used. Covariates included child's sex, race/ethnicity, and total energy intake as well as parent's age and household education. Energy was excluded as a covariate in the energy density and energy models. Significant changes occurred in energy density. A significant interaction (group by time) was observed (F6, 515=2.40; P<0.05) in energy density from food only, while a significant time effect was observed for energy density from all foods and beverages (F2, 388=13.75; P<0.0001). Desirable changes were also observed in F/V-related dietary components. Increasing F/V consumption improved energy density and diet quality considerably in preadolescent children.