Knowledge for better food systems

What makes a successful healthy food promotion intervention?

The paper is a systematic review of literature describing seven dietary interventions  aimed at increasing fruit and vegetable consumption in overweight or obese children. It points out that in the context of the global obesity problem, dietary interventions can be used to promote healthy eating habits, but taking a narrow and restrictive focus can result in an increased preference for the restricted foods and be unlikely at achieving positive, long-term change.

The paper is a systematic review of literature describing seven dietary interventions  aimed at increasing fruit and vegetable consumption in overweight or obese children. It points out that in the context of the global obesity problem, dietary interventions can be used to promote healthy eating habits, but taking a narrow and restrictive focus can result in an increased preference for the restricted foods and be unlikely at achieving positive, long-term change. The authors performed the literature search using a free-text search strategy in PubMed and Ovid MEDLINE to locate well designed, quality papers looking at randomized controlled trials of interventions that included an increase in fruit and/or vegetable consumption for  overweight/obese children. Three  out of the seven interventions showed statistically significant increases in consumption of fruits and vegetables attributed partly to factors like aspects of life targeted, parental involvement and provision of a supportive setting for changing behavior.  Finally, the authors discuss that the most successful intervention would involve a holistic approach that targets  children's' behavior at different points of their life and environment, provides nutritional education to the parents and the children and promotes healthy eating instead of limiting to a restricted diet. 

Abstract

Introduction Childhood obesity is now a global epidemic and the incidence continues to increase. Dietary interventions and nutritional education are possible options to manage childhood obesity. However, restrictive diets can result in negative outcomes, and therefore it may be more apt to encourage children to consume more fruit and vegetables and thereby develop a healthier positive attitude towards food.

Method A systematic review of literature of interventions to increase fruit and/or vegetable consumption in overweight or obese children and adolescents was conducted, applying a free-text strategy with a set of search terms.

Results A total of five studies describing seven interventions published in international peer-reviewed journals and meeting the review's eligibility criteria were identified. All five studies examined family-focused interventions to increase daily fruit and vegetable consumption measured either by child self-report or parent report. Only one intervention reported a lasting statistically significant increased consumption of fruit and vegetables.

Conclusions This review highlights that in order to tackle obesity narrow interventions focusing on single aspects of behaviour are unlikely to achieve long-term change. Successful public health interventions tackling childhood obesity will need to take a holistic approach and target behaviour change in multiple aspects of children's lifestyles and their surroundings, including nutritional education, parental support and physical activity.

Citation

Bourke M, Whittaker P J, Verma A, 2014, Are dietary interventions effective at increasing fruit and vegetable consumption among overweight children? A systematic review, J Epidemiol Community Health, doi:10.1136/jech-2013-203238

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