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Public health nutrition interventions can be simple and effective

Published online by Cambridge University Press:  29 June 2011

Agneta Yngve
Affiliation:
Editor-in-Chief
Allison Hodge
Affiliation:
Deputy Editors
Marilyn Tseng
Affiliation:
Deputy Editors
Irja Haapala
Affiliation:
Deputy Editors
Geraldine McNeill
Affiliation:
Deputy Editors
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Abstract

Type
Editorial
Copyright
Copyright © The Authors 2011

In the May editorial, the lack of good intervention papers was noted and we promised an article on writing such a paper. In this issue we have focused on interventions, including a relatively simple workplace intervention to increase fruit consumption, capacity building interventions, and an evaluation of a policy to improve food quality in English schools. It is likely that a combination of diverse approaches such as these will be necessary to have lasting and significant impacts on public health nutrition.

Some of the most effective interventions are very simple. In this issue, Alinia et al.(Reference Alinia, Lassen and Krogholm1) demonstrate how putting fruit in an accessible spot in the workplace increased intakes of fruit and fibre and decreased the intake of added sugar. This was achieved without additional health education or promotion effort. In a similar vein, Bucher et al.(Reference Bucher, van der Horst and Siegrist2) show that when people were offered two vegetables rather than one, they served themselves more vegetables. Because Boucher's study used replica foods, it is not clear whether the larger serving of vegetables would translate to greater intakes. The above studies are examples of simple approaches that could be applied in many situations and warrant further investigation.

At the policy level, the paper by Matthews et al.(Reference Matthews, Nelson and Kaur3) in this issue seeks to evaluate the effect on school food and beverage vending of the 2007 food-based standards for school food other than lunch. This was done by means of mailed surveys in English secondary schools, before and after the legislation was introduced. The findings suggest that the new legislation has contributed to an improved quality of food available and decreased its provision from vending machines.

A diverse range of papers relating to capacity building interventions has also been included in this issue. These relate not just to capacity building within the public health nutrition workforce, as described by Palermo et al.(Reference Palermo, Hughes and McCall4) and Fox and Beyers(Reference Fox and Beyers5), but also within communities. An example of the latter is provided by Bezner Kerr et al.(Reference Bezner Kerr, Berti and Shumba6) in their intervention to improve child growth rates in Malawi by providing education not only on nutrition but also on the use of legume crops along with the staple cereal, maize. Production of legumes as an additional nutritious crop has the added benefit of building up the soil to improve the maize crop. Despite some limitations in the study design and analysis, there was evidence to support an improvement in nutritional status in children related to the length of time and intensity of participation in the intervention. Konstantyner et al.(Reference Konstantyner, Taddei and Oliveira7) report on the impact of training educators on the health of children in day-care centres in Sao Paulo, Brazil, as assessed by the prevalence of anaemia. At the beginning of the trial, approximately 36% of the children were anaemic and training the child-care educators appeared to reduce the risk of anaemia, after controlling for other risk factors.

These studies offer a wide range of approaches that should be considered as means to improve nutrition at the population level. Other studies in this issue include more work on anaemia(Reference Kersey, Chi and Cutts8, Reference Pacey, Weiler and Egeland9), capacity building(Reference Parker, Steyn and Levitt10, Reference Jonsdottir, Hughes and Thorsdottir11), vending machines in schools(Reference Minaker, Storey and Raine12), a pilot of a workplace intervention to reduce salt intake(Reference Geaney, Harrington and Fitzgerald13), and a study of pledges from the food industry regarding marketing food to children(Reference Hawkes and Harris14). The latter study by Hawkes and Harris notes that despite a lot happening recently, there is a long way to go. Highlighting the importance of food advertising to children, the study by Jones and Kervin(Reference Jones and Kervin15) in Australia finds that short-term exposure to food advertisements influenced children's food choice immediately afterwards.

We hope you enjoy this selection of papers and are inspired by the achievements of these authors.

References

1.Alinia, S, Lassen, AD, Krogholm, KS et al. (2011) A workplace feasibility study of the effect of a minimal fruit intervention on fruit intake. Public Health Nutr 14, 13821387.CrossRefGoogle ScholarPubMed
2.Bucher, T, van der Horst, K & Siegrist, M (2011) Improvement of meal composition by vegetable variety. Public Health Nutr 14, 13571363.CrossRefGoogle ScholarPubMed
3.Matthews, A, Nelson, M, Kaur, A et al. (2011) Where has all the chocolate gone? A national survey assesses the effects of recent legislation to improve the nutritional quality of English secondary-school vending. Public Health Nutr 14, 13941402.CrossRefGoogle Scholar
4.Palermo, C, Hughes, R & McCall, L (2011) A qualitative evaluation of an Australian public health nutrition workforce development intervention involving mentoring circles. Public Health Nutr 14, 14581465.CrossRefGoogle ScholarPubMed
5.Fox, A & Beyers, J (2011) Planning a graduate programme in public health nutrition for experienced nutrition professionals. Public Health Nutr 14, 14791488.CrossRefGoogle ScholarPubMed
6.Bezner Kerr, R, Berti, PR & Shumba, L (2011) Effects of a participatory agriculture and nutrition education project on child growth in Northern Malawi. Public Health Nutr 14, 14661472.CrossRefGoogle ScholarPubMed
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9.Pacey, A, Weiler, H & Egeland, GM (2011) Low prevalence of iron deficiency anaemia among Inuit preschool children: Nunavut Inuit Child Health Survey, 2007–2008. Public Health Nutr 14, 14151423.CrossRefGoogle ScholarPubMed
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13.Geaney, F, Harrington, J, Fitzgerald, AP et al. (2011) The impact of a workplace catering initiative on dietary intakes of salt and other nutrients: a pilot study. Public Health Nutr 14, 13451349.CrossRefGoogle ScholarPubMed
14.Hawkes, C & Harris, J (2011) An analysis of the content of food industry pledges on marketing to children. Public Health Nutr 14, 14031414.CrossRefGoogle ScholarPubMed
15.Jones, SC & Kervin, L (2011) An experimental study on the effects of exposure to magazine advertising on children's food choices. Public Health Nutr 14, 13371344.CrossRefGoogle Scholar