To determine whether the ‘Read for Nutrition’ programme would increase liking and consumption of broccoli (a target vegetable) in preschool children and test acceptability and practicality of the programme.

Pilot pre-post intervention study, where childcare teachers received training and coaching followed by reading the book ‘Monsters Don’t Eat Broccoli’ multiple times with the children during a three-week intervention.

Five classrooms of Educare, Lincoln, Nebraska in 2018.

Sixty-nine (11 to 16 children per classroom) preschool-aged children and sixteen teachers (minimum, three per classroom).

Average total consumption of broccoli increased 35 % (0·14 ounces or 0·05th cup) after the ‘Read for Nutrition’ programme (t = 2·66; P = 0·01; 95 % CIs (0·035, 0·246)) for all children. Proportional consumption increased for children who received ≥ five exposures to the book (t46 = 2·77; P = 0·008). Exposures to the book predicted proportional consumption (β = 0·365; P = 0·002). Liking of broccoli increased (W69 = 2·2, P = 0·03) as well. Teachers rated the programme as acceptable, practical and enjoyable to children and to themselves.

Programmes such as ‘Read for Nutrition’ have the potential to improve children’s vegetable liking and consumption in early care and education settings with only book readings and no exposure to a real vegetable.

To evaluate the cost and cost-effectiveness of a farm-to-Special Supplemental Nutrition Programme for Women, Infants and Children (WIC) intervention to promote vegetable intake and the redemption of WIC vouchers for produce purchases at farmers’ markets.

An economic analysis was undertaken using data from a pilot of the intervention. Vegetable intake was assessed with a reflection spectroscopy device (the Veggie Meter® [VM]) and via self-report. Voucher redemption was reported by WIC. Total and per participant intervention costs and cost-effectiveness ratios (expressed as cost per intervention effect) were estimated in 2019 US dollars over a 6-month period from the perspective of the agency implementing the intervention.

A large, urban WIC agency.

Participants were 297 WIC-enrolled adults.

Post-intervention, VM scores, self-reported vegetable intake and voucher redemption were higher in the intervention as compared with the control study group. Over the 6-month period, intervention costs were $31 092 ($194 unit cost per participant). Relative to the control group, the intervention cost $8·10 per increased VM score per participant, $3·85 per increased cup/d of vegetables consumed per participant and $3·29 per increased percentage point in voucher redemption per participant.

Intervention costs and cost-effectiveness ratios compared favourably with those reported for other interventions targeting vegetable intake in low-income groups, suggesting that the programme may be cost effective in promoting vegetable purchases and consumption. As there is no benchmark against which to compare cost-effectiveness ratios expressed as cost per unit of effectiveness, conclusions regarding whether this is the case must await further research.

To describe associations between adolescents’ frequency of vegetable consumption, food parenting practices and socioemotional family characteristics, and to explore potential mediated relationships that may contribute to an understanding of the family processes involved.

Cross-sectional survey among adolescents aged 13–15 years.

A survey questionnaire including self-report measures on adolescents’ frequency of vegetable consumption, perceived food parenting practices (i.e. family dinner frequency, maternal/paternal healthy eating guidance (HEG), maternal/paternal social support for vegetable consumption) and socioemotional family characteristics (i.e. general family functioning and level of cohesion and conflict within the family) was distributed in a convenience sample of secondary school students.

Four hundred forty students from five secondary schools in eastern Norway completed the questionnaire.

Results from multiple linear regression analysis revealed positive and statistically significant associations between adolescents’ frequency of vegetable consumption, maternal HEG and family cohesion. A partial indirect (mediated) association between family cohesion and adolescents’ frequency of vegetable consumption, working through maternal HEG, was also found.

Results from the present study suggest that perceived family cohesion may influence adolescents’ frequency of vegetable consumption both directly and indirectly. However, there is a need for continued investigation of family-related factors influencing adolescent eating. In particular, the role of socioemotional family characteristics should be further scrutinised in future studies.

To examine participants’ experiences with nutrition education classes that were implemented with and designed to complement a cost-offset community-supported agriculture (CSA) programme.

Qualitative analysis of data from twenty-eight focus groups with ninety-six participants enrolled in Farm Fresh Foods for Healthy Kids (F3HK). Transcribed data were coded and analysed by a priori and emergent themes.

Rural and micropolitan communities in New York, North Carolina, Vermont and Washington (USA).

Ninety-six F3HK participants.

Participants found recipes and class activities helpful and reported improvements in nutrition knowledge, food preservation skills and home cooking behaviours for themselves and their children; they also reported that classes promoted a sense of community. Some educators better incorporated CSA produce into lessons, which participants reported as beneficial. Other obligations and class logistics were barriers to attendance; participants recommended that lessons be offered multiple times weekly at different times of day. Other suggestions included lengthening class duration to encourage social engagement; emphasising recipes to incorporate that week’s CSA produce and pantry staples and offering additional strategies to incorporate children in classes.

Complementing a cost-offset CSA with nutrition education may enhance programme benefits to low-income families by improving nutrition knowledge and cooking behaviours. However, future interventions will benefit from ongoing coordination between educators and local growing trajectories to maximise timely coverage of unfamiliar produce in lessons; synchronous scheduling of CSA pick-up and classes for participant convenience and creative strategies to engage children and/or provide childcare.

To examine perspectives on food access among low-income families participating in a cost-offset community-supported agriculture (CO-CSA) programme.

Farm Fresh Foods for Healthy Kids (F3HK) is a multicentre randomized intervention trial assessing the effect of CO-CSA on dietary intake and quality among children from low-income families. Focus groups were conducted at the end of the first CO-CSA season. Participants were interviewed about programme experiences, framed by five dimensions of food access: availability, accessibility, affordability, acceptability and accommodation. Transcribed data were coded on these dimensions plus emergent themes.

Nine communities in the US states of New York, North Carolina, Washington and Vermont.

Fifty-three F3HK adults with children.

CSA models were structured by partner farms. Produce quantity was abundant; however, availability was enhanced for participants who were able to select their own produce items. Flexible CSA pick-up times and locations made produce pick-up more accessible. Despite being affordable to most, payment timing was a barrier for some. Unfamiliar foods and quick spoilage hindered acceptability through challenging meal planning, despite accommodations that included preparation advice.

Although CO-CSA may facilitate increased access to fruits and vegetables for low-income families, perceptions of positive diet change may be limited by the ability to incorporate share pick-up into regular travel patterns and meal planning. Food waste concerns may be particularly acute for families with constrained resources. Future research should examine whether CO-CSA with flexible logistics and produce self-selection are sustainable for low-income families and CSA farms.

The Crunch&Sip programme is a school-based nutrition initiative designed to increase the fruit, vegetable and water intakes of primary-school children. In recognition of the notable deficits in children’s vegetable consumption, the present study explored the receptivity of school staff to a realignment of the Crunch&Sip programme to feature a primary focus on vegetable consumption. This involved investigating school staff members’ perceptions of relevant barriers, motivators and facilitators.

A multi-method approach was adopted that involved four focus groups and a survey (administered in paper and online formats) containing a mixture of open- and closed-ended items.

Western Australia.

Staff from Western Australian schools participated in the focus groups (n 37) and survey (n 620).

School staff were strongly supportive of modifying the Crunch&Sip programme to focus primarily on children’s vegetable consumption and this was generally considered to be a feasible change to implement. Possible barriers identified included children’s taste preferences and a perceived lack of parental support. Suggested strategies to overcome these barriers were education sessions for parents and children, teachers modelling vegetable consumption for their students and integrating vegetable-related topics into the school curriculum.

School staff are likely to support the introduction of school-based nutrition programmes that specifically encourage the consumption of vegetables. Potential barriers may be overcome through strategies to engage parents and children.

To identify determinants of fruit and vegetable (F&V) consumption among school-aged children.

A survey study was conducted in October 2010. The questionnaire contained questions concerning social and demographic data, lifestyle and dietary habits, particularly the frequency of F&V consumption, availability of F&V and knowledge about recommended amounts of F&V intake.

Polish primary schools.

Children (n 1255) aged 9 years from randomly selected primary schools and their parents.

The children’s consumption of fruit and of vegetables was influenced by the fruit consumption and vegetable consumption of their parents (r=0·333 and r=0·273, respectively; P=0·001), parents encouraging their children to eat F&V (r=0·259 and r=0·271, respectively; P=0·001), giving children F&V to take to school (r=0·338 and r=0·321, respectively; P=0·001) and the availability of F&V at home (r=0·200 and r=0·296, respectively; P=0·001). Parental education influenced only the frequency of fruit consumption (r=0·074; P=0·01). A correlation between parents’ knowledge of the recommended intakes and the frequency of vegetable and fruit consumption by children was noticed (r=0·258 and r=0·192, respectively, P=0·001).

Factors within the family environment such as parents’ dietary habits and F&V availability had the greatest influence on the F&V consumption by children. Educational activities aimed at parents are crucial to increase the consumption of F&V among children.

Food neophobia has been associated with decreased consumption of vegetables mainly among children. We hypothesized that food neophobia in adults is also associated with lower overall dietary quality and higher BMI.

Data for the present cross-sectional analyses were derived from parents in a follow-up family study.

The STEPS study, a longitudinal study of health and development of a cohort of children born in south-west Finland.

The parents, 1178 women (age 19–45 years, mean 32·2 years) and 1013 men (age 18–57 years, mean 34·1 years), completed a questionnaire at home when their child was 13 months old. The questionnaire included the Food Neophobia Scale (FNS; range 10–70), the Index of Diet Quality (IDQ; range 0–16) and a measure of fruit and vegetable consumption. At that time the participants’ height and weight were also measured by a research nurse to calculate BMI.

Compared with the food neophilics (FNS score 10–24), the food neophobics (FNS score 40–70) consumed fewer vegetables (women: 15 v. 10 portions/week; men: 13 v. 7 portions/week), scored lower on the IDQ (women: 9·7 v. 8·5; men: 8·8 v. 7·8) and had higher BMI (women: 24·2 v. 26·0 kg/m2; men: 26·5 v. 27·5 kg/m2) as tested by one-way ANOVA, with all P values <0·001 in women and <0·05 in men. The food neophobics followed a diet lower in nutritional quality than did the food neophilics, especially regarding vegetables.

Food neophobia may complicate adaptation to dietary recommendations and predispose to overweight.

To examine how increasing vegetable consumption from foods prepared at home (FAH) and foods prepared away from home (FAFH) would impact energy, dietary fibre and Na (sodium) intakes in the USA.

Using data from the 2003–2004 US National Health and Nutrition Examination Survey, dietary intake data from two separate days were fitted with a first-difference (fixed-effects) model. Vegetables consumed from all sources, including mixed foods and juices, were disaggregated and expressed as amounts equivalent to one cup of whole vegetables.

Nationally representative sample of the US population.

Individuals aged 2 years and above reporting 2 d of dietary intake data in 2003–2004 (n 7647).

Holding constant the total amount of food consumed, consuming an additional cup of tomatoes and potatoes from FAFH increases energy intake by respectively 1522 and 665 kJ, as compared with 246 and 367 kJ for FAH. Each additional cup of tomatoes from FAH is associated with an additional 179 mg of Na, compared with 113 mg for FAFH. All vegetable consumption increases fibre intake, except for potatoes and tomatoes from FAFH. Dark green and orange vegetables from FAH add the largest amount of fibre (1·38 g/cup).

Because US consumers frequently consume vegetables as part of mixed foods that add energy and Na, heavier consumption of vegetables as currently prepared raises the energy content and Na density of the overall diet. This is particularly true for vegetables prepared away from home.

This study employed a multilevel design to test the contribution of individual, social and environmental factors to mediating socio-economic status (SES) inequalities in fruit and vegetable consumption among women.

A cross-sectional survey was linked with objective environmental data.

A community sample involving 45 neighbourhoods.

In total, 1347 women from 45 neighbourhoods provided survey data on their SES (highest education level), nutrition knowledge, health considerations related to food purchasing, and social support for healthy eating. These data were linked with objective environmental data on the density of supermarkets and fruit and vegetable outlets in local neighbourhoods.

Multilevel modelling showed that individual and social factors partly mediated, but did not completely explain, SES variations in fruit and vegetable consumption. Store density did not mediate the relationship of SES with fruit or vegetable consumption.

Nutrition promotion interventions should focus on enhancing nutrition knowledge and health considerations underlying food purchasing in order to promote healthy eating, particularly among those who are socio-economically disadvantaged. Further investigation is required to identify additional potential mediators of SES–diet relationships, particularly at the environmental level.