1. In this cluster randomized controlled trial, most children in the intervention group were willing to eat vegetables as part of their daily breakfast.

2. Furthermore, exposure to vegetables at breakfast excited children and resulted in them asking for vegetables in subsequent weeks.

Evidence Rating Level: 1 (Excellent)

Consuming sufficient portions of vegetables is an important part of having a healthy diet, especially during childhood development. Previous interventions for increasing vegetable intake have focused on offering vegetables with midday/evening meals and snack times and have only had limited success. However, the impact of offering vegetables during breakfast time has not been investigated. Therefore, the purpose of the present study was to investigate the feasibility and acceptability of offering vegetables to children during breakfast time in nursery/kindergarten settings.

This randomized control trial included 351 children aged 18 months to 4 years and took place in 8 nurseries in the UK. Children who ate breakfast at a nursery at least once a week were included. Children with allergies to the intervention foods or any conditions which impacted feeding or eating were excluded. In the 6 intervention nurseries, staff offered 3 raw carrots and cucumber sticks alongside breakfast foods each day for 3 weeks. The 2 control nurseries offered children their usual breakfast. The primary outcomes were feasibility and acceptability, which were assessed by nursery staff’s ability to follow the trial protocol and children’s willingness to eat the vegetable at breakfast time, respectively.

The results demonstrated that 62.4% of children were willing to eat the vegetables offered, suggesting that this intervention had high acceptability. Qualitatively, staff reported that children initially asked questions about why vegetables were being served but later asked for vegetables before they were even offered. This study was limited by the lack of diversity in the nurseries included with regards to relative deprivation, which may have affected the generalizability of the results. Nonetheless, the study showed preliminary evidence supporting the inclusion of vegetables during breakfast time in nursery/kindergarten settings.

Click to read the study in International Journal of Behavioral Nutrition and Physical Activity

Image: PD

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