Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Sep;116(9):1443-1449.
doi: 10.1016/j.jand.2016.05.002. Epub 2016 Jun 15.

Improvement in Fruit and Vegetable Consumption Associated with More Favorable Energy Density and Nutrient and Food Group Intake, but not Kilocalories

Debbe Thompson, Robert J Ferry Jr, Karen W Cullen, Yan Liu
Randomized Controlled Trial

Improvement in Fruit and Vegetable Consumption Associated with More Favorable Energy Density and Nutrient and Food Group Intake, but not Kilocalories

Debbe Thompson et al. J Acad Nutr Diet. 2016 Sep.

Abstract

Background: 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.

Objective: 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.

Design: 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.

Participants/setting: 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.

Main outcome measures: 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.

Statistical analysis performed: 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.

Results: 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.

Conclusions: Increasing F/V consumption improved energy density and diet quality considerably in preadolescent children.

Trial registration: ClinicalTrials.gov NCT01004094.

Keywords: Children; Energy density; Fruit and vegetable consumption; Nutrients; Videogame.

PubMed Disclaimer

Conflict of interest statement

/ Conflicts of Interest The authors have no conflicts of interest to declare.

References

    1. Ogden CL, Carroll MD, Fryar CD, Flegal KM. NCHS data brief, no 219. Hyattsville, MD: National Center for Health Statistics; 2015. Prevalence of obesity among adults and youth: United States, 2011–2014. Available from: http://www.cdc.gov/nchs/data/databriefs/db219.htm. - PubMed
    1. U.S. Department of Agriculture. Dietary Guidelines for Americans 2015–2020. Washington, DC: U.S. Government Publishing Office; 2015. U.S. Department of Health and Human Services. Available from: http://health.gov/dietaryguidelines/2015/guidelines/
    1. U.S. Department of Agriculture. Dietary Guidelines for Americans, 2010. Washington, DC: U.S. Government Printing Office; 2010. U.S. Department of Health and Human Services. Available from: http://health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf.
    1. Vernarelli JA, Mitchell DC, Hartman TJ, Rolls BJ. Dietary energy density is associated with body weight status and vegetable intake in U.S. children. J Nutr. 2011;141(12):2204–2210. - PMC - PubMed
    1. Ledikwe JH, Blanck HM, Khan LK, et al. Low-energy-density diets are associated with high diet quality in adults in the United States. J Am Diet Assoc. 2006;106(8):1172–1180. - PubMed

Publication types

Associated data