title: "Healthy-start": outcome of an intervention to promote a heart healthy diet in preschool children.
abstract: OBJECTIVE
  We evaluated the effects of a preschool nutrition education and food service intervention "Healthy Start," on two-to-five-year-old children in nine Head Start Centers in upstate NY. The primary objective was to reduce the saturated fat (sat-fat) content of preschool meals to <10% daily energy (E) and to reduce consumption of sat-fat by preschoolers to <10% E.
  
  
  METHODS
  Six centers were assigned to the food service intervention and three to control condition. Food service intervention included training workshops for cooks and monthly site visits to review progress towards goals. Child dietary intake at preschool was assessed by direct observation and plate waste measurement. Dietary intake at home was assessed by parental food record and telephone interviews. Dietary data were collected each Fall/Spring over two years, including five days of menus and recipes from each center. Dietary data were analyzed with the Minnesota NDS software.
  
  
  RESULTS
  Consumption of saturated fat from school meals decreased significantly from 1.0%E to 10.4%E after one year of intervention and to 8.0%E after the second year, compared with an increase of 10.2% to 13.0% to 11.4%E, respectively, for control schools (p < 0.001). Total caloric intake was adequately maintained for both groups. Analysis of preschool menus and recipes over the two-year period of intervention showed a significant decrease in sat-fat content in intervention preschools (from 12.5 at baseline to 8.0%E compared with a change of 12.1%E to >11.6%E in control preschools (p < 0.001)). Total fat content of menus also decreased significantly in intervention schools (31.0% to >25.0%E) compared with controls (29.9% to >28.4%E).
  
  
  CONCLUSIONS
  The Healthy Start food service intervention was effective in reducing the fat and saturated fat content of preschool meals and reducing children's consumption of saturated fat at preschool without compromising energy intake or intake of essential nutrients. These goals are consistent with current U.S Dietary Guidelines for children older than two years of age.
authors.affiliation: Children's Cardiovascular Health Center, Columbia University, Institute of Human Nutrition and Department of Pediatrics, Babies and Children's Hospital, New York, NY 10032, USA. chrisw@pol.net
authors.forename: Christine L
authors.initials: CL
authors.lastname: Williams
authors.forename: Marguerite C
authors.initials: MC
authors.lastname: Bollella
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Strobino
authors.forename: Arlene
authors.initials: A
authors.lastname: Spark
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Nicklas
authors.forename: Laura B
authors.initials: LB
authors.lastname: Tolosi
authors.forename: Brian P
authors.initials: BP
authors.lastname: Pittman
mesh_terms: D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D015930:Diet Records; D004041:Dietary Fats / Q000008:administration & dosage*; D005260:Female; D005522:Food Services / Q000592:standards*; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D015397:Program Evaluation; D014481:United States
chemical_list: D004041:Dietary Fats