title: Nutrition-education program improves preschoolers' at-home diet: a group randomized trial.
abstract: OBJECTIVE
  This study evaluated whether a nutrition-education program in child-care centers improved children's at-home daily consumption of fruits and vegetables, at-home use of low-fat/fat-free milk, and other at-home dietary behaviors.
  
  
  METHODS
  Twenty-four child-care centers serving low-income families were matched by region, type, and size, and then randomly assigned to either an intervention or control condition. In the 12 intervention centers, registered dietitian nutritionists provided nutrition education to children and parents separately during a 6- to 10-week period. They also held two training sessions for center staff, to educate them on healthy eating and physical activity policies at the centers, and distributed weekly parent newsletters that included activities and recipes. Parents (n=1,143) completed a mail or telephone survey at baseline and follow-up to report information on their child's fruit, vegetable, and milk consumption and other dietary behaviors at home. This study used general and generalized linear mixed models to evaluate program impacts, while accounting for the clustering of children within centers. This study included child age, child sex, household size, respondent race/ethnicity, respondent age, and respondent sex as covariates.
  
  
  RESULTS
  The program had a substantial impact on children's at-home daily consumption of vegetables and use of low-fat/fat-free milk. This study also found a significant increase in the frequency of child-initiated vegetable snacking, which might have contributed to the significant increase in vegetable consumption. The program did not have a significant impact on fruit consumption or parental offerings of fruits and vegetables, child-initiated fruit snacking, or child fruit consumption.
  
  
  CONCLUSIONS
  This intervention in child-care settings that emphasized children, parents, and teachers significantly increased at-home vegetable and low-fat/fat-free milk consumption among low-income preschoolers.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Williams
authors.forename: Sheryl C
authors.initials: SC
authors.lastname: Cates
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Blitstein
authors.forename: James
authors.initials: J
authors.lastname: Hersey
authors.forename: Vivian
authors.initials: V
authors.lastname: Gabor
authors.forename: Melanie
authors.initials: M
authors.lastname: Ball
authors.forename: Katherine
authors.initials: K
authors.lastname: Kosa
authors.forename: Hoke
authors.initials: H
authors.lastname: Wilson
authors.forename: Sara
authors.initials: S
authors.lastname: Olson
authors.forename: Anita
authors.initials: A
authors.lastname: Singh
mesh_terms: D002656:Child Day Care Centers / Q000193:education*; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003611:Dairy Products; D004032:Diet; D005069:Evaluation Studies as Topic; D005247:Feeding Behavior; D005500:Follow-Up Studies; D005638:Fruit; D006266:Health Education; D006801:Humans; D055361:Multilevel Analysis; D010290:Parents / Q000193:education; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014675:Vegetables
keywords: Child care; Dairy products; Preschool; Randomized controlled trial; Vegetables