Strategies to Increase Vegetable Intake in the Early Years

Vegetables consumed regularly and in variety as part of a balanced diet are known to protect against non-communicable diseases. However, children across Europe fail to meet recommended intakes. Therefore, effective interventions for encouraging vegetable intake are needed for preschool children. The present thesis adopted a mixed methods design to investigate strategies to increase vegetable intake in children aged 2-5 years, who are at the peak of food fussiness. A systematic review synthesised evidence from the existing literature using meta-analyses and found that repeated taste exposure was the most effective strategy for promoting vegetable intake compared to other interventions. Study 1 investigated effects of taste exposure and nutrition education delivered separately or in combination, which showed that taste exposure significantly increased intake of an unfamiliar vegetable. Study 2 tested the effects of reading a storybook about vegetables and sensory play on intake of a novel vegetable, finding that learning and play are essential for recognition and intake, with sensory play also promoting willingness to taste. Study 3 used semi-structured interviews to explore parental perspectives on vegetable strategies. This indicated that parents use a range of strategies with children, yet their success varies. This study raised concerns of ecological validity in methods tested by scientific studies in comparison to how they are implemented in homes. The present thesis provides evidence for implementing strategies which increase familiarity and learned safety with vegetables, in particular taste exposure. Repeated multisensory learning, including tasting should be incorporated into nutrition education programmes to enhance vegetable consumption. Encouraging preschool children to eat more vegetables in balance with other foods provides protective health benefits for a lifetime. By making a commitment to prioritise greater vegetable intakes, parents and caregivers can apply known, successful strategies, suited to their specific child, to increase familiarity and intake of vegetables in the child’s diet.