School of Health and Rehabilitation Sciences, Western University, London, ON, Canada.
School of Food and Nutritional Sciences, Brescia University College; Department of Pediatrics, Department of Epidemiology & Biostatistics, Western University; Children's Health Research Institute, Lawson Health Research Institute, London, ON, Canada.
Public Health Nutr. 2021 Oct;24(14):4693-4705. doi: 10.1017/S1368980021001683. Epub 2021 Apr 19.
Fruits and vegetables (FV) distribution interventions have been implemented as a public health strategy to increase children's intake of FV at school settings. The purpose of this review was to examine whether snack-based FV distribution interventions can improve school-aged children's consumption of FV.
Systematic review and meta-analysis of articles published in English, in a peer-reviewed journals, were identified by searching six databases up to August 2020. Standardised mean differences (SMD) and 95 % CI were calculated using a random effects model. Heterogeneity was quantified using I2 statistics.
Population-based studies of interventions where the main focus was the effectiveness of distributed FV as snacks to schoolchildren in North America, Europe and Pacific were included.
Forty-seven studies, reporting on fifteen different interventions, were identified; ten studies were included in the meta-analysis. All interventions were effective in increasing children's consumption of FV, with only one intervention demonstrating a null effect. Pooled results under all classifications showed effectiveness in improving children's consumption of FV, particularly for multi-component interventions at post-intervention (SMD 0·20, 95 % CI 0·13, 0·27) and free distribution interventions at follow-up (SMD 0·19, 95 % CI 0·12, 0·27).
Findings suggest that FV distribution interventions provide a promising avenue by which children's consumption can be improved. Nonetheless, our results are based on a limited number of studies, and further studies should be performed to confirm these results. More consistent measurement protocols in terms of rigorous study methodologies, intervention duration and follow-up evaluation are needed to improve comparability across studies.
水果和蔬菜（FV）供应干预措施已作为一项公共卫生战略实施，以增加儿童在学校环境中摄入 FV。本研究旨在检验基于零食的 FV 供应干预措施是否能改善学龄儿童的 FV 摄入。
系统检索了截至 2020 年 8 月发表在同行评议期刊上的英文文章，通过六个数据库进行检索。使用随机效应模型计算标准化均数差值（SMD）和 95%置信区间。使用 I2 统计量衡量异质性。
纳入了以北美、欧洲和太平洋地区在校儿童分发 FV 作为零食的主要焦点的基于人群的干预措施研究。
共确定了 47 项研究，其中报道了 15 项不同的干预措施；10 项研究纳入了荟萃分析。所有干预措施均能有效增加儿童对 FV 的摄入，只有一项干预措施无效果。所有分类下的汇总结果表明，干预措施在改善儿童 FV 摄入方面具有有效性，特别是在干预后多组分干预（SMD 0·20，95%CI 0·13，0·27）和免费供应干预（SMD 0·19，95%CI 0·12，0·27）。
研究结果表明，FV 供应干预措施为改善儿童摄入提供了有前景的途径。然而，我们的研究结果基于有限数量的研究，需要进一步研究来证实这些结果。为了提高研究间的可比性，需要在严格的研究方法、干预持续时间和随访评估方面制定更一致的测量方案。
