通过多次聚类随机交叉试验发现，控制分量大小可以战略性地增加幼儿对蔬菜和水果的摄入量。
Portion size can be used strategically to increase intake of vegetables and fruits in young children over multiple days: a cluster-randomized crossover trial.
机构信息
Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.
Department of Food Science, The Pennsylvania State University, University Park, PA, USA.
出版信息
Am J Clin Nutr. 2022 Jan 11;115(1):272-283. doi: 10.1093/ajcn/nqab321.
BACKGROUND
Although dietary guidelines recommend that vegetables and fruits make up half the diet, it is unclear whether serving vegetables and fruits in larger portions will have sustained effects on children's intake over multiple days.
OBJECTIVES
This study tested the effects on children's intake of 2 strategies for increasing the proportion of vegetables and fruits: either adding or substituting extra portions as side dishes at meals and snacks over 5 d.
METHODS
In a cluster-randomized crossover design with 3 periods, we provided all meals and snacks for 5 d to 53 children aged 3-5 y in classrooms in their childcare centers. In the Control condition, we served typical portions for all food groups. In the Addition condition we increased portions of low-energy-dense vegetables and fruits by 50%, and in the Substitution condition we increased portions of vegetables and fruits by 50% and also reduced portions of other foods by an equivalent weight.
RESULTS
For vegetables, the Addition strategy increased daily intake compared with Control by 24% (mean ± SEM = 12 ± 3 g/d; P = 0.0002), and the Substitution strategy increased intake compared with Control by 41% (22 ± 3 g/d; P < 0.0001). For fruits, consumption increased by similar amounts: Addition by 33% (60 ± 6 g/d) and Substitution by 38% (69 ± 8 g/d; both P < 0.0001). Both strategies increased vegetable and fruit intakes compared with Control across all 5 days (all P < 0.004), although the increase in fruit consumption with Addition declined over time (P < 0.0001). Daily energy intake compared with Control increased by 5% with Addition (57 ± 17 kcal; P = 0.001) but decreased by 6% with Substitution (-64 ± 21 kcal; P = 0.004).
CONCLUSIONS
Both the Addition and Substitution strategies promoted increases in vegetable and fruit intake over 5 d in preschool children. When excess energy intake is a concern, substituting vegetables and fruits for other foods is a better option than simply serving more.This trial was registered at http://www.clinicaltrials.gov as NCT03242863 (https://clinicaltrials.gov/ct2/show/NCT03242863), where the protocol is available.
背景
尽管膳食指南建议蔬菜和水果应占饮食的一半，但目前尚不清楚在多天内增加蔬菜和水果份量是否会对儿童的摄入量产生持续影响。
目的
本研究通过两种增加蔬菜和水果份量的策略来检验对儿童摄入量的影响：在餐点和零食中作为配菜添加或替代额外份量，为期 5 天。
方法
采用 3 个周期的群组随机交叉设计，为 53 名 3-5 岁的儿童在其托儿中心的教室中提供所有餐点和零食 5 天。在对照条件下，我们为所有食物组提供典型份量。在添加条件下，我们将低能量密度蔬菜和水果的份量增加 50%，在替代条件下，我们将蔬菜和水果的份量增加 50%，并以同等重量减少其他食物的份量。
结果
对于蔬菜，与对照相比，添加策略使每日摄入量增加 24%（平均值±SEM=12±3 g/d；P=0.0002），替代策略使摄入量增加 41%（22±3 g/d；P<0.0001）。对于水果，摄入量增加的幅度相似：添加策略增加 33%（60±6 g/d），替代策略增加 38%（69±8 g/d；均 P<0.0001）。两种策略都使蔬菜和水果的摄入量与对照相比在所有 5 天都有所增加（均 P<0.004），尽管添加策略下水果摄入量的增加随时间而减少（P<0.0001）。与对照相比，添加策略下的每日能量摄入量增加 5%（57±17 kcal；P=0.001），而替代策略下则减少 6%（-64±21 kcal；P=0.004）。
结论
在学前儿童中，添加和替代策略均在 5 天内促进了蔬菜和水果摄入量的增加。当需要考虑过量能量摄入时，用蔬菜和水果替代其他食物是比简单地增加份量更好的选择。该试验已在 http://www.clinicaltrials.gov 注册，编号为 NCT03242863（https://clinicaltrials.gov/ct2/show/NCT03242863），可在该网站获取试验方案。
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