Fruit and vegetable intakes in relation to behavioral outcomes associated with a nutrition education intervention in preschoolers.

Background/objectives: Although a lot of effort has been put into increasing fruit and vegetable intakes in preschool children, vegetable intake in this group is still low. This study investigated whether nutrition education focusing on fruit and vegetable intakes can affect preschoolers' fruit and vegetable intakes as well as their behavioral outcomes.

Subjects/methods: Thirty-five preschoolers (54.3% boys, n = 19) aged 4-6 years residing in Seoul underwent weekly nutrition education intervention (8 sessions) between May and July 2016. Intakes of fruits and vegetables were measured during pre and post-intervention. At snack time, fresh fruit (150 g) and vegetable (120 g) snacks were distributed to each child by teachers. The remaining portions of the snacks were weighed and recorded for each child. Behavioral outcomes were measured by applying Child behavior checklist 1.5-5 and the Diagnostic and statistical manual of mental disorders.

Results: During post intervention, vegetable intake increased from 36.15 ± 30.64 g to 48.01 ± 31.23 g ( = 0.010). Among the emotional and behavioral problems measured by parents, levels of total problems ( = 0.001), internalizing ( = 0.004), externalizing ( = 0.003), anxiety and depression ( = 0.001), and aggressive behavior ( = 0.005) decreased. Anxiety ( = 0.026) score, as measured by teachers, also decreased.

Conclusions: Nutrition education of preschoolers regarding the intakes of fruits and vegetables had a positive effect on preschoolers' vegetable intake as well as on their emotional and behavioral outcomes. A long-term, large-scale study with a broader study design is warranted to further investigate the role of fruit and vegetable intake in cognitive development and behavior of preschoolers.