ORCID Profile
0000-0002-4065-4397
Current Organisation
University of Leeds
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Publisher: Springer Science and Business Media LLC
Date: 29-04-2019
Publisher: Springer Science and Business Media LLC
Date: 02-2018
DOI: 10.1038/S41430-017-0070-1
Abstract: The use of simple screening tools to measure nutritional adequacy in a public health context in developed countries are currently lacking. We explore the relationship between food variety and nutrient intake of London school children using a simple tool with potential use for screening for inadequate diets. A cross-sectional survey was carried out in 2010. The survey included 2579 children aged 7-10 years in 52 primary schools in East London in the United Kingdom. The analysis included 2392 children (93% of the original s le). Food variety was assessed as the total number of listed foods recorded over 24 h using the validated Child and Diet Assessment Tool (CADET) comprising 115 listed foods ided into 16 food categories. Dietary quality was determined by the proportion of children meeting recommended intakes of in idual micronutrients, namely, calcium, iron, zinc, folate, vitamin A and vitamin C. The mean number of CADET-listed foods consumed daily by children was 17.1 (95% CI: 16.8, 17.5). Children who consumed fewer than 11 foods on the collection day had particularly low nutrient intakes. Children consuming three different vegetables and two different fruits on average consumed 19-20 listed foods. It was estimated between 4 and 20% of children did not meet the recommended levels for in idual micronutrients during the period of data collection. A simple method using food counts to assess daily food variety may help public health nutritionists identify groups of children at risk of inadequate diets.
Publisher: BMJ
Date: 19-12-2012
Abstract: This study aims to explore how the home food environment and parental attitudes and values affect children's fruit and vegetable (F&V) intake. The s le consists of 2383 children with a mean age of 8.3 years (95% CI 8.2 to 8.3) attending 52 primary schools in London. These children are taking part in two randomised controlled trials to evaluate a school gardening programme. Diet was assessed using a validated 24-h food tick list, the Child And Diet Evaluation Tool (CADET). The CADET tool found that children consumed on average 293 g F&V (95% CI 287 to 303) per day. Clustered (by school) multilevel regression models with total F&V as the primary outcome were conducted to explore how the home environment affects children's F&V intake. Children of families who reported 'always' eating a family meal together at a table had 125 g (95% CI 92 to 157 p=<0.001) more F&V than families who never ate a meal together. Daily consumption of F&V by parents was associated with higher F&V (88 g, 95% CI 37 to 138) intake in children compared with rarely/never consumption of F&V by parents. Cutting up fruit and vegetables for children was associated with higher consumption. Families who reported always cutting up F&V for their children had 44 g (95% CI 18 to 71) more F&V than families who never cut up F&V. This study identified that cutting up F&V and family consumption of F&V facilitates children's intake. Eating a family meal together regularly could increase children's F&V intake and help them achieve the recommended intake. ISRCTN11396528.
Publisher: BMJ
Date: 13-08-2010
Abstract: Government standards are now in place for children's school meals but not for lunches prepared at home. The aim of this trial is to improve the content of children's packed lunches. A cluster randomised controlled trial in 89 primary schools across the UK involving 1291 children, age 8-9&emsp14 years at baseline. Follow-up was 12&emsp14 months after baseline. A "SMART" lunch box intervention programme consisted of food boxes, bag and supporting materials. The main outcome measures were weights of foods and proportion of children provided with sandwiches, fruit, vegetables, dairy food, savoury snacks and confectionery in each packed lunch. Levels of nutrients provided including energy, total fat, saturated fat, protein, non-milk extrinsic sugar, sodium, calcium, iron, folate, zinc, vitamin A and vitamin C. Moderately higher weights of fruit, vegetables, dairy and starchy food and lower weights of savoury snacks were provided to children in the intervention group. Children in the intervention group were provided with slightly higher levels of vitamin A and folate. 11% more children were provided with vegetables/salad in their packed lunch, and 13% fewer children were provided with savoury snacks (crisps). Children in the intervention group were more likely to be provided with packed lunches meeting the government school meal standards. The SMART lunch box intervention, targeting parents and children, led to small improvements in the food and nutrient content of children's packed lunches. Further interventions are required to bring packed lunches in line with the new government standards for school meals. Current controlled trials ISRCTN77710993.
Publisher: American Institute of Mathematical Sciences (AIMS)
Date: 2018
Publisher: Elsevier BV
Date: 10-2012
Abstract: To our knowledge, no reviews have assessed the impact of a range of multi- and single-component school-based programs on daily fruit and vegetable intake by using a meta-analysis. The aim of this study was to quantify the impact of school-based interventions on fruit and vegetable intake in children aged 5-12 y. A systematic literature review was carried out to identify randomized and nonrandomized controlled trials that were based in primary schools and designed to increase portions of daily fruit and vegetable intake. MEDLINE, Cochrane libraries, EMBASE, PsycINFO, and Educational Information Centre were searched from 1985 to 2009. Data were extracted, and mean effect sizes were calculated by using random effects models. A total of 27 school-based programs involving 26,361 children were identified that met the inclusion criteria and assessed the daily weight of fruit and vegetable intake combined, fruit intake only, or vegetable intake only, and 21 studies were used in meta-analyses. The results of the meta-analyses indicated an improvement of 0.25 portions (95% CI: 0.06, 0.43 portions) of fruit and vegetable daily intake if fruit juice was excluded and an improvement of 0.32 portions (95% CI: 0.14, 0.50 portions) if fruit juice was included. Improvement was mainly due to increases in fruit consumption but not in vegetable consumption. The results of the meta-analyses for fruit (excluding juice) and vegetables separately indicated an improvement of 0.24 portions (95% CI: 0.05, 0.43 portions) and 0.07 portions (95% CI: -0.03, 0.16 portions), respectively. School-based interventions moderately improve fruit intake but have minimal impact on vegetable intake. Additional studies are needed to address the barriers for success in changing dietary behavior, particularly in relation to vegetables.
Publisher: American Institute of Mathematical Sciences (AIMS)
Date: 2018
Publisher: Springer Science and Business Media LLC
Date: 20-08-2014
Abstract: The Child And Diet Evaluation Tool (CADET) is a 24-h food diary that measures the nutrition intake of children aged 3-7 years, with a focus on fruit and vegetable consumption. Until now CADET has not been used to measure nutrient intake of children aged 8-11 years. To ensure that newly assigned portion sizes for this older age group were valid, participants were asked to complete the CADET diary (the school and home food diary) concurrently with a 1-day weighed record. A total of 67 children with a mean age of 9.3 years (s.d.: ± 1.4, 51% girls) participated in the study. Total fruit and vegetable intake in grams and other nutrients were extracted to compare the mean intakes from the CADET diary and Weighed record using t-tests and Pearson's r correlations. Bland-Altman analysis was also conducted to assess the agreement between the two methods. Correlations comparing the CADET diary to the weighed record were high for fruit, vegetables and combined fruit and vegetables (r=0.7). The results from the Bland-Altman plots revealed a mean difference of 54 g (95% confidence interval: -88, 152) for combined fruit and vegetables intake. CADET is the only tool recommended by the National Obesity Observatory that has been validated in a U.K. population and provides nutrient level data on children's diets. The results from this study conclude that CADET can provide high-quality nutrient data suitable for evaluating intervention studies now for children aged 3-11 years with a focus on fruit and vegetable intake.
Publisher: Cambridge University Press (CUP)
Date: 04-05-2015
DOI: 10.1017/S1368980015000853
Abstract: Nutrient and food standards exist for school lunches in English primary schools although packed lunches brought from home are not regulated. The aim of the present study was to determine nutritional and dietary differences by lunch type. A cross-sectional survey was carried out in 2007 assessing diet using the Child and Diet Evaluation Tool (CADET), a validated 24 h estimated food diary. The data were analysed to determine nutritional and dietary intakes over the whole day by school meal type: school meals and packed lunches. Fifty-four primary schools across England. Children ( n 2709) aged 6–8 years. Children having a packed lunch consumed on average 11·0 g more total sugars (95 % CI 6·6, 15·3 g) and 101 mg more Na (95 % CI 29, 173 mg) over the whole day. Conversely, children having a school meal consumed, on average, 4·0 g more protein (95 % CI 2·3, 5·7 g), 0·9 g more fibre (NSP 95 % CI 0·5, 1·3 g) and 0·4 mg more Zn (95 % CI 0·1, 0·6 mg). There was no difference in daily energy intake by lunch type. Children having a packed lunch were more likely to consume snacks and sweetened drinks while children having a school meal were more likely to consume different types of vegetables and drink water over the whole day. Compared with children having a school meal, children taking a packed lunch to school consumed a lower-quality diet over the whole day, including higher levels of sugar and Na and fewer vegetables. These findings support the introduction of policies that increase school meal uptake.
Publisher: Springer Science and Business Media LLC
Date: 16-08-2014
Publisher: Cambridge University Press (CUP)
Date: 14-12-2012
DOI: 10.1017/S1368980012005290
Abstract: The present study aimed to determine whether a multi-component school-based intervention can maintain children's fruit and vegetable intake post eligibility for free school fruit and vegetables. A random s le of fifty-four English primary schools was randomised to receive the 10-month intervention Project Tomato, a multi-component theory-based intervention, or the control. Each group consisted of twenty-seven schools. Children's intake of fruit and vegetables is below recommendations. The English School Fruit and Vegetable Scheme has a short-term impact on intake while children are eligible for the scheme. Dietary measurements were collected from 658 Year 2 pupils aged 7–8 years at baseline and at follow-up 20 months later. Following an intention to treat analysis, the intervention as delivered compared with the control had no impact on the intake of fruit and vegetables (2 g/d, 95 % CI −23, 26 g/d) or on the number of portions of fruit (0·0 portions, 95 % CI −0·3, 0·3) or vegetables (0·0 portions, 95 % CI −0·2, 0·3) consumed daily by children. Intake of fruit and vegetables at school and home dropped by ∼100 g/d and 50 g/d, respectively, between baseline and follow-up in both the intervention and control groups. Implementation of the intervention was low, with associated lack of impact on fruit and vegetable consumption in children. Alternatives to the delivery of an intervention by teachers and parents are needed to improve the dietary intake of primary-school children.
Publisher: Cambridge University Press (CUP)
Date: 22-09-2009
DOI: 10.1017/S1368980009991509
Abstract: To describe the ‘Smart Lunch Box’ intervention and provide details on feedback from the participants on the acceptability and usability of the intervention materials. A cluster randomised controlled trial, randomised by school. English schools were stratified on percentage free-school-meals eligibility and attainment at Key Stage 2. A ‘Smart Lunch Box’ with supporting materials and activities on healthy eating was delivered to parents and children via schools in the intervention group. Feedback forms containing information on a total of fifteen intervention items were filled out by the parents and/or children participating in the intervention and were collected after each of the three phases of the intervention. Eighty-nine primary schools in England, Scotland, Wales and Northern Ireland, randomly selected forty-four schools in the intervention arm. A total of 1294 children, aged 9–10 years, took part in the trial. Of the 604 children in the intervention arm, 343 provided feedback after at least one of the three phases. A median of twelve items out of a total of fifteen were used by responders. The two intervention items most likely to be used were the in idual food boxes and the cooler bags. Whether a participant liked an item significantly affected whether they used it for all items except the cooler bag, fruity face and in idual food boxes. Practical intervention items aimed at parents are likely to be used in the longer term and therefore may be appropriate for use in an intervention strategy to improve packed lunches.
Publisher: Elsevier BV
Date: 03-2013
Publisher: Springer Science and Business Media LLC
Date: 26-04-2012
Publisher: Cambridge University Press (CUP)
Date: 11-08-2011
DOI: 10.1017/S1368980011001844
Abstract: The present analysis evaluates the overall appreciation and implementation of an intervention, Project Tomato, designed to maintain fruit and vegetable intake in children aged 8–9 years. A random s le of fifty-four English primary schools (658 children) were randomised to either the intervention group or the control. The intervention group received a multi-component programme delivered in school by teachers and items sent home for parents/children. Dietary measurements were collected at baseline and follow-up. The intervention participants completed questionnaires on the intervention materials, to identify implementation and appreciation of the intervention, and other environmental mechanisms. Fifty-four primary schools were randomly selected, with twenty-seven schools allocated to the intervention group. A total of 311 children received the intervention. Implementation of the intervention was low, 21·3 % of school items and 56·0 % of home items were implemented. The intervention materials were well received by teachers, parents and children. Other mechanisms that may affect fruit and vegetable intake were explored. Children who ate their main meal with their parents 3–7 nights/week on average consumed 37·6 (95 % CI 9·8, 65·4) g more fruit and vegetables than children who ate with their parents 0–2 times/week. Implementation of the trial components was poor. However, the results identified the importance of parental environment and mealtime structure on children's fruit and vegetable intake.
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.APPET.2015.04.076
Abstract: Involvement of children in gardening has the potential to increase liking of fruit and vegetables (FV) and consequently, intake, but research results are mixed. School gardening led by external specialists such as the Royal Horticultural Society (RHS) could have more impact than teacher-led gardening on children's knowledge of, and attitudes towards, FV. Data from a cluster randomised controlled trial were used to compare a RHS-led school gardening intervention with a teacher-led gardening intervention amongst 7-10 year olds in 21 London schools. A short questionnaire was developed and used to identify children's knowledge and attitudes towards FV consumption before the garden intervention and 18 months afterwards. Results from multilevel regression models, both unadjusted and adjusted for baseline responses and socio-demographic factors, were reported. Attitudes to FV intake were compared between groups. Change in FV knowledge was used to predict change in FV consumption assessed using 24-hour food diaries. In comparison with the RHS-led group (n = 373), teacher-led children (n = 404) were more likely to agree they ate lots of fruit (p < 0.009) and tried new fruits (p = 0.045), but RHS-led gardening was associated with a greater increase in the total number of vegetables recognised (p = 0.031). No other differences in improvements in attitudes, or associations between change in FV recognition and intake were found. In relation to improvements in children's recognition and attitudes towards eating FV, this trial produced limited evidence that gardening activity packages led by external specialists (RHS-led) provide additional benefits over those led by teachers trained by the RHS. Indeed, the latter were potentially more effective.
Publisher: MDPI AG
Date: 11-07-2017
DOI: 10.3390/NU9070736
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Charlotte Evans.