Trends of RCT studies on nutrition/health education aimed at preventing lifestyle-related diseases in pre-school children

Abstract

Objective: The purpose of this study was to review randomized controlled trial (RCT) studies using nutrition/health education to prevent lifestyle-related diseases in pre-school children, and published between 2000 and 2012.
Methods: A PubMed and Igaku Chuo Zasshi (ICHUSHI) search was performed with the key words “diet/nutrition”, “health education” and “intervention” to identify nutrition interventions targeting children aged 2-5, and published in English or Japanese between 2000 and 2012. The search retrieved 173 articles, of which there were ten RCT studies eligible for this review. References from the resulting papers were also examined for relevance. Two researchers, working separately, conducted the literature screening, hand searches, and intensive reading of the full texts, whereupon they discussed their findings to determine final article selection and interpretation.
Results: After screening, 16 papers (15 studies) were included for this review. Studies implemented in Japan were not available. Most of the studies employed a cluster randomized controlled trial design based upon a pre-school unit. Behavioral science theories such as the social cognitive theory and the ecological model of health behavior were used, suggesting that interventions were not only directed at children but also towards parents and pre-school teachers. Interventions that increased vegetable intake, and those that combined nutrition interventions with exercise showed decreases in BMI and the proportion of overweight participants.
Conclusion: Similar to pre 1999 reviews, the importance of applying the social cognitive theory and environment approach in nutrition education for pre-school children was reaffirmed. Also, research evaluations using physical indices such as BMI increased.