The effect of nutrition education intervention on the amount of school lunch consumption in children aged 3-5 years: case study in Bangkok, Thailand

Low vegetable and fruit intake and micronutrient deficiency has been reported for Thai children aged three to five years. Many nutrition education programs have been recommended to solve these problems, especially for preschool children. This study aims to investigate the effect of the novel nutrition education program on the amount of vegetables, fruit, energy and nutrients consumption in school lunches of children aged three to five years. United for Healthier Kids is a nutrition education program that desires to motivate healthy eating via a set of nutrition education tools by encouraging variety in the types of food consumed, increase vegetables and fruit consumption, and promote a healthy environment for preschool children. A total of 380 children, between three to five years of age (196 of which were female), from four schools in Bangkok participated in this study. The amount of vegetables, fruit, and other food intake was assessed by plate waste measurement for three days during the pre- and post-intervention period. Compared with the Thai DRIs, the percentage of vegetables and fruit consumption in the post-intervention period was closer to the recommended amount than in the pre-intervention period with increases of 16.02 and 8.79 in vegetable and fruit, respectively. Energy, fat, carbohydrate, calcium, iron, and vitamin C intake were significantly higher and more closely matched the recommendations in the post-intervention period. Vitamin A and vitamin B2 intake during the post-intervention period was lower than the pre-intervention period and there was no significant difference in the amounts of protein intake between the pre- and post-intervention periods. The new nutrition education has potential to increase vegetables, fruit, energy, fat, carbohydrate, calcium, iron, and vitamin C consumption of children aged 3 to 5 years. Future studies need to explore the effect of the program with larger and more diverse preschool children populations.据报道，泰国3至5岁儿童存在蔬菜、水果摄入不足及微量营养素缺乏问题。为此学界已推荐多项营养教育干预方案以解决上述问题，针对学龄前儿童的相关项目尤受关注。本研究旨在探究新型营养教育项目对3至5岁学龄前儿童学校午餐中蔬菜、水果、能量及营养素摄入量的影响。“为更健康儿童携手”（United for Healthier Kids）是一款营养教育项目，其通过一系列营养教育工具，倡导丰富食物种类、提升蔬菜与水果摄入量，并为学龄前儿童营造健康饮食环境，以此激励健康饮食行为。本研究共招募曼谷地区4所学校的380名3至5岁儿童参与，其中女童196名。在干预前与干预后阶段，分别通过餐盘剩余法连续3天评估儿童的蔬菜、水果及其他食物摄入量。以泰国膳食营养素参考摄入量（Dietary Reference Intakes, DRIs）为参照标准，干预后阶段儿童的蔬菜、水果摄入量达标率较干预前更接近推荐量，其中蔬菜摄入量提升16.02个百分点，水果摄入量提升8.79个百分点。干预后阶段儿童的能量、脂肪、碳水化合物、钙、铁及维生素C摄入量均显著提升，且更符合推荐摄入量标准。但干预后阶段儿童的维生素A与维生素B2摄入量较干预前有所下降，而蛋白质摄入量在干预前后无显著差异。本研究表明，新型营养教育项目可有效提升3至5岁儿童的蔬菜、水果、能量、脂肪、碳水化合物、钙、铁及维生素C摄入量，具备良好应用潜力。未来研究可针对更大规模、更多元化的学龄前儿童群体，进一步探究该项目的干预效果。