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Results from an experimental trial at a Head Start center to evaluate two meal service approaches to increase fruit and vegetable intake of preschool aged children

Lisa J Harnack14*, J Michael Oakes1, Simone A French1, Sarah A Rydell1, Farhiyah M Farah2 and Gretchen L Taylor3

Author Affiliations

1 Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA

2 Parents in Community Action, Hennepin County Head Start, University of Minnesota, Minneapolis, MN, USA

3 Diabetes Unit, Center for Health Promotion, Minnesota Department of Health, Minneapolis, MN, USA

4 Division of Epidemiology and Community Health, University of Minnesota, 1300 South 2nd St., Suite 300, Minneapolis, MN, 55454, USA

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International Journal of Behavioral Nutrition and Physical Activity 2012, 9:51  doi:10.1186/1479-5868-9-51

Published: 30 April 2012



Strategies to increase fruit and vegetable consumption of preschool aged children are needed.


Evaluate the independent effects of the following meal service strategies on intake of fruits and vegetables of preschool children: 1.) Serving fruits and vegetables in advance of other menu items as part of traditional family style meal service; and 2.) Serving meals portioned and plated by providers.


Fifty-three preschool aged children completed a randomized crossover experiment conducted at a Head Start center in Minneapolis, MN. Over a six week trial period each of the experimental meal service strategies (serving fruits and vegetable first and serving meals portioned by providers) was implemented during lunch service for two one-week periods. Two one-week control periods (traditional family style meal service with all menu items served at once) were also included over the six week trial period. Childrens lunch intake was observed as a measure of food and nutrient intake during each experimental condition.


Fruit intake was significantly higher (p<0.01) when fruits and vegetables were served in advance of other meal items (0.40 servings/meal) compared to the traditional family style meal service control condition when they were served in tandem with other menu items (0.32 servings/meal). Intakes of some nutrients found in fruits (vitamin A and folate) were concomitantly higher. In contrast, fruit and vegetable intakes were significantly lower and energy intake significantly higher during the provider portioned compared with control condition.


Serving fruits in advance of other meal items may be a low cost easy to implement strategy for increasing fruit intake in young children. However, serving vegetables first does not appear to increase vegetable intake. Results provide support for current recommendations for traditional family style meal service in preschool settings.

Fruit and vegetable promotion; Preschool aged children, Head Start