Effects of a multipronged beverage intervention on young children's beverage intake and weight: a cluster-randomized pilot study

Public Health Nutr. 2019 Oct;22(15):2856-2867. doi: 10.1017/S1368980019001629. Epub 2019 Jul 15.

Abstract

Objective: To evaluate whether a multipronged pilot intervention promoting healthier beverage consumption improved at-home beverage consumption and weight status among young children.

Design: In this exploratory pilot study, we randomly assigned four childcare centres to a control (delayed-intervention) condition or a 12-week intervention that promoted consumption of healthier beverages (water, unsweetened low- or non-fat milk) and discouraged consumption of less-healthy beverages (juice, sugar-sweetened beverages, high-fat or sweetened milk). The multipronged intervention was delivered via childcare centres; simultaneously targeted children, parents and childcare staff; and included environmental changes, policies and education. Outcomes were measured at baseline and immediately post-intervention and included children's (n 154) at-home beverage consumption (assessed via parental report) and overweight/obese status (assessed via objectively measured height and weight). We estimated intervention impact using difference-in-differences models controlling for children's demographics and classroom.

Setting: Two northern California cities, USA, 2013-2014.

Participants: Children aged 2-5 years and their parents.

Results: Relative to control group children, intervention group children reduced their consumption of less-healthy beverages from baseline to follow-up by 5·9 ounces/d (95 % CI -11·2, -0·6) (-174·5 ml/d; 95 % CI -331·2, -17·7) and increased their consumption of healthier beverages by 3·5 ounces/d (95 % CI -2·6, 9·5) (103·5 ml/d; 95 % CI -76·9, 280·9). Children's likelihood of being overweight decreased by 3 percentage points (pp) in the intervention group and increased by 3 pp in the control group (difference-in-differences: -6 pp; 95 % CI -15, 3).

Conclusions: Our exploratory pilot study suggests that interventions focused comprehensively on encouraging healthier beverage consumption could improve children's beverage intake and weight. Findings should be confirmed in longer, larger studies.

Keywords: Beverage consumption; Child care; Early childhood; Obesity prevention intervention; Overweight/obesity; Sugar-sweetened beverages; Water.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Beverages / adverse effects*
  • Body Weight*
  • California / epidemiology
  • Child Day Care Centers
  • Child Nutritional Physiological Phenomena
  • Child, Preschool
  • Cluster Analysis
  • Diet, Healthy / methods*
  • Feeding Behavior
  • Female
  • Health Promotion / methods*
  • Humans
  • Male
  • Obesity / epidemiology
  • Obesity / etiology
  • Overweight / epidemiology
  • Overweight / etiology
  • Pilot Projects