Abstract:
Introduction: Early childhood is a crucial period for establishing lifelong dietary habits. However, vegetable intake among children remains well below recommended levels. Early Childhood Development Centres (ECDCs) provide an important platform to address this by creating environments that reinforce positive eating behaviours. While strategies to increase vegetable intake have shown effectiveness in high-income countries, evidence from low-and middle-income countries remains limited. This study explored ECDC staff perceptions of vegetable acceptability and evaluated the effectiveness of an intervention to increase vegetable intake in ECDCs in Tshwane, Gauteng.
Methods: A two-phased study was conducted. Phase I was a cross-sectional descriptive study in which a census of ECDC staff (N=72) from 41 randomly selected ECDCs completed an online survey to inform the development of an intervention to improve vegetable intake in children. Phase II involved a pre–post intervention conducted over a one-week period in a subsample of three conveniently selected ECDCs. Spinach nuggets were introduced as a vegetable. The intervention included sensory-based activities, non-food rewards, vegetable gardening, and storybook reading. Changes in intake were assessed using a plate-waste study on day one (pre-intervention) and day five (post-intervention).
Results: Phase I identified key staff-reported strategies to improve children’s vegetable intake, including making vegetables fun (49.6%, n=56), providing nutrition education (41.6%, n=47), and fostering positive mealtime environments (35.4%, n=40). In Phase II, analysis of 147 pre- and 141 post-intervention plates showed a 19% reduction in vegetable plate waste (37% to 18%) and a twofold increase in mean vegetable intake, from 5.17 g (SD 1.56) to 11.40 g (SD 3.75).
Conclusion: A context-specific, multi-component intervention can improve vegetable intake among children attending ECDCs. These findings provide preliminary evidence to inform future research and interventions promoting healthy eating habits among South African children and add to the limited evidence on vegetable intake interventions in South African ECDCs.
