The impact of variety and free accessibility of snack vegetables on the intake of 3- to 7-year-old children: A randomized cross-over trial

Children's vegetable consumption is below recommended levels. Offering children a choice is an easy to implement strategy to increase vegetable intake in children, however, results are inconclusive about the effectiveness to enhance intake. This study investigates the independent and combined effects of two types of choice offerings on vegetable intake in children aged 3-7 years: a variety of snack vegetables (versus no variety) and providing free access (versus parent-initiated eating). The study had a 2x2 cross-over design with two levels of vegetable variety: one vegetable (no-variety) or three vegetables (variety), and two levels of initiation: parent-initiated eating moments (initiated) or child-initiated eating moments (free). In randomized order, 44 children (20 boys, age = 5.7 ± 1.1) received each condition twice. Vegetables were offered as an afternoon snack at the child's home on schooldays, and intake was assessed using pre- and post-consumption weighing of left-overs. Vegetable intake was 58 % higher when a variety was offered (Mean ± SEM, 221 ± 11 g) compared to a single type of vegetables (140 ± 11 g), p < .001. Intake was 14 % higher when children could choose when to eat (192 ± 11 g) versus a parent-initiated snack time (169 ± 11 g), p = .03. No interaction effects were found between conditions. These findings suggest that providing children with variety and free access are effective strategies to enhance vegetable intake, though the effects may be partially attributable to increased portion sizes and longer exposure times inherent to these interventions.