Strategies to increase primary school children's fruit and vegetable intake during 10AM snack time.

In this observational study, children's fruit and vegetable (F&V) consumption during the 10AM school break was assessed for two promising strategies: a 5-day-a-week F&V policy and free provision of F&V presented in an attractive fruit bowl. Schools without a school food policy served as reference group. A secondary aim was to explore the feasibility of the two strategies. A total of 569 children aged 6-9 years participated. Children's F&V consumption at school was assessed on two different week days via observations and weighing snack portions. Parents completed an online-questionnaire on their perceptions and experiences with the two strategies. Main outcomes were the proportion of children and frequency of eating F&V, and children's F&V portion sizes. Data were analysed via ANOVA and Chi-Square (p < 0.05). Average F&V consumption differed significantly between the three situations (p < 0.001): 250 g in the fruit bowl situation, 130 g in the 5-day-policy situation and 60 g in the no-policy situation. The proportion of children eating F&V was high for the 5-day-policy (97-98%) and fruit bowl situation (87-97%), whereas this was substantially lower (50-60%; p < 0.001) in the no-policy situation. The majority of parents considered both strategies as feasible. A 5-day-a-week F&V policy seems an effective, feasible and structural strategy to support children's fruit and vegetable consumption at school. The fruit bowl strategy with an additional eating moment may enhance children's intake even further, although additional requirements are needed for structural implementation at school.

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