Zespri explores the impact of fruit and vegetable consumption on children's wellbeing in world-first childhood dietary intervention study.

MOUNT MAUNGANUI, New Zealand, June 4, 2024 /PRNewswire/ -- Zespri, the world's leading marketer of kiwifruit, is investing in building knowledge and healthy eating habits among children through its latest feasibility study named the Feel Good Study, exploring the relationship between fruits and vegetables (FV) and children's wellbeing.

The nutritional benefits of FV to physical health are widely known, but according to a study in the PLOS Global Public Health Journal, almost one in two children globally are not consuming enough FVs. In line with Zespri's mission to promote good nutrition and healthy eating habits, the Feel Good Study was conducted by researchers at University of Auckland, New Zealand, who lead research, education, and clinics in nutrition science, nutrition, and dietetics.

The study primarily aimed to determine the feasibility and acceptability of a 10-week FV dietary intervention in primary school and the measurement of mental and cognitive health outcomes. The study investigated the effects of increased consumption of FV on children's wellbeing among those aged between eight and 10 years old.

"As stewards of the next generation's wellbeing, we understand the profound impact that early nutrition has on a child's lifelong health. It is only through cultivating positive eating habits in a sustainable manner that we can truly make a difference and thrive as a healthier society with a brighter future," said Ng Kok Hwee, General Manager of Global Marketing, Zespri.

The feasibility study explored strategies to increase exposure to unfamiliar FVs to promote acceptance in children. Increased FV acceptance from childhood paves the way for healthy dietary habits that extend to adulthood, in turn leading to improved overall wellbeing.

"We've always been invested in learning more about the nutritional benefits of kiwifruit to human health, but with this study, we sought to dig deeper into the nutritional outcomes of fruits and vegetables as part of a whole diet approach. We investigated areas that have not been studied as much – in particular, wellbeing and cognitive development – to show how choosing fruits and vegetables is not just a nutritional or dietary decision, it is an investment into the well-being of the child," said Dr Paul Blatchford, Innovation Manager – Core Products, Zespri. "This study represents Zespri's first step in understanding the tangible benefits to wellbeing. Given the varying nutritional challenges in each market, we plan to go beyond taking this first step and extend this research to future studies in our key markets."

The Findings
The Feel Good Study demonstrated the potential of increasing FV acceptance¹, overall diet quality, as well as vegetable intake² among participants through raising awareness of the diverse FV options available locally.

The intervention also prompted positive changes in parental behaviour, with increased awareness of healthy eating leading to a conscious selection of more low-fat, low-sugar options for their children³. The study also demonstrated a positive improvement to emotional wellbeing scores in the intervention group compared to the control group⁴.

"The Feel Good Study intervention had a robust design, incorporating both home- and school-based strategies to promote healthier habits among children. With a focus on experiential learning, the school sessions engaged students in interactive sensory experiences, complemented by the delivery of fruit boxes to encourage additional fruit consumption during the school day. Meanwhile, the home-based component provided families with weekly vegetable boxes, complete with recipes and tips, aiming to foster sustained engagement and long-term benefits," said Professor Clare Wall, Head of Discipline – Nutrition, Faculty of Medical and Health Sciences, University of Auckland.

Schools and homes are core environments for children. In schools, educational strategies that focus on incorporating elements of fun and enjoyment helped in building positive associations and promoting FV consumption in children. At home, empowering parents with knowledge and practical tips on diverse FV preparation methods fosters a wider range of options for their children, reducing food neophobia. Parents are key influencers in shaping children's food preferences and by incorporating FVs into their diets, they set a healthy example for their children to model after.

Designed as a feasibility study, the Feel Good Study was able to achieve good recruitment and retention rates and showed promising preliminary evidence including positive changes to diet quality, vegetable intake and behavioural outcomes. Zespri's Feel Good Study sets the foundation for larger scaled clinical trials that are set to take place in China and other key markets in the next few years as the company builds greater knowledge to encourage sustainable change and cultivate positive eating habits in children in the long run.

Globally, Zespri has rolled out various nutrition programmes designed to lift the consumption of fresh kiwifruit around the world and created 5 billion healthy eating occasions in the 2022/23 season – well on the way to its goal of lifting this to 6 billion by 2025. It has also supported 35 healthy lifestyle programmes in over 12 countries since 2020.

Appendix 1: Study Methodology
70 children aged between 8 and 10 years old, with 65 parents/caregivers who provided baseline demographic information for their child, participated in the Feel Good Study in New Zealand. The study followed a 10-week wait-listed controlled, cluster-randomised design, encompassing both school and home settings to investigate behaviour changes in children.

The intervention involved a multifaceted approach, utilising a streamlined fruit box delivery and educational package, to explore the factors influencing children's dietary behaviours and fostering shifts in their attitudes towards the intake of FVs. Assessment activities took place in both school and home environments, with the overarching objective of promoting an increase in the consumption of FVs.

Full details of the study methodology, results, and recommendations for future iterations can be found in the research study here.

¹ Anecdotally, respondents to the study said they were exposed to more varieties and were more adventurous with FV.
² The study saw an 8% increase in total diet quality and 19% increase in vegetable intake in participants.
³ The study saw a 32% increase in parents/caregivers choosing low fat and 38% increase in parents/caregivers choosing low sugar options after the intervention.
⁴ The study found a divergence of change to the emotional problems component of the strengths and difficulties questionnaire with a slight improvement to scores in the intervention group, and decline in the control group.