1. Professor Dominic Upton
Increasing children’s fruit and vegetable consumption: an evaluation of the Food Dudes programme
Professor Dominic Upton
Dr Penney Upton
Charlotte Taylor
ISBNPA Conference, May 2012.

2. The Food Dudes Programme (Horne, Lowe, Fleming & Dowey, 1995)
School-based intervention (4-11 years);
Encourages children to eat more fruit and vegetables both at school and at home;
Changes the ‘culture’ of a school to one that strongly supports healthy eating.

3. The 3Rs Based on psychological principles of behaviour change
Role modelling
Rewards
Repeated Tasting
Increased FV consumption

4. The Food Dudes Programme
Phase 1 (16 days)
Children are read a letter from the Food Dudes and watch a DVD episode
Given a portion of fruit and a portion of a vegetable
Children are given a reward if they eat both
Home Pack
Phase 2 (Maintenance)
Children still given rewards
Classroom wall charts to review progress
Some evidence of effectiveness but based on experimental model

5. The Study Ecological approach
8 intervention (n=1282) and 7 matched control (n=1151) schools
Evaluate impact on consumption at school and home of:
fruit and vegetables
unhealthy snack foods
Assess maintenance of any behaviour change 1 year after intervention

6. Overview of study design
Intervention schools
Control schools
Baseline
(pre intervention)
Phase 3
(12 months post intervention)
Phase 2
(3 months post intervention)
Food Dudes intervention
Baseline
(pre intervention)
Phase 3
(12 months post intervention)
Phase 2
(3 months post intervention)
No intervention

7. Measures Weighed intake method (school prepared lunch);
Visual estimation of intake (packed lunch);
Observation and child report (recess);
Photographic diary (home consumption);
Measures taken over 5 consecutive days.

8. Lunchbox Example
Baseline
3 month follow-up
PRE
POST

9. Results: Snack choice at recess
Fig 1. Mean consumption of FV – Recess snacks
Levels of FV consumption already higher in intervention schools
Increase in FV consumption for intervention schools at Phase 2, but Non significant
The increase in FV consumption displaced unhealthy snacks
FV consumption decreased over time in the control schools, whilst unhealthy snacks increased.

10. Results: School prepared lunch (FV)
Fig 2. Mean consumption of FV – School meals
Significant increase in FV consumption at Phase 2 (t=-2.54, p<0.05, d= 0.26, CI= ) for intervention schools
But not control schools (t=-0.97, p>0.05, d=0.07, CI= );
FV consumption decreased in both groups at Phase 3;
BUT no displacement of unhealthy foods seen

11. Results: School prepared lunch (FS)
Fig 6. Mean consumption of Fat/sugary foods– School meals
Significant increases for intervention (t=-4.87, p<0.05, d=0.49, CI= );
and control schools (t=-4.49, p<0.05, d=0.35, CI= ) at Phase 2;

12. Results: Packed lunches (FV)
Fig 3. Mean consumption of FV – Home prepared lunches
Significant increase in FV consumption at phase 2 for children in the control schools (t=-2.55, p<0.05, d=0.26, CI= ), but no change for intervention schools
However this was not maintained over time
Consumption of unhealthy food increased in intervention school

13. Results: Packed Lunches (FS)
Fig 7. Mean consumption of Fat/sugary foods– Home prepared lunches
Significant increases at phase 2 in the intervention schools (t=-2.66, p<0.05, d=0.31, CI= );
Reduction in this consumption means this is no longer significant at Phase 3 for intervention schools (t=-1.22, p>0.05, d=0.14, CI= );
Non significant increase at phase 3 for control schools (t=-1.25, p>0.05, d=0.13, CI= ).

14. Results: Home study (FV)
Non significant decrease in FV consumption at phase 2 for intervention (t=1.52 (19), p>0.05, d=-0.48, CI= );
and control schools (t=0.67 (24), p>0.05, d=-0.19, CI= );
Continued reduction in consumption at phase 3 also non significant for intervention (t=-1.73 (19), p>0.05), d=-0.55, CI= );
and controls (t=1.43 (24), p>0.05), d=0.41, CI= )
Fig 4. Mean consumption of FV – Food diary

15. Results: Home study (FS)
Consumption of unhealthy foods decreased in both the intervention and control schools over time;
Non significant at Phase 2 and 3 for intervention (t=0.88 (19), p>0.05, d=-0.29, CI= );
Significant at phase 3 for control schools (t=3.10 (24), p>0.05, (d=-0.88, CI= ).
Fig 8. Mean consumption of Fat/sugary foods– Food diary

16. Do the ‘Food Dudes’ change behaviour?
An improvement in children’s eating behaviours was seen in the short term for school-supplied food;
This was particularly noticeable at recess;
Are school policies most important factor?
Impact on food supplied from home less clear;
Packed lunches continued to be high in fatty sugary foods and low in FV;
Consumption of unhealthy foods decreased at home, but so did FV consumption;

17. Food Dudes…… Winning the battle against the Junk Punks……..
But is it enough to win the war on obesity?