***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Determine whether Color Me Healthy ( CMH ) , an interactive nutrition and physical activity program for preschool children , increases fruit and vegetable consumption . DESIGN Intervention study . Data were collected at baseline , 1 week post-intervention , and 3 months post-intervention . SETTING Child care centers . PARTICIPANTS Preschool children ( n = 263 ) in 17 child care centers . INTERVENTION Child care centers were r and omly assigned to 1 of 2 conditions ; children ( n = 165 ) in 10 centers received the CMH curriculum , and children ( n = 98 ) in 7 centers acted as comparisons and did not receive the curriculum . MAIN OUTCOME MEASURES Process and outcome evaluation . Consumption of fruit and vegetable snacks . ANALYSIS Data were analyzed using repeated- measures analysis of variance and hierarchical linear modeling . RESULTS Children who received CMH significantly increased their consumption of fruit snacks by approximately 20.8 % and vegetable snacks by approximately 33.1 % between baseline assessment and the assessment conducted 3 months after the completion of the CMH program . Hierarchical linear modeling determined that group assignment ( ie , CMH or control ) was the only significant predictor of fruit and vegetable consumption . CONCLUSIONS AND IMPLICATION S Findings suggest that CMH may be used in child care setting s for developing healthful eating habits Background Governments worldwide recommend daily consumption of fruit and vegetables . We examine whether this benefits health in the general population of Engl and . Methods Cox regression was used to estimate HRs and 95 % CI for an association between fruit and vegetable consumption and all-cause , cancer and cardiovascular mortality , adjusting for age , sex , social class , education , BMI , alcohol consumption and physical activity , in 65 226 participants aged 35 + years in the 2001–2008 Health Surveys for Engl and , annual surveys of nationally representative r and om sample s of the non-institutionalised population of Engl and linked to mortality data ( median follow-up : 7.7 years ) . Results Fruit and vegetable consumption was associated with decreased all-cause mortality ( adjusted HR for 7 + portions 0.67 ( 95 % CI 0.58 to 0.78 ) , reference category < 1 portion ) . This association was more pronounced when excluding deaths within a year of baseline ( 0.58 ( 0.46 to 0.71 ) ) . Fruit and vegetable  consumption was associated with reduced cancer ( 0.75 ( 0.59–0.96 ) ) and cardiovascular mortality ( 0.69 ( 0.53 to 0.88 ) ) . Vegetables may have a stronger association with mortality than fruit ( HR for 2 to 3 portions 0.81 ( 0.73 to 0.89 ) and 0.90 ( 0.82 to 0.98 ) , respectively ) . Consumption of vegetables ( 0.85 ( 0.81 to 0.89 ) per portion ) or salad ( 0.87 ( 0.82 to 0.92 ) per portion ) were most protective , while frozen/canned fruit consumption was apparently associated with increased mortality ( 1.17 ( 1.07 to 1.28 ) per portion ) . Conclusions A robust inverse association exists between fruit and vegetable consumption and mortality , with benefits seen in up to 7 + portions daily . Further investigations into the effects of different types of fruit and vegetables are warranted BACKGROUND The use of rewards to encourage children to eat healthily is controversial . However , research er-led interventions have shown that incentives combined with taste exposure can increase both intake and liking . To date , this has not been tested in the home setting . OBJECTIVES The objectives were to test the hypothesis that parent-administered repeated taste exposures to an initially disliked vegetable combined with reward will increase children 's liking and intake and to compare the effects of tangible and social rewards . DESIGN In this r and omized controlled trial , families with children aged 3 - 4 y ( n = 173 ) were r and omly assigned to exposure + tangible reward ( sticker ) , exposure + social reward ( praise ) , or no-treatment control conditions after a pretest assessment in which a target vegetable was selected for each child . In the intervention groups , parents offered their children 12 daily tastes of the vegetable , giving either praise or a sticker for tasting . No specific advice was given to the control group . Assessment s of intake and liking of the target vegetable were conducted by research ers immediately after the intervention period and 1 and 3 mo later . RESULTS Children who received exposure + tangible rewards increased their intake ( P = 0.001 ) and liking ( P = 0.001 ) of their target vegetable significantly more than did children in the control group . Differences were maintained at the 3-mo follow-up ( intake : P = 0.005 ; liking : P = 0.001 ) . Increases in intake and liking in the exposure + social reward group were not significantly different from the control group . CONCLUSION The findings of this home-based study support parental use of tangible rewards with repeated taste exposures to improve children 's diets . This trial is registered as IS RCT N42922680 Background Mexico has the highest adult overweight and obesity prevalence in the Americas ; 23.8 % of children < 5 years old are at risk for overweight and 9.7 % are already overweight or obese . Creciendo Sanos was a pilot intervention to prevent obesity among preschoolers in Instituto Mexicano del Seguro Social ( IMSS ) clinics . Methods We r and omized 4 IMSS primary care clinics to either 6 weekly educational sessions promoting healthful nutrition and physical activity or usual care . We recruited 306 parent-child pairs : 168 intervention , 138 usual care . Children were 2 - 5 years old with WHO body mass index ( BMI ) z-score 0 - 3 . We measured children ’s height and weight and parents reported children ’s diet and physical activity at baseline and 3 and 6-month follow-up . We analyzed behavioral and BMI outcomes with generalized mixed models incorporating multiple imputation for missing values . Results 93 ( 55 % ) intervention and 96 ( 70 % ) usual care families completed 3 and 6-month follow-up . At 3 months , intervention v. usual care children  increased vegetables by 6.3 servings/week ( 95 % CI , 1.8 , 10.8 ) . In stratified analyses , intervention participants with high program adherence ( 5 - 6 sessions ) decreased snacks and screen time and increased vegetables v. usual care .  No further effects on behavioral outcomes or BMI were observed . Transportation time and expenses were barriers to adherence . 90 % of parents who completed the post-intervention survey were satisfied with the program . Conclusions Although satisfaction was high among participants , barriers to participation and retention included transportation cost and time . In intention to treat analyses , we found intervention effects on vegetable intake , but not other behaviors or BMI .Trial registration Clinical Trials.gov NCT01539070.Comisión Nacional de Investigación Científica del IMSS : 2009 - 785 - 120 OBJECTIVE To measure the effects of two school-based interventions on  children 's intake of fruit and vegetables ( F&V ) . DESIGN AND METHODS A total of six primary schools were r and omly assigned to ( 1 ) a free F&V distribution programme , or ( 2 ) a multicomponent programme , consisting of a classroom curriculum and parental involvement . The two interventions were evaluated on their effects and compared with six control schools in a pre-test-post-test design . Two methods were used for dietary assessment : a pre-structured food recall and a food-frequency question naire including only F&V. SUBJECTS A total of 939 parents of children aged 4 - 12 years filled out the question naire at both pre-test and post-test . The response rate was 54 % . RESULTS Multilevel analyses showed that both programmes were equally effective in increasing children 's fruit consumption by 0.2 portions per day . The free F&V distribution increased vegetable intake among non-native children and the oldest age group , and the multicomponent programme among the oldest children and girls . The distribution also caused an increased 24 h fruit , juice and vegetable intake among the youngest and the oldest age groups , and the multicomponent programme among all children . CONCLUSION The results of this study indicate that both interventions were shown to be effective for different subgroups regarding age , gender and ethnicity . When comparing both interventions , the distribution programme was shown to be more effective , especially in increasing vegetable consumption . An important next step will be to investigate which intervention has the greatest potential to be implemented in primary schools BACKGROUND Evidence -based strategies for promoting vegetable consumption among children are limited . OBJECTIVE To determine the effects of providing a palatable “ dip ” along with repeated exposure to a raw vegetable on preschoolers ' liking and intake . PARTICIPANTS One hundred fifty-two predominately Hispanic preschool-aged children studied in Head Start classrooms in 2008 . DESIGN A between-subjects , quasiexperimental design was used . A moderately-liked raw vegetable ( broccoli ) was offered twice weekly at afternoon snacks for 7 weeks . Classrooms were r and omized to receive broccoli in one of four conditions differing in the provision of dip .  Bitter taste sensitivity was assessed using  6-n-propylthiouracil .  INTERVENTION Broccoli was provided in four conditions : with regular salad dressing as a dip , with a light ( reduced energy/fat ) version of the dressing as a dip , mixed with the regular dressing as a sauce , or plain ( without dressing ) . MAIN OUTCOME MEASURES Mean broccoli intake during 7 weeks of exposure and broccoli liking following exposure . STATISTICAL ANALYSES Descriptive statistics were generated . Multilevel models for repeated measures tested effects of condition and bitter sensitivity on mean broccoli intake during exposure and on pre- and post-exposure liking while adjusting for classroom effects and potential covariates . RESULTS The majority of Hispanic preschoolers ( 70 % ) showed sensitivity to the bitter taste of 6-n-propylthiouracil . Children 's broccoli liking increased following exposure but did not vary by dip condition or bitter sensitivity . Bitter-sensitive children , however , ate 80 % more broccoli with dressing than when served plain ( P<0.001 ) ; effects did vary based on whether regular or light dressing was provided as a dip or sauce . Dip did not promote broccoli intake among bitter-insensitive children . CONCLUSIONS Providing dip — regular , light , or as a sauce — increased raw broccoli intake among bitter-sensitive Hispanic preschoolers . Findings suggest that offering low-fat dips can promote vegetable intake among some children who are sensitive to bitter tastes Children 's consumption of vegetables is still below recommendations . Since preference is the most important predictor of children 's intake and most children dislike vegetables , new strategies are needed to increase their preferences for vegetables . Flavour nutrient learning ( FNL ) could be an effective mechanism to change preferences . Forty healthy toddlers were included in a r and omized intervention study . During an intervention period of 7weeks , they consumed vegetable soups ( endive and spinach ) twice per week . Half of the group received a high-energy variant of one soup ( e.g. HE spinach ) and a low energy variant of the other ( LE endive ) , whereas for the other half the order was reversed ( HE endive , LE spinach ) . Primary outcome measures were preference and ad libitum consumption ( with a maximum of 200 g ) of both vegetable products ( LE ) , measured before , shortly after the intervention period , and 2 and 6months following conditioning to assess longer-term effects . After completion of the intervention period , 28 children ( 14 girls and 14 boys , age 35months ; SD±8.3 ) met criteria for FNL to occur , and were included in further data analysis . Results showed a significant increase ( ~58 g ) in ad libitum intake for both vegetable soups ( stable over time ) , but irrespective of the energy content . This indicates a robust effect of mere exposure on intake , but no FNL . For preference , however , results showed a significant shift in liking for the vegetable soup consistently paired with high energy , supporting FNL Children are not consuming sufficient amounts of fruits and vegetables in their habitual diet . Methods derived from associative learning theories could be effective at promoting vegetable intake in pre-school children . The objective of the present study was to compare the effectiveness of different learning strategies in promoting the intake of a novel vegetable . Children aged between 9 and 38 months were recruited from UK nurseries . The children ( n 72 ) were r and omly assigned to one of three conditions ( repeated exposure , flavour-flavour learning or flavour-nutrient learning ) . Each child was offered ten exposures to their respective version of a novel vegetable ( artichoke ) . Pre- and post-intervention measures of  artichoke purée  and  carrot purée ( control vegetable ) intake were taken . At pre-intervention , carrot intake was significantly higher than artichoke intake ( P<0·05 ) . Intake of both vegetables increased over time ( P<0·001 ) ; however , when changes in intake were investigated , artichoke intake increased significantly more than carrot intake ( P<0·001 ) . Artichoke intake increased to the same extent in all three conditions , and this effect was persistent up to 5 weeks post-intervention . Five exposures were sufficient to increase intake compared to the first exposure ( P<0·001 ) . 
    Output:
    
The meta- analysis revealed that interventions implementing repeated taste exposure had better pooled effects than those which did not .
Intake increased with number of taste exposures and intake was greater when vegetables offered were in their plain form rather than paired with a flavor , dip or added energy ( e.g. oil ) .
Moreover , intake of vegetables which were unfamiliar/disliked increased more than those which were familiar/liked .
Repeated taste exposure is a simple technique that could be implemented in childcare setting s and at home by parents .