***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: Aims : To estimate the impact of school fruit tuck shops on  children ’s consumption of fruit and sweet and savoury snacks . Design : Cluster r and omised effectiveness trial with school as the unit of r and omisation . Setting : 43 primary schools in deprived areas in south Wales and south-west Engl and with a range of school food policies . Intervention : Schools operated fruit tuck shops throughout one academic year . Control schools did not do so . Measures : Repeated cross-sections of children aged 9–11 years completed a  computerised 24-hour recall question naire  at baseline ( n = 1902 ) and at 1-year follow-up ( n = 1924 ) , when a brief question naire was also completed ( n = 1976 ) . Results : Approximately 70 000 fruits were sold in the 23 intervention schools over the year , equivalent to 0.06 fruits per student per day . Children in intervention schools were more likely to report eating fruit as a snack at school ‘ often ’ ( OR 1.49 , 95 % CI 1.15 to 1.95 ) . There were no significant differences in children ’s intake of fruit or other snacks . There was a significant interaction ( p<0.02 ) between the intervention group and school food policy : where students were only allowed to bring fruit to school , fruit consumption was 0.37 portions per day ( 0.11 to 0.64 ) higher in intervention schools , compared to 0.14 portions ( −0.30 to 0.58 ) where no food was allowed and −0.13 portions ( −0.33 to 0.07 ) where there were no restrictions . Conclusions : In isolation , fruit tuck shops were not effective in changing children ’s snacking behaviour in schools . However , the results suggest that fruit tuck shops had a greater impact when reinforced by school policies restricting the types of foods students were allowed to bring to school Background Fruit and vegetable consumption is traditionally low in Icel and . The results of the Pro Children cross-Europe survey showed that the consumption was lowest among children in Icel and . The aim of this study was to identify determinants of fruit and vegetable intake among 11-year-old schoolchildren in Icel and . Methods A cross-sectional survey was performed in Icel and in the autumn of 2003 as a part of the Pro Children cross-Europe survey . The survey was design ed to provide information on actual consumption levels of vegetables and fruits by 11-year-old school children and to assess potential determinants of consumption patterns . A total of 1235 Icel and ic children ( 89 % ) from 32 r and omly chosen schools participated . Hierarchical regression analyses were performed to determine the explained variance of the children 's fruit and vegetable intake . In these analyses socio-demographic background variables were entered as a first block , perceived physical-environmental variables as a second block , perceived socio-environmental variables as a third block and personal variables as a fourth block . Results 64 % of the children ate fruit less than once a day , and 61 % ate vegetables less than once a day . Respectively , 31 % and 39 % of the variance in children 's fruit and vegetable intake was explained by the determinants studied . About 7 % and 13 % of the variance in fruit and vegetable intake was explained by the perceived physical-environmental determinants , mainly by availability at home . About 18 % and 16 % of the variance in fruit and vegetable intake was explained by the personal determinants . For both fruit and vegetable intake , the significant personal determinants were preferences , liking , knowledge of recommendations and self-efficacy . Conclusion Interventions to increase fruit and vegetable intake among children should aim at both environmental factors such as greater availability of fruit and vegetables , and personal factors as self-efficacy and knowledge levels concerning nutrition Objective : The aim of this study was to evaluate two interventions ( one reward-based and one exposure-based ) for increasing  children 's acceptance of an unfamiliar vegetable compared with a no-treatment control . It was predicted that the exposure condition would increase liking for , and consumption of , the vegetable relative to either the reward or control group . Design : Using a r and omized controlled design , participants were assigned to one of two intervention groups ( exposure or reward ) or to a no-treatment control condition , for a 2 week period . Liking for , and consumption of , red pepper was assessed before and after the treatment period . Setting : The study was conducted in three primary schools in London . Subjects : Parental consent was obtained for 49 out of a possible 72 children . Interventions : Interventions comprised eight daily sessions during which participants in the exposure group were offered a taste of sweet red pepper and told that they could eat as much as they liked . Participants in the reward group were shown a sheet of cartoon stickers and told that they could choose one of them on condition that they ate at least one piece of the pepper . Results : The exposure-based intervention significantly increased both liking ( P=0.006 ) and consumption ( P=0.03 ) compared with the control group . The outcome of the reward intervention was intermediate and did not differ significantly from the exposure or control conditions . Conclusions : Repeated exposure to the taste of unfamiliar foods is a promising strategy for promoting liking of previously rejected foods in children . Sponsorship : This study was financed by Cancer Research UK Abstract Objective : To assess if a school based intervention was effective in reducing risk factors for obesity . Design : Group r and omised controlled trial . Setting : 10 primary schools in Leeds . Participants : 634 children aged 7 - 11 years . Intervention : Teacher training , modification of school meals , and the development of school action plans targeting the curriculum , physical education , tuck shops , and playground activities . Main outcome measures : Body mass index , diet , physical activity , and psychological state . Results : Vegetable consumption by 24 hour recall was higher in children in the intervention group than the control group ( weighted mean difference 0.3 portions/day , 95 % confidence interval 0.2 to 0.4 ) , representing a difference equivalent to 50 % of baseline consumption . Fruit consumption was lower in obese children in the intervention group ( −1.0 , −1.8 to −0.2 ) than those in the control group . The three day diary showed higher consumption of high sugar foods ( 0.8 , 0.1 to 1.6 ) ) among overweight children in the intervention group than the control group . Sedentary behaviour was higher in overweight children in the intervention group ( 0.3 , 0.0 to 0.7 ) . Global self worth was higher in obese children in the intervention group ( 0.3 , 0.3 to 0.6 ) . There was no difference in body mass index , other psychological measures , or dieting behaviour between the groups . Focus groups indicated higher levels of self reported behaviour change , underst and ing , and knowledge among children who had received the intervention . Conclusion : Although it was successful in producing changes at school level , the programme had little effect on children 's behaviour other than a modest increase in consumption of vegetables . What is already known on this topic Obesity is increasing among school children and dem and s preventive strategies R and omised controlled trials of school based primary prevention programmes have all used a prescriptive approach What this study adds Behavioural changes were disappointing with this programme based on the health promoting schools philosophy , despite changes at school level The only positive outcome was a modest increase in vegetable consumption The discrepancy between changes achieved at the individual and school level raises issues regarding the problems inherent in such This study reports the effect of the Fruits and Vegetables Make the Marks intervention , a school-based fruit and vegetable intervention consisting of a home economics classroom component and parental involvement and encouraged participation in the Norwegian School Fruit Programme , all delivered during the school year of 2001 - 02 . Nine r and omly chosen schools received the intervention and 10 schools served as control schools . Participating pupils completed question naires at baseline ( September 2001 ) , at Follow-up 1 ( May-June 2002 ) and at Follow-up 2 ( May 2003 ) . A total of 369 pupils ( 69 % ; mean age , 11.3 years at baseline ) participated in all three surveys . No effect of the intervention was found for intake of fruit and vegetables eaten at school or all day , neither at Follow-up 1 nor at Follow-up 2 . On analysing the effects on potential mediators , significant differences between intervention and control groups were found for Awareness of the five-a-day recommendations only . The intervention programme was rated as very good by the teachers , and the pupils reported that they enjoyed it . However , the intervention failed to change fruit and vegetable intake , probably because it did not succeed in changing the pupils ' preferences for or the accessibility of fruit and vegetables -- the two strongest correlates of children 's fruit and vegetable intake OBJECTIVE To measure the effect of a  school fruit and vegetable subscription  on  children 's intake of fruit and vegetables after 5 weeks of intervention . SETTING Seven primary schools in Denmark . DESIGN AND METHODS Intervention schools ( n=4 ) were offered a fruit and vegetable subscription comprising one piece per day . Control schools situated in another municipality were not offered the subscription . Intake of fruit and vegetables was measured at baseline and 5 weeks after the start of the subscription . Two methods were used for dietary assessment : a pre-coded 24-hour recall form including total food intake and a food-frequency question naire ( FFQ ) including only fruit and vegetables . SUBJECTS Children aged 6 - 10 years ( n=804 from intervention schools and n=689 from control schools ) . Response rate in the dietary assessment was 31 % . RESULTS At intervention schools 45 % of the children enrolled in the subscription . After 5 weeks of intervention , both subscribers and non-subscribers had increased their intake of fruit by 0.4 ( P=0.019 ) and 0.3 ( P=0.008 ) pieces per school day , respectively , but no change was observed in vegetable intake . Total intake increased only for non-subscribers by 0.4 piece/school day ( P=0.008 ) mainly due to the consistent increase in fruit intake . No change in intake was measured at control schools . Only the 24-hour recall question naire was sensitive enough to pick up the changes of the subscription , whereas the FFQ was not . CONCLUSION Five weeks with the subscription affected both subscribers and non-subscribers to increase intake of fruit . This may indicate that the subscription had an additional effect of stimulating parents of non-subscribers to supply their children with fruit . The results stress the importance of evaluating the effect of this type of programme , and the carefulness needed in design ing the evaluation study BACKGROUND  Boy Scouts  are an important channel to complement school-based programs to enable boys to eat more fruit , 100 % juice , and vegetables ( FJV ) for chronic disease prevention . The " 5 a Day Achievement Badge " program was presented on a pilot study basis to African-American Boy Scout troops in Houston . METHODS Troops were the unit of recruitment and r and om assignment to treatment and control groups . The badge program was presented in Fall 1997 by trained dietitians and included activities to increase availability and accessibility of fruit and vegetables  at scouts ' homes , increase  preferences for vegetables , and train in the preparation of FaSST ( fast , simple , safe , and tasty ) recipes . Weekly comic books demonstrated and reinforced what scouts were expected to do at home . A weekly newsletter with recipes was sent to parents . The program was revised and presented to the control group in Winter 1998 . Two 24-h recalls were the primary assessment tools . Telephone interviews were conducted with parents . RESULTS The intervention result ed in a 0.8 FJV serving difference ( post values of treatment versus control groups with pre value covaried ) . CONCLUSIONS The changes obtained suggest that the intervention was effective in promoting dietary change PURPOSE To examine the feasibility and efficacy of a theory-driven and family-based program delivered online to promote healthy lifestyles and weights in Chinese American adolescents . METHODS A r and omized controlled study of a web-based intervention was developed and conducted in 54 Chinese American adolescents ( ages , 12 - 15 years ) and their families .  Data on anthropometry , blood pressure , dietary intake , physical activity , and knowledge and self-efficacy regarding physical activity and nutrition were collected at baseline and 2 , 6 , and 8 months after the baseline assessment . Data were analyzed using linear mixed modeling . RESULTS The intervention result ed in significant decreases in waist-to-hip ratio and diastolic blood pressure and increases in vegetable and fruit intake , level of physical activity , and knowledge about physical activity and nutrition . CONCLUSION This web-based behavior program for Chinese American adolescents and their families seems feasible and effective in the short-term . Long-term effects remain to be determined . This type of program can be adapted for other minority ethnic groups who are at high-risk for overweight and obesity and have limited access to programs that promote healthy lifestyles OBJECTIVE To assess the impact of a school-based nutrition education intervention aim ed at increasing the consumption of fruits and vegetables . DESIGN The intervention programme increased the provision of fruits and vegetables in schools and provided a range of point-of-purchase marketing material s , newsletters for children and parents , and teacher information . Curriculum material s at age 6 - 7 and 10 - 11 years were also developed and utilised . Evaluation was undertaken with groups of younger ( aged 6 - 7 years ) and older ( aged 10 - 11 years ) children . Methods included 3-day dietary records with interview and cognitive and attitudinal measures at baseline , with follow-up at 9 months , in intervention and control schools . SETTING The work was undertaken in primary schools in Dundee , Scotl and . SUBJECTS Subjects comprised 511 children in two intervention schools with a further 464 children from two schools acting as controls . RESULTS Children 
    Output:
    
Most studies implemented multi-faceted intervention strategies to increase FV access or consumption .
Conclusions While consumption measures were commonly reported , this review identified a small yet important subset of literature examining access to FV .
This is a critically important issue since consumption is contingent upon access .