P2B301: Dr. Yum Preschool Adventure: A Head Start-based Cooking Intervention Associated with Improvements in Weight Status Among Young Children

Background: Nearly 20 percent of children in the United States have obesity, with the transition from young to middle childhood identified as a critical time of excess weight gain. Additionally, many children eat significantly below the recommended amount of fruits and vegetables, which has been linked with increased risk of obesity, as well as risk of low weight. It is possible this link is at least partially due to food neophobia (i.e. hesitation to eat or try new foods). Among older children, previous school-based interventions promoting healthy eating have yielded successful outcomes, such as decreased food fussiness, increased willingness to try novel vegetables, and improved weight outcomes. We explored whether an interactive cooking class focused on the enjoyment of food could be an effective means of improving weight statuses among young children.

Methods: In a non-randomized trial, trained Head Start teachers facilitated preparation of an age-appropriate snack using an identified novel fruit/vegetable during once-monthly lessons. During these lessons, students were also introduced to the nutritional benefits of the fruit/vegetable and were guided through mindful appreciation of the new food. Families were provided with information on the curriculum presented at school and encouraged to incorporate new recipes at home. All recipes were previously identified as acceptable by young children. Teachers recorded BMI percentiles at baseline and end-of-year follow up. ANOVA analyses were used to compare change in BMI percentile among three initial baseline BMI classes (underweight, healthy weight, and high weight).

Results: Among 614 Head Start students in Alabama (2.8-5.1y; M: 4.0±0.6y; 44.6% female; BMI%ile: 53.8±33.1; 21.2% with high weight at baseline; 7.7% with underweight at baseline) we saw significant changes (p < .001) in BMI percentile based on weight status at baseline. Compared to children with healthy weight (BMI percentile between 5th and 84th; n= 437) those with high weight (BMI percentile ≥ 85th; n=130) lost 16.9 percentile points over the year. Conversely, children with low weight ( < 5th percentile; n=47) gained 24.7 percentile points over the course of the school year. Among the reference group, those with healthy weight at baseline, BMI percentile increased by 3.2 (±29.4).

Conclusion: Baseline weight status predicted a change in BMI percentile over the year such that among those with high weight, a decrease in BMI percentile was detected and among those with low weight an increase was detected. These results highlight the possibility that a school-based cooking intervention could be an effective prevention strategy for the development of both high and low weight. Exposure to novel fruits and vegetables may promote positive attitudes toward food and improvement in weight status. However, additional data are required to more fully understand the mechanisms that cause beneficial weight changes in preschool age children.