Effects of a multipronged beverage intervention on young children's beverage intake and weight: A cluster-randomized pilot study

Objective: To evaluate whether a multipronged pilot intervention promoting healthier beverage consumption improved at-home beverage consumption and weight status among young children. Design: In this exploratory pilot study, we randomly assigned four childcare centres to a control (delayed-intervention) condition or a 12-week intervention that promoted consumption of healthier beverages (water, unsweetened low- or non-fat milk) and discouraged consumption of less-healthy beverages (juice, sugar-sweetened beverages, high-fat or sweetened milk). The multipronged intervention was delivered via childcare centres; simultaneously targeted children, parents and childcare staff; and included environmental changes, policies and education. Outcomes were measured at baseline and immediately post-intervention and included children's (n 154) at-home beverage consumption (assessed via parental report) and overweight/obese status (assessed via objectively measured height and weight). We estimated intervention impact using difference-in-differences models controlling for children's demographics and classroom. Setting: Two northern California cities, USA, 2013-2014. Participants: Children aged 2-5 years and their parents. Results: Relative to control group children, intervention group children reduced their consumption of less-healthy beverages from baseline to follow-up by 5.9 ounces/d (95 % CI -11.2, -0.6) (-174.5 ml/d; 95 % CI -331.2, -17.7) and increased their consumption of healthier beverages by 3.5 ounces/d (95 % CI -2.6, 9.5) (103.5 ml/d; 95 % CI -76.9, 280.9). Children's likelihood of being overweight decreased by 3 percentage points (pp) in the intervention group and increased by 3 pp in the control group (difference-in-differences: -6 pp; 95 % CI -15, 3). Conclusions: Our exploratory pilot study suggests that interventions focused comprehensively on encouraging healthier beverage consumption could improve children's beverage intake and weight. Findings should be confirmed in longer, larger studies.