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News & Research
Valerie Duffy, PhD, RD – University of Connecticut
Valerie Duffy, PhD, RD, at the University of Connecticut, was the recipient of the ADA-- Healthy Food Choices Research grant funded by the ARAMARK Charitable Fund. Dr. Duffy’s research entitled, “The Captain 5 A Day Program:
Improving dietary quality and physical activity in preschoolers" could impact the long--term health goals of children in preventing obesity, a common risk factor for type 2 diabetes.
The Captain 5--A--Day program targeted preschoolers, parents and educators and provided a curriculum that increased vegetable and fruit consumption and encouraged healthy food choices. Teachers provided classroom guidance and incorporated a 16-- week lesson plan in addition to regular classroom instruction. Parental involvement was achieved through child--family activity worksheets, participating in workshops and logging in for web site activities.
The program’s impact was evaluated via preschooler’s consumption of vegetables served at lunch. Since teachers eat with preschoolers, their rating of vegetable consumption was evaluated for feasibility and utility as an outcome measure against vegetable consumption assessed by plate waste method. Teachers scored the preschooler’s vegetable as “less than usual," “always a poor vegetable eater," “improved," “always a good vegetable eater," and “more than usual." Improvements in preschooler’s vegetable consumption in the intervention versus control group were shown with both teacher scoring and plate waste, suggesting the former as a useful and less time--intensive way for evaluating the success of the Captain 5 A Day intervention. The student’s Body Mass Index was also calculated. The child’s information was collected and saved for a later comparison at the completion of the program. In its third year, the Captain 5--A--Day program has reached 800 preschoolers with teachers reporting a significant increase in vegetable intake at school lunches.
Despite the overall increase in vegetable consumption within the study, there were still some children who had not increased their vegetable intake. Dr. Duffy has identified the bitter taste of the vegetables as one barrier to the preschooler’s consumption. To address this, she treated the vegetables with a light misting of a sweetener--aspartame in pilot testing and sucralose in subsequent testing. Sucralose and Aspartame are common sugar substitutes used in commercial markets and are FDA approved. The ADA accepts that these substitutes are safe and in moderation can be implemented as part of a healthy diet.
Masking the bitter taste, Dr. Duffy found that 2 of 3 preschoolers preferred this preparation to the usual cooked vegetable--only preparation. This result parallels her research with adults; 1 of 3 adults likely taste minimal bitterness in vegetables. Balance between the natural sweetness and bitterness results in a greater preference for the vegetables. For the other 2 of 3 individuals, adding minimal sweetness with more pronounced bitterness increases their preference for vegetables (similar to adding a bit of sugar to the water when cooking vegetables).
In the next phase of research, the Captain 5–A--Day program will utilize the new method of food preparation as a means of increasing vegetable consumption. The goal of the study is to use the sweetener just to establish preference for the vegetable and then to do a gradual and “stealth" reduction of sweetener to maintain the vegetable preference without the need for sweetener additive. In addition, collaboration with Dr. Susan Mayne of Yale University will provide a new scientific method of quickly assessing fruit and vegetable consumption— resonance Ramen spectroscopy (RRS). RRS is a painless, non--invasive technique that uses light on the skin surface to determine the amount of pigments obtained from the vegetables. In this study, the skin on the palm of the hand is scanned for less than 30 seconds with a blue light.
Dr. Duffy’s research serves as a significant step forward in the prevention of type 2 diabetes in children. According to the ADA’s “Nutrition Recommendations and Interventions for Diabetes" published in Diabetes Care (Diabetes Care 2008 31: S61--S78), there is no data that can lend itself to recommendations for children. Research is still ongoing in children’s studies. However, the ADA suggests that adult nutrition recommendations for prevention of type 2 diabetes can be followed by youth and could be just as effective. Current nutritional recommendations from the American Diabetes Association include eating fruits and vegetables, eating whole grain foods, choosing lean meats, drinking water and cutting back on high calorie foods and desserts.
According to Dr. Duffy, the research grant provided by the American Diabetes Association has advanced school--based programs that are well--accepted by teachers, parents and administrators and improves the dietary quality of preschoolers. The funding is stimulating new and feasible means of evaluating the impact on school--based initiatives. The funding has also allowed dietetics students to increase their knowledge, skills and competence in community--based health promotion. The future scientists and practitioners who work on this project will take their knowledge with them as they advance in their careers. This research study has encouraged collaboration between field researchers and community partners in health promotion, influenced the future dietary behavior of children and contributed to the advancement of knowledge in children’s dietary research.
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