Background
Methods
Criteria for studies included in the review
Types of studies
Types of participants
-
families/participants from areas described as disadvantaged by authors (e.g. low income area, ghetto, social housing projects); or
-
families/participants of low socio-economic status (SES) (e.g. working class, low income, unemployed); and/or
-
disadvantaged minorities e.g. Indigenous peoples.
Types of interventions
Outcomes
-
Nutritional intake/food purchases (measured by validated dietary assessment techniques, food purchasing, or biomarkers)
-
Anthropometric measures-e.g. body weight, body mass index, waist circumference
-
Any measure of physical health- e.g. mortality, morbidity, hospital admissions or emergency department attendances
-
Pregnancy-related outcome measures- e.g. rate of pre-term delivery, or low birth weight (LBW), mean birth weight
-
Child growth and development measures e.g. BMI percentile for age
-
Health service utilization- e.g. vaccination rates, participation in preventive health activities
Search strategy
Data synthesis and analysis
Assessment of risk of bias in included studies
First author, year, Setting/Location | Participants, Recruitment | Interventions, No. of subjects | Methods | Outcomes | Duration of intervention | Potential risk of bias rating |
---|---|---|---|---|---|---|
Bailey 1983[48] | 101 pregnant women aged 15–41 years | 1. Standard WIC program- Monthly vouchers for specified quantities of milk, canned fish, carrots, cereal, cheese, eggs. 6 monthly nutrition education and health care referrals n=43 | Controlled before and after study | Serum iron, vitamin B6, folic acid, | 12 weeks | High |
WIC clinic and hospital prenatal clinic, Florida, USA | WIC and control participants recruited from different prenatal clinics at 30 weeks gestation | Red cell folate | ||||
2. Routine antenatal care through hospital clinic n=58 | Follow-up period 12 weeks | Dietary iron, vitamin B6, and folic acid | ||||
Birth weight | ||||||
% Low birth weight | ||||||
Metcoff 1985[42] | 824 pregnant women stratified by predicted birth weight; all WIC eligible | 1.Standard WIC program with research assessments and routine prenatal care n=238 | Randomised controlled trial | Birth weight | ~21 weeks | High |
Plasma B-carotene | ||||||
Hospital prenatal clinic, Oklahoma City, Oklahoma, USA | Maternal weight | |||||
All participants recruited from same hospital prenatal clinic | 2. Routine prenatal care with research assessments n=172 | Follow-up period 24 weeks | Plasma amino acids | |||
3. Routine prenatal care n=353 | ||||||
Caan 1987[38] | 703 post-partum women- all WIC participants prenatally | 1. Standard WIC program maintained for 6 months post-partum for non-lactating women n=333 | Controlled before and after study | Birth weight | 6 months | High |
Low birth weight | ||||||
Macrosomia | ||||||
48 local WIC agencies, California, USA | All WIC participants prenatally, divided into control &intervention groups retrospectively based on WIC benefits post-partum | 2. Standard WIC entitlement for 0–2 months post-partum n=309 | Maternal Hb | |||
Follow-up period-duration of prenatal care in second pregnancy | Maternal BMI | |||||
Rush 1988a[44] | 11,154,673 pregnant women from 1392 US counties in 19 states | 1. Standard WIC program | Interrupted time series | Birth weight | Duration of prenatal WIC participation | Low |
Duration of gestation | ||||||
National sample of counties, USA | WIC participants increased over time from 0 to 39% from government reports | Follow-up period 1972-1981 | Fetal mortality (>28 weeks) | |||
Infant mortality rate | ||||||
Inadequate prenatal care | ||||||
6563 pregnant women, all WIC eligible by income | 1. Standard WIC program and research assessments n=5205 | Controlled before and after study | Nutrient intake | Duration of prenatal WIC participation | High | |
174 WIC clinics and 55 prenatal clinics, national sample, USA | WIC participants recruited at WIC clinics, controls recruited at public prenatal clinics in counties with low WIC coverage | 2. Routine antenatal care and research assessments n=1358 | Follow-up period 6–9 months | |||
Mean nutrient intake % RDA | ||||||
Anthropometry | ||||||
Duration of gestation | ||||||
Birth weight | ||||||
Fetal mortality | ||||||
5004 pregnant women, mean age 22.4 years | 1. Standard WIC program n=4219 | Controlled before and after study | Family food expenditure | Duration of prenatal WIC participation | High | |
174 WIC clinics and 55 prenatal clinics, national sample, USA | 2. Routine antenatal care n=785 | Family grocery expenditure | ||||
WIC participants recruited at WIC clinics, controls recruited at public prenatal clinics in counties with low WIC coverage | A subset of women were asked to complete a food diary at follow-up: WIC n=1031, Control n=551 | Follow-up period 6–9 months | Family meals out expenditure | |||
Gunnell 2000[39] | 1089 children aged 2–14 years, mean age 8 years | 1. Daily school feeding soup/milk, halibut oil capsules, oranges or milk and marmite n=298 | Controlled before and after study | Height | 12 months | Moderate |
Leg length | ||||||
8 rural and urban locations in Scotland and England, UK | Disadvantaged families selected and divided into intervention and control groups arbitrarily | |||||
2. Family food packages weekly-milk, cheese, wheat germ, marmite, oranges, cod liver oil, eggs n=269 | Follow-up period 13 months for children′s growth and 60 years for mortality | Mortality | ||||
School in adjacent areas were also selected as intervention and controls non-randomly | 3. No food subsidy- control families n=261 | |||||
4. No food subsidy- control schools n=258 | ||||||
Pehrsson 2001[43] | 110 post-partum non-lactating females >18 years old, all WIC participants prenatally | 1. Standard WIC program for 6 months post-partum n=57 | Controlled before and after study | Haemoglobin | 6 months | Low |
Transferrin receptor | ||||||
Urban WIC clinics, Maryland, USA | Participants recruited at WIC clinics in different counties | 2. Standard WIC program for 0–2 months post-partum n=53 | Follow-up period 6 months | Anaemia % | ||
Ferritin | ||||||
Burr 2007[37] | 190 pregnant females aged >=17 yo | 1. Vouchers for free 2L fruit juice weekly (home delivery) n=63 | Randomised controlled trial | Frequency of specific fruit consumption | Throughout prenatal care period (~30 weeks) | High |
District hospital prenatal clinic, Wales, UK (disadvantaged area) | All participants recruited from one hospital prenatal clinic at booking visit | 2. Advice/written information from midwives to promote fruit intake during pregnancy n=63 | Follow-up period 30 weeks | Serum β-carotene | ||
3. Routine antenatal care n=64 | ||||||
602 post-partum women >18yo- all WIC participants | 1. $10 voucher weekly for F&V at local supermarket plus standard WIC program n=200 | Controlled before and after study | F&V intake | 6 months | High | |
3 WIC clinics, Los Angeles, California, USA | Intervention and control participants recruited at three separate WIC clinics with similar socio-demographics | 2. $10 voucher weekly for F&V at local farmers market plus standard WIC program n=200 | Follow-up period 1 year | |||
3. Standard WIC program n=202 | ||||||
Currie 2008[49] | All pregnant Californian women 1961–1974 n=4864673 | 1. Standard Food Stamp Program- monthly food vouchers for any foods up to $200/person/month dependent on income and household size | Interrupted time series | Median birthweight | Duration of prenatal FSP participation | Low |
Low birthweight rate | ||||||
California, USA | Food stamp participation rates by county used to calculate impacts | Follow-up period 1961-1974 | Probability of birthweight <specified cut-off | |||
Hoynes 2009[18] | 28,000,000 pregnant women in the 2059 US counties with a WIC program by 1979 (85% of US births in the 1970s) | 1. Standard WIC program | Interrupted time series | Birth weight | Duration of prenatal WIC enrolment | Low |
National sample of counties, USA | Follow-up period | % Low birth weight | ||||
WIC participation estimated from government reports | 1971-75 & 1978-82 | |||||
Kennedy 2009[41] | 40 African-American women aged >18yrs, non-pregnant | 1. F&V $10/week with recipes from mobile store at community centre, monthly nutrition education, cooking demonstrations and anthropometric assessment n=20 | Randomised controlled trial | Fruit and vegetable consumption | 6 months | High |
Community centre, East Baton Rouge, Louisiana, USA | Participants recruited by local community advertising and personal communication | 2. Monthly anthropometric assessment and written nutrition education n=20 | Follow-up period 6 months | Weight | ||
BMI | ||||||
BP | ||||||
Quality of life | ||||||
General and emotional health | ||||||
Ni Mhurchu 2010[30] | 1104 adult >18 years, main household shopper, 86% female | 1. Tailored nutrition education– computer-generated messages and shopping lists plus generic recipes monthly by mail n=274 | Randomised controlled trial | Total food purchased | 6 months | Low |
8 supermarkets in Wellington, Wanganui and New Plymouth, NZ | Follow-up period | Healthy food purchased | ||||
Participants recruited by mail invitation, supermarket advertisements and community group promotion (for Maori and Pacific communities) | 2. Price discount of 12.5% on healthy foods applied automatically at check-out n=275 | |||||
15 months | Less healthy food purchased | |||||
F&V purchased | ||||||
3. Price discount plus tailored nutrition education n=277 | Macronutrients purchased | |||||
4. Control n=278 |
Results
Scope of included studies
Risk of bias in included studies
Interventions and Outcomes
First Author, Year Intervention, Participants | Nutritional outcomes | Health outcomes | ||||||
---|---|---|---|---|---|---|---|---|
Bailey 1983[48] |
Dietary intake
|
Perinatal outcomes
| ||||||
Standard WIC program | Mean (SD) | I | C | p | Mean (SD)) | I | C | p |
Iron, mg | 17 (10) | 16 (6) | NS | Birth weight, g | 3229 (546) | 3276 (563) | NS | |
Vitamin B6, mg | 1.4 (1.1) | 1.1 (0.7) | NS | Low birth weight, %(<2500g) | 5 | 10 | NS | |
Protein, g | 90 (39) | 105(39) | <0.05 | |||||
Pregnant women | Folic acid, μg | 264 (216) | 239 (159) | <0.05 | Ponderal index, g/cm [3] | 2.6 (1.2) | 2.4 (0.3) | NS |
Energy, kcal | 2390 (916) | 2496 (879) | <0.05 | (Infant weight x100/length [3]) | ||||
Biomarkers
|
Birth weight
| |||||||
Smokers, g | 3286 (515) | 2976 (596) | ||||||
Mean (SD) | I | C | p | Non-smokers, g | 3218 (538) | 3461 (520) | ||
Serum iron, ug/dL | 106 (44) | 99 (42) | NS | p<0.05 for smoking status of control groups only | ||||
PlasmaVit. B6, ng/ml | 4.6 (6.8) | 3.3 (1.8) | NS | |||||
Transferrin sat. % | 37 (23) | 23 (10) | <0.05 | |||||
Serum folate, ng/ml | 14 (11) | 26 (26) | <0.05 | |||||
RBC folate, ng/ml | 353 (278) | 602 (321) | NS | |||||
Haematocrit, % | 35 (3) | 35 (3) | NS | |||||
Metcoff 1985[42] |
Biomarkers
|
Perinatal outcomes
| ||||||
Mean (SD) | I | C | p | Mean | I | C | p | |
Standard WIC program | Leukocyte protein synthesis** | |||||||
Pregnant participants | pMol 3H-leucine/h | 126.6 (33.2) | 115.2 (34.3) | 0.009 | Birth weight, g* | |||
Results from 410 mother-baby pairs with complete data available | All births† | 3254 | 3163 | 0.040 | ||||
Alanine** | 334 (68.4) | 350 (70.2) | 0.046 | Smokers >10 cig/day | 3234(n=68) | 3059 (n=53) | 0.017 | |
Cystine** | 68 (13.7) | 72 (11.7) | 0.001 | Low birth weight, % | 8.7 | 6.9 | 0.40 | |
**Adjusted for week of gestation for initial measurement, initial value, elapsed interval between measurements |
Maternal outcomes
| |||||||
Maternal wt gain, kg | 16.1 | 14.7 | 0.19 | |||||
Biceps skin fold, mm | 16.2 | 14.7 | 0.059 | |||||
*Adjusted for gestational age, sex of baby, prenatal care, smoking, interval since last pregnancy, race, history of previous LBW baby | ||||||||
†After adjusting for maternal weight at entry to study, the effect of WIC on all births was not statistically significant | ||||||||
Caan 1987[38] |
Perinatal outcomes
| |||||||
Mean (SE) | I | C | p | |||||
Birthweight, g* | 3468 (30.0) | 3337 (31.1) | 0.003 | |||||
WIC program maintained for 6 months post-partum for non-lactating women instead of normal 0–2 months | Ponderal index,002A g x 100/cm3 | 2.72 (0.03) | 2.73 (0.02) | NS | ||||
Low birth weight, % | 3.2 | 5.1 | 0.08 | |||||
Macrosomia, OR | (95% CI) (I vs C) | 1.30 (0.70-2.42) | NS | |||||
Pregnant women in subsequent pregnancy |
Maternal outcomes
| |||||||
Mean (SE) | I | C | p | |||||
Hb, g/dL** | 12.43 (0.08) | 12.14 (0.08) | 0.02 | |||||
Low Hb, OR (95%CI) (I vs C) | 0.65 | (0.45-1.07) | 0.07 | |||||
Mat. de Quetelets index lb/in [2] x100† | 3.43 (0.36) | 3.59 (0.36) | 0.003 | |||||
*Adjusted for parity, pregravid weight/height, infant sex, birth weight of last infant, race and smoking status | ||||||||
**Adjusted for race, parity, BMI, duration of gestation at time of measurement and anaemia status during 1st pregnancy | ||||||||
† Adjusted for race, age, interbirth interval, birth weight of first infant, weight status in first pregnancy, smoking status | ||||||||
Rush 1988a[44] |
Perinatal outcomes
| |||||||
Mean | All births | WIC births | p | |||||
Standard WIC program | Birth weight, g | 3335 | 3358 | <0.01 | ||||
Pregnant women | Low birth weight (<2500g), % | 6.84 | 6.41 | NS | ||||
Fetal mortality, >28 wk gest/1000 | 6.21 | 4.09 | NS | |||||
Infant mortality/1000 | ||||||||
0-27days, total | 10.59 | 8.30 | NS | |||||
28-364 days | 3.77 | 4.46 | NS | |||||
Duration of gestation, weeks | 39.06 | 39.26 | <0.05 | |||||
Dietary intake*
|
Perinatal outcomes*
| |||||||
Mean | I | C | p | Mean | I | C | p | |
Protein, g | 80.76 | 75.54 | <0.01 | Birth weight, g | 3292 | 3285 | NS | |
Low birth weight (<2501g), % | 5.62 | 6.75 | NS | |||||
Standard WIC program | Calcium, mg | 1003.7 | 871.0 | <0.001 | Duration gestation, days | 279.0 | 279.3 | NS |
Iron, mg | 17.22 | 14.06 | <0.001 | Preterm births, % | ||||
Pregnant women | Vitamin A, mg | 2.06 | 1.83 | NS | < 33 weeks | 0.30 | 0.90 | <0.05 |
Vitamin C, mg | 134.11 | 111.68 | <0.001 | < 37 weeks | 9.45 | 12.07 | NS | |
Other macro- and micronutrients had statistically significant increases in WIC participants including energy, carbohydrate, fat, magnesium, phosphorus, vitamins B1, B2, B3, B6, B12 | Head circumference, cm | 34.13 | 33.95 | <0.05 | ||||
Fetal mortality/1000 | 5.09 | 9.54 | NS | |||||
Nutrient intake as % of RDA*
| ||||||||
Mean | I | C | *Adjusted for duration of gestation and 35 other maternal characteristics including smoking status, age, race, family income and size, woman and partner′s educational and employment status, social security benefits/program participation | |||||
(%) | (%) |
Maternal outcomes*
| ||||||
Energy (2400kcal) | 84 | 79 | Mean | I | C | p | ||
Protein (74g) | 109 | 102 | Initial weight, kg | 65.17 | 65.89 | <0.05 | ||
Calcium (1200mg) | 84 | 73 | Follow-up weight, kg | 72.17 | 72.17 | NS | ||
Magnesium (450mg) | 60 | 54 | (36 weeks gestation) | |||||
Vitamin B6 (2.6mg) | 73 | 60 | WIC group women initially lighter than control women had caught up with control women by 36 weeks gestation | |||||
Phosphorus, Vitamins A, B1, B2, B3, B12 and C were all 95%-180% of RDA at baseline and follow-up in both WIC and control groups. RDA for pregnant women aged 19–22 years old | No clinical (or statistically) significant difference in haemoglobin at baseline or follow-up. Data not shown | |||||||
*Adjusted for duration of gestation, conception weight and 35 other maternal characteristics as above | ||||||||
*Adjusted for duration of gestation, initial intake, 35 other maternal characteristics including smoking status, age, race, family income and size, woman and partner′s educational and employment status, social security benefits and program participation | ||||||||
181 of the 711 controls had enrolled in WIC before follow-up. The diet intake data for this group were analysed separately and were similar to the WIC intervention group | ||||||||
No difference in nutrient intake for groups at baseline | ||||||||
Food purchases*†
| ||||||||
Mean (SD) | I | C | p | |||||
Total expenditures, $ | ||||||||
Standard WIC program | Recall | 48.28 | 52.07 (33.34) | <0.001 | ||||
Pregnant women | Diary | 61.20 | 62.85 (39.44) | NS | ||||
Groceries, $ | ||||||||
Recall | 38.30 | 39.95 (22.97) | <0.05 | |||||
Diary | 50.50 | 49.15 (35.68) | NS | |||||
Meals away from home, $ | ||||||||
Recall | 3.84 | 4.94 (6.44) | <0.001 | |||||
Diary | 10.93 | 13.69 (16.20) | <0.001 | |||||
* Adjusted for family size, income, ethnicity, presence of father in household, maternal education, amount of food stamps and free school meals, number of guests and baseline expenditure | ||||||||
†Baseline food expenditures differed with WIC families spending significantly less on total food, groceries and meals away from home | ||||||||
Pehrsson 2001[43] |
Dietary intake
|
Maternal outcomes
| ||||||
Iron No data presented. No significant differences between groups. All intakes <74% RDA (15mg/day) | Mean (SD) | I | C | p | ||||
Haemoglobin, mmol/L* | 8.01 (0.82) | 7.63 (0.82) | <0.05 | |||||
Standard WIC program continued for 6 months post-partum | g/dL | 12.8 (1.31) | 12.2 (1.31) | |||||
Vitamin C No data presented. No significant differences between groups. All intakes >150% RDA (60mg/day) | Anaemia, % * | 17 | 51 | <0.05 | ||||
(Hb<7.45mmol/L or 12g/dL) | ||||||||
Postpartum women |
Biomarkers*
| *Results at 6 month follow-up | ||||||
Mean (SD) | I | C | p | |||||
Ferritin, ug/L | 36 (20.1) | 35 (20.3) | NS | |||||
Transferrin receptor, mg/L | 6.1 (2.1) | 6.5 (2.1) | NS | |||||
*Results at 6 month follow-up | ||||||||
Currie 2008[49] |
Perinatal outcomes
| |||||||
Change in low birth weight | ||||||||
% (SD) | All parity | First birth | Teen mum | |||||
Standard Food Stamp program | White | −0.014 (1.05) | 0.062 (1.00) (0.92)* | 0.27 | ||||
Pregnant women | Black | 0.47 (1.64) | 0.26 (1.43) (1.58) | 0.175 | ||||
*p<0.05 | ||||||||
Fertility outcomes*
| ||||||||
% increase in births | All parity | First birth | Teen mum | |||||
White | 3.0 | 13.0 | 6.9 | |||||
Black | 12 | 9.0 | 24.6 | |||||
*Statistically significant for blacks in all categories and white first births and teen births | ||||||||
Hoynes 2009[18] |
Perinatal outcomes
| |||||||
Standard WIC program | Mean | All births | WIC births | |||||
Pregnant participants | Birth weight, g | 3316 | ||||||
Change in birth weight, g | 2.7 | 29 (estimated) | ||||||
Low birth weight, % | 7.2 | |||||||
Change in low birth weight | 0 (−0.0784- 0.0784) | |||||||
%, 95% CI | ||||||||
Fertility rates No statistically significant difference after WIC introduction |
First Author, Year Intervention, Participants | Nutritional outcomes | Health outcomes | ||
---|---|---|---|---|
Ni Mhurchu 2010[30] |
Food purchases*
| |||
12.5% discount on healthier foods at point-of-sale (PD) | Change in foods/nutrients at 6 months (PD- no PD) | |||
Mean (95%CI) | PD | p | ||
Foods, kg/week | ||||
or tailored nutrition education (NE) or both compared to no intervention | All foods | 0.90 (0.29-1.52) | 0.004 | |
All healthier | 0.79 (0.43-1.16) | <0.001 | ||
All less healthy | 0.07 (−0.15-0.29) | 0.56 | ||
Main household shoppers >18 years | Healthier F&V | 0.48 (0.21-0.75) | <0.001 | |
Healthier meat | 0.06 (0.02-0.11) | <0.001 | ||
Healthier dairy | 0.21 (0.10-0.31) | <0.001 | ||
No change was noted in intake of saturated fat (primary outcome), energy density or any other macronutrients | ||||
There were no effects of tailored nutrition education on food purchases at 6 months. | ||||
Change in foods/nutrients at 12 months (PD- no PD)** | ||||
Mean (95%CI) | PD | p | ||
Foods, kg/week | ||||
All foods | 0.37 (−0.26-1.00) | 0.25 | ||
All healthier | 0.38 (0.01-0.76) | 0.045 | ||
All less-healthy | 0.05 (−0.18-0.27) | 0.67 | ||
Healthier F&V | 0.28 (0.00-0.56) | 0.05 | ||
Healthier meat | 0.03 (−0.01-0.08) | 0.15 | ||
Healthier dairy | 0.06 (−0.04-0.18) | 0.21 |
First Author, Year Intervention, Participants | Nutritional outcomes | Health outcomes | |||
---|---|---|---|---|---|
Gunnell 2000[39] |
Growth outcomes*
| ||||
Intervention included either daily school feeding (SF) or family food packages weekly (FP) and two control groups with no food subsidy- families and school students | Mean, (SD) | I | C | p | |
Height increase, cm | 6.10(1.50) | 5.56(1.45) | <0.0001 | ||
Leg length increase, cm | 4.98 (2.07) | 4.87(2.25) | 0.0006 | ||
Trunk increase, cm | 1.12 (2.17) | 0.69 (2.23) | 0.17 | ||
Stature increases by method of feeding,† | |||||
Children aged 2–14 years | Mean (95%CI) | SF | FP | ||
Change in height (I-C), mm | 6.7 (2.7-10.6) | 2.0 (−0.7-4.8) | |||
Change in leg length (I-C),mm | 7.2 (1.9-12.4) | 2.3 (−1.5-6.2) | |||
Mortality
| |||||
Hazard ratio I vs C (95%CI) | p | ||||
All causes | 1.15 (0.7,1.7) | 0.46 | |||
CHD | 1.62 (0.8,3.5) | 0.21 | |||
Cancer | 0.69 (0.4,1.4) | 0.30 | |||
Non-smoking | |||||
related cancer | 0.59 (0.2,2.0) | 0.59 |
First Author, Year Intervention, Participants | Nutritional outcomes | Health outcomes | |||||||
---|---|---|---|---|---|---|---|---|---|
Burr 2007[37] |
Dietary intake
| ||||||||
Net % consuming more fruit | |||||||||
Free home-delivered orange juice using vouchers(V) nutritional advice promoting fruit and fruit juice (A) or standard care during prenatal care period (C) | Mean | V | A | C | |||||
Apples | 2.2 | −13.2 | −2.7 | ||||||
Oranges | −2.2 | −21.1 | −11.8 | ||||||
Bananas | −17.4 | −7.9 | −29.7 | ||||||
Fruit juice | 34.8* | −7.9 | −24.3 | ||||||
*Voucher group net % significantly greater than advice or control (p<0.05) | |||||||||
Pregnant women |
Biomarkers
| ||||||||
Mean (SD) | |||||||||
β-carotene change, ng/ml | |||||||||
V | A | C | p | ||||||
n=39 | n=37 | n=42 | |||||||
35.6(77.2) | −20.2(43.3) | <0.0001 | |||||||
2.7(65.5) | −20.2(43.3) | 0.435 | |||||||
Dietary intake
| |||||||||
Standard WIC program plus $10 voucher weekly for F&V from local supermarket (SM) or farmer′s market (FM) | Mean | SM | FM | C | p | ||||
F&V intake, | |||||||||
serves/4186kJ/day | |||||||||
End of intervention | 4.1 | 3.9 | 3.0 | F=9.75, p<0.001 | |||||
Post-partum women >18yo- all WIC participants | 6 mths post-intervention | 4.0 | 4.0 | 3.1 | F=6.66, p=0.001 | ||||
Vegetable intake, serves/4186kJ/day | |||||||||
End of intervention | 2.3 | 2.1 | 1.5 | F=11.0, p<0.001 | |||||
6 mths post-intervention Data not shown F=−0.59, p=0.02 | |||||||||
Fruit intake | |||||||||
Data not shown, no significant differences between SM, FM and control | |||||||||
Kennedy 2009[41] |
Dietary intake
|
Anthropometric and cardiovascular outcomes
| |||||||
Change in intake at six months | Change at six months | ||||||||
Free fruit and vegetables $10/week with recipes from mobile store at community centre with monthly nutrition/cooking sessions and anthropometric assessment | Mean (SD) | I | C | p | Mean (SD) | I | C | p | |
Energy, kcal/day | −456 (1032) | −636 (1326) | 0.48 | Weight, kg | −2.0 (3.2) | 1.1 (2.0) | <0.001 | ||
Fiber, g/day | 1.7 (5.7) | −4.3 (19.7) | 0.03 | ||||||
African-American women | Fruit, serves/day | 1.0 (1.7) | 0 (1.2) | 0.02 | |||||
Veg, serves/day | 0.9 (1.2) | −0.2 (1.8) | 0.002 | BMI, kg/m [2] | −0.7 (1.2) | 0.4 (0.8) | 0.001 | ||
Waist size, cm | −0.5 (5.3) | 1.9 (3.7) | 0.12 | ||||||
Syst BP, mmHg | −2.3 (13.0) | −1.4 (12.3) | 0.14 | ||||||
Dias BP, mmHg | 0.8 (8.1) | 0.1 (9.3) | 0.68 | ||||||
Self-rated health
| |||||||||
General health and quality of life were rated across multiple domains. Trends generally favoured intervention group, but only self-esteem (p=0.03) and emotional role (p=0.04) improved significantly |