A pilot study of the effect of providing daily free fruit to primary-school children in Auckland, New Zealand.

OBJECTIVE: To determine the uptake of a free fruit provision to low-decile primary-school children by quantitatively assessing changes in fruit intake. DESIGN: A randomised controlled trial using a paired, cluster randomisation. SETTING: Twenty low-decile primary schools (schools attended by the most deprived children) in Auckland, New Zealand. SUBJECTS: In total 2032 children, aged 7-11 years, provided data on at least one occasion. INTERVENTION: Ten pairs of low-decile primary schools matched by roll size and location were randomly allocated to control (no free fruit) or intervention (free fruit) for a school term. Dietary assessments using the 24 h recall methodology were made at baseline, on the last week of the intervention and 6 weeks post-intervention. RESULTS: Fruit intakes in this cohort were lower than the national average with over 40 % reporting no fruit intake at baseline and did not differ between groups. After the free fruit period the intervention group increased school fruit intakes by 0.39 pieces/school d from baseline (P < or = 0.001) and the proportion of children consuming no fruit reduced to 22 %. This increase, however, was not sustained and fruit intakes fell below baseline levels at 6 weeks post-intervention. Control subjects did not significantly alter their fruit intakes throughout the study. CONCLUSIONS: Improving exposure and accessibility to fruits at school increases fruit intakes of low socio-economic group children, particularly those who do not normally eat fruit. The present pilot study demonstrates some possible negative effects of short-term free fruit interventions, but is informative for developing and evaluating sustained fruit intervention programmes.

Nutritional advice to increase soluble fibre intake does not change plasma folate or homocysteine in men with angina: a randomised controlled trial.

OBJECTIVE: To study the effect of advice to increase dietary soluble fibre, including fruit and vegetables, on plasma folate and homocysteine in men with angina. DESIGN: Data were collected on a subset of subjects from the Diet and Angina Randomised Trial (DART II). In a randomised (2 x 2) factorial design, subjects received advice on either, neither or both interventions to: (1) increase soluble fibre intake to 8.0 g day(-1) (fruit, vegetables and oats); (2) increase oily fish intake to 2 portions week(-1). Those who received soluble fibre advice were compared with those who did not. Subjects were genotyped for C677T variant 5,10-methylenetetrahydrofolate reductase (MTHFR). SETTING/SUBJECTS: Seven hundred and fifty-three male angina patients were recruited from general practice. RESULTS: Plasma homocysteine concentrations were at the upper end of the normal range (median 11.5, 25% 9.4, 75% 14.0 micromol l(-1)). Baseline intake of fruit and vegetables was positively correlated with plasma folate (r(s) = 0.29, P < 0.01). Smokers had lower intakes of fruit and vegetables, lower plasma folate and higher homocysteine (all P < 0.01). Homozygotes for variant MTHFR had higher homocysteine concentrations at low plasma folate (P < 0.01). Reported intakes of fruit and vegetables and estimated dietary folate increased in the intervention group (ca. +75 g day(-1), P < 0.01 and ca. +20 g day(-1), P < 0.05, respectively). However, neither plasma folate (baseline/follow-up 4.5 vs. 4.4 microg l(-1), P = 0.40) nor homocysteine (baseline/follow-up 11.7 vs. 11.7 micromol l(-1), P = 0.31) changed. CONCLUSIONS: Plasma homocysteine, a cardiovascular risk factor, is influenced by MTHFR genotype, plasma folate and smoking status. Dietary advice successfully led to changes in fruit and vegetable intake, but not to changes in plasma folate or homocysteine, possibly because the fruits and vegetables that were chosen were not those richest in folate.