Improving children's dairy food and calcium intake: can intervention work? A systematic review of the literature

Objective: Strategies are needed to address the shortfall in children's dairy food and Ca intakes. The present review identified interventions targeting an increase in children's dairy food or Ca intakes, and determined characteristics associated with successful intervention. Design: A systematic literature search identified fourteen intervention studies, published in English, between 1990 and 2010. Studies were evaluated for study population, setting and mode of delivery, dietary targets and outcome measures, measures of intervention intensity, intervention description, the use of behaviour change techniques and intervention effectiveness. Setting: Interventions targeting an increase in dairy food or Ca intake. Subjects: Children aged 5-12 years. Results: Ten of the fourteen studies were considered to be effective. Studies focusing on encouraging intake of dairy foods or Ca alone were all effective, compared with 55% of studies promoting dairy within the context of a healthy diet. Effective interventions tended to be higher in intensity, provide dairy foods and were delivered across a variety of settings to a range of primary targets. The number of behaviour change techniques used did not differentiate effective and ineffective interventions, but the use of taste exposure and prompting practice appeared to be important for effective intervention. Conclusions: Interventions that target an increase in children's dairy food or Ca intake could potentially increase children's dairy food intake by about one serving daily. Research conducted outside the USA is needed. The review has identified some promising strategies likely to be part of effective interventions for improving dairy and Ca intakes in countries where children's intake is insufficient.