Preschoolers can distinguish between healthy and unhealthy foods: The all 4 kids study

Madeleine Sigman-Grant, Teresa A. Byington, Anne R. Lindsay, Minggen Lu, Amy R. Mobley, Nurgül Fitzgerald, Deana Hildebrand

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Objective: To determine changes in preschoolers' ability to distinguish between healthy and unhealthy foods and stated food preferences after participation in a nutrition education program. Design: Pre-post comparison/intervention study with sites clustered based on center size and language. Setting: Preschool classrooms. Participants: A total of 191 preschoolers from Nevada and 128 from Connecticut, New Jersey, and Oklahoma. Intervention: All 4 Kids, a 24-lesson program taught by trained instructors. Main Outcome Measures: Pre- and post-assessment sum scores for identifying 18 foods; stated preference for, and distinguishing between, healthy vs unhealthy choice from 9 food pairs using a newly designed tool. Analysis: t tests; multiple linear and logistic regression models. Results: There was a statistically significant improvement in identification scores from pre- to post-study for both groups from Nevada (P < .001). For preference and distinguishing between healthy and unhealthy foods, no differences were noted at pretest. At posttest, significantly more intervention than comparison preschoolers indicated a preference for healthier foods (P < .006) and an ability to distinguish them (P < .03). Outcome comparison between Nevada and 3 states demonstrated generalizability of the study tool. Conclusions and Implications: Participation in All 4 Kids resulted in preschoolers' increased understanding of healthy foods and changed their stated food preferences.

Original languageEnglish (US)
Pages (from-to)121-127
Number of pages7
JournalJournal of Nutrition Education and Behavior
Issue number2
StatePublished - Mar 2014

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


  • Food preference
  • Health
  • Intervention
  • Nutrition education
  • Preschoolers


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