Child Dietary and Eating Behavior Outcomes up to 3.5 Years After an Early Feeding Intervention: The NOURISH RCT

Objective: To evaluate dietary intake impact outcomes up to 3.5 years after the NOURISH early feeding intervention (concealed allocation, assessor masked randomized controlled trial). Methods: In this study, 698 first-time mothers with healthy term infants were allocated to receive anticipatory guidance on protective feeding practices or usual care. Outcomes were assessed at 2, 3.7, and 5 years (3.5 years post-intervention). Dietary intake was assessed by 24-h recall and Child Dietary Questionnaire. Mothers completed a food preference questionnaire and Children's Eating Behavior Questionnaire. Linear mixed models assessed group, time, and time x group effects. Results: There were no group or time x group effects for fruit, vegetable, discretionary food, and non-milk sweetened beverage intake. Intervention children showed a higher preference for fruit (74.6% vs. 69.0% liked, P<0.001), higher Child Dietary Questionnaire score for fruit and vegetables (15.3 vs. 14.5, target >= 18, P = 0.03), lower food responsiveness (2.3 vs. 2.4, of maximum 5, P = 0.04), and higher satiety responsiveness (3.1 vs. 3.0, of maximum 5, P = 0.04). Conclusions: Compared with usual care, an early feeding intervention providing anticipatory guidance regarding positive feeding practices led to small improvements in child dietary score, food preferences, and eating behaviors up to 5 years of age, but not in dietary intake measured by 24-h recall.