Evidence mapPaperPMID 42469529Full record

Trial reportEuropean journal of nutrition2026

The effect of system-level intervention in early childhood education and care on children's dietary intake and environmental impact of the diet.

Mari Åkerlund, Venla Kyttä, Jelena Meinilä, Arto Pietilä, Tuuli E Korhonen, Henna Vepsäläinen, Liisa Korkalo, Satu Kinnunen, Sari Niinistö, Susanna Raulio and 4 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in European journal of nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Mari Åkerlund *Department of Public Health, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland. mari.akerlund@thl.fi.ORCID http://orcid.org/0009-0005-3780-3821
Venla Kyttä *Natural Resources Institute Finland, Latokartanonkaari 9, FI- 00790, Helsinki, Finland. venla.kytta@luke.fi.ORCID http://orcid.org/0000-0003-3700-5959
Jelena MeiniläDepartment of Food and Nutrition, University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0002-6377-1377
Arto PietiläDepartment of Public Health, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland.ORCID http://orcid.org/0000-0002-9298-0012
Tuuli E KorhonenDepartment of Public Health, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland.ORCID http://orcid.org/0000-0003-0334-3618
Henna VepsäläinenDepartment of Food and Nutrition, University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0002-0177-3609
Liisa KorkaloDepartment of Food and Nutrition, University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0002-0525-9877
Satu KinnunenDepartment of Food and Nutrition, University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0001-7673-0243
Sari NiinistöDepartment of Public Health, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland.ORCID http://orcid.org/0000-0003-2041-6241
Susanna RaulioDepartment of Public Health, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland.ORCID http://orcid.org/0009-0000-9073-1090
Leena FormaUnit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.ORCID http://orcid.org/0000-0002-8656-3722
Maijaliisa ErkkolaDepartment of Food and Nutrition, University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0002-6966-1523
Merja SaarinenNatural Resources Institute Finland, Latokartanonkaari 9, FI- 00790, Helsinki, Finland.ORCID http://orcid.org/0000-0002-4375-7682
Suvi M VirtanenUnit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.ORCID http://orcid.org/0000-0001-8928-0878

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFood systems have a large impact on human health and environmental sustainability. Early childhood education and care is an ideal setting for systemic change. We performed a cluster-randomised trial aiming at climate-friendly and healthy sustainable diet at 23 daycare centres in four Finnish municipalities in 2022 and evaluated system-level intervention effects on food consumption and nutrient intake, and climate and biodiversity impacts of the diet.

methodsThe intervention was initially designed by the research group and refined through co-creation workshops with food service and daycare professionals, and municipal decision makers. The 10-month intervention comprised a modified menu towards more plant-based food supply, and food education. Children's (n = 111) diet was assessed at baseline, mid-term, and/or at the end of the intervention by food frequency questionnaires. The climate and biodiversity impacts per megajoule were assessed using previously specified coefficients for the foods. Multilevel linear mixed models were used in the analysis.

resultsDuring the intervention, children's consumption of legumes and legume products and fish from nearby areas increased, while that of red meat, sausages, and other meat products decreased (Bonferroni-corrected p < 0.001). The changes in food consumption were substantial, with effect sizes ranging from 0.9 to 2.69. Nutrient intake was not affected by the intervention. Intervention decreased climate and biodiversity impacts of food provided at daycare (Bonferroni-corrected p < 0.001, p = 0.003, respectively).

conclusionThis study demonstrated that well-planned systemic change in meal provision and food education at daycare resulted in healthier and more climate-friendly diets among children.

Indexed as

DietDiet, HealthyChild Day Care CentersChild, PreschoolDiet, Plant-BasedFemaleFinlandFood ServicesFood SupplyHumansMaleDaycareFood consumptionFood educationNutrient intakePreschoolSustainability

Identifiers

PMID42469529
PMCPMC13379481

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.