1 
 

Parental provision and children’s consumption of fruit and vegetables did not increase 

following the Food Dudes programme 

 

Abstract: 

Purpose: This study is based on previous research which suggests that the Dudes 

programme increases children’s fruit and vegetable consumption for school provided meals 

by assessing its effectiveness in increasing the provision and consumption of fruit and 

vegetables in home-provided meals. 

Design/methodology/approach: Two cohorts of children participated from 6 schools in the 

West Midlands in the UK, one receiving the Food Dudes intervention and a matched control 

group who did not receive any intervention. Participants were children aged 4-7 years from 

6 primary schools, 3 intervention (n=123) and 3 control schools (n=156). Parental provision 

and consumption of fruit and vegetables was assessed pre-intervention, then 3 and 12 

months post-intervention.  Consumption was measured across five consecutive days in each 

school using digital photography. 

Findings: No significant increases in parental provision or consumption were found at 3 or 

12 months for children in the intervention schools however increases were evident for 

children in the control group. 

Research limitations/implications: Further development of the Food Dudes programme 

could develop ways of working with parents and children to increase awareness of what 

constitutes a healthy lunch.  

Originality/value: This is the first independent evaluation to assess the influence of the Food 

Dudes programme on parental provision and children’s consumption of lunchtime fruit and 

vegetables. 

Keywords: children; nutrition, eating, parents, school, health promotion Article 

Classification: Research Paper 

 

 

 

 

 

 



2 
 

Introduction 

The English Department of Health (2000) recommend that adults and children over the age 

of two years should consume at least five portions of fruit and vegetables per day due to the 

associated long-term health benefits (Boeing et al., 2012; O’Flaherty et al., 2012) However, 

evidence suggests that many children in the UK do not consume adequate levels of fruit and 

vegetables (The Health and Social Care Information Centre, 2012) which has resulted in a 

number of initiatives to improve children’s eating habits, including the School Fruit and 

Vegetable Scheme (SFVS) and the introduction of the food and nutrient based standards 

(School Food Trust, 2008). However, whilst the SFVS has increased children’s snack time 

consumption of fruit and vegetables (Department of Health, 2010) and the food and 

nutrient based standards have improved the nutritional content of school-supplied meals 

(Haroun et al., 2010), evidence suggests that only 44.1% of children choose to consume 

school meals with the majority of children opting to bring in lunches from home (Nelson et 

al., 2012).  

It is known that the nutritional content of packed lunches is far lower than that of school-

supplied meals (Rees et al., 2008), containing only half the recommended amount of fruit 

and vegetables (Rogers et al., 2007). As a result, schools are encouraged to develop lunch 

box policies that support a whole-school healthy eating environment (School Food Trust, 

2011). However, such policies may be difficult to implement as they require engagement 

with both parents and children in addition to involvement of the school. Consequently, 

school-based interventions, such as the Food Dudes programme, which aim to improve 

children’s fruit and vegetable consumption, are also recommended. Evidence suggests that 

the Food Dudes programme can increase children’s lunchtime fruit and vegetable 

consumption (Horne et al., 2004; Horne et al., 2009; Lowe et al., 2004) and also produce 

long lasting increases in the provision of fruit, vegetables and juices for children consuming 

home supplied lunches (Horne et al., 2009). However, studies conducted in the UK have 

mainly focused upon school-supplied meals, neglecting those supplied from home. It is 

therefore important that the effectiveness of the Food Dudes programme in increasing fruit 

and vegetable consumption, including those eating home-supplied lunches, is explored. 



3 
 

The aims of the present study were therefore twofold: firstly, to investigate the 

effectiveness of the Food Dudes programme in increasing the provision and consumption of 

fruit and vegetables for children consuming home-supplied meals; and secondly, to 

establish the extent to which the programme is able to influence long-term maintenance (12 

months post intervention) of any behaviour changes observed.   

 

Methods 

This study formed part of a large scale independent evaluation of the Food Dudes 

programme (See Upton et al., 2012). 

 

Design 

Two cohorts of children participated in the study; one receiving the Food Dudes 

intervention and a matched control group who did not receive the intervention. The impact 

of the Food Dudes programme on provision and consumption of fruit and vegetables was 

assessed at baseline (prior to the intervention), 3 month follow-up (post intervention) and 

12 month follow-up.  

Participants 

The programme was evaluated in 6 primary schools in the West Midlands, UK. Participants 

were 279 children aged between 4-7 years, 123 in the intervention schools (70 boys and 53 

girls) and 156 in the control schools (85 boys and 71 girls). Intervention schools were 

selected by the local health authority and control schools matched as far as possible in 

terms of: school size, proportion of children entitled to free school meals and proportion of 

children from ethnic minorities.  

Food Dudes Intervention 

The Food Dudes programme consists of an initial 16 day intervention phase during which 

children watch a series of DVD episodes of the Food Dudes adventures. The Food Dudes are 

four super-heroes who gain special powers by eating their favourite fruit and vegetables 

that help them maintain the life force in their quest to defeat General Junk and the Junk 

Punks. The Dudes encourage children to ‘keep the life force strong’ by eating fruit and 

vegetable every day. Class teachers also read letters to the children from the Food Dudes to 



4 
 

reinforce the DVD messages. During the intervention, children are given rewards for either 

tasting or consuming both the target fruit and vegetables. Children are also provided with a 

Food Dudes home pack containing information and tips for parents on healthy eating to 

encourage children to eat fruit and vegetables at home as well as school (Lowe et al., 2004). 

Following the intervention, a maintenance phase of up to one year is implemented during 

which fruit and vegetable consumption is encouraged, but with less intensity than the 

intervention phase. Classroom wall charts are used to record consumption of fruit and 

vegetables and children are rewarded with further Food Dudes prizes and certificates. This 

phase of the programme aims to enable the school to develop a self-sustaining approach to 

rewarding fruit and vegetable consumption and a culture of healthy eating (Lowe and 

Horne, 2009). 

Procedure 

The same procedure was employed in both the intervention and control schools at each 

study phase and measures were recorded across five consecutive days in each school. 

Baseline data were recorded in June 2010, 3 month follow-up during October 2010 (due to 

school summer holidays) and 12 month follow-up in June 2011. In line with guidelines 

developed by the Health Promotion Agency (2009)
 
a child’s portion of fruit or vegetables 

was defined as 40g. Control schools remained under baseline conditions during the 16 day 

intervention phase. At the start of the day, lunchboxes were labelled with the child’s ID 

number, name and class and a digital photograph taken of lunchbox contents after morning 

break (See Figure 1). Following lunchtime, lunchboxes were collected and a photograph 

taken of any leftovers (See Figure 2). Lunchtime staff instructed children to leave any 

uneaten food or packaging in their lunchboxes at the end of lunchtime. All rubbish bins 

were located away from tables to ensure that the children did not throw any food items 

away and also enabling close monitoring of food disposal by the research team. 

The number of portions of fruit, and vegetables consumed was visually estimated on a five 

point likert scale (0, ¼, ½, ¾, 1). Inter-rater reliability analysis was performed using 

correlation to determine consistency among raters. Agreement was calculated for 10% 

(n=28) of the study sample at baseline and was found to be excellent   (r (26) = .94, p<0.01). 

 



5 
 

Figure 1. Example of a lunchbox, pre-consumption 

 

Figure 2. Example of a lunchbox, post-consumption 

 

 

 

Ethical approval 

Ethical approval was gained from the University of Worcester research ethics committee. 

Consent was sought from head teachers acting in loco parentis supplemented by parental 

“opt-out” consent whereby the child is included in the study unless their parents withdraw 

them (Severson and Biglan, 1989). A letter detailing the purpose of the study was sent to 

parents prior to the baseline phase and again at 3 and 12 month follow-up with the option 

to notify the class teacher by the specified date if they did not wish for their child(ren) to 

participate. 

Data analysis 

Mean values were computed for each child to provide an indication of the average amount 

of fruit and vegetables provided and consumed with the criterion that data were available 

for a minimum of 3 out of 5 days during each phase. Data were analysed using the Statistical 



6 
 

Package for Social Science version 19.0 (IBM, USA) and differences in consumption tested 

using repeated measures ANOVA. Paired t tests determined the source of any variance and 

effect sizes, using Cohen’s d, were calculated to establish practical significance. An α level of 

0.05 was used in all statistical analyses unless otherwise stated. 



7 
 

Results 

Figure 3 shows mean provision of fruit and vegetables in the intervention and control 

schools. Analysis of fruit and vegetable provision indicated a significant main effect of study 

phase (F (2, 276) = 12.10, p<0.01, ηp
2 

=0.08) but not school setting (F (1, 277) = 3.34, p>0.05, 

ηp
2 

=0.01. The interaction between time and school setting was also not significant (F (2, 

276) = 0.74, p >0.05, ηp
2 

= 0.005. Post hoc t tests (bonferroni adjustment, 0.05/5 = 0.025) 

indicated no significant difference between the intervention and control schools in parental 

provision of fruit and vegetables at baseline (t=-0.95, p=0.34, d=0.11). Within group 

comparisons suggested that in the intervention schools, parental fruit and vegetable 

provision was not statistically higher at 3 month follow-up compared to baseline (t=2.22, 

p=0.03, d=0.28, CI =0.16-0.38) or between baseline and 12 month follow-up (t=1.08, p=0.28, 

d=-0.14, CI = -0.24 to -0.04). However, in the control schools parental provision of fruit and 

vegetables was statistically higher between baseline and 3 month follow-up (t=-4.01, 

p<0.00, d=0.46, CI= 0.36-0.54) but not between baseline and 12 month follow-up (t=-0.56, 

p=0.58, d=0.07, CI = -0.03-0.16. 

Figure 3. Mean provision (in portions) of fruit and vegetables (N=279) 

 

 

 

(53g) 

(58g) 
(62g) 

(71g) 

(48g) 

(60g) 

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

Intervention Control

M
e
a
n
 p

o
rt

io
n
s
 p

ro
v
id

e
d

 

Baseline

3 month follow-up

12 month follow-up



8 
 

Figure 4. Mean consumption (in portions) of fruit and vegetables (N=279) 

 

Mean consumption of fruit and vegetables in the intervention and control schools is shown 

in Figure 4. Results indicated a significant main effect of time (F (2, 276) = 4.80, p <0.01, ηp
2 

= 

0.03 but not school setting (F, (2, 277) =2.78, p >0.05, ηp
2 

= 0.01.The interaction between 

study phase and school setting was also not significant (F (2, 276) = 1.63, p >0.05, ηp
2 

= 0.01. 

Post hoc t tests (bonferroni adjustment, 0.05/5 = 0.025) suggested no significant difference 

between the intervention and control schools in fruit and vegetable consumption at 

baseline (t= -0.12, p=0.90, d=0.02). Within group comparisons indicated that, in the 

intervention schools, consumption of fruit and vegetables was not significantly higher at 

either 3 or 12 month follow-up relative to baseline (t=-.60, p=0.55, d=0.08, CI= 0.01-0.16 

and t= 1.05, p=0.29, d=0.16, CI= -0.24 - -0.09 respectively). In the control schools, mean fruit 

and vegetable consumption was statistically higher at 3 month follow-up than at baseline 

(t= -3.08, p=0.002, d=0.35, CI= 0.27-0.42) but not at 12 month follow-up (t=-0.98, p=0.33, 

d=0.09, CI= 0.02-0.16).  

 

 

(28g) 

(29g) (30g) 

(39g) 

(24g) 

(31g) 

0.0

0.1

0.2

0.3

0.4

0.5

0.6

Intervention Control

M
e
a
n
 p

o
rt

io
n
s
 c

o
n
s
u
m

e
d
 

Baseline

3 month follow-up

12 month follow-up



9 
 

Discussion  

This study indicated that the Food Dudes intervention did not lead to short or long-term 

increases in parental provision of lunchbox fruit and vegetables. Likewise, the intervention 

did not result in significant increases in consumption of fruit and vegetables at either 3 or 12 

month follow-up. In contrast, significant increases in fruit and vegetable provision and 

consumption were evident in the control schools, and with a medium effect size, suggesting 

that these increases were of moderate practical significance. However, the non-significant 

interaction effects for both parental provision and consumption indicate that changes in the 

provision and consumption of fruit and vegetables over time did not reflect a programme 

effect and therefore must be attributed to another influence. Nevertheless, no statistically 

significant baseline differences were evident between the intervention and control schools 

in terms of provision or consumption of fruit and vegetables.  

Schools were matched as far as possible in terms of: school size, proportion of children 

entitled to free school meals and proportion of children from ethnic minorities to control for 

differences in participant demographics. Furthermore, to our knowledge no form of healthy 

eating intervention was implemented in the control schools during the study which may 

have contributed to the increases in parental provision or consumption however we cannot 

be certain that this was not the case. If any form of health promotion programme was 

implemented during the course of the study, this may have impacted on study findings. 

Indeed, many, if not all schools are committed to developing whole school approaches to 

enhance the health and educational outcomes for children and young people and may 

choose to implement their own health promotion programme independent of interventions 

such as the Food Dudes programme.  

Previous research (Horne et al., 2004; Lowe et al., 2004) has largely focused on school-

provided meals and not those supplied from home. Whilst one study (Horne et al., 2009) did 

report increases in parental provision and consumption of fruit and vegetables following the 

intervention, this study was conducted in Ireland where, unlike the UK, there is no school 

meal provision and children instead bring in their lunch from home
 
(Horne et al., 2009). 

Therefore it is possible that there was greater parental involvement or information provided 

to parents in the programme implemented in Ireland than in the UK. The inability of the 



10 
 

present study to replicate these findings suggests that further evidence is required to 

investigate the potential of the intervention to change fruit and vegetable provision and 

consumption for home-provided meals in a UK context. In contrast to school provided meals 

which are required to adhere to food and nutritional based standards (School Food Trust, 

2008), there are no such guidelines for meals provided from the home. Consequently, the 

ability of the intervention to modify parental provision and consumption of lunchtime fruit 

and vegetables may be more difficult to establish as it requires behaviour change from both 

children and parents.  

Further development of the Food Dudes programme in the UK could develop ways of 

working with parents and children to increase awareness of what constitutes a healthy 

lunch (Rogers et al., 2007). Indeed, we are aware that the programme is currently being 

developed with this in mind through the implementation of the Food Dudes Forever phase 

which is designed to strengthen the changes in dietary behaviours following the initial phase 

of the programme (Lowe, 2013). 

Strengths of the study 

A particular strength of this study is the use of digital photography for measuring dietary 

intake. Evaluations of such interventions should be based upon robust measures of dietary 

intake (Klepp et al., 2005) however many evaluations of interventions designed to increase 

children’s fruit and vegetable consumption rely on self-report measures, which are clearly 

limited by the ability of respondents (in this case children) to accurately recall and record 

consumption.  In contrast, the present study used digital photography, which offers a 

pragmatic and reliable tool for assessing consumption in the school setting (Swanson, 2008). 

This method is particularly effective for studies that require rapid acquisition of data and 

minimal disruption to the eating environment such as the study reported here (Williamson 

et al., 2003). 

Conclusion 

In conclusion, the results offer no support for the effectiveness of the Food Dudes 

intervention in increasing parental provision or consumption of lunchtime fruit and 

vegetables for children consuming home-provided meals. Clearly further development work 

is required to ensure both the short and long term effectiveness of interventions promoting 



11 
 

fruit and vegetable consumption in children such as the Food Dudes programme.
 
The Food 

Dudes Forever phase (Lowe, 2013) of the programme currently underway is one approach 

that may enhance the short and long term effects of the programme on children’s eating 

habits. 

References 

Boeing, H,. Bechthold, A., Bub, A., Elinger, S., Haller, D., Kroke, A., Leschik-Bonnet, E., Müller, 

M.J., Oberritter, H., Schulze, M., Stehle, P. and Watzl, B. (2012), “Critical review: vegetables 

and fruit in the prevention of chronic diseases”, European Journal of Nutrition, Vol. 51 No. 6, 

pp. 637-663. 

Department of Health, (2000), The National School Fruit Scheme, London, Department of 

Health, London. 

Haroun, D., Harper, C., Wood, L. and Nelson, M. (2010), “The impact of the food-based and 

nutrient-based standards on lunchtime food and drink provision and consumption in 

primary school in England”, Public Health Nutrition, Vol. 14 No. 2, pp. 209-218. 

Health Promotion Agency. (2009), “Nutritional Standards for School Lunches: A guide for 

implementation”, available at: 

http://www.healthpromotionagency.org.uk/Resources/nutrition/pdfs/food_in_school_09/N

utritional_Standard-1EEBDB.pdf (accessed 30 August 2013). 

Horne, P., Tapper, K., Lowe, C.F, Hardman, C.A., Jackson, M.C. and Woolner, J. (2004), 

“Increasing children's fruit and vegetable consumption: a peer-modelling and rewards-

based intervention”, European Journal of Clinical Nutrition, Vol. 58 No. 12, pp. 1649-1660. 

Horne, P.J., Hardman, C.A., Lowe, C.F., Tapper, K., Le Noury, J., Madden, P., Patel, P. and 

Doody, M. (2009), “Increasing parental provision and children's consumption of lunchbox 

fruit and vegetables in Ireland: the Food Dudes intervention”, European Journal of Clinical 

Nutrition, Vol. 63 No. 5, pp. 613-618. 

Klepp, K., Pérez-Rodrigo, C., De Bourdeaudhuij, I., Due, P.P., Elmadfa, I., Haraldsdóttir, 

Koniq, J., Sjostrom, M., Thórsdóttir, I., Vaz de Almeida, M.D., Yngve, A. and Brug, J. (2005), 

http://www.healthpromotionagency.org.uk/Resources/nutrition/pdfs/food_in_school_09/Nutritional_Standard-1EEBDB.pdf
http://www.healthpromotionagency.org.uk/Resources/nutrition/pdfs/food_in_school_09/Nutritional_Standard-1EEBDB.pdf


12 
 

“Promoting Fruit and Vegetable Consumption among European Schoolchildren: Rationale, 

Conceptualization and Design of the Pro Children Project”, Annals of Nutritional 

Metabolism, Vol. 49 No.4, pp. 212-220. 

Lowe, C.F. (2013), “Children's fruit and vegetable intake, programme evaluation”, Public 

Health Nutrition. Epub ahead of print 02 April 2013 

DOI: http://dx.doi.org/10.1017/S1368980013000694.  

Lowe, F. and Horne, P. (2009), “Food Dudes: Increasing children's fruit and vegetable 

consumption”, Cases in Public Health Communication & Marketing, Vol 3, pp. 161-185. 

Lowe, C.F., Horne, P.J., Tapper, K.K., Bowdery, M. and Egerton, C. (2004), “Effects of a peer 

modelling and rewards-based intervention to increase fruit and vegetable consumption in 

children”, European Journal of Clinical Nutrition, Vol. 58 No. 3, pp. 510-522.  

Nelson, M., Nicholas, J., Riley, K. and Wood, L. (2012), “Seventh annual survey of take up of 

school lunches in England”, available at: 

http://www.childrensfoodtrust.org.uk/assets/research-

reports/seventh_annual_survey2011-2012_full_report.pdf (accessed 29
 
August 2013) 

O'Flaherty, M., Flores-Mateo, G., Nnoaham, K., Lloyd-Williams, F. and Capewell, S. (2012), 

“Potential cardiovascular mortality reductions with stricter food policies in the United 

Kingdom of Great Britain and Northern Ireland”, Bulletin of the World Health Organisation, 

Vol. 90, pp. 522-531.  

Rees, G., Richards, C. and Gregory J (2008), “Food and nutrient intakes of primary school 

children: a comparison of school meals and packed lunches”, Journal of Human Nutrition 

and Dietetics, Vol. 21 No. 5, pp. 420-427. 

Rogers, I.S., Ness, A.R., Hebditch, K.K., Jones, L.R. and Emmett, P.M. (2007), “Quality of food 

eaten in English primary schools: school dinners vs packed lunches”, European Journal of 

Clinical Nutrition, Vol. 61 No. 7, pp. 856-864. 

School Food Trust, (2008), “A Guide to Introducing the Government’s Food-Based and 

Nutrient-Based Standards for School Lunches, pp. 2.1–2.4”, available at: 

http://dx.doi.org/10.1017/S1368980013000694
http://www.childrensfoodtrust.org.uk/assets/research-reports/seventh_annual_survey2011-2012_full_report.pdf
http://www.childrensfoodtrust.org.uk/assets/research-reports/seventh_annual_survey2011-2012_full_report.pdf


13 
 

http://www.healthyeatinginschools.co.uk/pdfs/sft_nutrition_guide.pdf  (accessed 12 

January 2013). 

School Food Trust, (2011), “Packed Lunch Policy Toolkit: Step by Step Guide to developing a 

healthy packed lunch policy”, available at: 

http://www.childrensfoodtrust.org.uk/schools/packed-lunches/packed-lunch-policy 

(accessed 30 August 2013) 

Severson, H. and Biglan, A (1989), “Rationale for the use of passive consent in smoking 

prevention research: politics, policy and pragmatics”, Preventive Medicine, Vol. 18 No.2, pp. 

267-279. 

Swanson, M. (2008), “Digital photography as a tool to measure school cafeteria 

consumption”, Journal of School Health, Vol. 78 No. 8, pp. 432-437. 

Teeman, D., Lynch, S., White, K., Scott, E., Waldman, J., Benton, T., Shamsan. Y., Stoddart, S., 

Ransley, J., Cade, J. and Thomas, J. (2010), The Third Evaluation of the School Fruit and 

Vegetable Scheme. Department of Health, London. 

The Health and Social Care Information Centre, (2012), “Statistics on obesity, physical 

activity and diet: England, 2012”, available at: 

https://catalogue.ic.nhs.uk/publications/public-health/obesity/obes-phys-acti-diet-eng-

2012/obes-phys-acti-diet-eng-2012-rep.pdf (accessed 12 January 2013) 

Upton, D. Upton, P. and Taylor, C. (2012), “Increasing children’s lunchtime consumption of 

fruit and vegetables: an evaluation of the Food Dudes programme”, Public Health Nutrition, 

Vol. 16 No. 6, pp. 1066-1072. 

Williamson, D.A., Allen, H., Martin, P.D., Alfonso, A.J., Gerald, B. and Hunt, A. (2003), 

“Comparison of digital photography to weighed and visual estimation of portion 

sizes”, Journal of the American Dietetic Association, Vol. 103, No. 9 pp. 1139-1145. 

http://www.healthyeatinginschools.co.uk/pdfs/sft_nutrition_guide.pdf
http://www.childrensfoodtrust.org.uk/schools/packed-lunches/packed-lunch-policy
https://catalogue.ic.nhs.uk/publications/public-health/obesity/obes-phys-acti-diet-eng-2012/obes-phys-acti-diet-eng-2012-rep.pdf
https://catalogue.ic.nhs.uk/publications/public-health/obesity/obes-phys-acti-diet-eng-2012/obes-phys-acti-diet-eng-2012-rep.pdf