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

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.