Planet Munch (prevention)
Note on provider involvement: This provider has agreed to EIF’s terms of reference, and the assessment has been conducted and published with the full cooperation of the programme provider.
Planet Munch (formerly known as Trim Tots) is a community-based programme targeted at children between the ages of 1 and 5 years and their caregivers. It is a universal programme delivered in children’s centres aiming to reduce obesity in preschool children.
Planet Munch consists of weekly group sessions delivered over 24 weeks which incorporate arts and crafts, music and active play into educational workshops to teach children and adults about physical activity, diet and nutrition. There are opportunities to apply and consolidate this knowledge by engaging in cooking and exercise sessions and portion size activities. Learning about healthy dietary and activity patterns in an engaging environment aims to engender sustained behaviour change in the participants such that families go on to lead healthier lifestyles. This, in turn, reduces the prevalence of obesity in preschool children.
By involving the child’s caregiver in the intervention and providing children and adults with opportunities for active play and exercise, Planet Munch draws upon National Institute for Health and Care Excellence (NICE) recommendations for interventions aimed at the prevention of obesity in preschool children. Both universal and targeted variants of Planet Munch are available, aimed at preventing and treating obesity, respectively. This review relates to the preventative programme.
EIF Programme Assessment
Planet Munch (prevention) has preliminary evidence of improving a child outcome, but we cannot be confident that the programme caused the improvement.
What does the evidence rating mean?
Level 2 indicates that the programme has evidence of improving a child outcome from a study involving at least 20 participants, representing 60% of the sample, using validated instruments.
This programme does not receive a rating of 3 as its best evidence is not from a rigorously conducted RCT or QED evaluation.
What does the plus mean?
The plus rating indicates that a programme’s best available evidence is based on an evaluation that is more rigorous than a level 2 standard but does not meet the criteria for level 3.
Both universal and targeted variants of Planet Munch are available, aimed at preventing and treating obesity, respectively. This review relates to the evidence for the preventative programme, for the general population of healthy preschool children.
Child outcomes
According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:
Preventing obesity and promoting healthy physical development
Planet Munch (prevention)
Key programme characteristics
Who is it for?
The best available evidence for this programme relates to the following age-groups:
- Toddlers
- Preschool
How is it delivered?
The best available evidence for this programme relates to implementation through these delivery models:
- Group
Where is it delivered?
The best available evidence for this programme relates to its implementation in these settings:
- Children's centre or early-years setting
How is it targeted?
The best available evidence for this programme relates to its implementation as:
- Universal
Where has it been implemented?
United Kingdom
UK provision
This programme has been implemented in the UK.
UK evaluation
This programme’s best evidence includes evaluation conducted in the UK.
Spotlight sets
EIF does not currently include this programme within any Spotlight set.
Planet Munch (prevention)
About the programme
What happens during delivery?
How is it delivered?
- Planet Munch is delivered in 24 sessions of two hours duration each by early years professionals to groups of carer–child dyads.
What happens during the intervention?
- The 24-week intervention is divided into main sessions occurring during the first 12 weeks followed by consolidation sessions in the final 12 weeks.
- The content of the main sessions includes:
- arts & crafts workshops, with a focus on nutrition and healthy lifestyles
- music and movement sessions, which provide the opportunity for children and carers to engage in physical activity
- healthy snack time, which introduces new foods and promotes a healthy balanced diet
- nutrition education workshops, which offer age-appropriate advice and training to improve diet and physical activity level
- structured play sessions, which act as a source of physical activity and promote the importance of exercise in daily life
- adult exercise sessions
- stretching, relaxing and cooling down after activity play, involving health-focused storytelling
- supplementary material, such as fact sheets and a list of useful websites, to support the delivery of these sessions.
- Consolidation sessions mirror the main sessions but are designed to be more practical. For instance, families participate in cooking, food labelling and portion size activities.
What are the implementation requirements?
Who can deliver it?
The practitioners delivering the programme consist of:
- programme leaders who are experts in nutrition and physical health
- programme facilitators who are early years professionals based within children’s centres.
What are the training requirements?
- Information not yet available.
How are the practitioners supervised?
- Information not yet available.
What are the systems for maintaining fidelity?
- Information not yet available.
Is there a licensing requirement?
Not available
How does it work? (Theory of Change)
How does it work?
- Establishing healthy dietary and activity behaviours in children directly improves their BMI which in turn treats or prevents obesity. Improving dietary and activity patterns at a parental level reinforces the positive lifestyle changes in children and increases the likelihood that they are maintained.
- The programme intends to improve eating habits and physical activity levels by delivering educational workshops which contain age-appropriate nutritional information and advice and promote the importance of leading an active lifestyle. This teaching is nested within sessions of arts and crafts and music and movement to engage the children and parents. Behaviour change is supported by fact sheets and lists of useful websites and by setting SMART goals.
- In the short term, children engage in more physical activity and develop better eating behaviours, which contributes to maintaining a healthy BMI. Parent outcomes such as understanding what constitutes a healthy diet and the importance of this are also developed in the short run, which supports the attainment of the short-term child outcomes.
- In the long term, the improved behaviour patterns are repeated and consolidated leading to sustained lifestyle changes for both children and adults. Evidence shows that obesity developed early in life tracks throughout childhood and into adulthood, thus, by establishing healthy dietary habits during these formative years, in the long run, children maintain a health BMI and avoid the risks associated with obesity.
Intended outcomes
Preventing obesity and promoting healthy physical development
Contact details
Julie Lanigan
University College London
[email protected]
Planet Munch (prevention)
About the evidence
Planet Munch’s most rigorous evidence comes from an RCT which was conducted in the UK.
This study identified statistically significant positive impact on child outcomes.
A programme receives the same rating as its most robust study, which in this case is the Lanigan et. al, 2013 study, and so the programme receives a level 2+ rating overall.
Study 1
| Citation: | Lanigan et al., 2013 |
|---|---|
| Design: | RCT |
| Country: | United Kingdom |
| Sample: | 85 children and their parent or usual carer, with children between 1 and 5 years old (mean age 2.1 years) from the general population of healthy preschool children, where families are enrolled in a Sure-Start Children’s Centre. |
| Timing: | Post-test |
| Child outcomes: |
Reduced waist circumference
Reduced skinfold thickness |
| Other outcomes: | None measured |
| Study rating: | 2+ |
Lanigan, J., Collins, S., Birbara T., Kokoreli, M., & Singhal, A. (2013) “The TrimTots programme for prevention and treatment of obesity in preschool children: evidence from two randomised controlled trials”, The Lancet, Vol. 382, Supplement 3, Page S58.
Available at:
https://www.sciencedirect.com/science/article/pii/S0140673613624836
Study design and sample
The first study is an RCT.
This study involved random assignment of children to a Planet Munch treatment group and a waiting list control group.
This study was conducted in the UK, with a sample of children from the general population of healthy preschool children, aged between 1 and 5 (average age 2.1). The majority of the children in the sample were Caucasian (69%) from a range of socio-economic backgrounds (41% of carers with a university degree and 59% in non-manual work).
Measures
- Body weight, height and waist circumference were measured via direct assessment according to standard operating procedures (direct assessment).
- BMI was calculated based on the previous measures (direct assessment).
- Skinfold thickness was measured at four sites (triceps, biceps, sub-scapular and suprailiac) using skinfold callipers (direct assessment).
- Systolic and diastolic blood pressure were measured in supine position on the left arm using an appropriately sized cuff and an automated blood pressure monitor. Heart rate was measured using the same device (direct assessment).
- Heart rate variability was measured using an electrocardiogram (direct assessment).
- Hours per week of physical and sedentary activity were parent reported.
Findings
This study identified a statistically significant positive impact on two child outcomes. Following participation in the programme, the treatment group had significantly lower waist circumference and skinfold thickness relative to the control group.
The conclusions that can be drawn from this study are limited by methodological issues pertaining to baseline differences after attrition has taken place, and small sample sizes, hence why a higher rating is not achieved.
Other studies
The following studies were identified for this programme but did not count towards the programme's overall evidence rating. A programme receives the same rating as its most robust study or studies.
Neville E. (2018), “Planet Munch Post Evaluation Report”, Camden Pilot - This reference refers to a randomised control trial, conducted in the UK.
Published April 2024