Rodrigues 1999

Methods	Study design: quasi‐experimental, controlled before‐and‐after study Conducted in: Recife, Brazil ‐ metropolitan area in Brazil Unit of randomisation: nursery Unit of analysis: individual Setting: non‐fee‐paying nurseries (kindergartens) in Brazil Funded by: "The study was funded by CAPES" Duration of the study: Baseline commenced September 1993 Follow‐up examinations: September to November 1994
Participants	Inclusion criteria: Non‐fee‐paying nursery Exclusion criteria: Fee‐paying and part‐time operated nurseries were not included in the study. Children with learning difficulties were excluded Age at baseline: 36 to 47 months N (controls baseline): 265 children in 17 control nurseries N (controls follow‐up): not reported N (interventions baseline): 245 children in 12 intervention nurseries N (interventions follow‐up): not reported Total N: 510 children; 78% of those approached were examined Recruitment: through 29 selected kindergartens Gender: not reported – sex of children in both groups similar
Interventions	Intervention: adopted guidelines on reduction of sugar intake Control: did not adopt sugary guidelines Duration of intervention: not clear – measurement of food at nurseries took place at an interval of 6 months
Outcomes	DMFT
Implementation related factors	Theoretical basis: policy Resources for implementation: observer to weigh food, dietary guidelines Who delivered the intervention: unclear PROGRESS categories assessed at baseline: SES, education levels of parents, family income, age and gender PROGRESS categories analysed at outcome: SES Outcomes related to harms/unintended effects: not reported Intervention included strategies to address diversity or disadvantage: low SES Economic evaluation: not reported
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Study authors randomly selected 29 of the 50 largest nurseries but did not specify the method of randomisation
Allocation concealment (selection bias)	Unclear risk	Unclear
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Unclear
Selective reporting (reporting bias)	Unclear risk	Unclear
Other bias	Unclear risk	Unclear
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Unclear
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Independent observer weighed food in nurseries; other personnel not reported