Television viewing and its associations with overweight,sedentary lifestyle,and insufficient consumption of fruits and vegetables among US high school students: differences by race,ethnicity, and gender

Television (TV) viewing has been associated with overweight, decreased physical activity, and unhealthy dietary behavior among children and adolescents, and may represent a modifiable cause of childhood obesity. This study examined race, ethnic, and gender-specific differences in these associations among high school students in the United States. The study analyzed data from the 1999 national Youth Risk Behavior Survey, a representative sample (N = 15,349) of US high school students. Logistic regression tested for significant associations. TV viewing on an average school day exceeded 2 hours/day among 43% of students; it was greater among Black (74%) and Hispanic (52%) than White (34%) students. Overall, 11% of students were overweight, 31% of students were sedentary (i.e., did not participate in moderate or vigorous physical activity at recommended levels), and 76% ate less than five servings/day of fruits and vegetables. Watching TV more than 2 hours/day was associated with being overweight, being sedentary, and eating insufficient fruits and vegetables among White females, and with being overweight among Hispanic females. No significant associations were found among Black females. TV viewing was associated with being overweight and eating insufficient fruits and vegetables among White males. No significant associations were found among Hispanic males. Among Black males, TV viewing was associated with greater participation in physical activity. These findings suggest the presence of cultural factors to consider when developing interventions to promote physical activity, healthy eating, and healthy weight through reduced TV viewing among adolescents.     

Weight management goals and practices among U.S. high school students: associations with physical activity, diet, and smoking.

PURPOSE: To examine associations of physical activity, fruit and vegetable consumption, and cigarette smoking with weight management goals and practices of U.S. high school students.METHODS: Data were from the 1999 national Youth Risk Behavior Survey, a representative sample of U.S. high school students (n = 15,349). Adjusted odds ratios (OR) were calculated to describe associations, controlling for demographic characteristics.RESULTS: Based on self-reported height and weight, 25% of students were either overweight (11%) or at risk for becoming overweight (14%). However, 43% of students were trying to lose weight and 19% of students were trying to maintain their current weight. Female students were less likely than male students to be overweight, but more likely to be trying to lose weight. Trying to lose weight was associated with vigorous physical activity (OR = 1.5), strengthening exercises (OR = 2.2), and cigarette smoking (OR = 1.4) among female students; and vigorous physical activity (OR = 1.6), strengthening exercises (OR = 1.8), and eating > or =5 servings/day of fruits and vegetables (OR = 1.5) among male students. Among students trying to lose weight or stay the same weight, only 62% of females and 41% of males combined exercise with a reduced fat and calorie diet, while 32% of females and 17% of males used unhealthy weight control methods (fasting, diet pills, vomiting, or laxatives).CONCLUSIONS: Efforts to promote healthy weight management among adolescents are needed and should place greater emphasis on combining physical activity with a reduced fat and calorie diet, increasing fruit and vegetable consumption, and discouraging smoking and other unhealthy weight control practices.     

Fruit and vegetable consumption among high school students--United States, 2010

A diet high in fruits and vegetables is associated with a decreased risk for many chronic diseases and some cancers, and can aid in weight management. Current daily fruit and vegetable recommendations for adolescents who participate in <30 minutes of physical activity daily are 1.5 cups of fruit and 2.5 cups of vegetables for females and 2 cups of fruit and 3 cups of vegetables for males (1 cup is approximately equal to one medium apple, eight strawberries, 12 baby carrots, or one large tomato). However, recently published data from the National Health and Nutrition Examination Survey 2003-2004 revealed that consumption was considerably below these levels. To assess fruit and vegetable consumption among high school students, CDC analyzed data from the 2010 National Youth Physical Activity and Nutrition Study (NYPANS). This report describes the results of that analysis, which indicated that, in 2010, the median number of times per day that high school students consumed fruits and vegetables was 1.2 for both. For vegetables, the median number of times per day was lower for non-Hispanic black students (1.0) and Hispanic students (1.1) than non-Hispanic white students (1.4). Overall, 28.5% of high school students consumed fruit <1 time daily, and 33.2% of high school students consumed vegetables <1 time daily. The infrequent fruit and vegetable consumption by high school students highlights the need for effective strategies to increase consumption. Policy and environmental approaches to provide greater access to and availability of fruits and vegetables are among the strategies that schools and communities might choose to achieve this goal.     

Benefits and barriers to fruit and vegetable intake: relationship between attitudes and consumption

Consumption of fruits and vegetables is suggested to be beneficial in cancer prevention. However, surveys indicate that a large percentage of the population does not consume the recommended intake of fruits and vegetables. A mail survey was conducted in 1990 to examine attitudes toward nutrition and reported fruit and vegetable intake among randomly sampled Washington state residents (n = 1069; age range = 20–88 years). Individuals in low-income and low-education categories and males had significantly higher scores measuring barriers to fruit and vegetable intake compared to the highest income and education groups or females. All respondents had high nutrition concern despite income or education level. Nutrition behavior scores were significantly higher for individuals with high income. Results of the multiple regression analysis indicated that 16% of the variance in fruit and vegetable intake was accounted for by attitude variables. Barriers to fruit and vegetable intake were the largest component of variability in actual fruit and vegetable consumption. Results suggest a relationship between attitudes about barriers to fruit and vegetable intake and nutrition behaviors. Additionally, males and individuals with limited education and lower income may benefit from education directed toward reducing barriers to fruit and vegetable intake.     

Predicting childhood obesity prevention behaviors using social cognitive theory: children in China

Four commonly suggested public health strategies to combat childhood obesity are limiting television viewing, encouraging daily physical activity, increasing fruit and vegetable intake, and increasing water consumption. This study examined the extent to which selected social cognitive theory constructs can predict these four behaviors in upper elementary Chinese children. A 55-item valid and reliable scale was administered to 282 fifth-graders. Minutes of physical activity was predicted by self-efficacy to exercise and number of times taught at school (R2 = 0.198). Hours of TV watching was predicted by self-efficacy of watching less than two hours of TV (R2 = 0.155). Glasses of water consumed was predicted by self-efficacy for drinking water, gender, and number of times taught about physical activity at school (R2 = 0.100). Servings of fruits and vegetables consumed was predicted by self-efficacy of eating fruits and vegetables (R2 = 0.197). Social cognitive theory offers a useful framework for designing primary prevention interventions to reduce childhood obesity.     

Predicting childhood obesity prevention behaviors using social cognitive theory

Four commonly suggested public health strategies to combat childhood obesity are limiting television viewing, encouraging daily physical activity, increasing fruit and vegetable intake, and increasing water consumption. This study examined the extent to which selected social cognitive theory constructs can predict these four behaviors in upper elementary children. A 52-item valid and reliable scale was administered to 159 fifth graders. Minutes of physical activity was predicted by self-efficacy to exercise and number of times taught at school (R2 = 0.072). Hours of TV watching were predicted by number of times taught about healthy eating at school and self-control through goal setting (R2 = 0.055). Glasses of water consumed were predicted by expectations for drinking water (R2 = 0.091). Servings of fruits and vegetables consumed were predicted by self-efficacy of eating fruits and vegetables (R2 = 0.137). Social cognitive theory offers a practically useful framework for designing primary prevention interventions to reduce childhood obesity.     

Estimates of fruit and vegetable intake in childhood and adult dietary behaviors of African American women

OBJECTIVE: This exploratory study examined how estimates of one's fruit and vegetable intake in childhood are related to 3 current dietary behaviors among African American women: intake of fruits and vegetables, exposure to and preference for fruits and vegetables, and preference for trying new foods. DESIGN: Baseline data from a randomized dietary intervention trial. Setting: Ten urban public health centers in St. Louis, Missouri. PARTICIPANTS: 1227 African American women. Variables Measured: A 33-item fruit and vegetable food frequency questionnaire, items measuring estimates of childhood fruit and vegetable intake, adult fruit and vegetable intake, exposure to and preference for fruit and vegetable, and preference for trying new foods. ANALYSIS: Linear regression evaluated the association between predictors and continuous measures; logistic regression determined the association between predictors and categorical measures. RESULTS: Estimates of one's vegetable intake as a child were significantly related to exposure and preference for both fruits and vegetables, trying of new foods, and intake of both fruits and vegetables in adulthood. Estimates of eating fruit as a child were not significantly associated with these adult dietary behaviors. CONCLUSIONS AND IMPLICATIONS: Developmental influences on adult dietary patterns may be stronger for vegetables than fruits among African American women. Additional emphasis is needed regarding exposure to and preference for vegetable intake in childhood.     

A Fresh Fruit and Vegetable Program Improves High School Students' Consumption of Fresh Produce

Low fruit and vegetable intake may be associated with overweight. The United States Department of Agriculture implemented the Fresh Fruit and Vegetable Program in 2006-2007. One Houston-area high school was selected and received funding to provide baskets of fresh fruits and vegetables daily for each classroom during this period. This study assessed the impact of the program on students' fruit and vegetable intake. At program end (May 2007), fruit and vegetable intake surveys were distributed to students at the intervention school as well as at a comparison high school that did not receive the program. Surveys, which were completed anonymously, were received from 34% of intervention and 42% of comparison school students. The students were classified as to whether they met the recommended daily intake of fruit, 100% fruit juice, and vegetables. The probability of meeting the recommendations was assessed with logistic regression analyses, controlling for sex, age, and ethnicity. Compared with the comparison control school students, intervention school students were more likely to report eating fruit and drinking 100% fruit juice at least two times per day (39.3% vs 27.3%; P<0.05) and consuming total fruit, juice, and vegetables (22% vs 18.4%; P<0.05) five or more times per day in the preceding 7 days. More intervention school students (59.1%) than comparison school students (40.9%) reported eating fruit at least one time per day (P<0.05). There were no group differences in vegetable intake. Fresh fruit and vegetable distribution programs provide the opportunity for students to taste a variety of fruits and vegetables, and may improve consumption of these foods by adolescents.     

Fruit and Vegetable Consumption,Fat Intake,and Physical Activity Participation in Relation to Socio-demographic Factors Among Medically Underserved Adults

Fruit and vegetable intake as well as physical activity participation in Mississippi is consistently lower than recommendations. We conducted a cross-sectional study to examine fruit and vegetables consumption, fat intake, and moderate-intensity physical activity participation and how these variables relate to socio-demographic factors among medically underserved adults in south Mississippi. Fruit and vegetable consumption and fat intake along with physical activity participation and socio-demographic characteristics was collected from a sample of 161 (48 male and 113 female) adults in south Mississippi. A majority (81.9%) of participants reported consuming less than five servings of fruits and vegetables per day and 54% reported exercising less than three times a week. Only 14% of participants reported eating a low fat diet. Bivariate correlations revealed no significant relationships between fruit and vegetable consumption and fat intake as well as no significant relationships between fruit and vegetable consumption and gender, ethnicity, income, marital status, or education. However, there were significant correlations between physical activity and fat intake (r = -0.21, p = 0.01), and physical activity with fruit and vegetable consumption (r = 0.16, p = 0.05). Higher physical activity rates were associated with decreased fat intake and increased fruit and vegetable consumption. Physical activity was also higher among men (r = -0.16, p = 0.05) and positively correlated with income level (r = 0.21 p = 0.01). In order to effectively identify or develop strategies to improve health by promoting increased fruit and vegetable intake and physical activity, further research is needed to understand the factors that affect behavior choices regarding nutrition and physical activity in this medically underserved adult population.     

Food spending behaviors and perceptions are associated with fruit and vegetable intake among parents and their preadolescent children

OBJECTIVE: Examine the role of food spending behaviors and perceptions on fruit and vegetable intake among preadolescent children and their parents. DESIGN: Cross-sectional study. SETTING: Metropolitan city. PARTICIPANTS: Five hundred fifty-five parent/child dyads participating in the PARADE study. More than 50% of participants were African American and nearly 40% of households were low income. VARIABLES MEASURED: Body mass index calculated from child anthropometric data and parents' self-reported height and weight. Adult and child fruit and vegetable intake, annual household income, and food purchase behavior and perceptions obtained from parent questionnaire. ANALYSIS: Analysis of variance used to identify differences in means at P<.05 level. RESULTS: No statistically significant differences in fruit and vegetable intake by income status were observed. Children in households spending the least per week on groceries consumed fewer daily fruits and vegetables. Perceptions of cost of fruits and vegetables were also found to be significantly associated with fruit and vegetable intake among children and parents. CONCLUSIONS AND IMPLICATIONS: Public health efforts to raise awareness of the relatively low cost of fruits and vegetables should be continued. These efforts may be complemented with policy strategies that make fruits and vegetables more viable options for low-income households.     

A Garden Pilot Project Enhances Fruit and Vegetable Consumption among Children

Fruit and vegetable intake among children is inadequate. Garden-based nutrition education programs may offer a strategy for increasing fruit and vegetable intake in children. A 12-week pilot intervention was designed to promote fruit and vegetable intake among 4th to 6th grade children (n=93) attending a YMCA summer camp. Children participated in garden-based activities twice per week. Weekly educational activities included fruit and vegetable taste tests, preparation of fruit and vegetable snacks, and family newsletters sent home to parents. The pilot intervention was evaluated using a pre and post survey to determine participant satisfaction and the short-term impacts of the program. The process evaluation focused on program satisfaction, whereas the short-term impact evaluation assessed fruit and vegetable exposure, preference, self-efficacy, asking behavior, and availability of fruits and vegetables in the home. Data from the impact evaluation were compared from baseline to follow-up using McNemar's test (dichotomous variables) and Wilcoxon signed rank test (scales/continuous variables). Children reported high levels of enjoyment in the intervention activities. Most children (97.8%) enjoyed taste-testing fruits and vegetables. Children also liked preparing fruit and vegetable snacks (93.4%), working in their garden (95.6%), and learning about fruits and vegetables (91.3%). Impact data suggest that the intervention led to an increase in the number of fruits and vegetables ever eaten (P<0.001), vegetable preferences (P<0.001), and fruit and vegetable asking behavior at home (P<0.002). Garden-based nutrition education programs can increase fruit and vegetable exposure and improve predictors of fruit and vegetable intake through experiential learning activities. Participation in the “seed to table” experience of eating may help promote healthful eating behaviors among youth. Food and nutrition professionals should consider garden-based nutrition education programs that connect children with healthful foods through fun, hands-on activities.     

Parental pressure, dietary patterns, and weight status among girls who are "picky eaters"

OBJECTIVE: To determine whether mothers' fruit and vegetable intake and mothers' use of pressure in the feeding domain when their daughters were 7 years old predicted picky eating and dietary intake when their daughters were 9 years old, and to examine diet and weight status in picky and nonpicky eaters. DESIGN/SUBJECTS: Participants were 173 9-year-old non-Hispanic white girls and their mothers. A longitudinal analysis was used to assess maternal influences on picky eating and diet. A cross-sectional analysis was used to examine diet and weight status between picky and nonpicky eaters. Measures included maternal feeding practices, daughters' pickiness, mothers' fruit and vegetable intake, daughters' food intake, and weight status. STATISTICAL ANALYSES: t tests examined differences between picky and nonpicky eaters. Structural equation modeling examined relationships among mothers' fruit and vegetable intake; child feeding practices; daughters' pickiness; and fruit, vegetable, micronutrient, and fiber intakes. RESULTS: Mothers consuming more fruits and vegetables were less likely to pressure their daughters to eat and had daughters who were less picky and consumed more fruits and vegetables. Picky eaters consumed fewer fruits and vegetables, but also fewer fats and sweets. All girls consumed low amounts of vitamin E, calcium, and magnesium, but more picky girls were at risk for not meeting recommendations for vitamins E and C and also consumed significantly less fiber. In addition, picky eaters were less likely to be overweight. CONCLUSIONS: Mothers influenced daughters' fruit and vegetable intake via their own patterns of fruit and vegetable intake and by influencing their daughters' tendencies to be picky eaters. Both picky and nonpicky eaters had aspects of their diets that did not meet recommendations. Taken together, these findings suggest that parents should focus less on "picky eating" behavior and more on modeling fruit and vegetable consumption for their children.     

The influence of sociodemographic factors on patterns of fruit and vegetable consumption in Canadian adolescents

BACKGROUND: Poor dietary habits may increase risk for obesity and chronic diseases among Canadian adolescents. OBJECTIVES: The aims of the present study were to: (a) establish the patterns of fruit and vegetable intake by Canadian adolescents, and (b) identify the impact of sociodemographic factors-including age, household income, household education, ethnicity, living arrangement, and location-on the pattern of fruit and vegetable intake in this population. DESIGN: This is a cross-sectional study using the data from the Canadian Community Health Survey, Cycle 2.1, Public Use File. The survey used questions similar to a food frequency questionnaire. METHODS: Total fruit and vegetable intake of 18,524 Canadian adolescents (12 to 19 years old) was cross-tabulated between two age groups (12 to 14 years old [n=7,410] and 15 to 19 years old [n=11,114]) by sex, level of household education, total household income, ethnicity, living arrangement, and geographical location. RESULTS: The data revealed that a 38.3% of Canadian adolescents in this study consumed fruits and vegetables five to 10 times per day; fewer older adolescents (15- to 19-year-olds) reported eating fruits and vegetables at that frequency as compared with the younger subgroup (12- to 14-year-olds) (P<0.001). Household education and income independently had a significant (P<0.001) positive impact on fruit and vegetable consumption. Females reported a significantly (P<0.05) higher frequency of intake than did males. Adolescents living in homes with only one parent reported a significantly (P<0.005) lower frequency of intake, as compared with adolescents living with two parents. CONCLUSIONS: These results may help to identify adolescent groups at risk for poor eating habits and support the implementation of programs to encourage higher fruit and vegetable intakes.     

US adults' fruit and vegetable intakes, 1989 to 1991: a revised baseline for the Healthy People 2000 objective.

OBJECTIVES. This study provides revised baseline data for the Healthy People 2000 objective related to fruit and vegetable intakes, accounting for fruits and vegetable intakes, accounting for fruits and vegetables from all sources and measuring servings in a manner consistent with current dietary guidance. METHODS. Dietary data from 8181 adults in the US Department of Agriculture's 1989-1991 Continuing Surveys of Food Intakes by Individuals were examined. All foods were disaggregated into their component ingredients; all fruit and vegetable ingredients were assigned specific weights to correspond to a serving as defined by current dietary guidance materials; and the number of servings was tallied. RESULTS. While mean intakes of fruits and vegetables--4.3 servings per day--were not far from the Year 2000 objective, only 32% of American adults' intakes met the objective. When more stringent standards were set either to compensate for higher calorie levels or to achieve the balance between fruits and vegetables suggested in current guidance, only 24% and 12%, respectively, met the recommendations. CONCLUSIONS. These results suggest a need to develop strategies for overcoming barriers to eating fruits and vegetables.     

Factors associated with adequate fruit and vegetable intake by schoolchildren in Santa Catarina State, Brazil

This study aimed to estimate fruit and vegetable intake and identify associated factors among schoolchildren in Santa Catarina State, Brazil. A cross-sectional study was conducted with 4,964 students from public and private schools in eight districts in the State, analyzing socioeconomic and anthropometric data and dietary intake. Adequate fruit and vegetable intake was defined as five or more servings per day. Poisson regression was performed to test associations between fruit and vegetable intake and independent variables (p < 0.05). Adequate intake was found in 2.7% of children, while 26.6% of the sample did not consume any fruits and vegetables. In the analysis of the association between independent variables and adequate fruit and vegetable intake in the total sample, only geographic region (residents in western Santa Catarina) and consumption of candy were significantly associated. In the stratified analysis by sex, for boys, only geographic region was associated, while among girls, region and candy consumption were significantly associated with adequate fruit and vegetable intake. The findings indicate the need for specific strategies in the school community to improve fruit and vegetable intake by schoolchildren.     

Validity of a questionnaire to assess fruit and vegetable intake in adults

OBJECTIVE: To validate a method for assessing fruit and vegetable intake among adults in a population of low intake. The method assesses mean intake and ranks individuals by their usual intake. DESIGN: A precoded fruit and vegetable Questionnaire included a 24-h recall and a food frequency. The participants filled in the Questionnaire, a week later they started a 7-day food record, 1-day weighed record and 6 days using household measures. SUBJECTS: Following advertisements 40 participants were recruited, 36 returned food records(mean age=37 years). RESULTS: No difference was observed between the average intake yielded by the 24-h recall and that from the 1-day weighed food record of fruits or vegetables. Correlation coefficients between results from the food frequency questionnaire and the 7-day food records were 0.45 (P=0.007) for vegetables, 0.63 (P<0.001) for fruits and 0.73 (P<0.001) for fruits and vegetables combined. Cross-classification into quartiles showed that the proportion of participants in the same or the adjacent quartile of the intake distribution were 94% for fruit intake and 80% for vegetable intake. Registered intake of fruits and vegetables was higher the first 4 days of the record than the last 3 days (P=0.002). The 4-day food record correlated with the food frequency questionnaire in similar manner as the 7-day record. CONCLUSION: The present study indicates that the precoded 24-h recall may be valuable tool for measuring average intake of fruits and vegetables among adults in a population of low intake. Moreover, the food frequency questionnaire was valid for ranking individuals according to their usual intake. A 4-day food record might be sufficient when validating food frequency questionnaires for fruits and vegetables.     

Knowledge, barriers, and stage of change as correlates of fruit and vegetable consumption among urban and mostly immigrant black men

BACKGROUND: Daily fruit and vegetable consumption in black men is low and has remained relatively unchanged during the past 20 years. OBJECTIVE: To examine awareness of fruit and vegetable recommendations promoted by federal agencies and correlates of fruit and vegetable consumption among an urban and mostly immigrant population of adult black men. DESIGN: A cross-sectional study analyzing baseline data (n=490) from a randomized controlled trial. SETTING: A large health care worker's union. MAIN OUTCOME MEASURES: Knowledge, perceived benefits, stage of readiness, perceived barriers, and daily servings of fruit and vegetable intake. STATISTICAL ANALYSES PERFORMED: One-way analysis of variance and t tests were used to compare fruit and vegetable intake across main study variables. Regression analysis was used to identify independent predictors of fruit and vegetable intake. RESULTS: Fruit and vegetable intake was low (mean was three servings/day). Ninety-four percent were not aware that men should consume at least nine servings of fruits and vegetables daily and 59.8% were not aware that eating a colorful variety is important. In contrast, over half (54.7%) were aware that a single serving is equal to about a handful; 94.1% correctly reported fruit and vegetables as an important source of fiber; 79.6% correctly reported vitamin pills were not a substitute for eating fruits and vegetables; and 94.5% recognized that there are health benefits to eating fruits and vegetables, although identification of specific benefits was minimal. In regression analysis, a greater level of fruit and vegetable consumption was significantly associated with greater knowledge of fruit and vegetable recommendations, lower perceived barriers, and a more advanced stage of change (action vs contemplation/preparation). Perceived health benefits were not associated with fruit and vegetable consumption. CONCLUSIONS: There is a lack of awareness of the current fruit and vegetable recommendations. In addition, men reported fruit and vegetable intakes that were far below national recommendations. Greater efforts are needed to help urban and primarily immigrant black men realize the importance of and recommendations for fruit and vegetable consumption.     

青少年水果蔬菜摄入行为的家庭环境因素分析

目的 了解青少年水果/蔬菜摄入行为的家庭环境影响因素,为进行有效的营养环境干预提供依据.方法 采用方便随机整群抽样方法,选取北京、辽宁、贵州城乡小学四年级至高中三年级的3 165名学生作为研究对象,进行问卷调查.结果 中小学生水果摄入达标率为24.2％,蔬菜摄入达标率为44.1％.水果摄入不足的家庭环境危险因素包括缺乏父母的帮助(OR=1.230)、家庭允许规矩差(OR=1.161)、家庭可及性差(OR=1.506);蔬菜摄人不足的家庭环境危险因素包括蔬菜的家庭可及性差(OR=1.181)、母亲受教育水平低(OR=1.117).结论 家庭环境是中小学生水果/蔬菜摄人的重要影响因素.对青少年水果/蔬菜摄人行为进行干预,应注意改善家庭营养环境.     

Television use and food choices of children: qualitative approach

This study reports the results of 12 focus group interviews with primary school students (7-10 years old, n=57) in Florianópolis, Brazil, regarding their food choices, television (TV) viewing, and physical activity habits. In 2005, an average Brazilian child aged 4-11 years watched TV almost 5 h per day. Intensive TV use in childhood and adolescence may contribute to sedentarism and unhealthy eating habits, and excessive viewing might have long-lasting adverse effects on health. Results indicated that frequent ingestion of snack foods was not a habit for most students, possibly because of an acknowledged parental interference, but these were the food items they bought with their own money. Daily TV viewing was reported by almost all students, especially during meals and before bedtime, but students still found the time to be physically active. Most of them mentioned going to sports classes and engaging in active play regularly. No attempts by the parents to regulate TV viewing in the household were mentioned. The habit of eating while watching TV, together with the students' behavior as primary consumers of food products, pointed to the need for strategies that will reduce TV viewing and educate the children as consumers.