Taste preferences, liking and other factors related to fruit and vegetable intakes among schoolchildren: results from observational studies

The present paper explores the relative importance of liking and taste preferences as correlates of fruit and vegetable (FV) intakes among schoolchildren in Europe. The paper first provides an overview of potential determinants of food choice among children and subsequently summarizes the results of two recent observational studies on determinants of FV intakes among school-aged children. It is proposed that taste preferences and liking are important for children's food choices as part of a broader spectrum of nutrition behaviour determinants. Taste preferences and liking are important for motivation to eat certain foods, but social-cultural and physical environmental factors that determine availability and accessibility of foods, as well as nutrition knowledge and abilities should also be considered. Study 1 shows that children with a positive liking for FV have a greater likelihood to eat fruits (odds ratio (OR) = 1.97) or vegetables (OR = 1.60) every day, while ability and opportunity related factors such as knowledge, self-efficacy, parental influences and accessibility of FV were also associated with likelihood of daily intakes (ORs between 1.16 and 2.75). These results were consistent across different countries in Europe. Study 2 shows that taste preferences were the strongest mediator of gender differences in FV intakes among children; the fact that girls eat more could for a large extend be explained by there stronger taste preferences.     

Correlates of fruit and vegetable consumption among 11-year-old Belgian-Flemish and Dutch schoolchildren

OBJECTIVE: To determine factors associated with the consumption of fruit and vegetables among 11-year-old schoolchildren in Belgium-Flanders and the Netherlands. DESIGN: In total, 2468 school children from 98 randomly selected schools participated in a cross-sectional survey. VARIABLES MEASURED: Frequency of fruit and vegetable intake and potential personal, social and environmental correlates were measured by means of self-administered, school-based, written questionnaires. ANALYSIS: Hierarchical multiple regression analyses were conducted to assess potential correlates of schoolchildren's fruit and vegetable consumption. Separate analyses were conducted for boys and girls. RESULTS: Bringing fruit to school, modeling behavior of parents and friends, parents demanding that their child eat fruit, knowledge about recommended intake levels, liking fruit, and self-efficacy to eat fruit were the strongest correlates of fruit intake. For vegetables, gender, parental demand, parents facilitating the consumption of vegetables by cutting them for their child, modeling behavior of parents and friends, and preferences for vegetables emerged as strongest correlates. No substantial differences in significant correlates were found according to gender. The percentage of explained variance was 33.7% for fruit and 28.4% for vegetable intake. CONCLUSIONS: Interventions need to be focused on personal (taste preferences), social (parental influences), and environmental factors (availability).     

Psychosocial predictors of increases in fruit and vegetable consumption

OBJECTIVES: To examine psychosocial predictors of changes in fruit and vegetable consumption. METHODS: Baseline psychosocial variables were used to explain differences in changes in consumption in 83 healthy women with children after they received free fruit and vegetables for one month. RESULTS: One-month changes in fruit consumption (mean 144; SE 16 g/day) were positively associated with perceived costs and perceived health benefits for the children, and negatively associated with perceived behavioral control. Changes in vegetable consumption (68 (11) g/day) were positively related with the intention to eat at least 200 g of vegetables and taste preferences of the children. CONCLUSIONS: Fruit and vegetable consumption may be encouraged by influencing the above variables.     

Association between parenting styles and own fruit and vegetable consumption among Portuguese mothers of school children

The aim of the present study was to evaluate the association between parenting styles and own fruit and vegetable consumption among Portuguese mothers of school children. A cross-sectional study was performed in Portugal as part of the Pro Children cross-sectional European survey. Portuguese mothers (n 1601) of 11-13-year-old school children were included in the present study. A self-administered questionnaire was developed to assess fruit and vegetable consumption as well as the parenting styles. Fruit and vegetable consumption was assessed by a validated FFQ. Parenting styles based on two dimensions - strictness and involvement - were classified into authoritative, authoritarian, indulgent and neglectful. The higher mean intakes of fruit, vegetables and total fruit and vegetables were observed for mothers classified as indulgent, whereas the lower mean intakes were observed for mothers classified as neglectful. Differences in intake among parenting styles were significant for fruit, vegetables and total fruit and vegetables. When partial correlations were calculated between the two dimensions, strictness and involvement (controlled one for the other), and intakes, only involvement was positively associated with fruit, vegetables and total fruit and vegetable intake. Findings from the present study show that fruit and vegetable consumption of Portuguese mothers of school children seems to be related to their own parenting styles, especially with the dimension involvement. Future interventions to promote fruit and vegetable intake should take into account these variables.     

Association of awareness, intrapersonal and interpersonal factors, and stage of dietary change with fruit and vegetable consumption: a national survey.

PURPOSE: To examine associations of awareness, intrapersonal and interpersonal factors, and stage of change with consumption of fruits and vegetables. DESIGN: Nationally representative, random digit dial survey conducted in 1997 with a response rate of 44.5%. Psychosocial correlates of fruit and vegetable consumption were assessed using regression analyses. SETTING: United States. SUBJECTS: A total of 2605 adults who were 18 years and older. MEASURES: Awareness of the "5 A Day for Better Health" program and its message, along with stage of change; taste preferences; self-efficacy; and perceived benefits, barriers, threats, social support, and norms related to fruit and vegetable consumption. RESULTS: Awareness and intrapersonal and interpersonal factors explained 24% of the variance in fruit and vegetable consumption beyond the 9% explained by demographic characteristics. Knowledge of the 5 A Day message was associated with a 22% increase in fruit and vegetable consumption. Self-efficacy for eating fruits and vegetables and taste preferences (affect) were the factors most consistently and strongly associated with both higher consumption and higher likelihood of being in action or maintenance stages of change. Affect and perceived barriers were more strongly associated with increased vegetables and salad than fruit. CONCLUSIONS: Dietary intervention programs to increase fruit and vegetable consumption should emphasize the 5 A Day message, increased self-efficacy, and ways to make vegetables more palatable and easily accessible. Understanding the factors that influence dietary choices should be used when designing dietary interventions.     

Fruit and vegetable intake correlates during the transition to young adulthood

BACKGROUND: During the transition from adolescence to young adulthood, the intake of fruit and vegetables tends to decline, and national survey data indicate that few young adults consume the recommended amounts. This study aimed to identify longitudinal correlates of follow-up fruit and vegetable intake in early young adulthood. METHODS: Surveys and food frequency questionnaires were completed by 1495 adolescent participants in high school classrooms at baseline (in 1998-1999; mean age=15.9 years, SD=0.8) and by mail at follow-up (in 2003-2004; mean age=20.4 years, SD=0.8). In 2007, linear regression methods were used to identify baseline factors associated with follow-up fruit and vegetable intake. RESULTS: Baseline taste preferences, perceived benefits of healthy eating, fast-food intake, time spent watching television, family-meal frequency, and home food availability were correlates of both fruit and vegetable intake during young adulthood across gender. After adjusting for baseline intake, the only correlate of both fruit and vegetable intake during young adulthood across gender was taste preferences. CONCLUSIONS: The findings suggest that nutrition interventions for adolescents should provide opportunities for them to taste more fruit and vegetables, and should address supports for healthy eating both within and outside the home environment.     

Environmental and personal correlates of fruit and vegetable consumption in low income, urban Mexican children.

BACKGROUND: Epidemiological evidence suggests that populations with high fruit and vegetable (FV) consumption have a lower risk for childhood obesity, cancer and cardiovascular diseases. There are no studies that address the correlates of FV intake in Mexican children; therefore, the aim of this study was to identify the frequency of FV consumption by children in Mexico City's low income state schools and their personal (preferences, expectancy, knowledge and self-efficacy) and environmental (accessibility and person in charge of cooking at home) correlates. METHODS: A validated questionnaire to assess accessibility, expectancy, self-efficacy, preference and knowledge; and a 2-day dietary recall were used to assess the FV intake and its correlates in 327 children. Statistical analysis included chi-square and stepwise logistic regression. RESULTS: Average consumption of FV was once a day with a higher proportion of girls consuming FV 3 or more times per day (15.2% versus 6.7%; P < 0.01). The environmental factors that influenced a higher consumption of FV were the mother being responsible for cooking at home (P < 0.02) and accessibility to FV (P < 0.01); whereas the personal factors were self-efficacy (P < 0.05) and preference (P < 0.03) to vegetables. CONCLUSION: Correlates of fruit and vegetable consumption in children from Mexico City's State Schools were being female and accessibility to fruits and vegetables. Home and school environments are decisive for the children to increase FV consumption. Creative ways to encourage FV consumption in boys should be explored. These factors should be considered when designing programmes aimed at increasing consumption of fruits and vegetables in children.     

Explaining school children's fruit and vegetable consumption: the contributions of availability, accessibility, exposure, parental consumption and habit in addition to psychosocial factors

We studied the contributions of parental fruit and vegetable (F&V) consumption, availability and accessibility of F&V in the home, exposure to F&V, and habit, in addition to psychosocial factors, in explaining F&V consumption in 4-12-year-old children. Furthermore, we looked for effect modification by ethnicity and gender. Children's parents (n = 1739) completed a questionnaire assessing psychosocial and additional factors regarding their children's F&V consumption. Consumption was assessed by a food-frequency questionnaire. The model explained the children's F&V consumption better when the additional factors were included (R2 = .49 and R2 = .50 for fruit consumption, and R2 = .33 and R2 = .33 for vegetable consumption). Stepwise multi-level regression analyses revealed that habit was the most influential correlate of F&V consumption. It is concluded that nutrition education interventions aimed at stimulating F&V consumption among children should take into account that the consumption of fruit and that of vegetables are clearly different behaviors, with different influencing factors for boys and girls and children of native or non-native background. Furthermore, interventions to increase F&V consumption should include strategies aimed at making these behaviors habitual.     

Individual and familial factors associated with fruit and vegetable intake among 11‐ to 14‐year‐old Romanian school children

The healthy nutrition guidelines proposed by international research institutes and the World Health Organization recommend a daily intake of fruit and vegetables of at least 400 g, representing five servings a day (each serving contains around 80 g). Moreover, the recommendations stress the importance of consuming both fruit and vegetables daily, preferably at least two portions of fruit and three portions of vegetables per day. To efficiently develop interventions for promoting fruit and vegetable consumption among children, it is essential to identify and understand the factors that influence these behaviours. The present study aims at identifying the individual and familial factors which influence fruit and vegetable consumption among Romanian children. A cross‐sectional survey by means of anonymous questionnaires was conducted among 361 school children, aged 11–14, from Cluj‐Napoca, Romania (April–May 2011). Multiple linear regression analyses were used to assess the correlates of fruit and vegetable intake. The results show that 44.6% of the children met the recommendations regarding fruit intake, while 9.1% of the children declared eating the daily recommended portions of vegetables. Knowledge regarding the recommended number of daily servings and higher self‐efficacy concerning the intake of fruit and vegetables every day were positively associated with higher consumption of fruit and vegetables. Fruit preference also influenced positively the consumption of fruit. The familial factor associated with vegetable intake was the perceived behaviour of the mother, while fruit intake was higher among children who declared higher fruit availability at home. Hence, it is necessary to develop in Romania nutrition interventions addressing the determinants of fruit and vegetable intake as identified by this study; these interventions should target both children and parents.     

Predictors of changes in adolescents' consumption of fruits, vegetables and energy-dense snacks

Understanding the predictors of developmental changes in adolescent eating behaviours is important for the design of nutrition interventions. The present study examined associations between individual, social and physical environmental factors and changes in adolescent eating behaviours over 2 years. Consumption of fruits, vegetables and energy-dense snacks was assessed using a Web-based survey completed by 1850 adolescents from years 7 and 9 of secondary schools in Victoria, Australia, at baseline and 2 years later. Perceived value of healthy eating, self-efficacy for healthy eating, social modelling and support, and home availability and accessibility of foods were assessed at baseline. Self-efficacy for increasing fruit consumption was positively associated with the change in fruit and vegetable consumption, while self-efficacy for decreasing junk food consumption was inversely associated with the change in energy-dense snack consumption. Home availability of energy-dense foods was inversely associated with the change in fruit consumption and positively associated with the change in energy-dense snack consumption, while home availability of fruits and vegetables was positively associated with the change in vegetable consumption. Perceived value of healthy eating and modelling of healthy eating by mothers were positively associated with the change in fruit consumption. Support of best friends for healthy eating was positively associated with the change in vegetable consumption. Self-efficacy and home availability of foods appear to be consistent predictors of change in fruit, vegetable and energy-dense snack consumption. Future study should assess the effectiveness of methods to increase self-efficacy for healthy eating and to improve home availability of healthy food options in programmes promoting healthy eating among adolescents.     

Correlates of fruit and vegetable intake among adolescents. Findings from Project EAT

BACKGROUND: This study aims to identify correlates of fruits and vegetables from within the domains of personal factors (taste preferences, health/nutrition attitudes, weight/body concerns, and self-efficacy), behavioral factors (meal frequency, fast food intake, and weight control behaviors), and socio-environmental factors (social support for healthy eating, family meal patterns, food security, socio-economic status, and home availability of fruits/vegetables). This study further aims to identify correlates of home availability and taste preferences for fruits/vegetables, and to explore patterns of interaction between availability and taste preferences. METHODS: The population included 3957 adolescents from 31 public middle and high schools in Minnesota. Structural equation modeling was used for model testing. RESULTS: The strongest correlates of fruit/vegetable intake were home availability of fruits/vegetables and taste preferences of fruits/vegetables. The final model explained 13% of the variance in fruit/vegetable intake, 45% of the variance in home availability, and 28% of the variance in taste preferences. Correlates of home availability included social support for healthy eating, family meal patterns, family food security, and socio-economic status. Correlates of taste preferences included health/nutrition attitudes and home availability of fruits/vegetables. A test of interaction effects indicated that when home availability of fruits/vegetables was low, intake patterns did not differ, regardless of taste preferences. In contrast, even when taste preferences for fruits/vegetables were low, if fruits/vegetables were available, intake increased. CONCLUSIONS: Interventions to increase fruit/vegetable intake in adolescents need to target socio-environmental factors such as greater availability of fruits/vegetables.     

Fruit, vegetable, and fat intake among non-Hispanic black and non-Hispanic white adolescents: associations with home availability and food consumption settings

OBJECTIVE: This study sought to explore home food availability and common settings of food consumption as correlates of fruit, vegetable, and fat intake among a sample of non-Hispanic black and non-Hispanic white adolescents. PARTICIPANTS AND DESIGN: Adolescents (n=144 black, 84 white) and their parents completed a cross-sectional survey in an urban adolescent health clinic. The adolescent survey included screening measures for fruit, vegetable, and fat intake and items on frequency of eating meals with family, while watching television, and at three types of restaurants. Parents provided information on home availability of foods. MAIN OUTCOMES: Correlates of fruit, vegetable, and fat consumption. STATISTICAL ANALYSIS: Spearman correlations for associations among variables, t tests for mean comparisons, and multiple stepwise regression conducted separately for black and white adolescents. RESULTS: In multiple regression, home availability was not significantly associated with fruit, vegetable, or fat intake except for fruit intake among white adolescents only. Use of non-fast-food restaurants was the strongest positive predictor of vegetable intake. For both black and white adolescents, fast-food and buffet restaurant use and eating while watching television were the strongest predictors of fat intake. CONCLUSIONS: Compared with restaurant use and eating while watching television, home availability had a relatively small impact on fruit, vegetable, and fat consumption for both black and white adolescents. Intervention programs on adolescent nutrition should target not just availability of healthful foods, but also ease of access, such as the preparation of fruits and vegetables so that they are flavorful and ready to eat.     

Family and child-care provider influences on preschool children's fruit, juice, and vegetable consumption

Children's intakes of fruit, juice, and vegetables (FJV) do not meet the recommended minimum of five daily servings, placing them at increased risk for development of cancer and other diseases. Because children's food preferences and practices are initiated early in life (e.g., 2-5 years of age), early dietary intervention programs may have immediate nutritional benefit, as well as reduce chronic disease risk when learned healthful habits and preferences are carried into adulthood. Families and child-care settings are important social environments within which food-related behaviors among young children are developed. FJV preferences, the primary predictor of FJV consumption in children, are influenced by availability, variety, and repeated exposure. Caregivers (parents and child-care providers) can influence children's eating practices by controlling availability and accessibility of foods, meal structure, food modeling, food socialization practices, and food-related parenting style. Much remains to be learned about how these influences and practices affect the development of FJV preferences and consumption early in life.     

Environmental interventions to promote vegetable and fruit consumption among youth in school settings

Five multicomponent school-based interventions that primarily targeted VF intake were identified. Most of these interventions were framed in terms of Social Cognitive Theory, and included classroom-based educational or behavior change curricula, food service cafeteria intervention, parent outreach/home-based activities, and in some cases, community-based components. The environmental component is typically defined in terms of changes in VF availability as part of the school lunch program. Food service staff are trained to increase the availability of VF in the school cafeteria and to promote VF consumption to students. Typically, this includes increases in the numbers of VF items available to students, promotional signage, and activities such as taste tests.Overall, the multicomponent school interventions have been effective in increasing F intake, with reported increases ranging from 0.2 to 0.6 servings. Impact on V intake has been less effective, with increases ranging from 0 to 0.3 servings. Total VF increases ranged from 0 to 0.6 servings. Only one of the four multicomponent interventions that separately reported changes in F and V intake reported significant increases in V intake. By contrast, three of the four studies reported significant increases in F intake. The results of the environmental-only intervention that examined price reductions on VF found large increases in VF sales. Sales of fresh fruit increased by 400% and sales of baby carrots increased by 200%.The results of multicomponent school-based interventions that targeted VF intake as one of several behaviors have been mixed. The results of school-based environmental interventions that targeted lower fat foods have shown some positive effects on student food choices. These studies primarily have utilized increases in availability, lower prices, and point-of-purchase promotional strategies.

Conclusion

The results of several multicomponent school-based programs to increase VF intake have shown effective results on F intake, with increases ranging from 0.2 to 0.6 servings per day. V intake has proven more difficult to change. Most of these programs included classroom education and behavior change curricula, food service changes, and a parent home activity component. Because no separate evaluation of the environmental intervention components was done, evaluation of the relative impact of environmental vs behavioral or educational interventions on VF behaviors is not possible. Results of school-based environmental interventions targeting lower fat foods suggest that increasing the availability, reducing prices, and providing point of purchase promotions are effective strategies to increase choice of targeted foods Future research is merited to separately evaluate school-based environmental intervention components for their independent, additive, or synergistic effects on VF choices among youth.

Research recommendations

1.Identification of environmental strategies to increase the availability of vegetables and fruits and to support their choice by students.

2.Separate evaluation of the environmental intervention components of multicomponent vegetable and fruit intervention programs.

3.Direct comparison of environmental-only and multicomponent interventions to promote vegetable and fruit intake.

4.Direct comparison of school-based and school-plus-community-based interventions to promote vegetable and fruit intake.

5.Evaluation of school food policies that aim to increase the availability of vegetables and fruits and support their choice by students.

6.Evaluation of the effects on school food service revenues of increases in the availability of vegetables and fruits in the school meal and in a la carte and vending machines.

7.Research on the effects of simultaneous price increases on higher fat foods and price reductions on vegetables and fruits on student food choices and on food service revenues.

8.Research on the effects of simultaneous increases in the availability of vegetables and fruits and decreases in the availability of higher fat foods on student vegetable and fruit intake and on food service revenues.

9.Research on the dissemination of environmental strategies that produced significant and meaningful results in research settings to determine their feasibility, efficacy, and cost-effectiveness in “real world” settings.

     

Longitudinal and cross-sectional influences on youth fruit and vegetable consumption

Both cross-sectional and longitudinal research depict a decline in the fruit and vegetable consumption (FVC) of children and youths with age, but identifying developmental changes and their influences with regard to FVC cannot be fully explained with application of only one of these research designs. Reviewed here are results from longitudinal and cross-sectional research, and a proposal is presented for a lifespan development methodology that uses a sequential design strategy to illuminate the multilevel processes that determine FVC. Conclusions from the review were similar for both cross-sectional and longitudinal research, with fruit and vegetable (FV) preferences and FV accessibility/availability being the most consistent influences on FVC. Furthermore, this review illuminates several methodological issues, offering suggestions to strengthen comparisons between studies. Research designs that incorporate longitudinal, cross-sectional, and time-lag data are warranted.     

The benefits of authoritative feeding style: caregiver feeding styles and children's food consumption patterns

This research tested the associations between caregiver feeding styles and children's food consumption patterns among African-American (AA) and Hispanic (H) caregivers and their preschool children. Participants were 231 caregivers (101 AA; 130 H) with children enrolled in Head Start. Caregivers completed questionnaires on authoritarian and authoritative feeding styles (Caregiver's Feeding Styles Questionnaire; CFSQ) and various aspects of children's food consumption patterns (availability of, feeding attempts for, and child's consumption of dairy, fruit, and vegetables). Simultaneous multiple regression analyses tested the unique contribution of feeding styles in predicting food consumption patterns. Authoritative feeding was positively associated whereas authoritarian feeding was negatively associated with the availability of fruit and vegetables. Authoritative feeding was also positively associated with attempts to get the child to eat dairy, fruit, and vegetables, and reported child consumption of dairy and vegetables. Authoritarian feeding was negatively associated with child's vegetable consumption. All results remained significant after controlling for child's gender and body mass index (BMI), and caregiver's ethnicity, BMI, and level of education. Overall, results provide evidence for the benefits of authoritative feeding and suggest that interventions to increase children's consumption of dairy, fruit, and vegetables should be targeted toward increasing caregivers' authoritative feeding behaviors.     

Trends in adolescent fruit and vegetable consumption, 1999-2004: project EAT

BACKGROUND: Diets abundant in fruits and vegetables are associated with reduced risk for chronic disease, but intakes of adolescents are often inadequate. To design effective interventions it is important to understand how dietary intake changes longitudinally during adolescence and to monitor progress in the population toward fruit and vegetable consumption recommendations. The objective of this study was to examine longitudinal and secular trends in fruit and vegetable intake among two cohorts of Minnesota adolescents over the period 1999-2004. METHODS: Measures of fruit and vegetable intake and demographics were completed by 944 boys and 1161 girls who were Project EAT participants in 1999 and 2004. In 2005, mixed linear regression models were used to estimate (1) longitudinal trends among two cohorts of young people during developmental transitions and (2) age-matched secular trends between the two cohorts of young people at middle adolescence. RESULTS: Longitudinal trends indicated that adolescents decreased their daily intake of fruit and vegetables by an average of 0.7 servings during the transition from early to middle adolescence and by 0.6 servings from middle to late adolescence. Analyses of age-matched secular trends at middle adolescence showed a mean daily decrease of 0.7 servings among girls and 0.4 servings among boys between 1999 and 2004. CONCLUSIONS: The large longitudinal and secular declines in fruit and vegetable intakes of adolescents indicate a strong need for further research to understand why consumption is decreasing among adolescents and to develop more effective interventions for increasing fruit and vegetable consumption during this critical developmental period.     

Availability, accessibility, and preferences for fruit, 100% fruit juice, and vegetables influence children's dietary behavior.

The relationships among home fruit (F), 100% fruitjuice (J), and vegetable (V) availability and accessibility separately, as reported by 225 fourth- through sixth-grade children and their parents (n = 88), separately, and FJV preferences to child-reported FJV consumption were assessed. For girls, child-reported FJV availability and accessibility accounted for 35% of the variability in FJV consumption. Child-reported availability and parent-reported accessibility were significantly correlated with child FJV consumption in a combined model. For children with high FJV preferences, FJV availability was the only significant predictor, whereas both availability and accessibility were significantly related to consumption for children with low FJV preferences. Interventions targeting child dietary behaviors may need to tailor to the home environment, separately by gender. Extra efforts are necessary by parents to enhance accessibility among children who do not like FJV.     

Changing fruit and vegetable consumption among children: the 5-a-Day Power Plus program in St. Paul,Minnesota.

OBJECTIVES: A randomized school based trial sought to increase fruit and vegetable consumption among children using a multicomponent approach. METHODS: The intervention, conducted in 20 elementary schools in St. Paul, targeted a multiethnic group of children who were in the fourth grade in spring 1995 and the fifth grade in fall 1995. The intervention consisted of behavioral curricula in classrooms, parental involvement, school food service changes, and industry support and involvement. Lunchroom observations and 24-hour food recalls measured food consumption. Parent telephone surveys and a health behavior questionnaire measured psychosocial factors. RESULTS: The intervention increased lunchtime fruit consumption and combined fruit and vegetable consumption, lunchtime vegetable consumption among girls, and daily fruit consumption as well as the proportion of total daily calories attributable to fruits and vegetables. CONCLUSIONS: Multicomponent school-based programs can increase fruit and vegetable consumption among children. Greater involvement of parents and more attention to increasing vegetable consumption, especially among boys, remain challenges in future intervention research.     

Changes in accessibility and preferences predict children's future fruit and vegetable intake

Background  

Most children eat fewer fruits and vegetables than recommended. To be able to design effective interventions, understanding the aetiology of the behaviour is important. Accessibility and preferences have shown to be strong correlates of fruit and vegetable intake in several cross-sectional studies. The aim of this study was to identify predictors of future fruit and vegetable intake and to explore longitudinal patterns of interactions between accessibility and preferences.