Parental influences on young girls' fruit and vegetable, micronutrient, and fat intakes.

OBJECTIVE: To evaluate parents' fruit and vegetable intake and their use of pressure to eat in child feeding as predictors of their 5-year-old daughters' fruit and vegetable, micronutrient, and fat intakes. SUBJECTS: Data were obtained from 191 non-Hispanic white families with 5-year-old girls. DESIGN: Parent data included reports of pressure in child feeding and their own fruit and vegetable intake. Girls' intakes of fruits and vegetables, selected micronutrients, and fat were the main outcomes of interest. STATISTICAL ANALYSIS: Structural equation modeling was used to test a model describing relationships among parents' fruit and vegetable intake, parents' use of pressure in child feeding, and daughters' fruit and vegetable, micronutrient, and fat intakes. RESULTS: The model provided a good fit to the data, revealing that girls' fruit and vegetable intake was positively related to their parents' reported fruit and vegetable intake. Parents who consumed fewer fruits and vegetables tended to report greater pressure in child feeding and had daughters who consumed fewer fruits and vegetables. Girls' reported fruit and vegetable intakes were positively related to their micronutrient intakes and negatively associated with fat intake. APPLICATIONS/CONCLUSIONS: This research demonstrates that parents' own fruit and vegetable intake may encourage fruit and vegetable intake in their daughters, leading to higher micronutrient intakes and lower dietary fat intakes. Conversely, pressure to eat may discourage fruit and vegetable intake among young girls.     

水果和蔬菜摄入与老年人认知功能关系

目的 了解不同膳食果蔬摄入水平与老年人认知功能之间的关系。方法 采用随机抽样方法对北京市南苑社区卫生服务中心辖区内的5个居民社区内457名55～75岁老年人志愿者进行一般状况及饮食情况调查,并使用蒙特利尔量表对其认知功能进行评估;对认知功能进行logistic回归分析,对不同果蔬摄入水平与认知功能的关系进行协方差分析。结果 多因素logistic回归分析结果显示,读书看报（OR=0.608）是老年人认知功能的保护因素,而年龄（OR=1.072）是认知功能的危险因素;水果摄入频率不同的分组中,每周摄入7～8次的老年人MoCA总分最高（27.021分）,蔬菜摄入量不同的分组中,每日摄入350～500g的老年人MoCA定向得分最高（5.995分）,蔬菜摄入种类不同的分组中,每周食用8～10种的老年人,MoCA总分（27.077分）和延迟回忆得分（3.677分）最高,每周食用2～4种的老年人,抽象得分最高（1.770分）;水果摄入量和水果摄入种类不同的分组中,MoCA总分及7个认知领域的得分差异均无统计学意义（P>0.05）。结论 为改善老年人的认知功能,可适当增加日常饮食中水果的食用频率、蔬菜的食用量和种类。     

Association between fruit and vegetable intake and risk for glioma: A meta-analysis

ObjectiveEpidemiologic studies evaluating the association between the intake of vegetables and fruit and the risk for glioma have produced inconsistent results. Therefore, the aim of this study was to test the hypothesis that higher vegetable and fruit intake may have a protective effect on risk for glioma.MethodsPertinent studies were identified by a search in PubMed, Web of Knowledge, and Wan Fang Med Online up to January 2014. Random-effect model was used to combine study-specific results. Publication bias was estimated using Begg's funnel plot and Egger's regression asymmetry test.ResultsFifteen studies involving 5562 cases focusing on vegetable intake and 17 studies involving 3994 cases of fruit intake compared with the risk for glioma were included in this meta-analysis. The combined relative risk (RR) of glioma associated with vegetable intake was 0.775 (95% confidence interval [CI], 0.688–0.872) overall, and the association for subgroup analysis by study design, sources of control, ethnicity, and number of cases was consistent with overall data. For fruit intake and glioma risk, significant protective associations were found in an Asian population (RR, 0.573; 95% CI, 0.346–0.947), but not in a white population. No publication bias was found.ConclusionsThis analysis indicated that intake of vegetables might have a protective effect on glioma. The intake of fruit might have a protective effect on glioma in the Asian population; however, the results need to be confirmed.     

Decaying behavioral effects in a randomized, multi-year fruit and vegetable intake intervention

Objective

To examine the effects of a multi-component, theory-based, 2.5-year intervention on children's fruit and vegetable consumption, preferences, knowledge and body mass index.

Methods

Four inner city elementary schools in the Northeastern United States were randomized to an intervention (n = 149) or control group (n = 148) in 2005. Fruit and vegetable consumption during school lunch (measured by plate waste), preferences, and knowledge, as well as body mass index, were assessed five times across 3.5 years (pre-intervention, spring 2006, 2007, 2008 and 2009). Hierarchical linear modeling was used to analyze program outcomes.

Results

At the first post-test assessment, children in the experimental group ate 0.28 more servings/lunch of fruit and vegetable relative to children in the control group and changes in fruit and vegetable consumption were found in each year throughout the program. However, this effect declined steadily across time so that by the delayed one-year follow-up period there was no difference between the groups in fruit and vegetable consumption. There were persistent intervention effects on children's knowledge. There were no effects on fruit and vegetable preferences and body mass index throughout the study.

Conclusion

Although there was initial fruit and vegetable behavior change, annual measurements indicated a gradual decay of behavioral effects. These data have implications for the design of school-based fruit and vegetable interventions.     

Comparison of 4 questionnaires for assessment of fruit and vegetable intake.

OBJECTIVE: This study compared fruit and vegetable assessments derived from 4 self-administered questionnaires. METHODS: Among 102 adolescents, servings of fruits and vegetables assessed by 4 questionnaires were compared with estimates from 24-hour recalls. RESULTS: The prevalence of consuming 5 or more servings of fruits and vegetables a day was underestimated by the questionnaires. Questionnaires asking subjects to recall their diet over the previous year were more effective in ranking subjects (r's > or = .42) than those assessing previous-day diet (r's > or = .30). CONCLUSIONS: Brief assessments of fruit and vegetable intake are more useful for ranking subjects than for estimating prevalence of consumption of 5 or more servings per day.     

Predictors of fruit and vegetable intake in young adulthood

Few young adults meet national recommendations to consume at least 2 c fruit and 2 to 3 c vegetables daily. Effective strategies and messaging are needed to address this disparity, but research examining influences on fruit and vegetable (F/V) intake during young adulthood has been limited and primarily cross-sectional. This study was conducted to identify 5-year and 10-year longitudinal predictors of F/V intake in young adulthood. The sample included 476 male and 654 female participants enrolled in a population-based cohort study (Projects EAT-I, II, and III [Eating and Activity in Teens and Young Adults]). Participants completed surveys and food frequency questionnaires in Minneapolis/St Paul, MN, high school classrooms in 1998-1999 (mean age=15.8 years, adolescence) and follow-up measures in 2003-2004 (mean age=20.4 years, emerging adulthood) and 2008-2009 (mean age=26.2 years, young adulthood). In young adulthood, average daily intake was 0.9 servings of fruit (excluding juice) and 1.8 servings of vegetables (excluding potatoes). Factors examined in adolescence and in emerging adulthood that were predictive of F/V intake in young adulthood included favorable taste preferences, fewer perceived time barriers to healthy eating, higher home availability of F/V, and limited home availability of unhealthy foods. Analyses also identified additional factors that were specifically relevant to fruit (eg, breakfast patterns) or vegetable intake (eg, home food preparation) and of particular relevance during emerging adulthood (eg, significant other's healthy eating attitudes). Findings suggest individual and socioenvironmental factors, particularly food preferences and home food availability, during adolescence and emerging adulthood may influence F/V intake in young adulthood.     

Determinants of fruit and vegetable intake among 11-year-old schoolchildren in a country of traditionally low fruit and vegetable consumption

Background  

Fruit and vegetable consumption is traditionally low in Iceland. The results of the Pro Children cross-Europe survey showed that the consumption was lowest among children in Iceland. The aim of this study was to identify determinants of fruit and vegetable intake among 11-year-old schoolchildren in Iceland.     

Parental influences on young girls’ fruit and vegetable, micronutrient, and fat intakes

Objective To evaluate parents’ fruit and vegetable intake and their use of pressure to eat in child feeding as predictors of their 5-year-old daughters’ fruit and vegetable, micronutrient, and fat intakes.Subjects Data were obtained from 191 non-Hispanic white families with 5-year-old girls.Design Parent data included reports of pressure in child feeding and their own fruit and vegetable intake. Girls’ intakes of fruits and vegetables, selected micronutrients, and fat were the main outcomes of interest.Statistical analysis Structural equation modeling was used to test a model describing relationships among parents’ fruit and vegetable intake, parents’ use of pressure in child feeding, and daughters’ fruit and vegetable, micronutrient, and fat intakes.Results The model provided a good fit to the data, revealing that girls’ fruit and vegetable intake was positively related to their parents’ reported fruit and vegetable intake. Parents who consumed fewer fruits and vegetables tended to report greater pressure in child feeding and had daughters who consumed fewer fruits and vegetables. Girls’ reported fruit and vegetable intakes were positively related to their micronutrient intakes and negatively associated with fat intake.Applications/conclusions This research demonstrates that parents’ own fruit and vegetable intake may encourage fruit and vegetable intake in their daughters, leading to higher micronutrient intakes and lower dietary fat intakes. Conversely, pressure to eat may discourage fruit and vegetable intake among young girls. J Am Diet Assoc. 2002;102:58–64.     

Relationship between total fruit and vegetable intake and self-reported knee pain in older adults

Objectives

Knee pain is one of the most common symptoms of knee osteoarthritis (OA) that affects the quality of life in the older adults, and identifying the contributing factors of knee pain is important. We hypothesized that higher fruit and vegetable consumption might be associated with the severity of knee pain lower prevalence of severe knee pain by affecting pain perception in the knee joint. Therefore, we investigated the relationship between self-reported knee pain and the consumption of fruits vegetables, carotenoids and vitamin C and self-reported knee pain.

Design

Nationally representative cross sectional study.

Setting

2010-2011 rounds of the Korean National Health and Nutrition Examination Survey.

Participants

A total of 6588 subjects aged ≥50 years were participated.

Methods

Severity of knee pain was estimated using a 10-point numeric rating scale (NRS). Daily intake of fruits, vegetables, and vitamins were estimated using data from 24-hour recalls and food frequency questionnaires.

Results

The NRS scores of knee pain decreased significantly with increasing fruit and vegetable intake quartiles. A multivariate logistic regression analysis showed that the fourth quartile of vegetable and fruit consumption was associated with decreased prevalence of severe knee pain (OR 0.59, 95% CI 0.48-0.73) compared with first quartile of vegetable and fruit consumption; however, carotenoids and vitamin C consumption was not associated with the severity of knee pain.

Conclusions

In conclusion, severe knee pain was independently associated with fruit and vegetable consumption. Our findings suggest that intake of whole fruits and vegetables may help improve knee pain in older adults.

     

Associations between dietary added sugar intake and micronutrient intake: a systematic review

There is increasing concern that high intakes of added sugars might compromise intakes of micronutrients. The objectives of this systematic review were (1) to determine whether dietary added sugar intake was associated with micronutrient intakes, and if so, whether there was evidence of micronutrient dilution as a result of higher dietary added sugar intake and (2) if micronutrient dilution was present, to determine whether there was sufficiently robust evidence to support a threshold effect above which there was a significant decline in micronutrient intake or status relative to the recommended intakes. A systematic computerised literature search was undertaken, limited to studies written in English published from 1980 onwards and further studies identified through hand searching papers. Fifteen studies that assessed associations between intakes of added sugars or non-milk extrinsic sugars and micronutrients were included. Overall, there are insufficient data and inconsistency between studies in relationships between added sugars and micronutrient intakes, with no clear evidence of micronutrient dilution or a threshold for a quantitative amount of added sugar intake for any of the micronutrients investigated. The current evidence base is considerably constrained by methodological issues. Further research is required to determine which food products high in added sugars might adversely affect micronutrient intakes by displacing other food items from the diet. Analyses should take into account the magnitude of any observed associations to determine their true biological significance.     

蔬菜水果食用频率与慢性阻塞性肺疾病的相关性

目的 探讨中国城乡居民蔬菜和水果食用频率与慢性阻塞性肺疾病(COPD)的关系.方法 2007年在全国疾病监测系统的161个监测点中,采用多阶段按比例分层随机抽样的方法,抽取了48 974名15～69岁居民作为调查对象,采用标准化问卷调查收集相关信息,比较不同蔬菜食用频率(<4、4～5、6～7 d/周)和水果食用频率(<2、2～4、5～7 d/周)的自报COPD患病风险.结果 蔬菜食用频率为6～7和<4 d/周者分别占89.9%(44 019/48 974)和4.6%(2262/48 974),水果食用频率为5～7和<2 d/周者分别占30.8%(15 072/48 974)和31.5%(15 432/48 974).自报COPD患病率为2.9%(1412/48 974).调整了年龄、性别、城乡、被动吸烟和COPD家族史后,与水果食用频率较低(<2 d/周)的人群相比,水果食用频率较高的人群(5～7 d/周)患COPD的风险降低(在不吸烟者中,OR=0.80,95%CI:0.66～0.98;在吸烟者中,OR=0.80,95%CI:0.64～0.99).在不吸烟者中,高蔬菜食用频率(6～7 d/周)者患COPD风险较低(OR=0.65,95%CI:0.48～0.89).结论 食用蔬菜和水果可能对COPD有保护性作用.

Abstract：

Objective To explore the association between frequency of fruit and vegetable intake and chronic obstructive pulmonary disease(COPD).Methods In 2007,48 974 Chinese residents aged 15-69 years were selected as study participants by multistage stratified proportionate to size random sampling from the 161 sites of Disease Surveillance Points System.Standardized questionnaires were used to collect relevant information to compare the risk for self-reported physician diagnosed COPD between different frequency groups for fruit(<2,2-4,5-7 d/week) and vegetable(<4,4-5,6-7 d/week) intake.Results The proportion of vegetable intake was 89.9%(44 019/48 974) and 4.6%(2262/48 974) for individuals with frequency of 6-7 and <4 d/week respectively.The proportion of fruit intake was 30.8%(15 072/48 974) and 31.5%(15 432/48 974) for individuals with frequency of 5-7 and <2 d/week respectively.The prevalence of self-reported COPD was 2.9%(1412/48 974).After adjusting for age,sex,urban/rural areas,passive smoking exposure and family history,the risk of COPD decreased among those with high frequency(5-7 d/week) of fruit intake( OR=0.80,95%CI:0.66-0.98 for never smokers; OR=0.80,95%CI:0.64-0.99 for ever smokers),compared to subjects with low frequency of fruit intake(<2 d/week).Among never smokers, those with high frequency of vegetable intake(6-7 d/w) had a low risk of developing COPD (OR=0.65,95%CI:0.48-0.89).Conclusion There were beneficial effects of fruit and vegetable intake on COPD.     

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.     

Sex differences in fruit and vegetable intake in older adults

Fruits and vegetables are important components of a healthy diet, but intakes in most Western countries are well below the recommended five servings a day. Men in particular are eating too little. The aim of this study is to understand the processes underlying this gender difference. Fruit and vegetable intake, nutrition knowledge, taste preferences, attitudes to fruit and vegetable intake, and dieting status, were assessed in a simple questionnaire in 1,024 older adults attending population-based cancer screening across the UK. The results confirmed the pattern of men consuming fewer servings of fruit and vegetables daily than women (2.52 vs 3.47; p<0.01). Fewer men than women knew the current recommendations for fruit and vegetable intake, and fewer were aware of the links between fruit and vegetable consumption and disease prevention. Women rated their liking for vegetables but not fruit higher, and there were no differences in attitudes. Men were less likely to be dieting to lose weight. Multivariate analysis showed that the gender difference in intake was substantially attenuated by controlling for nutrition knowledge. There were no significant attenuating effects of preferences, attitudes or dieting status. These results indicate that men's poorer nutrition knowledge explains a significant part of their lower intake of fruit and vegetables.     

Few favorable associations between fruit and vegetable intake and biomarkers for chronic disease risk in American adults

Using 24-hour dietary recall data from the National Health and Nutrition Examination Survey 1999 to 2006, the possible link between fruit and vegetable intake and chronic disease risk was assessed. C-reactive protein (CRP), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), fasting plasma glucose (FPG), total cholesterol, and glycosylated hemoglobin were selected as biomarkers for chronic disease risk. It is hypothesized that individuals who consume more fruits and vegetables will have reduced chronic disease risk because of the healthful benefits of these foods. The objective of this study was to examine the relationship between fruit and vegetable consumption on selected biomarkers for chronic disease risk. Although some associations were significant for FPG, HDL-C, and low-density lipoprotein cholesterol in some of the models, no trend was present. After adjusting for demographic factors, socioeconomic factors, lifestyle factors, body mass index, total energy intake, and the presence of at least 1 of our 5 predetermined comorbidities, no associations of reduced or increased risk were observed in any quartiles of combined fruit and vegetable intake. Fruit and vegetable intakes were weakly associated with an increased HDL-C level and decreased FPG, glycosylated hemoglobin, and C-reactive protein levels in some of the models; however, no association was observed in the final model. Because selected biomarkers of future disease risk remained in reference ranges at both high and low intake and no significance was observed in the final model, no protective association was observed between fruit and vegetable intake and biomarkers for chronic disease risk. However, fruit and vegetable consumption is recommended as part of an overall healthy diet and to displace other energy-dense foods for weight maintenance, which can lead to a decrease in future disease risk.     

Reproducibility, validity, and responsiveness to change of a short questionnaire for measuring fruit and vegetable intake

The reproducibility, relative validity, and responsiveness to change of an eight-item food frequency questionnaire designed to measure fruit and vegetable consumption was assessed among 157 women (mean age = 41 years) in the Netherlands from spring 2001 to spring 2002. Plasma concentrations of vitamin C and total and specific carotenoids served as biomarkers against which validity was assessed. The questionnaire was completed and biomarker concentrations were determined three times: immediately preceding and following a controlled intervention of 1 month aimed at increasing fruit and vegetable consumption and 1 year after the start of the intervention. The 1-month and 1-year reproducibility of total fruit and vegetable consumption assessed in the control group was 0.80 and 0.79 (Spearman's r ). Correlations between consumption and plasma carotenoids and vitamin C at baseline were 0.39 and 0.37, respectively, for fruits and 0.24 and 0.26, respectively, for vegetables. Correlations between changes in consumption and plasma carotenoids and vitamin C were 0.32 and 0.33, respectively, for fruits and 0.28 and 0.30, respectively, for vegetables. On the basis of similar correlations reported in the literature, the authors conclude that the questionnaire appears to be suitable for ranking individuals according to their consumption of fruits and vegetables and according to changes in their consumption. However, the validity of the questionnaire remains to be established in males, other age groups, and populations of lower educational levels.     

Baseline fruit and vegetable intake among adults in seven 5 a day study centers located in diverse geographic areas.

OBJECTIVE: To examine baseline rates of fruit and vegetable consumption among adults in the 5 A Day research trials in order to identify any regional and sociodemographic differences associated with daily servings. DESIGN: The main outcome measure was the frequency of fruits and vegetables consumed within 1 month of the baseline survey as assessed by a 7-item food frequency questionnaire (FFQ). SUBJECTS/SETTING: Participants (N = 15,060) were from 7 study centers. Study centers included schools (N = 48), worksites (N = 60), churches (N = 50), or the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics (N = 15) in interventions to increase fruit and vegetable consumption. STATISTICAL ANALYSES: Means and standard errors, adjusting for clusters, were calculated. A mixed linear model analyzed relationships between fruit and vegetable consumption and regional center, gender, age, race, education, income, marital status, food-shopping responsibility, and whether one lives with children. RESULTS: Results indicate an overall mean intake of 3.6 daily servings of fruits and vegetables. Significant differences in mean daily servings were found among the regional study centers (low of 3.0 to high of 4.1). There were significant differences in mean daily consumption by age (< 30 years = 3.7 servings per day; 30 to 49 years = 3.4; > or = 50 years = 3.7), education (> high school = 3.4 servings per day; high school graduate = 3.4; some college = 3.5; college graduate = 3.9), race (black = 3.7 servings per day; Hispanic = 3.0; white = 3.6; other = 3.7), marital status (married = 3.6 servings per day; single = 3.5), and food-shopping responsibilities (little = 3.2 servings per day; about half = 3.6; most = 3.8). Only 17% of respondents ate 5 or more servings of fruits and vegetables per day. CONCLUSIONS: The 7 regions showed significant variability in daily fruit and vegetable consumption, suggesting that a single national message to increase fruit and vegetable consumption may not reach the population segments most in need of changing. It is advisable to spend more time understanding the food consumption habits of the population under investigation to develop messages to foster behavior change.     

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.