Validation of a fruit,juice, and vegetable availability questionnaire

OBJECTIVE: To assess the validity of a self-reported fruit, juice, and vegetable home availability measure. DESIGN: Cross-sectional. SETTING: In-home interviews. PARTICIPANTS: Forty-eight parents of fourth to sixth grade children. MAIN OUTCOME MEASURES: Scales assessing self-reported home availability of fruit, 100% fruit juice, and vegetables over the past 7 days compared with an observed home inventory conducted on the interview day. ANALYSES: Cohen's kappa of agreement, specificity and sensitivity, and correlations, with significance level <.05. RESULTS: There was substantial agreement between self-reported and observed home inventories of many fruit, 100% fruit juice, and vegetables among participating families in this study. CONCLUSIONS AND IMPLICATIONS: Self-reported shelf inventories can be an effective tool for use in assessing the availability of fruit, juice, and vegetables in the home.     

Fruit and vegetable consumption and skeletal health: is there a positive link?

Summary The health‐related benefits of a high consumption of ‘fruit and vegetables’ and the influence of this food group on a variety of diseases has been gaining increasing prominence in the literature over a number of years. Of considerable interest to the osteoporosis field is the role that bone plays in acid–base balance. Surprisingly, consideration of the skeleton as a source of ‘buffer’, contributing to both the preservation of the body's pH and the defence of the system against acid–base disorders has been in existence for many years, yet it is only more recently that the possibility of a positive link between a high consumption of fruit and vegetables and indices of bone health has been more fully discussed. The following review reports on a plenary paper presented at the Fourth International Symposium on Nutritional Aspects of Osteoporosis (May 2000, Switzerland), which looks specifically at the importance of these alkaline‐forming foods on skeletal health.     

Understanding barriers and facilitators of fruit and vegetable consumption among a diverse multi-ethnic population in the USA

A diet high in fruits and vegetables (F&V) has been associated with a decreased risk of certain cancers, reduced morbidity and mortality from heart disease, and enhanced weight management. Yet to date, most of the US population does not consume the recommended amount of F&V despite numerous interventions and government guidelines to promote consumption. Research has found various impediments to F&V consumption, such as high costs, an obesogenic environment and low socio-economic status. However, studies have not sufficiently focused on barriers and enablers to F&V intake among adult multi-ethnic populations. The present qualitative study examines 147 focus group participants' perceptions of impediments and enablers to F&V consumption. Twelve focus groups were conducted among African American, Hispanic and Caucasian men and women in North Carolina and Connecticut. Focus groups were audiotaped, transcribed verbatim and entered into QSR NVivo Software. Text data were systematically analyzed by investigators to identify recurrent themes both within and across groups and states. Focus group results indicate that most participants were aware of the health benefits associated with a diet rich in F&V. Yet many admitted not adhering to the Health and Human Service's recommendations. Individual impediments consisted of the high costs of F&V and a perceived lack of time. Early home food environment was perceived as affecting F&V consumption later in life. Other barriers reported were ethnic-specific. The African American participants reported limited access to fresh produce. This finding is consistent with numerous studies and must be addressed through health promotion intervention. Both the church and primary care clinics were described by African Americans as appropriate settings for health behavior interventions; these findings should be considered. Hispanic participants, mostly immigrants, cited inhibiting factors encountered in their adopted US environment. There is a need to improve the availability and access to fresh F&V commonly available in the home countries of Hispanic immigrants.     

Factors associated with fruit and vegetable consumption among adults

Background: The higher consumption of fruit and vegetables is considered to be an indicator of healthy eating and the protective effects of fruit and vegetable (FV) consumption for noncommunicable diseases have been investigated extensively. The present study aimed to investigate the association between fruit and vegetable intake (FVI), health behaviours and socio‐demographic factors among adult Canadians. Methods: This analysis was based on the information from the Canadian Community Health Survey, Cycle 3.1. Daily intake of fruit and vegetables from a total number of 15 512 apparently healthy individuals, aged 18–64 years, were assessed using a structured questionnaire, which included 20 questions on the frequency of consumption of different types of fruit and vegetables. Multiple logistic regression models were used to determine the association between FVI and some socio‐economic factors and lifestyle behaviour among adult Canadians. Results: In total 77% of Canadian adults consumed fruit and vegetables less than five times per day. Females were more likely to consume more fruit [odds ratio (OR) 2.05; 95% confidence interval (CI) 1.75–2.4], vegetables (OR 1.95; 95% CI 1.65–2.29) and FV (OR 2.52; 95% CI 2.20–2.90) than males. Single/never married individuals, individuals with higher levels of education, never smokers, former drinkers and older people reported more consumption of fruit and vegetables than others. Conclusions: The results obtained in the present study indicate an association between FVI and some socio‐economic and healthy lifestyle behaviours, and that a substantial gap exists between the recommended level and the actual intake of the FV among the Canadian population. Because a higher intake of FV improves public health, it is imperative to tailor nutrition education at the individual and community levels in Canadian populations.     

Increasing daily fruit and vegetable consumption: what changes do cardiac patients make?

BACKGROUND: Interventions targeting fruit and vegetable consumption report significant increases in consumption but do not detail how increases are achieved. This prospective study explored (i) the changes in daily fruit and daily vegetable consumption of cardiac patients participating in an intervention study and (ii) how participants made these changes. METHODS: A total of 120 cardiac patients were asked to increase their daily fruit and vegetable consumption by two portions and to maintain this over 3 months. They were telephoned at 7-, 28- and 90-day follow-up to record daily consumption using a dietary questionnaire; 94 participants completed all parts of the study. RESULTS: Mean reported daily fruit and daily vegetable consumption increased by 1.07 (SD = 1.26) and 0.34 (SD = 0.96) portions, respectively, over 3 months. These increases were statistically significant (P < 0.001) and greatest for participants who reported eating low levels of fruit and vegetables at recruitment. Eating fresh fruit as a snack and at mealtimes were preferred choices for participants. CONCLUSIONS: Providing information and telephone follow-up could be used by busy healthcare professionals instead of face-to-face contact. Interventions to increase total fruit and vegetable consumption could usefully focus on eating fruit. Interventions to increase vegetable consumption need further investigation.     

Serum salicylic acid and fruit and vegetable consumption in obese and normal-weight children: a pilot-study

Salicylic acid (SA), a phenolic compound produced by plants, may play a beneficial role on health. This pilot study evaluated whether there might be an association between serum SA and fruit and vegetable (FV) consumption in obese and normal-weight children. Thirty-four obese children (17 boys and 17 girls) and 34 normal-weight children were recruited. Dietary intake was evaluated by the 7-day dietary record. Serum SA was measured using gas chromatography-mass spectrometry method. FV intake in obese and normal-weight children was not different between groups (175.00 (97.66) g versus 192.29 (90.54) g, p?=?.455). Obese children had lower serum SA than normal-weight children [mean difference, ?0.025; 95% CI (?0.044; ?0.006) μmol/L]. Serum SA was not associated with daily intake of FV in obese (p?=?.111) and normal-weight (p?=?.092) children. Further studies are needed to evaluate the role of FV on serum SA, taking into account also the quantity and the type.     

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.     

Psychosocial correlates of fruit and vegetable consumption among African American men

OBJECTIVE: To determine the best predictors of fruit and vegetable consumption among African American men age 35 years and older. DESIGN: Data (n = 291) from a 2001 nationally representative mail survey commissioned by the American Cancer Society. PARTICIPANTS: 291 African American men age 35 years and older. MAIN OUTCOME MEASURES: Dependent variables: (1) total fruits and vegetables without fried potatoes, (2) total fruit with juice, and (3) total vegetables without fried potatoes. Independent variables included 3 blocks of predictors: (1) demographics, (2) a set of psychosocial scales, and (3) intent to change variables based on a theoretical algorithm. ANALYSIS: Linear regression models; analysis of variance for the intent to change group. Alpha = .05. RESULTS: Regression model for total fruits and vegetables, significant psychosocial predictors: social norms, benefits, tangible rewards, and barriers-other. Total fruit with juice: social norms, benefits, tangible rewards. Total vegetables, no fried potatoes: tangible rewards, barriers-other interests. CONCLUSIONS AND IMPLICATIONS: For African American men, fruit consumption appears to be motivated by perceived benefits and standards set by important people in their lives; vegetable consumption is a function of extrinsic rewards and preferences for high-calorie, fatty foods. The results suggest that communications to increase fruit and vegetable consumption should be crafted to reflect differences in sources of motivation for eating fruits versus eating vegetables.     

Ecological and socioeconomic correlates of fruit, juice, and vegetable consumption among African-American boys

BACKGROUND: Investigators have reported that the availability of foods in local grocery stores correlated with consumption when using large geopolitical units of analysis, e.g., zip codes. Associations across smaller geopolitical units, e.g., census tracts, have not been tested, nor has this work focused on restaurant availability, child consumption, or specific ethnic groups. METHODS: This study examined whether median family income and fruit, juice, and vegetable (FJV) availability in grocery stores, restaurants, and homes in 11 census tracts correlated with FJV consumption among 11- to 14-year-old African-American Boy Scouts. FJV consumption was measured in 90 scouts using two 24-h food recalls. Instruments were developed to measure the availability of FJV at area grocery stores, restaurants, and homes where troop members resided. RESULTS: Median household income (from 1990 census) was significantly correlated with restaurant fruit availability. Significant correlations were found between restaurant juice and vegetable availability and Boy Scout reported consumption of juice and vegetables. CONCLUSION: Census tract may be a useful unit when studying restaurant, but not grocery store, FJV availability. Within a census tract, restaurant FJV availability may be a significant target for community intervention and process evaluation.     

Fruit and vegetable intake: Few adolescent girls meet national guidelines

OBJECTIVE: To examine longitudinal changes in daily fruit and vegetable consumption among black and white adolescent girls and calculate the percent of girls who met the Healthy People 2010 recommendations. METHODS: Girls (1186 black and 1126 white) who participated in the National Heart, Lung, and Blood Institute Growth Health Study (NGHS) were included if they had completed a 3-day food diary for at least one of six annual assessments visits, beginning at ages 11 or 12. Mixed models estimated the association of visit and race with (a) average daily consumption of fruits and vegetables and (b) the probability of meeting intake recommendations on one or more out of 3 days. RESULTS: For girls of both races, fruit and vegetable consumption increased with age; white girls showed a greater increase in fruit and nutrient-rich vegetable intake than black girls. Across visits, girls consumed considerably fewer than the recommended daily servings of fruits (1.0-1.5), vegetables (1.7-2.5), or nutrient-rich vegetables (0.25). Most girls (95%) failed to meet Healthy People 2010 recommendations. CONCLUSIONS: Public health efforts are needed to meet Healthy People 2010 objectives.     

What epidemiologic studies tell us about the relationship between fruit and vegetable consumption and body weight

Clinical evidence shows that combining advice to increase fruit and vegetable consumption with caloric restriction is an effective strategy for weight management. The purpose of this review is to evaluate epidemiologic evidence to determine whether it supports an association between fruit and/or vegetable consumption and body weight. Few studies have been designed to specifically address this issue, and those that are available vary in methodology and offer inconsistent results. We make recommendations on how to strengthen future studies so that the influence of fruit and vegetable consumption on body weight in free-living individuals is better understood.     

Patterns of fruit, vegetable, and milk consumption among smoking and nonsmoking female teens

BACKGROUND: The increase in teenage smoking, and the fact that concern about body weight is given as a reason for smoking initiation by girls, suggest that food intake may be compromised in female teens who smoke. Daily consumption of a variety of foods is important due to the health-protective constituents they contain. Few studies have documented how smoking and the consumption of fruits, vegetables, and milk may be associated in female teens. METHODS: This study examined the relationship of smoking and the consumption of fruit, fruit juice, vegetables, and milk in ninth- to twelfth-grade Caucasian (n=2797), African-American (n=2196), and Hispanic (n=2052) female teens. Data from the Youth Behavior Risk Survey (1999) were analyzed with SUDAAN software, using logistic regression models. RESULTS: Smoking was significantly associated with decreased odds of consuming milk at 0.74 (95% confidence interval [CI], 0.55-0.98); fruit, 0.70 (95% CI, 0.54-0.92); fruit juice, 0.74 (95% CI, 0.56-0.98); and vegetables, 0.75 (95% CI, 0.63-0.89) among Caucasian female teens, and with decreased odds of consuming fruit juice among Hispanic female teens at 0.59 (95% CI, 0.40-0.89). For each significant food variable, a dose-response relationship was detected with significantly more females consuming each food at lower smoking levels and significantly fewer doing so at the highest level (p<0.05). By contrast, African-American female teen smokers tended to consume higher levels of the specified food/beverages than nonsmokers, but this relationship was not statistically significant. IMPLICATIONS: This study establishes a smoking/food intake interaction for the specific foods tested, in an adolescent female population. Compromising the intake of healthy foods and their protective nutrients leaves young women more vulnerable to the serious health consequences of smoking. These results underscore the need for young women to be educated on the importance of eating maximum servings of fruits and vegetables and dairy products, such as milk, particularly if they smoke or are at risk for smoking initiation. The study also underscores the need to culturally tailor programs according to differences in smoking initiation and eating/dieting behaviors.     

Promoting Fruit and Vegetable Consumption for Childhood Obesity Prevention

Currently, food marketing for unhealthy foods is omnipresent. Foods high in fat, salt, and sugar (HFSS) are advertised intensively on several media platforms, including digital platforms that are increasingly used by children, such as social media, and can be bought almost everywhere. This could contribute to the obesity epidemic that we are facing. As the majority of children and adolescents do not eat the recommended amount of fruits and vegetables (F&V), which leads to chronic diseases, we need to change the obesogenic environment to a healthogenic environment. Reducing the marketing of energy-dense snacks to children and increasing the promotion of healthier foods, such as fruits and vegetables, may be an effective and necessary instrument to improve the dietary intake of children and reduce the risk of their experiencing some chronic diseases later in life. With this focused narrative review, we provide an overview of how children and adolescents react to food promotions and how food promotional efforts might be a useful tool to increase the attractiveness of fruit and vegetables. This review therefore contributes to the question of how changing the advertising and media environment of children and adolescents could help create a world where the healthy choice is the easier choice, which would reduce childhood obesity and improve children’s health, as well as to make the food system more sustainable.     

Fruit and vegetable consumption among Turkish university students

A questionnaire was developed to determine the behaviors associated with eating fruit and vegetables and to assess perceived benefits and barriers to increasing fruit and vegetable consumption. A total of 713 non-food/nutrition major university students were randomly selected from seven universities in Turkey. Self-reported mean intake was found to be 3.67+/-1.81 servings of fruit and vegetables per day. Positive correlations existed between daily fruit and vegetable portions. Male students were significantly higher than female students in body mass index measurements (BMI 22.71 vs. 20.1, p < or = .05). Among male students only BMI was positively associated with age. Compared to male students, female students were more likely to eat fruit and vegetables. Male students were less likely to eat fruit instead of dessert. Vegetables were more preferred by female students at lunch and dinner. Exploratory principal-components analyses showed that a two-component solution best represented the data. The first component represented the benefits of eating more fruit. The second component described barriers to eating more fruit. Both components have an internal consistency of 0.73 and 0.56 respectively, with benefits accounting for 17% and barriers 12% of variance These scales may be used to increase the benefits to get students to think about change, and decreasing the barriers to allow the behavior to change in fruit and vegetable consumption should follow this. Since Turkish students do not eat enough fruit and vegetables, nutrition education efforts must be targeted at students (i.e. acceptability of these foods in different meal and snacks is maintained, promoted, and encouraged). Barriers may be reduced, thereby allowing students to take action and maintain the behavior change.     

Parent and child reports of fruit and vegetable intakes and related family environmental factors show low levels of agreement

OBJECTIVE: The purpose of the present study was to determine the level of agreement between child and parent reports of 9- to 10-year-old children's consumption of fruit and vegetables and potential family-environmental determinants. METHODS: Schoolchildren and their parents completed parallel questionnaires at baseline and at follow-up (1 year later) about usual fruit and vegetable consumption of the child, potential determinants and general demographics. Matched child-parent couples were included in the analyses (baseline = 380; follow-up = 307). To assess the level of agreement between child and parent reports at both points in time, dependent-sample t-test, correlation coefficients, weighted Cohen's kappa coefficients and Bland-Altman plots including limits of agreement were used. RESULTS: Both at baseline and at follow-up, the mean intake of fruit and vegetable reported by the children were significantly higher than reported by their parents, but differences were smaller at follow-up. Correlation coefficients between child and parent reports (0.28-0.43) and weighted Cohen's kappa coefficients (0.25-0.28) were weak to moderate. Limits of agreement were wide. CONCLUSION: The agreement between parent and child reports is weak to moderate and may depend on the age of the child. Fourth graders may overestimate their own intake of fruit and vegetables.