Association between fruit and vegetable consumption in mothers and children in low-income, urban neighborhoods.

To understand factors influencing fruit and vegetable (F&V) consumption in children, the authors studied the association between F&V consumption in mothers and children in a sample of 1,106 boys and girls in Grades 4-6 in 24 elementary schools in low-income, multiethnic neighborhoods in Montreal, Canada. Approximately 10% of girls and 19% of boys reported not having eaten any vegetables in the week prior to questionnaire administration; 53% of girls and 63% of boys did not consume whole fruits daily. Each unit increase in F&V consumption in mothers was associated with a 10% to 20% increase in F&V consumption in children. Interventions to improve F&V consumption should aim to improve awareness among parents of the importance of fruits and vegetables and of the impact of their own behavior on their children's F&V consumption.     

The relationship of weight-related perceptions, goals, and behaviors with fruit and vegetable consumption in young adolescents

BACKGROUND: The effect of dieting and weight-control perceptions, goals, and behaviors on food intake, including fruit and vegetable (F&V) consumption, is not completely understood. We examined these associations in 1,755 young adolescents. METHODS: Data from the Teens Eating for Energy and Nutrition at School (TEENS) study were analyzed separately by gender using mixed linear modeling. Surveys completed at the beginning and end of 7th grade asked students to self-report fruit and vegetable consumption, weight-related perceptions, goals, and behaviors, and demographic variables. RESULTS: Underweight boys reported 0.8 fewer F&V servings per day than boys who reported their weight to be 'about right' (P = 0.002), while overweight girls reported 0.7 fewer F&V than girls who reported their weight to be 'about right' (P = 0.005). Boys with weight-related goals consumed significantly more F&V than did boys not wanting to do anything about their weight (P < 0.05). Girls engaging in weight-related behaviors reported 0.7 more F&V than girls who did not engage in weight-related behaviors (P = 0.006). CONCLUSIONS: Because F&V intake is low among all adolescents, population interventions should take place to increase F&V intake. These data support the inclusion of gender-specific intervention components related to weight-related perceptions, goals, and behaviors.     

Psychosocial predictors of fruit and vegetable consumption among elementary school children

A self-efficacy questionnaire for fruit and vegetable (F&V)consumption among fourth and fifth grade students was developed,pilot tested with 140 students from one school and field testedwith 252 students from two schools. The questionnaire included34 items generated by inventorying behaviors targeted for changein the F&V school curriculum. The four subscales derivedfrom principal components analysis were labeled ‘after-schoolF&V snacks’; ‘breakfast and lunch F&V, andpaying for F&V'; ‘independent shopping for F&V';and ‘assisted shopping for F&V'; they accounted for43.8% of the total variance. Subscale test-re-test reliabilitiesand internal consistencies were acceptable. Criterion validitiesagainst F&V consumption from food records were low. Relationshipswere stronger with preferences and outcome expectations. Resultsfrom stepwise regression analyses indicated that preferenceswere the only significant predictors of fruit and total F&Vconsumption, as well as the main predictor of vegetable consumption;however, the models accounted for less than 13% of the variance.Nutrition education programs which target preferences may bemore effective in increasing F&V consumption among elementaryschool children than programs which target self-efficacy andoutcome expectations. However, since preferences accounted foronly small proportions of the variances, further research shouldconsider other issues such as availability.     

Physical activity correlates for Native Hawaiians and Pacific Islanders in the mainland United States

Native Hawaiian and Pacific Islander (NHPI) people are an understudied population that demonstrates high obesity rates and low physical activity levels. This study's aim was to examine possible correlates of physical activity in NHPI adults. Height and weight were recorded in N=100 NHPIs (46.9±5.4 years; 56% males) following completion of an anonymous questionnaire addressing health behaviors (physical activity, smoking, diet), psychosocial characteristics (social support, barriers, stage of change), neighborhood environment attributes, and knowledge of physical activity recommendations. This study sample demonstrated low physical activity (20% met recommendations) and fruit and vegetable (F&V) consumption (1% met recommendations), and a high prevalence of overweight or obesity (94%). After adjusting for gender and education, F&V intake was the only significant correlate of physical activity (p<.001). Common correlates of physical activity did not generalize to NHPIs. Further investigations of culturally-specific correlates are needed so that physical activity interventions can be culturally tailored for NHPIs.     

The effects of a fruit and vegetable promotion intervention on unhealthy snacks during mid‐morning school breaks: results of the Dutch Schoolgruiten Project

Background: Ample fruit and vegetable (F&V) intake has been associated with a decreased risk of chronic disease. The health‐enhancing effects of increased F&V consumption, however, would be even more apparent if the increased F&V consumption additionally led to a lower intake of unhealthy, high calorie snacks. Therefore, the present study aimed to investigate whether a primary school‐based intervention (the Dutch Schoolgruiten Project) that promoted F&V intake could additionally reduce the intake of unhealthy, high calorie snacks during school breaks. Methods: The study applied a longitudinal design with baseline and two follow‐up measurements. Children were aged 9–10 years old at baseline; 705 children were included. The main strategy was a F&V scheme that improved the availability, accessibility and exposure to F&V at school by providing one serving of fruit or vegetables twice a week at no cost. The amounts of F&V and unhealthy snacks for consumption at school were measured using a single‐item question included in a questionnaire. Multilevel autoregressive logistic regression models with a three‐level structure (school, child and time) were used to assess the effect of the intervention on both F&V and unhealthy snack consumption. Results: The children of the intervention group brought F&V from home to school at follow‐up significantly more often than the children of the control schools [odds ratio (OR) = 1.41, 95% confidence interval (CI) = 1.04; 1.90] and brought fewer unhealthy snacks (OR = 0.56, 95% CI = 0.34; 0.92). Conclusion: The present study provides some evidence that the Schoolgruiten intervention effect on F&V intake also reduced unhealthy snacking during school breaks.     

Increasing fruit and vegetable intake among children: comparing long-term effects of a free distribution and a multicomponent program

The aim of this study was to evaluate and compare the effectiveness of two primary school-based interventions on children's fruit and vegetable (F&V) consumption on the long term (2 years after the start of the interventions). Six primary schools were recruited and randomly assigned to (i) a daily free distribution program for the whole school or (ii) a multicomponent program consisting of a classroom curriculum and parental involvement (without free F&V), and six schools served as controls. Follow-up measurements were conducted at the end of the intervention (Follow-up I) and 1 year later (Follow-up II). Random coefficient analyses for longitudinal data showed that the effects of both interventions did not differ between the two follow-up measurements. The results showed similar effects for the free distribution program and the multicomponent program in increasing children's fruit consumption over time (respectively, 7.2 and 15.2 g day(-1)). The distribution program also increased children's vegetable consumption over time (3.25 g day(-1)), even after repeating the analyses using a pessimistic scenario. Despite the large dropout and its consequences for generalizability of our results, the distribution program is considered as the preferred intervention of the two, and implementation on a larger scale should be investigated.     

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.     

Patterns of fruit and vegetable consumption among Iranian adults: a SuRFNCD-2007 study

The aim of the present study was to describe the patterns of fruit and vegetable (F&V) intake in a nationally representative sample of the Iranian population. The data collected in the Third National Surveillance of Risk Factors of Non-communicable Diseases (SuRFNCD-2007) were used. In a sample of 3702 Iranian adult participants, patterns of F&V consumption were assessed using the WHO STEPwise method. Low F&V consumption was defined as intake of less than five servings of fruit and/or vegetable daily according to the WHO guidelines. F&V consumption was compared among different age groups, sex and urban/rural areas using complex sample analysis. On average, 1·26 servings of fruit and 1·32 servings of vegetables were consumed daily. Taken together, Iranian adults consumed 2·58 F&V servings per d, with females eating more than males (P ≤ 0·001). Moreover, there was a trend towards lower consumption rates in older-age categories (P = 0·003). Prevalence of low F&V intake (less than five servings daily) was 87·5 % and also tended to be higher in older-age categories (P = 0·004). Prevalence of low intake did not differ significantly among men and women or urban and rural areas. A high prevalence of low F&V consumption in the Iranian adult population was documented. These findings may guide health policy makers in developing specific plans to encourage adequate F&V intake.     

Psychosocial Factors and Health Behaviors Associated with Inadequate Fruit and Vegetable Intake among American-Indian and Alaska-Native Adolescents

The purpose of the study was to examine fruit and vegetable intake patterns among American Indian and Alaska Native adolescents and to assess psychosocial factors and health behaviors related to inadequate consumption. The study was conducted in nonurban schools from eight Indian Health Service Areas in the U.S.A total sample of 13,454 7th- through 12th-grade American-Indian and Alaska-Native youths living on or near reservations were given, in classroom settings, a revised version of the Minnesota Adolescent Health Survey.The health questionnaire assessed fruit and vegetable consumption patterns and psychosocial variables and health-related behaviors. The results indicated that fruit and vegetable consumption was below the recommended amounts. Less than daily consumption of vegetables was reported by 30% of adolescents and less than daily consumption of fruits was reported by 20% of youths. Psychosocial and health behavior risk associated with inadequate intake included being overweight, low family connectedness, poor school achievement, poor perceived health status, and tobacco use. Our study shows that fruit and vegetable consumption is low among American-Indian and Alaska-Native youths. More attention needs to be placed on developing culturally appropriate interventions to promote healthy eating patterns and addressing factors related to inadequate intake.     

Parents are accurate reporters of their preschoolers' fruit and vegetable consumption under limited conditions

OBJECTIVE: To assess the accuracy of parents as reporters of both their own and their 2- to 5-year-old children's fruit and vegetable intake. DESIGN: Observational study with a 1-meal intake assessment by an independent observer, followed by a telephone survey to determine the previous day's consumption using a 29-item fruit, juice, and vegetable food frequency questionnaire. SETTING: Two separate meal assessments in community-based settings. PARTICIPANTS: A convenience sample of 61 parent-child dyads from Eastern Missouri was recruited from a school health fair and the Parents as Teachers program. The mean age of the parents was 31.1 years, and 91% were female. The mean age for children was 39.0 months, and 60% were female. VARIABLES MEASURED: Parent and child fruit and vegetable intake. ANALYSIS: Interobserver agreement using a kappa statistic. RESULTS: Parents accurately reported their children's intake on most fruits and vegetables (kappa=0.59-0.61). Parents were the least accurate in recalling the consumption of raisins from oatmeal cookies (kappa=0.05) and 100% juice (kappa=0.17). CONCLUSIONS AND IMPLICATIONS: Parents can serve as accurate proxies to report fruit and vegetable consumption by their preschoolers on a food frequency questionnaire used to determine intake for the previous day. This can be a helpful evaluation method for research involving young children.     

Serving larger portions of fruits and vegetables together at dinner promotes intake of both foods among young children

Serving larger portions of energy-dense foods has been shown to promote children's energy intake at meals. Whether larger portions increase children's intake of both fruits and vegetables (F&V) is less clear. A 2×2 within-subjects design systematically varied portion sizes of fruit (75 vs 150 g) and vegetable (75 vs 150 g) side dishes served at dinner. Children's F&V liking was measured using a validated tasting method. Thirty children aged 4 to 6 years were tested in a laboratory setting at 5:00 pm on weekdays from November 2008 through March 2009. Mixed linear models were used to determine effects of fruit portion size, vegetable portion size, and their interaction on food and energy intakes. Data are presented as model-based means±standard error unless otherwise indicated. When portions were doubled, children increased their vegetable intake by 37% (12±4 g; P<0.01) and their fruit intake by 70% (41±6 g; P<0.01). Vegetable portion size effects were not influenced by offering more fruit and vice versa. Portion size effects were limited to children who liked that particular food. Total meal energy intake did not vary by portion size condition. These results indicate that serving larger F&V portions at meals can be used to promote young children's intake of both foods without influencing total meal energy intake. Effects were not seen in children who disliked F&V, suggesting a need to combine increased F&V portions with strategies to increase their acceptance.     

中国农村地区高血压患者果蔬摄入对血压进展的影响研究

目的 基于前瞻性队列研究探讨我国农村地区高血压患者果蔬摄入与血压进展的关系.方法 中国代谢综合征社区干预研究暨中国家庭健康研究于2007-2008年开展基线调查,收集膳食、体力活动和血压等信息,并于2012-2015年进行随访调查.膳食资料采用食物频率问卷获取,按照研究对象总果蔬、水果和蔬菜摄入量是否达到推荐摄入水平和...     

Stability of television viewing and electronic game/computer use in a prospective cohort study of Australian children: relationship with body mass index

Background

The purpose of this study was to (1) compare parental and child recording of children's fruit and vegetable (F&V) consumption, including family-related factors, and (2) investigate the potential differences in the relation of children's and parents' perceptions of family-related factors.

Methods

Children were recruited from Dutch seventh and eighth grade classrooms. Each child and one of their parents completed parallel questionnaires. A total of 371 matched child-parent surveys were included in the analyses. To compare parental and child reports of consumption and family-related factors regarding F&V intake several techniques were used such as paired sample t-test, chi-square tests, Pearson's correlations and Cohens's kappa as measurement of agreement. To investigate potential differences between the parent's and children's perceptions of family-related factors, linear regression analyses were conducted.

Results

The results indicated weak agreement for F&V consumption (Cohen's kappa coefficients of .31 and .20, respectively) but no differences in mean consumption of fruit at the group level. Regarding the family-environmental factors related to fruit consumption, significant differences were found between the perceptions of subjective norm, and the availability and accessibility of fruit. Perceptions of subjective norm, parental modelling and exposure regarding vegetable consumption were also viewed differently by the two groups. The family-environmental factors reported by the children were similarly associated with F&V consumption compared to those reported by their respective parents. However, parents rated these factors more favourably than their children did.

Conclusion

The results indicated a low level of agreement between parental and child reporting of F&V intake and their assessment of family-environmental factors on individual level. This has important implications for the development and evaluation of interventions and we recommend that researchers clearly indicate which source of information they use in their studies as it remains unclear which source is more valid. However, when the effects of interventions are studied at the group level, our results suggest that it makes no difference whether children or parents report the child's fruit consumption. The same holds for determinant studies; both parental and child reports can be used. However, perceptions of these factors differ significantly.     

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.     

Overweight and average-weight children equally responsive to "Kids Choice Program" to increase fruit and vegetable consumption

Secondary analyses were conducted for children participating in the school-based Kids Choice Program [Hendy, H. M., Williams, K., & Camise, T. (2005). "Kids Choice" school lunch program increases children's fruit and vegetable acceptance. Appetite, 45, 250-263.] to examine whether fruit and vegetable consumption and preference ratings by overweight and average-weight children within the original sample were equally responsive to the program. The Kids Choice Program produced increased fruit and vegetable consumption by both overweight and average-weight children that lasted throughout the month-long program, while avoiding "over-justification" drops in later fruit and vegetable preference ratings. We believe that the Kids Choice Program shows promise for encouraging overweight children to improve nutrition and weight management behaviors while in their everyday peer environment.     

Life-course events and experiences: association with fruit and vegetable consumption in 3 ethnic groups

OBJECTIVE: To examine how life-course experiences and events are associated with current fruit and vegetable consumption in 3 ethnic groups. DESIGN: A theoretic model developed from previous qualitative research guided the development of a telephone survey. Data were collected on fruit and vegetable consumption, sociodemographic characteristics, ethnic identity, and life-course events and experiences, including food upbringing, social roles, food skills, dietary changes for health, and practice of food traditions. SUBJECTS/SETTING: Low- to moderate-income adults living in a northeastern US city were selected randomly from 3 ethnic groups: black (n = 201), Hispanic (n = 191), and white (n = 200). STATISTICAL ANALYSES: Bivariate and multiple linear regression analysis of associations between life-course variables and fruit and vegetable consumption. RESULTS: Black, Hispanic, and white respondents differed significantly in life-course experiences, family roles, socio-demographic characteristics, and place of birth. Explanatory models for fruit and vegetable consumption differed among ethnic groups and between fruits and vegetables. Among black respondents, a college education was positively associated with fruit consumption; education and family roles contributed most to differences in fruit (R2 = .16) and vegetable (R2 = .09) consumption. Among Hispanic respondents, life-course experiences such as liking fruits and vegetables in youth, making dietary changes for health, and food skills were positively associated with fruit (R2 = .25) and vegetable (R2 = .35) consumption. Among white respondents, socio-demographic characteristics, such as being married with a young child or single with no child and having a garden as an adult, were positively associated with fruit (R2 = .20) and vegetable (R2 = .22) consumption. APPLICATIONS/CONCLUSIONS: An understanding of the determinants of food choice in different subcultural groups can be used to design effective nutrition interventions to increase fruit and vegetable consumption. Experiences such as eating fresh-picked fruits and vegetables while growing up or vegetable gardening as an adult may enhance fruit and vegetable consumption among members of some ethnic groups.     

Longitudinal trends in consumption of vegetables and fruit in Finnish children in an atherosclerosis prevention study (STRIP)

OBJECTIVE: To assess prospectively the consumption of fruit and vegetables and its' correlation to the parental consumption in boys and girls taking part in an atherosclerosis prevention study (Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study). HYPOTHESIS: Nutrition counselling focused on cardiovascular health effects vegetable and fruit consumption. DESIGN: A prospective, randomised, clinical trial. SUBJECTS: Children were recruited to the STRIP study between 1989 and 1992. At the age of 7 months, children were randomised to the intervention (n = 540) or the control group (n = 522) and were followed up until the age of 11 years. INTERVENTION: Families in the intervention group have, since randomisation, received biannual individualised dietary counselling aimed at reduction of cardiovascular risk factors, especially saturated fat intake. Food records were used to assess fruit and vegetable consumption of children and parents. RESULTS: The percentage of total energy intake provided by fruit and vegetables decreased when the children grew older (P for age <0.001). The 1- to 10-year-old intervention boys consumed more vegetables (mean difference 3.18 g/day; CI 1.48-4.86; P < 0.001) and fruit (mean difference 10.1 g/day; CI 5.28-14.94; P < 0.001) than did the control. Mother's consumption correlated with the consumption of their daughters and sons, whereas father's consumption correlated only with the consumption of their sons. CONCLUSIONS: Finnish children taking part in the atherosclerosis prevention study had a remarkably low fruit and vegetable consumption, which furthermore decreased with age. The children's consumption correlated with the parental consumption, except between boys and mothers. A slight intervention effect was present only among boys.     

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.     

5-Year Follow-Up of a Telephone Intervention to Increase Fruit and Vegetable Consumption in Preschoolers: The ‘Healthy Habits’ Cluster Randomised Trial

Little is known about the long-term impact of telephone-based interventions to improve child diet. This trial aimed to assess the long-term effectiveness (after 5 years) of a telephone-based parent intervention in increasing children’s fruit and vegetable consumption. Parents of 3–5 year olds were recruited from 30 Australian preschools to participate in a cluster randomised controlled trial. Intervention parents received four, weekly, 30-min support calls aimed at modifying the home food environment. Control parents received printed materials. Consumption was assessed using the Fruit and Vegetable subscale of the Children’s Dietary Questionnaire (F&V-CDQ) (children) and daily servings of fruit and vegetables (children and parents) via parent telephone interview. Of the 394 parents who completed baseline, 57% (99 intervention, 127 control) completed follow-up. After 5-years, higher intervention F&V-CDQ scores, bordering on significance, were found in complete-case (+1.1, p = 0.06) and sensitivity analyses (+1.1, p = 0.06). There was no difference in parent or child consumption of daily fruit servings. Complete-case analysis indicated significantly higher consumption of child vegetable servings (+0.5 servings; p = 0.02), which was not significant in sensitivity analysis (+0.5 servings; p = 0.10). This telephone-based parent intervention targeting the family food environment may yield promising improvements in child fruit and vegetable consumption over a 5-year period.