Influences on adolescent eating patterns: the importance of family meals.

PURPOSE: To provide national estimates of the frequency and determinants of adolescents' consumption of fruits, vegetables, and dairy foods. METHODS: Analyses were based on 18,177 adolescents in the first interview of the National Longitudinal Study of Adolescent Health. Multivariate logistic regressions provide estimates of the unique contribution of sociodemographic characteristics, body weight perception, and parental influences on adolescent food consumption. RESULTS: Almost one in five adolescents reported skipping breakfast the previous day. A large percentage of adolescents reported eating less than the recommended amount of vegetables (71%), fruits (55%), and dairy foods (47%). Adolescents with better-educated parents had better consumption patterns than those with less-educated parents. Consumption patterns differed significantly by race. Adolescents who perceived themselves to be overweight were significantly more likely to have poor consumption patterns. Parental presence at the evening meal was associated with a lower risk of poor consumption of fruits, vegetables, and diary foods as well as the likelihood of skipping breakfast. CONCLUSION: Parental presence at the evening meal is positively associated with adolescents' higher consumption of fruits, vegetables, and dairy foods. Nutrition and health professionals should educate parents about the role of family mealtimes for healthy adolescent nutrition.     

The association between family meals, TV viewing during meals, and fruit, vegetables, soda, and chips intake among Latino children

ObjectiveExamine the relationship of family meals to children's consumption of fruit and vegetables as well as soda and chips. Additionally, to assess the relationship between viewing TV during family meals and children's diet.DesignCross-sectional study that used a questionnaire completed by parents.SettingThirteen schools in San Diego, California.ParticipantsSeven hundred ninety-four children and their parents.AnalysisOrdinal regression assessed associations between children's intake of fruit, vegetables, soda, and chips with family meal frequency and TV viewing during family meals.ResultsChildren who consumed breakfast, lunch, or dinner with their family at least 4 days per week ate fruit and vegetables 5 or more times a week 84%, 85%, and 80%, respectively. Of those children who ate breakfast, lunch, or dinner with their family at least 4 days per week, 40%, 44%, and 43% consumed soda and chips 5 or more times a week, respectively. Children who ate breakfast with their families at least 4 times a week were more likely to consume fruit and vegetables, and children whose TV was never or rarely on during family meals were less likely to consume soda and chips (P = .04 and P < .001, respectively).ConclusionsInterventions geared at increasing the frequency of eating breakfast as a family and decreasing the amount of TV watched during family meals are needed, especially among acculturating Latino families.     

Would Students Prefer to Eat Healthier Foods at School?

BACKGROUND: This study sought to elucidate students' perceptions of school food environments and to assess correlations between perceptions and purchasing and consumption behaviors at school. METHODS: Seventh and ninth graders (n = 5365) at 19 schools in multiethnic, low‐income California communities participating in the Healthy Eating Active Communities program completed questionnaires assessing their attitudes and behaviors regarding school food environments during spring 2006. RESULTS: Most students (69%) reported that fresh fruit was important to be able to buy at school; more than chips (21%), candy (28%), or soda (31%). Reported importance of food offerings was correlated with the consumption of those items. Most students did not perceive foods/beverages offered at school to be healthy; fewer than a quarter reported eating fruits or vegetables (FV) at school. Students eating school lunch were more than twice as likely to consume FV, though if they also purchased from competitive venues, their consumption of candy, chips, and soda was similar to their peers who purchased only competitive foods. CONCLUSION: Students report healthy foods to be important to be able to buy at school, but do not perceive their school food environment to be healthy and consume more unhealthy foods at school. Students served healthy items via school lunch are more likely to consume them; however, they also purchase and consume unhealthy items if available. Findings suggest that modifying school food environments to facilitate consumption of healthy foods and limit unhealthy foods will better match students' preferences and could lead to improved dietary intake.     

Use of the Grade of Membership method to identify consumption patterns and eating behaviors among adolescents in Rio de Janeiro, Brazil

To identify food patterns and eating behaviors among adolescents and to describe the prevalence rates, this study applied the Grade of Membership method to data from a survey on health risk factors among adolescent students in Rio de Janeiro, Brazil (N = 1,632). The four profiles generated were: "A" (12.1%) more frequent consumption of all foods labeled as healthy, less frequent consumption of unhealthy foods, and healthy eating behaviors; "B" (45.8%) breakfast and three meals a day as a habit, less frequent consumption of fruits and vegetables and of five markers of unhealthy diet; "C" (22.8%) lack of healthy eating behaviors, less frequent consumption of vegetables, fruit, milk, cold cuts, cookies, and soft drinks; and "D" (19.3%) more frequent consumption of all unhealthy foods and less frequent consumption of fruits and vegetables. The results indicate the need for interventions to promote healthy eating in this age group.     

Lunch,recess and nutrition: Responding to time incentives in the cafeteria

ObjectivesIn this study, we evaluate if moving recess before lunch has an effect on the amount of fruits and vegetables elementary school students eat as part of their school-provided lunch.MethodsParticipants were 1st–6th grade students from three schools that switched recess from after to before lunch and four similar schools that continued to hold recess after lunch. We collected data for an average of 14 days at each school (4 days during spring 2011, May 3 through June 1, 2011 and 9 days during fall 2011, September 19 through November 11, 2011). All of the schools were in Orem, UT. Data was collected for all students receiving a school lunch and was based on observational plate waste data.ResultsWe find that moving recess before lunch increased consumption of fruits and vegetables by 0.16 servings per child (a 54% increase) and increased the fraction of children eating at least one serving of fruits or vegetables by 10 percentage points (a 45% increase). In contrast, the schools in our control group actually experienced a small reduction in fruit and vegetable consumption during the same time period.ConclusionsOur results show the benefits of holding recess before lunch and suggest that if more schools implement this policy, there would be significant increases in fruit and vegetable consumption among students who eat school lunch as part of the National School Lunch Program.     

Fruits, vegetables, milk, and sweetened beverages consumption and access to à la carte/snack bar meals at school

OBJECTIVES: We assessed the impact of access to school snack bars on middle school students' fruit, vegetable, milk, and sweetened beverage consumption. METHODS: Five hundred ninety-four fourth- and fifth-grade students completed lunch food records 4 times during a 2-year period. RESULTS: The fourth-grade cohort consumed fewer fruits, regular (not fried) vegetables, and less milk and consumed more sweetened beverages and high-fat vegetables during year 2. CONCLUSIONS: Middle school students who gained access to school snack bars consumed fewer healthy foods compared with the previous school year, when they were in elementary schools and only had access to lunch meals served at school. Healthy food choices and school policies that require healthier foods at school snack bars should be promoted.     

Breakfast habits and factors influencing food choices at breakfast in relation to socio-demographic and family factors among European adolescents. The HELENA Study

Breakfast consumption has been shown to be an important indicator of a healthy lifestyle. Little is known however about factors influencing breakfast consumption and food choices at breakfast in adolescents. The aim of the present study was therefore to describe breakfast habits, and factors influencing food choices at breakfast within the framework of the EU-funded HELENA Study, in 3528 adolescents from ten European cities. Additionally, socio-demographic differences in breakfast habits and in influencing factors were investigated. Half of the adolescents (and fewer girls than boys) indicated being regular breakfast consumers. Girls with mothers with a high level of education, boys from 'traditional' families and boys who perceived low family affluence were positively associated with breakfast consumption. Boys whose parents gave encouragement and girls whose peers ate healthily were more likely to be regular breakfast consumers. 'Hunger', 'taste', 'health concerns' and 'parents or guardian' were the most important influences on the adolescents' food choices at breakfast. Adolescents from southern Europe and girls reported to be more influenced by personal and socio-environmental factors. Socio-demographic differences, in particular regional and gender differences, need to be considered in discussions surrounding the development of nutritional intervention programs intended for adolescents.     

Effect of meal sequence on postprandial lipid, glucose and insulin responses in young men

OBJECTIVE: To investigate whether the postprandial changes in plasma triacylglycerol (TAG), nonesterified fatty acids (NEFA), glucose and insulin concentrations in young men were the same if an identical meal was fed at breakfast and lunch, and if the response to lunch was modified by consumption of breakfast. METHODS: In two trials (1 and 2) healthy subjects (age 22+/-1 y, body mass index 22+/-2 kg/m(2)) were fed the same mixed macronutrient meal at breakfast at 08:00 h and lunch at 14:00 h. In the third trial, no breakfast was fed and the overnight fast extended until lunch at 14:00 h. Addition of [1,1,1-(13)C]tripalmitin to one meal in each trial was used to distinguish between endogenous and meal-derived lipids. RESULTS: The postprandial changes in TAG, NEFA and glucose concentrations were similar in trials 1 and 2. The change in plasma total TAG concentration was about two fold less (P<0.05) after lunch compared to breakfast. Postprandial NEFA suppression was the same after breakfast and lunch. Glucose and insulin responses were significantly greater following lunch suggesting decreasing insulin sensitivity during the day. Consumption of breakfast did not alter the postprandial total TAG or NEFA responses after lunch. Measurement of [(13)C]palmitic acid concentration showed that handling of TAG and NEFA from the meal was the same after breakfast and lunch, and was not altered by consumption of breakfast. CONCLUSIONS: Overall, these data suggest that in young, healthy men regulation of plasma TAG from endogenous sources, principally VLDL, but not chylomicrons during the postprandial period leads to differences in the magnitude of lipaemic response when the same meal was consumed at breakfast or at lunch 6 h later.     

Fruit and vegetable intake and knowledge increased following a community-based intervention in older adults in Georgia senior centers

Our purpose was to evaluate a community-based fruit and vegetable intervention conducted in rural and urban areas of Georgia. Participants were a convenience sample from Georgia senior centers that completed a pre-test, the intervention, and a post-test (N = 558, mean age = 75, 83% female, 47% white, 53% black). The 4-month intervention had eight sessions focused on practical ways to increase intake of fruits and vegetables at meals and snacks and included physical activity. Pre- and post-tests examined self-reported intakes of fruits and vegetables at breakfast, lunch, the evening meal, and snacks, knowledge of recommended intakes, and barriers to intake. Following the intervention, the number of participants reporting consumption of at least 7 servings of fruits and vegetables daily increased by 21-percentage points (P < or = 0.001), knowledge that 7 to 10 servings of fruits and vegetables are recommended daily (for 1,600 to 2,200 calories) increased from 7% to 57% (P < or = 0.001), and three barriers to fruit and vegetable intake decreased (P < or = 0.05): "difficulties with digestion," "too many are recommended," and "too much trouble." Regression analyses indicated that increased intake following the intervention was independently associated with living in more urban rather than rural areas, improved knowledge of intake recommendations, decrease in perception of cost as a barrier, and increase in digestive problems as a barrier (P < or = 0.05). These results provide an evidence base for the effectiveness of this community intervention for improving knowledge and intake and decreasing barriers to fruit and vegetable intake in older adults.     

Patterns in children's fruit and vegetable consumption by meal and day of the week.

To assess differences in children's consumption of fruit and vegetables (F&V) by day of the week and meal of the day.

Baseline data from two school based nutrition education studies were combined for analysis.

2984 third grade students from 48 participating elementary schools in three school districts in the metropolitan Atlanta area.

The frequency of consumption of F&V abstracted by trained registered dietitians from prompted 7-day food records. STATISTICAL-ANALYSES PERFORMED: Mixed model analysis with meals and days as terms, controlling for the within school correlation, gender and ethnic group.

F&V were most frequently consumed at weekday lunch, and second most frequently at dinner. Participation in school lunch accounted for a substantial proportion of F&Vs consumed at lunch. Few F&Vs were consumed at breakfast or snack.

School lunch makes an important contribution to elementary school students' F&V consumption. Dietary change programs should target parents to increase F&V consumption at dinner, and target students for the meals over which they assert the most control: breakfast and snacks.     

Fourth-grade children's consumption of fruit and vegetable items available as part of school lunches is closely related to preferences

OBJECTIVE: To use data from observations and interviews to document fourth-graders' preferences for, and consumption of, fruits compared to vegetables available as part of school lunches. DESIGN: Observations and interviews were conducted for studies regarding the impact of time interval between eating and reporting on the accuracy of children's school lunch recalls. SUBJECTS/SETTINGS: Children were recruited from up to 4 schools in one district during 3 school years; 63% agreed to participate. Randomly selected children (n = 237) were each observed eating school lunch once and were interviewed (regarding items eaten and preferences for items eaten) within 11/2 hours or the next morning. MAIN OUTCOME MEASURES: Observed consumption of servings of items available as part of school lunch was recorded as none, taste, little bit, half, most, and all. Response options for preferences for items available as part of school lunch were liked not at all, a little, and a lot. STATISTICAL ANALYSES PERFORMED: Mixed-model analysis of variance. RESULTS: Preferences were higher for fruits than vegetables. As preferences increased, consumption increased (P <.0001). Consumption of fruits compared to vegetables was similar after adjusting for preferences. IMPLICATIONS: Research is needed to understand how to increase children's preferences for vegetables as a means of increasing consumption.     

Regular consumption of fruits and vegetables by university students in Rio Branco, Acre State, Brazil: prevalence and associated factors

This cross-sectional study with university students examined the prevalence of regular consumption of fruits and vegetables and associated factors among students at a Federal university in Rio Branco, Acre State, Brazil. 863 undergraduates were interviewed in 2010. Overall prevalence of regular consumption of fruits and vegetables was 14.8%. Factors associated with regular consumption of fruits and vegetables were: socioeconomic classes A and B (PR = 1.70; 95%CI: 1.10-2.62), living with a partner (PR = 1.53; 95%CI: 1.02-2.29), regular physical activity (PR = 1.69; 95%CI: 1.11-2.56), and consumption of fast food twice a week or less (PR = 1.49; 95%CI: 1.04-2.13). A minority of the students met the recommendation to consume fruits and vegetables 5 or more days a week. Regular fruit and vegetable consumption was associated with socioeconomic status and healthy habits such as physical exercise and low consumption of fast food.     

农村贫困地区小学生早餐现状

了解农村贫困地区小学生早餐频率及食物摄入情况,为制定营养宣传教育和干预措施提供基础数据.方法 采用多阶段分层随机整群抽样的方法,抽取河北省平泉县等5个贫困农村县区15所小学的2 939名小学生为研究对象,问卷调查每周的早餐食用频率及主要食物的摄入情况.结果 参加调查的小学生达不到每天吃早餐的比例为23.2%.早餐食用频率最高的食物是米面制品(66.6%),其次为奶类(35.6%)、蔬菜(33.3%)、肉/蛋/鱼类(29.5%)、豆类(27.7%)和水果(19.3%).早餐营养质量差的小学生比例达到75.3%.Logistic回归分析结果显示,男生、四/五年级、云南地区、父母未在外打工的学生早餐食用频率相对较低;三/四年级、云南地区和住宿的学生早餐质量相对较差.结论 我国贫困农村地区小学生每天吃早餐的频率较低,早餐营养质量差.建议对学生、家长和老师加强合理早餐的教育,改善学生的早餐摄入状况.     

北京市海淀区城市小学生饮食行为及其与家庭环境因素的关系

了解城市小学生的饮食行为现状及家庭环境因素对饮食行为的影响,为儿童的饮食行为干预提供建议.方法 采用随机整群抽样方法,对北京市海淀区4所规模和教育水平中等的小学五年级共507名学生及其家长进行问卷调查.结果 80.3%的儿童蔬菜食用频率达到每周6~7d,水果的食用频率低于蔬菜(67.8%),肉、蛋、奶豆类的食用频率较低(每周食用6~7d的分别占57.5%,45.3%,60.0%,17.3%);部分儿童每周不食用蔬菜水果肉蛋奶豆类食品,其中不食用豆类的儿童最多,达9.9%.多元线性回归分析结果显示,家长的饮食行为(β=0.21)、家长对零食的限制(β=0.21)、家庭亲密程度(β=0.15)、家庭月收入(β=0.13)可促进儿童养成良好饮食行为,家庭零食的储备情况与儿童良好饮食行为养成呈负相关(β=-0.11)(P值均<0.05).结论 城市小学生的饮食行为受多种家庭环境因素的影响,尤其是家庭的饮食环境.可以通过对家长的宣教和引导,规范家庭饮食环境,帮助儿童养成良好的饮食行为.     

Lebensmittelverzehr bei Kindern und Jugendlichen in Deutschland

Since dietary behaviour has an essential impact on health, information on food consumption was obtained in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The average food frequency and portion size "in recent weeks" was assessed with a food frequency questionnaire. Two versions of the questionnaire, identical in content, exist: one aimed at parents of 1-10-year-olds and the other directly at 11-17-year-olds. The results include data on 7,186 boys and 6,919 girls, aged 3-17. About half of the participants each consume bread, milk and fresh fruits every day. The majority (about three quarter) eat fast food only once a month or less. However, 16 % of the participants eat chocolate, and almost 20 % other sweets every day. More boys than girls individually consume soft drinks, milk, dairy products, meat, sausage, cereals and white bread every day. More girls consume fresh fruits and raw vegetables each day. With increasing age the proportion of daily consumers of soft drinks, cheese (and among boys also meat and sausage) increases, but the proportion of daily consumers of juices, tap water, milk, dairy products, fresh fruits, raw vegetables, cookies, chocolate, sweets (and among girls also breakfast cereals) falls. As expected the consumption of sweets and soft drinks is relatively high. Whereas more than half of the children each consume fruits and vegetables on a daily base, this consumption declines with increasing age.     

Family correlates of breakfast consumption among children and adolescents. A systematic review

Regular breakfast consumption can have a multitude of positive health benefits, yet young people are more likely to skip breakfast than any other meal. Given the evidence that dietary behaviours established in childhood and adolescence track into adulthood along with evidence that breakfast skipping increases with age, identifying correlates of children's and adolescent's breakfast behaviours is imperative. The family environment is an important influence on the dietary behaviours of young people, and therefore we systematically reviewed the literature on family correlates of children and adolescent's breakfast consumption. From the 24 papers reviewed, 6 studied children and 19 studied adolescents. Few studies have examined the same specific family correlates of breakfast consumption, limiting the possibilities of drawing strong or consistent conclusions. Research in this area is relatively new and this review has identified areas for further investigation. Parental breakfast eating and living in two-parent families were the correlates supported by the greatest amount of evidence in association with adolescent's breakfast consumption. The results suggest that parents should be encouraged to be positive role models to their children by targeting their own dietary behaviours and that family structure should be considered when designing programmes to promote healthy breakfast behaviours.