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

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

Stages of change for fruit and vegetable consumption in deprived neighborhoods.

This article describes the association of external and psychosocial factors on the stages of change for fruit and vegetable consumption, among 2,781 inhabitants, aged 18 to 65 years, in deprived neighborhoods (response rate 60%). To identify correlates of forward stage transition, an ordinal logistic regression model, the Threshold of Change Model (TCM), was used to analyze the data. The results indicate that men, those from Dutch origin, those with (rather) low health locus of control, those displaying risk behaviors, and those without knowledge of dietary guidelines were less likely to move from one stage to another and therefore were more likely to be in a lower stage-of-change category. The results make it possible to distinguish target groups, which should receive more attention in future health promotion campaigns, and to identify factors to be addressed in those programs.     

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

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

Association between fruit and vegetable consumption and oral cancer: a meta-analysis of observational studies

BACKGROUND: Oral cancer ranks as the seventh most common form of cancer worldwide. Recent reports have examined the effect of fruit and vegetable intake on the risk of oral cancer, but results are controversial. OBJECTIVE: A meta-analysis was performed to arrive at quantitative conclusions about the contribution of fruit and vegetable intakes to the occurrence of oral cancer. DESIGN: A comprehensive, systematic bibliographic search of medical literature published up to September 2005 was conducted to identify relevant studies. Separate meta-analyses were conducted for fruit and vegetable consumption. The effect of portion or daily intake of fruit or vegetables on the risk of oral cancer was calculated. A multivariate meta-regression analysis was performed to explore heterogeneity. This multivariate meta-regression analysis examined the effect of quality score, the type of cancers included, citrus fruit and green vegetable consumption, and the time interval for dietary recall of the studies on the role of fruit or vegetable consumption in the risk of oral cancer. The presence of publication bias was assessed with a funnel plot for asymmetry. RESULTS: Sixteen studies (15 case-control studies and 1 cohort study) met the inclusion criteria and were included in the meta-analysis. The combined adjusted odds ratio (OR) estimates showed that each portion of fruit consumed per day significantly reduced the risk of oral cancer by 49% (OR: 0.51; 95% CI: 0.40, 0.65). For vegetable consumption, the meta-analysis showed a significant reduction in the overall risk of oral cancer of 50% (OR: 0.50; 95% CI: 0.38, 0.65). The multivariate meta-regression showed that the lower risk of oral cancer associated with fruit consumption was significantly influenced by the type of fruit consumed and by the time interval of dietary recall. CONCLUSION: The consumption of fruit and vegetables is associated with a reduced risk of oral cancer.     

Evaluating a school-based fruit and vegetable co-op in low-income children: A quasi-experimental study

The purpose of this study was to evaluate the effectiveness of a new school-based food co-op program, Brighter Bites (BB), to increase fruit and vegetable intake, and home nutrition environment among low-income 1st graders and their parents. This was a non-randomized controlled comparative effectiveness trial (2013–2015). Six schools received BB (n = 407 parent-child dyads); six comparison schools implemented a coordinated school health program (n = 310 parent-child dyads) in Houston, Texas, 2013–2015. Brighter Bites (BB) is a 16-week school-based food co-op comprising weekly distribution of fresh produce (50 servings); nutrition education in schools and for parents; and weekly recipe tastings. Measurements included parent-reported home nutrition environment surveys, and food frequency questionnaires for parent and child. Intervention effects were examined using multivariate analyses. At baseline, the sample was 71% Hispanic, 24% African American; 43% of 1st graders were overweight/obese. Children receiving BB had significant increases in intake of fruit servings (P = 0.046), vegetable servings (P = 0.049), and decreased intake of added sugars (P = 0.014). Among parents, there were significant increases in fruit consumed (P = 0.032); vegetable intake increased baseline to midpoint but not post-intervention. Among BB families, there were significant improvements in the home environment including understanding and usage of nutrition facts labels to make food purchases (P < 0.05), frequency of cooking (P = 0.007), rules and practices regarding eating family meals (P = 0.022), serving fruits (P = 0.005) and vegetables (P = 0.028) at meals, and limiting portion sizes (P = 0.016).In conclusion, a school-based food co-op model shows promising results in improving dietary habits and home nutrition environment among low-income families.     

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.     

Spousal similarities in fruit and vegetable consumption

PURPOSE: To explore similar patterns of fruit and vegetable consumption between health center employees and their spouses. DESIGN: Cross-sectional mailed survey assessing frequency of fruit and vegetable consumption, as well as demographics and knowledge, attitudes, access, and social support related to fruit and vegetable consumption. SETTING: Six Massachusetts health centers. SUBJECTS: Two hundred eleven health center employee/spouse pairs (422 individuals). MEASURES: The kappa statistic measured agreement in fruit and vegetable consumption between employees and spouses. The Spearman rho coefficient measured correlations for individual responses. Multiple Linear Regression Models examined variables that explained fruit and vegetable consumption level differences. RESULTS: Response rate was 59%. Mean fruit and vegetable daily intake was 4.68 and 4.30 servings for employees and spouses, respectively. Over 75% of employee and spouse estimates measuring fruit and vegetable consumption-related information, on average, were within one survey response category of each other. Knowledge, attitudes, and access indices were significantly correlated with fruit and vegetable consumption for both employees and spouses. The social support index was significantly correlated with fruit and vegetable consumption only for the spouses. Differences in knowledge, attitudes, and access indices between employees and spouses helped to explain different fruit and vegetable consumption levels. Nonresponse, selection, recall, and seasonal reporting biases may limit the findings' generalizability. CONCLUSIONS: The effectiveness of worksite nutrition interventions may be improved by involving family/household members.     

The association between fruit and vegetable consumption and peripheral arterial disease

BACKGROUND: High fruit and vegetable consumption has been associated with a lower risk of cardiovascular diseases, but few studies have focused on peripheral arterial disease. In this study, we evaluated the association of consumption of fruits and vegetables with peripheral arterial disease. METHODS: In a cohort of 44,059 men initially free of cardiovascular disease and diabetes, we documented 295 cases of peripheral arterial disease during a 12-year follow-up. Fruit and vegetable consumption was assessed by food frequency questionnaire. RESULTS: In the age-adjusted model, men in the highest quintile had a relative risk of 0.55 (95% confidence interval = 0.38-0.80) for overall fruit and vegetable intake, 0.52 (0.36-0.77) for fruit intake, and 0.54 (0.36-0.81) for vegetable intake, compared with those in the lowest quintile of intake. However, the associations were greatly weakened after adjustment for smoking and other traditional cardiovascular disease risk factors. Comparing men in the highest quintile versus the lowest quintile, relative risks and 95% confidence intervals were 0.95 (0.62-1.44) for overall fruit and vegetable intake, 0.97 (0.64-1.48) for fruit intake, and 0.76 (0.50-1.17) for vegetable intake. CONCLUSIONS: We did not find evidence that fruit and vegetable consumption protects against peripheral arterial disease, although a modest benefit cannot be excluded.     

Goal setting is differentially related to change in fruit, juice, and vegetable consumption among fourth-grade children.

The impact of goal attainment in a dietary change program to increase fruit, 100% juice, and vegetable consumption was assessed among fourth-grade students. At each session, the students were given goals related to increasing fruit, juice, and vegetable consumption. Baseline consumption and postconsumption were assessed with up to 4 days of computerized dietary recalls. Analyses included regression models predicting postconsumption from the numbers of fruit-juice goals, vegetable goals, or total number of general goals attained, respectively. For students with low baseline fruit-juice preferences, attaining more fruit-juice goals resulted in increased post-fruit-juice consumption. Among those with low baseline vegetable consumption, attaining one vegetable goal was related to higher post-vegetable consumption. For boys and those with high baseline fruit, juice, and vegetable consumption, attaining three general goals was related to increased fruit, juice, and vegetable intake. The results show that goal attainment was somewhat effective in promoting dietary change among children.     

Supports, stressors, and depressive symptoms in low-income mothers of young children.

We investigated the association of social supports and stresses with depressive symptoms in a sample of 111 predominantly low-income mothers of young children. The prevalence of high depressive symptoms, as measured by the Center for Epidemiologic Studies--Depression Scale (CES-D), was 48 per cent. Among unmarried women, everyday stressors were strongly associated with depressive symptoms, while life events were weakly related. Associations between these variables were not found for married women. Comparing the relative importance of two different types of support--the quality of primary intimate relationships, and the social network--only the quality of the husband-intimate relationship was associated with CES-D scores among married women, whereas the social network demonstrated a moderate, inverse association with CES-D scores among unemployed women.     

Cultural tailoring for mammography and fruit and vegetable intake among low-income African-American women in urban public health centers

BACKGROUND: It is widely accepted that disease prevention efforts should consider cultural factors when addressing the needs of diverse populations, yet there is surprisingly little evidence that doing so enhances effectiveness. The Institute of Medicine has called for randomized studies directly comparing approaches that do and do not consider culture. METHODS: In a randomized trial, 1227 lower-income African-American women from 10 urban public health centers were assigned to either a usual care control group, or to receive a series of six women's health magazines with content tailored to each individual. By random assignment, these magazines were generated from either behavioral construct tailoring (BCT), culturally relevant tailoring (CRT) or both (BCT + CRT). The CRT magazines were based on four cultural constructs: religiosity, collectivism, racial pride, and time orientation. All tailored magazines sent to women ages 40-65 promoted use of mammography; magazines sent to women ages 18-39 promoted fruit and vegetable (FV) intake. Analyses examined changes from baseline to 18-month follow-up in use of mammography and servings of FV consumed daily. RESULTS: Women receiving BCT + CRT magazines were more likely than those in the BCT, CRT, and control groups to report getting a mammogram (76% vs. 65% vs. 64% vs. 55%, respectively), and had greater increases in FV servings consumed daily (+0.96 vs. + 0.43 vs. + 0.25 vs. + 0.59). CONCLUSIONS: Systematically integrating culture into tailored cancer prevention and control interventions may enhance their effectiveness in diverse populations.     

Association of fruit and vegetable intake with cardiovascular risk factors in urban south Indians

The study examines the relationship between fruit and vegetable intake (g/d) and CVD risk factors in urban south Indians. The study population comprised of 983 individuals aged > or = 20 years selected from the Chennai Urban Rural Epidemiological Study (CURES), a population-based cross-sectional study on a representative population of Chennai in southern India. Fruit and vegetable intake (g/d) was measured using a validated semi-quantitative FFQ. Linear regression analysis revealed that after adjusting for potential confounders such as age, sex, smoking, alcohol, BMI and total energy intake, the highest quartile of fruit and vegetable intake (g/d) showed a significant inverse association with systolic blood pressure (beta = - 2.6 (95 % CI - 5.92, - 1.02) mmHg; P = 0.027), BMI (beta = - 2.3 (95 % CI - 2.96, - 1.57) kg/m2; P < 0.0001), waist circumference (beta = - 2.6 (95 % CI - 3.69, - 1.46) cm; P < 0.0001), total cholesterol (beta = - 50 (95 % CI - 113.9, - 13.6) mg/l; P = 0.017) and LDL-cholesterol concentration (beta = - 55 (95 % CI - 110.8, - 11.1) mg/l; P = 0.039) when compared with the lowest quartile. A higher intake of fruit and vegetables explained 48 % of the protective effect against CVD risk factors. Increased intake of fruits and vegetables could play a protective role against CVD in Asian Indians who have high rates of premature coronary artery disease.     

The role of health behaviors and food insecurity in predicting fruit and vegetable intake in low-income children

Research supports the importance of adequate fruit and vegetable intake during childhood. The current study examines relationships between physical activity, sedentary behavior, sleep, food insecurity, and fruit and vegetable intake in a sample of low-income, elementary-aged children. 148 participants were recruited from several agencies serving low-income families in a large midwestern metropolitan area. A measurement model was specified to ensure good fit between the data and predictive model. A structural model was run and several significant findings emerged. Food insecurity significantly predicted vegetable intake (latent regression coefficient = ?0.18, p < 0.05), such that children with higher food insecurity consumed fewer servings of vegetables. Physical activity also significantly predicted fruit intake (latent regression coefficient = 0.32, p < 0.01) and vegetable intake (latent regression coefficient = 0.26, p < 0.01), such that children who were more physically active consumed more servings of fruits and vegetables. Data indicate that children with high food insecurity consumed fewer vegetables, and that physical activity is significantly related to fruit and vegetable intake. Possible implications for public policy are discussed.     

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.     

A randomized school trial of environmental strategies to encourage fruit and vegetable consumption among children.

The Cafeteria Power Plus project examined whether a cafeteria-based intervention would increase the fruit and vegetable (FV) consumption of children. Twenty-six schools were randomly assigned to either an intervention or control condition. Baseline lunch observations of a sample (N = 1668) of first- and third-grade students occurred in the spring of 2000; follow-up was in the spring of 2002. The intervention took place during two consecutive school years beginning in the fall of 2000 and consisted of daily activities (increasing the availability, attractiveness, and encouragement for FV) and special events (kick-offs, samplings, challenge weeks, theater production, and finale meal). Training of food-service staff and cook managers was ongoing throughout the intervention phase. Students in the intervention schools significantly increased their total fruit intake. Process measures indicated that verbal encouragement by food-service staff was associated with outcomes. The outcomes suggest that multicomponent interventions are more powerful than cafeteria programs alone with this age group.