Ethnic differences in 1-year follow-up effect of the Dutch Schoolgruiten Project - promoting fruit and vegetable consumption among primary-school children

OBJECTIVE: To evaluate the effect of a primary school-based intervention providing free fruit and vegetables (F&V), separately for children of Dutch and of non-Western ethnicity. SETTING: Primary schools in two regions (west and east) in The Netherlands. DESIGN AND METHODS: Participating schoolchildren and their parents completed questionnaires at baseline and 1 year later, including questions on usual F&V intake, potential determinants and general demographics. Primary outcomes were the usual fruit intake and the usual vegetable intake as assessed by parent- and child self-reported food frequency measures. Secondary outcome measures were child- or parent-reported taste preference, knowledge of daily recommendations, availability, and accessibility for fruit intake. Multilevel regression analyses were used to assess differences at follow-up adjusted for baseline values between the control and intervention group using both child and parent reports. SUBJECTS: Five hundred and sixty-five children of Dutch ethnicity and 388 children of non-Western ethnicity (mean age 9.9 years at baseline) and their parents. RESULTS: Children of non-Western ethnicity in the intervention group reported a significantly higher vegetable intake (difference = 20.7 g day-1, 95% confidence interval (CI) = 7.6-33.7). A significant positive intervention effect was also found for fruit intake for children of Dutch ethnicity (difference = 0.23 pieces day-1, 95% CI = 0.07-0.39). No significant effects in intake were observed based on parent reports. Significant positive intervention effects were also found for perceived accessibility among children of non-Western ethnicity, as well as for parent-reported taste preference of their child among children of non-Western ethnicity and boys of Dutch ethnicity.CONCLUSION: Providing children with free F&V had some positive effects on child-reported intakes and important correlates of intakes.     

Stimulated esophageal groove closure in adult goats

In healthy adult goats, closure of the esophageal groove was induced by thirst, IV administered vasopressin, and intracarotid administration of hypertonic NaCl solutions. The efficiency of stimulation was tested directly by visual inspection of the course taken by orally administered solutions through a ruminal or abomasal fistula, palpation of the lips of the esophageal groove through a ruminal fistula, and indirectly by following the glucose dynamics in the blood after oral administration of glucose solution. Esophageal groove closure was observed during drinking after a 48-hour period of water deprivation. Intracarotid administration of 1.5 ml of a saturated solution or 10.5 ml of a 1.5% solution of NaCl also stimulated groove closure; however, groove closure stimulated by administration of vasopressin is the most satisfactory procedure for passing compounds of therapeutic importance directly from the cardiac orifice to the abomasum.     

A multilevel study of socio-economic inequalities in food choice behaviour and dietary intake among the Dutch population: the GLOBE study

OBJECTIVE: To examine the influence of individual- and area-level socio-economic characteristics on food choice behaviour and dietary intake. SETTING: The city of Eindhoven in the south-east Netherlands. DESIGN: A total of 1339 men and women aged 25-79 years were sampled from 85 areas (mean number of participants per area = 18.4, range 2-49). Information on socio-economic position (SEP) and diet was collected by structured face-to-face interviews (response rate 80.9%). Individual-level SEP was measured by education and household income, and area-level deprivation was measured using a composite index that included residents' education, occupation and employment status. Diet was measured on the basis of (1) a grocery food index that captured compliance with dietary guidelines, (2) breakfast consumption and (3) intakes of fruit, total fat and saturated fat. Multilevel analyses were performed to examine the independent effects of individual- and area-level socio-economic characteristics on the dietary outcome variables. RESULTS: After adjusting for individual-level SEP, few trends or significant effects of area deprivation were found for the dietary outcomes. Significant associations were found between individual-level SEP and food choice, breakfast consumption and fruit intake, with participants from disadvantaged backgrounds being less likely to report food behaviours or nutrient intakes consistent with dietary recommendations. CONCLUSIONS: The findings suggest that an individual's socio-economic characteristics play a more important role in shaping diet than the socio-economic characteristics of the area in which they live. In this Dutch study, no independent influence of area-level socio-economic characteristics on diet was detected, which contrasts with findings from the USA, the UK and Finland.     

Are the Dutch acquainted with and willing to try healthful food products? The role of food neophobia

OBJECTIVES: To assess participants' acquaintance with and willingness to try healthful food alternatives, and to test the psychometric properties of an adapted Dutch version of the Food Neophobia Scale (FNS) in order to study the role of food neophobia in this context. DESIGN: A cross-sectional study incorporating two web-based questionnaires, including a retest of the FNS one week later. Measures included acquaintance with and willingness to try 15 healthful food alternatives, level of food neophobia, level of education, gender and age. Multiple linear regression analyses were used to study associations between demographics and level of food neophobia as well as associations between level of food neophobia and acquaintance with and willingness to try the healthful alternatives. SETTING: The study was conducted in The Netherlands using a representative Internet panel. PARTICIPANTS: A total of 326 participants aged 18-50 years participated. RESULTS: Internal consistency and test-retest reliability of the FNS version used were sufficient. On average participants were acquainted with 7.9 of the products and modestly willing to try the products. Lowly educated participants had significantly higher FNS scores than highly educated participants (beta = -0.23, P < 0.01). FNS score was significantly associated with acquaintance with (beta = -0.21, P < 0.001) and willingness to try the healthful alternatives (beta = -0.26, P < 0.001).CONCLUSION: Further research into the role of food neophobia is warranted when wanting to stimulate the integration of healthful alternative products in the daily diet, especially among persons with low education.     

School-based internet-tailored fruit and vegetable education combined with brief counselling increases children's awareness of intake levels

OBJECTIVE: Children's fruit/vegetable intake is still below recommended levels. This study applied Internet-tailored advice for schoolchildren and Internet-supported brief dietary counselling (with child and parent) within preventive health care to promote fruit/vegetable intake. SETTING/SUBJECTS: The study involved 30 seventh-grade classes (16 in the intervention group and 14 in the control group) with a total of 675 children aged 9-12 years, of whom 495 were allowed to participate. DESIGN: A cluster-randomised baseline-post-test experimental design was applied. During school hours, all children completed Internet-administered questionnaires on fruit/vegetable intake and related determinants. Children in the intervention group received immediate online individually tailored nutrition feedback. For each child in the intervention group, a nurse received information concerning the assessment of fruit/vegetable intake via the Internet to support a 5 min counselling protocol to promote fruit/vegetable intake. Children completed a similar post-test questionnaire 3 months after the first assessment. Intention-to-treat analyses were conducted using multilevel regression analyses. RESULTS: A total of 486 children (98% of 495) participated (263 in the intervention group, 223 in the control group); 240 child-parent couples in the intervention group attended the counselling. Awareness of inadequate fruit intake (odds ratio (OR) = 3.0; 95% confidence interval (CI) = 1.8-5.3) and knowledge of recommended vegetable intake levels (OR = 2.7; 95% CI = 1.8-4.1) were significantly more likely at post-test in the intervention group than in the control group. No significant effects were found on intake or other determinants. CONCLUSIONS: A compact, integrated two-component intervention can induce positive changes in knowledge and awareness of intake levels of fruit/vegetables among schoolchildren. To induce changes in intake levels, more comprehensive interventions may be needed.     

Using epidemiological models to estimate the health effects of diet behaviour change: the example of tailored fruit and vegetable promotion

OBJECTIVE: To explore the use of epidemiological modelling for the estimation of health effects of behaviour change interventions, using the example of computer-tailored nutrition education aimed at fruit and vegetable consumption in The Netherlands. DESIGN: The effects of the intervention on changes in consumption were obtained from an earlier evaluation study. The effect on health outcomes was estimated using an epidemiological multi-state life table model. Input data for the model consisted of relative risk estimates for cardiovascular disease and cancers, data on disease occurrence and mortality, and survey data on the consumption of fruits and vegetables. RESULTS: If the computer-tailored nutrition education reached the entire adult population and the effects were sustained, it could result in a mortality decrease of 0.4 to 0.7% and save 72 to 115 life-years per 100,000 persons aged 25 years or older. Healthy life expectancy is estimated to increase by 32.7 days for men and 25.3 days for women. The true effect is likely to lie between this theoretical maximum and zero effect, depending mostly on durability of behaviour change and reach of the intervention. CONCLUSION: Epidemiological models can be used to estimate the health impact of health promotion interventions.     

Slaughterhouse effluent discharges into rivers not responsible for environmental occurrence of enteroaggregative Escherichia coli

Enteroaggregative Shiga-toxin-producing Escherichia coli strains were responsible for a massive outbreak in Europe in 2011, and had been previously isolated from French patients. The objective of this study was to investigate the presence of enteroaggregative E. coli (EAEC) in slaughterhouse effluents (wastewater, slurry, sludge and effluents), and in river waters near these slaughterhouses. A total of 10,618 E. coli isolates were screened by PCR for the presence of EAEC-associated genetic markers (aggR, aap and aatA). None of these markers was detected in E. coli isolated from slaughterhouse samples. A unique enteroaggregative E. coli (EAEC) O126:H8 was detected in river water sampled upstream from slaughterhouse effluent discharge. These results confirmed that animals might not be reservoirs of EAEC, and that further studies are required to evaluate the role of the environment in the transmission of EAEC to humans.