Trends in fruit, vegetable and salad intakes in 9-10-year-old schoolchildren living in Liverpool, 2000-2005

OBJECTIVE: To report on the fruit, vegetable and salad intakes of Liverpool schoolchildren aged 9-10 years over a 5-year period (2000-2005). DESIGN: Cross-sectional observational study. SETTING: Between 75 and 100 Liverpool primary schools took part in each survey year. SUBJECTS: Subjects consisted of five separate cohorts of 9-10-year-old children from all areas of the city. MAIN OUTCOME MEASURES: Number and proportion of boys and girls who reported eating fruit, vegetables and salad on the previous day. RESULTS: There was an upward trend in the reported intake of fruit between 2002 and 2005. Girls were more likely than boys to report eating fruit (P < 0.001). The trend in salad intake was positive. Between 2000 and 2005 there were significant increases in the number of boys (chi2 = 17.57, P = 0.001) and girls (chi2 = 80.56, P = 0.001) eating salad. Girls were significantly more likely to eat salad than boys in all years (chi2 = 58.75, P = 0.001). Trends in vegetable intake were similar to those for salad, with both sexes reporting yearly increases over the 5-year period. The increase in the number of boys who reported eating vegetables between 2000 and 2005 was 23.5% (chi2 = 32.9, P = 0.000). In girls there was a 44.8% increase over the same period (chi2 = 110.3, P < 0.000). CONCLUSIONS: The data reveal positive trends in the fruit, vegetable and salad intakes of Liverpool schoolchildren between 2000 and 2005. Further research is needed to elucidate the specific factors that have enabled the changes to take place.     

Demographic, familial and trait predictors of fruit and vegetable consumption by pre-school children

OBJECTIVE: To examine the contribution to fruit and vegetable eating in children of potential predictive variables within the domains of demographics, parental feeding practices and personality traits. DESIGN: Cross-sectional survey. SETTING: Questionnaires were distributed to parents through 22 London nursery schools. SUBJECTS: Questionnaires were completed and returned by 564 parents or principal caregivers of 2-6-year-old children. RESULTS: Significant predictors of children's fruit and vegetable intake emerged from all three domains examined. Demographic variables associated with child's vegetable consumption were mother's education and child's age and gender. Only ethnicity was significantly associated with fruit consumption. Parental consumption, breast-feeding and early introduction to fruit and vegetables were related to intake of both. Family meal times were associated with higher intake of vegetables, but not of fruit. Two characteristics of children themselves (food neophobia and enjoyment of food) were strongly related to the consumption of fruit and vegetables. Subsequent multivariate analyses revealed that parental intake and child food neophobia independently predicted intake of both foods. In the presence of these, fruit consumption was affected by breast-feeding and early introduction to fruit, whereas vegetable consumption was related only to child's gender and enjoyment of food. CONCLUSIONS: These findings may be used to inform future interventions aimed at increasing children's consumption of fruit and vegetables. Parents should be made aware of the possible impact of their own behaviour on the eating habits of their children.     

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.     

Prevalence and predictors of food insecurity among low-income households in Los Angeles County

OBJECTIVES: To assess the prevalence and identify the predictors of food insecurity among households in Los Angeles County with incomes below 300% of the federal poverty level. METHODS: The Six-Item Short Form of the US Department of Agriculture's Household Food Security Scale was used as part of a 1999 county-wide, population-based, telephone survey. RESULTS: The prevalence of food insecurity was 24.4% and was inversely associated with household income. Other independent predictors of food insecurity included the presence of children in the household (odds ratio (OR) 1.7, 95% confidence interval (CI) 1.2-2.3) and a history of homelessness in the past five years (OR 5.6, 95% CI 3.4-9.4). CONCLUSION: Food insecurity is a significant public health problem among low-income households in Los Angeles County. Food assistance programmes should focus efforts on households living in and near poverty, those with children, and those with a history of homelessness.     

Associations of psychosocial factors with fruit and vegetable intake among African-Americans

OBJECTIVE: To examine associations of various psychosocial factors with fruit and vegetable intake in African-American adults. METHODS: A cross-sectional survey of a population-based sample of 658 African-Americans, aged 18-70 years, in North Carolina. Information was collected on diet-related psychosocial (predisposing, reinforcing and enabling) factors based on the PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation) planning framework; demographic, lifestyle and behavioural characteristics, and fruit and vegetable intake. RESULTS: The mean participant age was 43.9 years (standard deviation 11.6), 57% were female and 76% were overweight/obese. Participants expressed healthy beliefs regarding many of, but not all, the psychosocial factors. For example, although half of the respondents believed it is important to eat a diet high in fruits/vegetables, only 26% knew that >or=5 daily servings are recommended. The strongest associations of the psychosocial factors with fruit/vegetable intake were for predisposing factors (e.g. belief in the importance of a high fruit/vegetable diet and knowledge of fruit/vegetable recommendations) and one reinforcing factor (social support), with differences between the healthiest and least healthy responses of 0.5-1.0 servings per day. There was evidence of effect modification by gender in associations between psychosocial factors and fruit/vegetable consumption (e.g. self-efficacy was only significant in women), with higher intakes and generally healthier responses to the psychosocial variables in women than men. CONCLUSIONS: Interventions to increase fruit/vegetable intake in African-Americans may be more effective if they focus primarily on predisposing factors, such as knowledge, self-efficacy and attitudes, but not to the exclusion of reinforcing and enabling factors. The psychosocial factors that are targeted may also need to be somewhat different for African-American men and women.     

Correlates of fruit and vegetable intake among Norwegian schoolchildren: parental and self-reports

OBJECTIVES: To identify correlates of 6th and 7th graders' (age 10-12 years) fruit and vegetable intake, to investigate parent-child correlations of fruit and vegetable intake, and to compare parents' and children's reports of children's accessibility, skills and preferences with respect to fruit and vegetables. DESIGN: The results presented are based on the baseline survey of the 'Fruits and Vegetables Make the Marks Project', where 38 schools participated. SETTING: Fruit and vegetable intake was measured by food frequency questions. Theoretical factors, based on Social Cognitive Theory, potentially correlated to intake were measured, including behavioural skills, accessibility, modelling, intention, preferences, self-efficacy and awareness of 5-a-day recommendations. SUBJECTS: In total, 1950 (participation rate 85%) 6th and 7th graders and 1647 of their parents participated. RESULTS: Overall, 34% of the variance in the pupils' reported fruit and vegetable intake was explained by the measured factors. The strongest correlates to fruit and vegetable intake were preferences and accessibility. The correlation between the children's and their parents' fruit and vegetable intake was 0.23. The parents perceived their children's accessibility to be better than what was reported by the children (P<0.01), while the children reported their skills to be better than what was perceived by their parents (P<0.01). CONCLUSION: The results from this study clearly point to a need for nutrition interventions aimed at parents. An important next step will be to investigate whether the identified correlates predict future fruit and vegetable intake, and whether they mediate any changes in intake in an intervention study.     

Neighbourhood fruit and vegetable availability and consumption: the role of small food stores in an urban environment

OBJECTIVE: Previous studies on the relationship of dietary intake to the neighbourhood food environment have focused on access to supermarkets, quantified by geographic distance or store concentration measures. However, in-store food availability may also be an important determinant, particularly for urban neighbourhoods with a greater concentration of small food stores. This study synthesises both types of information - store access and in-store availability - to determine their potential relationship to fruit and vegetable consumption. DESIGN: Residents in four census tracts were surveyed in 2001 about their fruit and vegetable intake. Household distances to food stores in these and surrounding tracts were obtained using geographical information system mapping techniques. In-store fruit and vegetable availability was measured by linear shelf space. Multivariate linear regression models were used to measure the association of these neighbourhood availability measures with consumption. SETTING: Four contiguous census tracts in central-city New Orleans. SUBJECTS: A random sample of 102 households. RESULTS: Greater fresh vegetable availability within 100 m of a residence was a positive predictor of vegetable intake; each additional metre of shelf space was associated with 0.35 servings per day of increased intake. Fresh fruit availability was not associated with intake, although having a small food store within this same distance was a marginal predictor of fruit consumption. CONCLUSIONS: The findings suggest the possible importance of small neighbourhood food stores and their fresh produce availability in affecting fruit and vegetable intake.