Little is known about the mediating effects of the determinants of fruit and vegetable (FV) intake in school-based interventions that promote FV intake, and few studies have examined the impact of the degree of implementation on the effects of an intervention. The present study examined whether the degree of implementation of an intervention had an effect on children's fruit or vegetable intake and determined possible mediators of this effect. The study is part of the European PRO GREENS intervention study which aimed to develop effective strategies to promote consumption of fruit and vegetables in schoolchildren across Europe. Data from 727 Finnish children aged 11 years were used. The baseline study was conducted in spring 2009 and the follow-up study 12 months later. The intervention was conducted during the school year 2009-2010. The effects were examined using multilevel mediation analyses. A high degree of implementation of the intervention had an effect on children's fruit intake. Knowledge of recommendations for FV intake and liking mediated the association between a high degree of implementation of the intervention and an increase in the frequency of fruit intake. Knowledge of recommendations for FV intake and bringing fruits to school as a snack mediated the association between a low degree of implementation of the intervention and an increase in the frequency of fruit intake. Overall, the model accounted for 34 % of the variance in the change in fruit intake frequency. Knowledge of recommendations acted as a mediator between the degree of implementation of the intervention and the change in vegetable intake frequency. In conclusion, the degree of implementation had an effect on fruit intake, and thus in future intervention studies the actual degree of implementation of interventions should be assessed when considering the effects of interventions.
This longitudinal study examined the frequency of consumption of vegetables for dinner by Norwegian adolescents and their parents. Associations of perceived availability, correlations and stability were explored. The longitudinal cohort consist of 1950 adolescents attending 6th/7th (2002) and 9th/10th (2005) grade, and their parents (n=1647). Only 40% of the adolescents and 60% of the adults reported to have eaten vegetables for dinner yesterday, the reported frequency of vegetables for dinner were 3.7 and 4.1 times/week in 2002 and 2005, respectively, and 4.8 times/week for parents. Girls ate more than boys, and high SES adolescents ate more than low SES adolescents. There were significant differences between adolescent and parent report of both frequency of consumption and perceived availability of vegetables for dinner. Adolescent's frequency of consumption of vegetables was related to the parent's consumption, and the adolescent response from 2002 to 2005 showed strong correlations. There were good tracking in the frequency of consumption of vegetables for dinner, and 25% of the adolescents showed a stable high frequency. To conclude, few adolescents and their parents consumed vegetables for dinner. Interventions are needed to meet the recommendations, and parents should be targeted in intervention programs.
To assess the relationship between number of meals eaten and weight status, and to assess potential confounders of this relationship.
A total of 2870 (participation rate: 85%) 9th and 10th graders (mean age: 15.5 years) at 33 schools completed questionnaires in May 2005. Number of meals was measured with questions asking whether they ate breakfast, lunch, dinner, and supper the day before, giving a scale ranging from zero to four meals/day. Data on gender, height, weight, education plans, intake of fruits and vegetables, consumption of unhealthy snacks, TV/computer time, physical activity level, and dieting were also collected.
The proportions of overweight adolescents related to the number of meals eaten were: 10% (0-1 meals, n = 107), 18% (2 meals, n = 399), 14% (3 meals, n = 925), and 10% (4 meals, n = 1402), p = 0.001. Low education plans, high TV/computer time, low physical activity level, and dieting were all positively associated with both being overweight and not having four meals. Being a boy was positively associated with being overweight but negatively associated with not having four meals. High intake of unhealthy snacks was negatively associated with being overweight, but positively associated with not having four meals. In a logistic regression analysis, adjusting for all variables mentioned, odds ratio for being overweight were 0.8 (95% CI 0.3-1.9), 1.8 (95% CI 1.2-2.7) and 1.6 (95% CI 1.2-2.3), respectively, for eating one or zero, two, and three meals compared to four meals.
Eating four meals/day was significantly negatively related to being overweight, also when controlling for potential confounding factors.
To investigate the intakes of sugar-sweetened beverages (SSB), fruit and vegetables (FV) among adolescents and their parents and to explore differences in the perceived availability by gender and parental education.
Baseline data from the HEIA (HEalth In Adolescents) study.
Data on intake of SSB were collected assessing frequency and amounts, whereas consumption of FV was assessed on the basis of frequency. Further, perceived availability at home and at school (taken from home) was reported.
Participants were 1528 Norwegian adolescents aged 11 years, as well as 1200 mothers and 1057 fathers.
The adolescents' intake of SSB was low on weekdays but doubled during weekend days. This pattern was observed among parents as well. There were significant differences in intake between boys, girls, mothers and fathers, except for vegetables. Fathers reported the lowest frequency of FV intake. Compared with adolescents, mothers reported lower availability of SSB and higher availability of FV. Compared with their sons, fathers reported higher availability of vegetables and lower availability of sugar-sweetened fruit drinks at school. Significant differences in adolescents' intake of SSB and in the perceived availability of both SSB and FV by parental education were found.
The intake of SSB was higher during weekend days than during weekdays, whereas the frequency of FV intake was low. Differences in adolescents' perceived availability of both SSB and FV on the basis of parental education were found, whereas the differences in intake were significant only for SSB. Increasing parental awareness of availability and their potential as role models across parental gender and educational level could improve adolescents' dietary habits.
The home environment is the first environment to shape childhood dietary habits and food preferences, hence greater understanding of home environmental factors associated with vegetable consumption among young children is needed. The objective has been to examine questionnaire items developed to measure the sociocultural home environment of children focusing on vegetables and to assess the psychometric properties of the resulting factors. Further, to explore associations between the environmental factors and vegetable consumption among Norwegian 3-5 year olds. Parents (n 633) were invited to participate and filled in a questionnaire assessing the child's vegetable intake and factors potentially influencing this, along with a 24-h recall of their child's fruit and vegetable intake. Children's fruit and vegetable intakes at two meals in one day in the kindergarten were observed by researchers. Principal components analysis was used to examine items assessing the sociocultural home environment. Encouragement items resulted in factors labelled "reactive encouragement", "child involvement" and "reward". Modelling items resulted in the factors labelled "active role model" and "practical role model". Items assessing negative parental attitudes resulted in the factor labelled "negative parental attitudes" and items assessing family pressure/demand resulted in the factor labelled "family demand". The psychometric properties of the factors were for most satisfactory. Linear regression of the associations between vegetable intake and the factors showed, as expected, generally positive associations with "child involvement", "practical role model" and "family demand", and negative associations with "negative parental attitudes" and "reward". Unexpectedly, "reactive encouragement" was negatively associated with vegetable consumption. In conclusion, associations between sociocultural home environmental factors and children's vegetable consumption showed both expected and unexpected associations some of which differed by maternal education - pointing to a need for further comparable studies.
OBJECTIVE: Guided by theory, this study explored cross-sectional differences in factors influencing adolescent eating behaviour including gender and socio-economic status (SES), and subsequently tested the longitudinal predictive power of the models. DESIGN/SETTING/SUBJECTS: Data were collected by questionnaires in a longitudinal study of adolescents (age 13 years at baseline) and their parents from Hordaland County, Norway. Association of personal and environmental variables (family, friends, school/society) with the consumption of fruit and vegetables (FV) and selected sources of fat and of sugar were assessed at age 15 The final cross-sectional models were subsequently employed in groups stratified by gender/SES and to predict consumption at age 21 RESULTS: The model explained more of the variation in the sugar score (21%) and the FV score (13.5%) than in the fat score (5%). SES was associated with both the sugar and FV scores. The strongest associations with the sugar score and FV were for antisocial behaviour and evaluation of own diet, respectively. The former association was significant in all gender/SES groups, whereas the latter association was only significant in the low SES groups. For all three types of food, the strongest significant predictors in the longitudinal models were frequency of consumption at age 15. CONCLUSION: The model's ability to explain variation in eating behaviours differed by food type, and possibly by gender/SES, but previous eating behaviour was an important predictor for all three foods. Prospective studies should carefully operationalize theoretical constructs when further investigating the influences of and interrelationships between these factors and gender/SES on the development of eating behaviours.
The present study investigates the changes and tracking of dietary behaviours in Norwegian 11-year-olds and examines the association between parental education and dietary tracking over a time period of 20 months.
Longitudinal data from the Norwegian HEalth In Adolescents (HEIA) cohort study followed up at three time points (2007-2009).
Intakes of fruits, vegetables and snacks were assessed by frequency and intakes of sugar-sweetened soft drinks and squash were assessed by frequency and amount. Tracking of dietary behaviours was assessed by adolescents' relative position in rank over time and Cohen's kappa was used to measure tracking coefficients. Multinomial logistic regression analyses were performed to assess the association between parental education and the tracking of dietary behaviours.
In total, 885 adolescents from the HEIA cohort study participated by answering Internet-based questionnaires at three time points.
The results indicated that boys and girls maintained their relative position in rank of dietary intake over time, when grouped by baseline consumption. Fair to moderate tracking coefficients of dietary variables were observed. An inverse association was found between parental education and stability of soft drink and squash consumption during the 20 months.
The observed tracking pattern indicates the importance of promoting healthy dietary behaviours at an even earlier age. Furthermore, interventions should focus particularly on adolescents from families with low parental education and their consumption of sugar-sweetened beverages.
First, to explore item pools developed to measure the physical home environment of pre-school children and assess the psychometric properties of these item pools; second, to explore associations between this environment and vegetable consumption among Norwegian 3-5-year-olds.
Data were collected in three steps: (i) a parental web-based questionnaire assessing the child's vegetable intake and factors potentially influencing the child's vegetable consumption; (ii) direct observation of the children's fruit, berry and vegetable intakes at two meals in one day in the kindergarten; and (iii) a parental web-based 24 h recall.
The target group for this study was pre-school children born in 2010 and 2011, attending public or private kindergartens in the counties of Vestfold and Buskerud, Norway.
A total of 633 children participated.
Principal component analysis on the thirteen-item pool assessing availability/accessibility resulted in two factors labelled 'availability at home' and 'accessibility at home', while the eight-item pool assessing barriers resulted in two factors labelled 'serving barriers' and 'purchase barriers'. The psychometric properties of these factors were satisfactory. Linear regression of the associations between vegetable intake and the factors showed generally positive associations with 'availability at home' and 'accessibility at home' and negative associations with 'serving barriers'.
This age group has so far been understudied and there is a need for comparable studies. Our findings highlight the importance of targeting the physical home environment of pre-school children in future interventions as there are important modifiable factors that both promote and hinder vegetable consumption in this environment.