Evaluation of the impact of a school gardening intervention on children's fruit and vegetable intake: a randomised controlled trial.

Background: Current academic literature suggests that school gardening programmes can provide an interactive environment with the potential to change children’s fruit and vegetable intake. This is the first cluster randomised controlled trial (RCT) designed to evaluate whether a school gardening programme can have an effect on children’s fruit and vegetable intake. Methods: The trial included children from 23 schools; these schools were randomised into two groups, one to receive the Royal Horticultural Society (RHS)-led intervention and the other to receive the less involved Teacher-led intervention. A 24-hour food diary (CADET) was used to collect baseline and follow-up dietary intake 18 months apart. Questionnaires were also administered to evaluate the intervention implementation. Results: A total of 641 children completed the trial with a mean age of 8.1 years (95% CI: 8.0, 8.4). The unadjusted results from multilevel regression analysis revealed that for combined daily fruit and vegetable intake the Teacher-led group had a higher daily mean change of 8 g (95% CI: −19, 36) compared to the RHS-led group -32 g (95% CI: −60, −3). However, after adjusting for possible confounders this difference was not significant (intervention effect: −40 g, 95% CI: −88, 1; p = 0.06). The adjusted analysis of process measures identified that if schools improved their gardening score by 3 levels (a measure of school gardening involvement - the scale has 6 levels from 0 ‘no garden’ to 5 ‘community involvement’), irrespective of group allocation, children had, on average, a daily increase of 81 g of fruit and vegetable intake (95% CI: 0, 163; p = 0.05) compared to schools that had no change in gardening score. Conclusions: This study is the first cluster randomised controlled trial designed to evaluate a school gardening intervention. The results have found very little evidence to support the claims that school gardening alone can improve children’s daily fruit and vegetable intake. However, when a gardening intervention is implemented at a high level within the school it may improve children’s daily fruit and vegetable intake by a portion. Improving children’s fruit and vegetable intake remains a challenging task

A longitudinal study on physical activity and fruit and vegetable intake

This study aimed to examine the interrelation of physical activity and fruit and vegetable intake. The influence of stage congruence between physical activity and fruit and vegetable intake on multiple behavior change was also investigated. Health behaviors, social-cognitions, and stages of change were assessed in 2693 adults at two points in time. Physical activity and fruit and vegetable intake were assessed 4 weeks after the baseline. Social-cognitions, stages as well as stage transitions across behavior domains were positively interrelated. Stage congruence was not related to changes in physical activity and fruit and vegetable intake. Physical activity and nutrition appear to facilitate rather than hinder each other. Having intentions to change both behaviors simultaneously does not seem to overburden individuals

Recalled Fruit and Vegetable Intake while Growing up and its Association with Adult Fruit and Vegetable Intake among U.S. Adults - Analysis of the Food Attitudes and Behaviors Survey

ABSTRACT MARY D. HILL Recalled fruit and vegetable intake while growing up and its association with adult fruit and vegetable intake among U.S. adults – analysis of the food attitudes and behaviors survey (Under the direction of DR. KYMBERLE STERLING) High dietary intake of fruits and vegetables (FVs) is associated with a lower risk for chronic disease including certain cancers, optimal child growth, and weight management. More than 72 million U.S. adults are obese; therefore, fruit and vegetable intake is important in weight management. Using data from the Food Attitude and Behavior survey, this study will address the following questions: is there a correlation between recalled fruit and vegetable intake during childhood and adult fruit and vegetable intake among U.S. adults? Secondly, is reported fruit and vegetable consumption associated with sociodemographic variables and other health-related behaviors? Results indicated there is a positive correlation between recalled FV intake and reported FV intake in adults. Therefore, public health practitioners should develop initiatives to increase the amount of FV intake in children so that these FV consumption habits may continue in adulthood

Determinants of fruit and vegetable intake among 11-year-old schoolchildren in a country of traditionally low fruit and vegetable consumption

BACKGROUND: Fruit and vegetable consumption is traditionally low in Iceland. The results of the Pro Children cross-Europe survey showed that the consumption was lowest among children in Iceland. The aim of this study was to identify determinants of fruit and vegetable intake among 11-year-old schoolchildren in Iceland. METHODS: A cross-sectional survey was performed in Iceland in the autumn of 2003 as a part of the Pro Children cross-Europe survey. The survey was designed to provide information on actual consumption levels of vegetables and fruits by 11-year-old school children and to assess potential determinants of consumption patterns. A total of 1235 Icelandic children (89%) from 32 randomly chosen schools participated. Hierarchical regression analyses were performed to determine the explained variance of the children's fruit and vegetable intake. In these analyses socio-demographic background variables were entered as a first block, perceived physical-environmental variables as a second block, perceived socio-environmental variables as a third block and personal variables as a fourth block. RESULTS: 64% of the children ate fruit less than once a day, and 61% ate vegetables less than once a day. Respectively, 31% and 39% of the variance in children's fruit and vegetable intake was explained by the determinants studied. About 7% and 13% of the variance in fruit and vegetable intake was explained by the perceived physical-environmental determinants, mainly by availability at home. About 18% and 16% of the variance in fruit and vegetable intake was explained by the personal determinants. For both fruit and vegetable intake, the significant personal determinants were preferences, liking, knowledge of recommendations and self-efficacy. CONCLUSION: Interventions to increase fruit and vegetable intake among children should aim at both environmental factors such as greater availability of fruit and vegetables, and personal factors as self-efficacy and knowledge levels concerning nutrition

Study protocol: can a school gardening intervention improve children's diets?

BACKGROUND: The current academic literature suggests there is a potential for using gardening as a tool to improve children's fruit and vegetable intake. This study is two parallel randomised controlled trials (RCT) devised to evaluate the school gardening programme of the Royal Horticultural Society (RHS) Campaign for School Gardening, to determine if it has an effect on children's fruit and vegetable intake. METHOD/DESIGN: Trial One will consist of 26 schools; these schools will be randomised into two groups, one to receive the intensive intervention as "Partner Schools" and the other to receive the less intensive intervention as "Associate Schools". Trial Two will consist of 32 schools; these schools will be randomised into either the less intensive intervention "Associate Schools" or a comparison group with delayed intervention. Baseline data collection will be collected using a 24-hour food diary (CADET) to collect data on dietary intake and a questionnaire exploring children's knowledge and attitudes towards fruit and vegetables. A process measures questionnaire will be used to assess each school's gardening activities. DISCUSSION: The results from these trials will provide information on the impact of the RHS Campaign for School Gardening on children's fruit and vegetable intake. The evaluation will provide valuable information for designing future research in primary school children's diets and school based interventions. TRIAL REGISTRATION: ISRCTN11396528

Association of Dietary Intake With Suicidal Ideation or Suicide Attempts in Adolescents

Suicide is among the leading cause of adolescent deaths worldwide and thus a significant public health concern. Risk factors for suicidal behavior include drinking alcohol, smoking, and engaging in risky sexual behaviors. One area of concern is dietary patterns and their association with depressive symptoms and suicidal ideation. Bandura\u27s social cognitive theory emphasizes the assumption that one can perform specific actions to bring about desired outcomes. The primary research questions for this quantitative, retrospective, cross-sectional study concerned whether there is a statistically significant interaction between fruit and vegetable intake and suicidal ideation or suicide attempts. Data from 71,776 adolescents in the Centers for Disease Control\u27s Youth Risk Behavioral Surveillance Survey were analyzed using complex samples binominal logistic regression. The dependent variable was suicidal ideation or suicide attempts, and the independent variable was intake of fruits and vegetables. Suicidal ideation was significantly, positively correlated with fruit and vegetable intake. Even after controlling for age, sex, race, and depression, there was a significant, positive correlation with fruit and vegetable intake. Suicide attempt was significantly, positively correlated with fruit and vegetable intake even after controlling for age, sex, race, and depression. Although the results of this study were contrary to previous findings, these results do support the claim that sugary foods and fast foods have a dopaminergic \u27reward effect\u27. The findings may foster positive social change by identifying the relationship between fruit and vegetable intake and suicidal ideation or suicide attempts in adolescents

Fruit and Vegetable Intake and Food Store Access: A Cross-Sectional Survey Study in Ypsilanti, Michigan

Given declines in supermarkets in Washtenaw County, Michigan (MI), we aim to characterize the relationship between food store access and fruit and vegetable intake in Ypsilanti, MI. A cross-sectional, convenience sample survey was conducted in March 2011 at the Ypsilanti District Library (n=83). Self-reported food store access, perceived food environment, and fruit and vegetable intake were assessed. Linear and logistic regressions were performed between store access, fruit and vegetable intake, and meeting dietary recommendations. Perception was evaluated for effect modification. Adjusting for demographics, each food store within one mile of participants’ homes increased odds of meeting recommended intake by 105% (OR 2.05, 95% CI: 1.02, 4.10). However, contrary to previous literature, each additional minute to the food store was associated with consumption of 0.37 (95% confidence interval [CI]: 0.10, 0.64) more servings of fruits and vegetables per day. Perception was not a statistically significant effect modifier, but data suggest differences for those with divergent perceptions. Food environment is associated with fruit and vegetable intake in Ypsilanti, MI. Inconsistent findings suggest that programs should focus on enhancing the food environment within the context of perceptions and preferences

Changes in accessibility and preferences predict children's future fruit and vegetable intake

BACKGROUND: Most children eat fewer fruits and vegetables than recommended. To be able to design effective interventions, understanding the aetiology of the behaviour is important. Accessibility and preferences have shown to be strong correlates of fruit and vegetable intake in several cross-sectional studies. The aim of this study was to identify predictors of future fruit and vegetable intake and to explore longitudinal patterns of interactions between accessibility and preferences. METHODS: Data presented are based on baseline (September 2001) and follow-up (May/June 2002) surveys of 20 control schools in the Norwegian intervention study Fruits and Vegetables Make the Marks. A total of 816 pupils (77%) completed both baseline and follow-up questionnaires. The average age of the sample at baseline was 11.8 years. The research instrument assessing potential predictor variables was guided by Social Cognitive Theory, and included Accessibility at home, Accessibility at school, Modelling, Intention, Preferences, Self-Efficacy and Awareness of the 5-a-day recommendations. Multiple regression analyses were performed. RESULTS: All independent variables (measured at baseline) were significantly correlated to future fruit and vegetable intake (measured at follow-up). When reported fruit and vegetable intake at baseline (past intake) was included in this model, the effect of the other independent variables diminished. Together with past intake, the observed change in the independent variables from baseline to follow-up explained 43% of the variance in the reported intake at follow-up. Past intake remained the strongest predictor, but changes in accessibility at home and at school, as well as changes in preferences for fruits and vegetables, also explained significant amounts of the variance in fruit and vegetable intake at follow-up. In addition, baseline accessibility was found to moderate the relationship between change in preferences and change in intake. CONCLUSION: Change in accessibility and preferences appear to be important predictors of future fruit and vegetable intake among school children. Interventions should focus on strategies to modify these factors

Low fruit and vegetable intake is associated with poor self-rated health in the Czech part of the HAPIEE study

BACKGROUND: Although fruits and vegetables are considered a pillar of healthy eating, previous evidence suggests that their consumption in Eastern European countries is low, and their association with health outcomes has rarely been researched in this region. AIMS: To examine the effect of fruit and vegetable intake on self-rated health (SRH) in the Czech arm of the Health, Alcohol and Psychosocial factors in Eastern Europe prospective cohort study. METHODS: Dietary data on fruit and vegetable intake was measured at baseline using food frequency questionnaires, and SRH from the second wave was chosen as the main outcome. The relationship between fruit and vegetable intake and SRH was analysed using multivariable ordinal regression. RESULTS: A total of 4255 persons aged 45-69, in good and very good SRH at baseline were included in the longitudinal analysis, with a median follow-up time of 3.7 years. In the second wave, 218 (5.1%) individuals reported poor or very poor SRH. In the fully adjusted model, individuals in the lowest fruit and vegetable intake quartile had higher odds of poor SRH compared to those in the highest quartile (OR = 1.24, 95% CI: 1.01-1.52). When examined separately, the results were similar: for vegetables (OR = 1.25, 95% CI: 1.03-1.51) and fruit (OR = 1.18, 95% CI: 0.97-1.44). CONCLUSIONS: The observed longitudinal association suggests that low fruit and vegetable intake is associated with poor SRH in the Czech Republic. Considering almost half of our sample reported less than the daily recommended intake of 400 grams of fruits and vegetables, higher consumption should be supported

Casting Health Messages in Terms of Responsibility for Dietary Change: Increasing Fruit and Vegetable Consumption

Objective To compare the effectiveness of messages emphasizing the importance of either personal or social responsibility for dietary behavior change in increasing fruit and vegetable intake. Design/Setting Randomly assigned individually or socially oriented messages were delivered at baseline, 1 week, and 2 and 3 months later. Telephone surveys were conducted at baseline and 1 and 4 months later. Participants 528 callers to a cancer information hotline who were not meeting the “5 A Day” dietary recommendation. Interventions A brief telephone-delivered message and 3 mailings of pamphlets and promotional items encouraging fruit and vegetable intake that emphasized either personal or social responsibility. Main Outcome Measures Fruit and vegetable intake 1 and 4 months postbaseline. Analysis Chi-square, t tests, and analyses of variance and covariance. Results Both types of messages increased intake substantially (P = .01). To some extent, the social responsibility message continued to motivate increased intake over time compared with the personal responsibility message. Conclusions and Implications These minimal interventions had a substantial impact on fruit and vegetable intake. Health messages might be more effective over the longer term if they are designed to emphasize the importance of social responsibility, although further study is needed to confirm the robustness of these findings