Differences in fruit and vegetable intake and determinants of intakes between children of Dutch origin and non-Western ethnic minority children in the Netherlands - a cross sectional study.

BACKGROUND: Fruit and vegetable consumption is low in the Netherlands and a key target in healthy diet promotion. However, hardly any information is available on differences in fruit and vegetable consumption between Dutch children and ethnic minority children. Therefore, the aim of present study was to determine differences in usual fruit and vegetable intake between native Dutch and non-Western ethnic minority children and to study differences in and mediating effects of potential psychosocial and environmental determinants. METHODS: Ethnicity, usual fruit and vegetable consumption, psychosocial and environmental determinants and mothers' educational level were measured with a self-administered questionnaire during school hours in primary schools in Rotterdam, the Netherlands. Complete data was available for 521 10-11 year-old-children, of which 50.5% of non-Western origin. Differences between the groups regarding potential determinants and fruit and vegetable intake were assessed with Mann Whitney tests or multiple regression analyses. Multiple regression analyses were also conducted to assess mediating effects. RESULTS: Ethnic minority girls ate fruit more frequently (1.41 +/- 1.0 times/day) than Dutch girls (1.03 +/- 0.82 times/day); no differences in frequency of intake were found for vegetables or among boys. Ethnic differences were found for almost all potential determinants. The Dutch children reported lower scores on these determinants than the ethnic minority children, except for perceived self-efficacy and barriers to eat fruit and vegetables. Knowledge of recommendations and facilitating behaviors of the parents mediated the association between ethnicity and fruit consumption among girls. CONCLUSION: Ethnic minority girls in the Netherlands appear to have more favorable fruit intakes than Dutch girls, and ethnic minority children in general show more positive prerequisites for fruit and vegetable consumption. Interventions addressing multi-ethnic populations of children must take such differences into account

Mediators of the effect of the JUMP-in intervention on physical activity and sedentary behavior in Dutch primary schoolchildren from disadvantaged neighborhoods.

<p>Abstract</p> <p>Background</p> <p>Important health benefits can be achieved when physical activity in children from low socio-economic status is promoted and sedentariness is limited. By specifying the mediating mechanisms of existing interventions one can improve future physical activity interventions. This study explored potential mediators of the long-term effect of the school-based multicomponent JUMP-in intervention on sport participation, outdoor play and screen time in Dutch primary schoolchildren from disadvantaged neighborhoods.</p> <p>Methods</p> <p>In total, 600 primary schoolchildren (aged 9.8 ± 0.7, 51% girls, 13% Dutch ethnicity, 35% overweight) from 9 intervention and 10 control schools were included in the analyses. JUMP-in was developed using Intervention Mapping, and targeted psychological and environmental determinants of physical activity. Outcome behaviors were self-reported sport participation, outdoor play, TV-viewing behavior and computer use. Potential mediators were self-reported psychological, social and physical environmental factors.</p> <p>Results</p> <p>JUMP-in was effective in improving sport participation after 20 months, but not in improving outdoor play, or reducing TV-viewing or computer time. JUMP-in was not effective in changing hypothesized mediators so no significant mediated effects could be identified. However, changes in self-efficacy, social support and habit strength were positively associated with changes in sport participation, and changes in social support, self-efficacy, perceived planning skills, enjoyment and habit strength were positively associated with changes in outdoor play. Changes in enjoyment was positively associated with changes in TV-viewing while parental rules were negatively associated. Having a computer in the bedroom and enjoyment were positively associated with changes in computer use, while changes in parental rules were negatively associated.</p> <p>Conclusions</p> <p>Besides a significant positive effect on sports participation, no significant intervention effect on outdoor play, screen time or any of the potential mediators was found. This suggest that other (unmeasured) factors operated as mediating mechanisms of the intervention, that we used unsuccessful intervention strategies, that the strategies were inappropriately implemented, or that children are unable to accurately recall past activities and cognitions. Additionally, the school setting might not be the sole channel to influence leisure time activities. Still, several personal and environmental constructs were found to be relevant in predicting change in sport participation, outdoor play and screen behavior and seem to be potential mediators. Future interventions are recommended including more effective strategies targeting these relevant constructs, addressing different constructs (e.g. pedagogic skills of parents), and focusing on different implementation settings.</p> <p>Trail registration</p> <p>ISRCTN17489378</p

Micro-level economic factors and incentives in Children's energy balance related behaviours findings from the ENERGY European cross-section questionnaire survey

<p>Abstract</p> <p>Background</p> <p>To date, most research on obesogenic environments facing school children has focused on physical and socio-cultural environments. The role of economic factors has been investigated to a much lesser extent. Our objective was to explore the association of micro-level economic factors and incentives with sports activities and intake of soft drinks and fruit juice in 10-12 year-old school children across Europe, and to explore price sensitivity in children’s soft drink consumption and correlates of this price sensitivity.</p> <p>Methods</p> <p>Data for the study originate from a cross-sectional survey undertaken in seven European countries (Belgium, Greece, Hungary, Netherlands, Norway, Slovenia and Spain) in 2010 among 10-12 year-old school children and their parents. In total, 7234 child questionnaires and 6002 parent questionnaires were completed. The child questionnaire included questions addressing self-reported weekly intake of soft drinks and fruit juices and time spent on sports activities, perception of parental support for sports activities, use of pocket money for soft drinks and perceived price responsiveness. Parent questionnaires included questions addressing the role of budget and price considerations in decisions regarding children’s sports activities, soft drink consumption, home practices and rules and socio-demographic background variables. Data were analysed using multiple linear regression and discrete-choice (ordered probit) modelling.</p> <p>Results</p> <p>Economic factors were found to be associated with children’s sports participation and sugary drink consumption, explaining 27% of the variation in time for sports activities, and 27% and 12% of the variation in the children’s soft drink and juice consumption, respectively. Parents’ financial support was found to be an important correlate (Beta =0.419) of children’s sports activities. Children’s pocket money was a strong correlate (Beta =21.034) of soft drink consumption. The majority of the responding children reported to expect that significantly higher prices of soft drinks would lead them to buy less soft drinks with their own pocket money, but a majority of parents did not expect higher soft drink prices to reduce their children’s soft drink consumption.</p> <p>Conclusions</p> <p>We conclude that economic factors, especially parents’ financial support and amount of pocket money, appear to be of importance for children’s sports participation and soft drink consumption, respectively.</p

Primary prevention of overweight in preschool children, the BeeBOFT study (breastfeeding, breakfast daily, outside playing, few sweet drinks, less TV viewing): Design of a cluster randomized controlled trial

Background: Two overweight prevention interventions were developed to be offered by preventive Youth Health Care (YHC) in addition to the currently applied overweight prevention protocol to parents of 0-3 year old children. The two interventions aim to support parents of preschool children to realize healthy child nutrition and activity behaviors of their young child. The aim of this study is to assess the effects of the two overweight prevention interventions with regard to child health behaviors and child Body Mass Index. Methods/Design. A cluster randomized controlled trial was conducted among parents and their preschool children who attend one of 51 participating YHC teams. The teams were randomly allocated to one of the two intervention groups, or to the control group (care as usual).The 'BBOFT+' intervention focuses on effective child rearing by parents from birth onwards by enlarging parental skills concerning healthy behavioural life-style habits. Parents who are allocated to the 'E-health4Uth Healthy toddler' intervention group, at the child age of circa 18 and 24 months old, are invited to complete an online E-health module providing tailored health education regarding healthy child nutrition and activity behaviors. The E-health messages are discussed and reinforced during the subsequent regularly scheduled visits by YHC professionals, and were repeated after 4 weeks.The primary outcome measures at child age 3 years are: overweight inducing/reducing behaviors, (for 'BBOFT+' only) healthy sleep, Body Mass Index and prevalence of overweight and obesity. Secondary outcome measures are attitudes and other cognitive characteristics of the parents regarding the overweight-related behaviors of their child, parenting styles and practices, and health-related quality of life of the children. Discussion. We hypothesize that the use of the additional interventions will result in a healthier lifestyle of preschool children and an improved BMI and less development of overweight and obesity compared to usual care. Trial registration. Nederlands Trial Register NTR1831

Long-term effects of the Dutch Schoolgruiten Project-promoting fruit and vegetable consumption among primary-school children

V intakes as assessed by parent and child self-reported food frequency measures. Secondary outcome measures were taste preference, knowledge of daily recommendations, availability and accessibility for fruit intake. Multilevel linear regression analyses were used to assess differences at second follow-up adjusted for baseline values between control and intervention groups. SUBJECTS: Reports were available for 346 intervention children (148 parents) and 425 control children (287 parents). RESULTS: Both child and parent reports indicated that the intervention group had a significantly higher fruit intake at 2-year follow-up (difference, servings/d: 0.15; 95 % CI 0.004, 0.286 for child reports; 0.19; 95 % CI 0.030, 0.340 for parent reports). No significant effects on vegetable intake were observed. Significant positive intervention effects were also found for knowledge of fruit recommendations among boys. Some evidence was found for partial mediation analyses of the effects on fruit intake. CONCLUSION: The present study indicates that the Schoolgruiten scheme was effective in increasing children's fruit intake and that appreciation of the project partially mediated this effec

Dutch Young Adults Ratings of Behavior Change Techniques Applied in Mobile Phone Apps to Promote Physical Activity: A Cross-Sectional Survey

BACKGROUND: Interventions delivered through new device technology, including mobile phone apps, appear to be an effective method to reach young adults. Previous research indicates that self-efficacy and social support for physical activity and self-regulation behavior change techniques (BCT), such as goal setting, feedback, and self-monitoring, are important for promoting physical activity; however, little is known about evaluations by the target population of BCTs applied to physical activity apps and whether these preferences are associated with individual personality characteristics. OBJECTIVE: This study aimed to explore young adults’ opinions regarding BCTs (including self-regulation techniques) applied in mobile phone physical activity apps, and to examine associations between personality characteristics and ratings of BCTs applied in physical activity apps. METHODS: We conducted a cross-sectional online survey among healthy 18 to 30-year-old adults (N=179). Data on participants’ gender, age, height, weight, current education level, living situation, mobile phone use, personality traits, exercise self-efficacy, exercise self-identity, total physical activity level, and whether participants met Dutch physical activity guidelines were collected. Items for rating BCTs applied in physical activity apps were selected from a hierarchical taxonomy for BCTs, and were clustered into three BCT categories according to factor analysis: “goal setting and goal reviewing,” “feedback and self-monitoring,” and “social support and social comparison.” RESULTS: Most participants were female (n=146), highly educated (n=169), physically active, and had high levels of self-efficacy. In general, we observed high ratings of BCTs aimed to increase “goal setting and goal reviewing” and “feedback and self-monitoring,” but not for BCTs addressing “social support and social comparison.” Only 3 (out of 16 tested) significant associations between personality characteristics and BCTs were observed: “agreeableness” was related to more positive ratings of BCTs addressing “goal setting and goal reviewing” (OR 1.61, 95% CI 1.06-2.41), “neuroticism” was related to BCTs addressing “feedback and self-monitoring” (OR 0.76, 95% CI 0.58-1.00), and “exercise self-efficacy” was related to a high rating of BCTs addressing “feedback and self-monitoring” (OR 1.06, 95% CI 1.02-1.11). No associations were observed between personality characteristics (ie, personality, exercise self-efficacy, exercise self-identity) and participants’ ratings of BCTs addressing “social support and social comparison.” CONCLUSIONS: Young Dutch physically active adults rate self-regulation techniques as most positive and techniques addressing social support as less positive among mobile phone apps that aim to promote physical activity. Such ratings of BCTs differ according to personality traits and exercise self-efficacy. Future research should focus on which behavior change techniques in app-based interventions are most effective to increase physical activity

Determinants of adolescents' soft drink consumption

Objective: To identify determinants of adolescents' consumption of carbonated soft drinks (regular and diet), both of total consumption and of consumption at school. Design/Setting/Subjects: Regular and diet soft drink consumption was measured by food frequency questions that were dichotomised. Several potential environmental and personal determinants of consumption were measured. A total of 2870 (participation rate: 85%) 9th and 10th graders, within 33 Norwegian schools, participated in the study. Multilevel logistic regression analyses were preformed for total soft drink consumption (twice a week or more vs. less) and for consumption at school (once a week or more vs. less). Results: A total of 63% and 27% of the participants reported to drink respectively regular and diet soft drinks twice a week or more, and 24% and 8%, respectively, reported to drink soft drinks once a week or more at school. Preferences, accessibility, modelling and attitudes were the strongest determinants of both regular and diet soft drink consumption. In addition, gender, educational plans and dieting were related to both total soft drink consumption and consumption at school. Pupils with longer distance from school to shop and those in schools with rules concerning soft drink consumption tended to have lower odds of drinking both regular and diet soft drinks at school. Conclusion: This Study shows that gender, educational plans, dieting, accessibility, modelling, attitudes and preferences all seem to be strong determinants of adolescents' soft drink consumption. Parents and the home environment appear as great potential intervention targets