School food policy at primary and secondary schools in Belgium-Flanders: does it influence young people's food habits?

Consumption of fruit, vegetables, sweets and soft drinks are associated with psychological dimensions of eating behaviour in parents and their 12-year-old children

Objective

We investigated associations between consumption of fruits, vegetables, sweets and soft drinks and the psychological dimensions of eating in parents and their children. The role of the parent’s characteristics for their children’s food intake was also explored.

Design

Food intake patterns were assessed by self-reported consumption of the respective foods. Eating behaviour was measured by the Dutch Eating Behaviour Questionnaire and self-esteem by Harter self-perception scale. The participants were 1441 families (mother, father and their 12-year-old child), and additionally 354 mothers and thirty fathers.

Results

Among parents, reported intake of fruit and vegetables were associated with restrained eating, higher self-esteem, and higher education and age. Intake of sweets was related to more external and less restrained eating, and for mothers also emotional eating. Parent’s intake of soft drink was foremost related to a younger age, and also weakly associated with psychological characteristics. The food intake of parents was more important for the children’s food intake than any other characteristics. However, children’s intake of sweets showed clear-cut positive associations with external eating.

Conclusions

Psychological dimensions of eating behaviour are associated with patterns of food intake, in particular for consumption of sweets, and are most prominent in the parents. The children’s food intake mirrored their parents’ intake. Being sensitive to external food cues may increase unhealthy food consumption in our society, whereas more restrained eating may indicate proneness or intention to healthier food choices among parents. Emotional eating may imply a proneness to consume sweets for comfort, in particular among mothers.

Food consumption among preschoolers. Does the school make a difference?

Few preschool children have a diet in line with nutrition recommendations. The school food policy is one of the factors that can influence children's eating habits. Multilevel regression analyses were carried out to test the potential influence of a school's food policy (N=50) on the children's (N=1678; ages 2.5-6.5 year) consumption of fresh fruit, snacks, water, fruit juice, milk, sugared milk drinks and sugared soft drinks. Between-school variation remained significant after controlling for individual level characteristics for fruit juice, sugared milk drinks and fruit. Significant school level variables were availability of sugared milk drinks and having food rules in the school policy.

The effects of a middle-school healthy eating intervention on adolescents' fat and fruit intake and soft drinks consumption

OBJECTIVES

To evaluate the effects of a middle-school healthy eating promotion intervention combining environmental changes and computer-tailored feedback, with and without an explicit parent involvement component.

DESIGN

Clustered randomised controlled trial.

SETTING

Fifteen West-Flemish (Belgian) middle schools.

SUBJECTS

A random sample of 15 schools with 2991 pupils in 7th and 8th grades was randomly assigned to an intervention group with parental support (n = 5), an intervention group without parental support (n = 5) and a control group (n = 5). In these 15 schools an intervention combining environmental changes with computer-tailored feedback was implemented. Fat and fruit intake, water and soft drinks consumption were measured with food-frequency questionnaires in the total sample of children.

RESULTS

In girls, fat intake and percentage of energy from fat decreased significantly more in the intervention group with parental support, compared with the intervention alone group (all F>3.9, P < 0.05) and the control group (all F>16.7, P < 0.001). In boys, there were no significant decreases in fat intake (F = 1.4, not significant (NS)) or percentage of energy from fat (F = 0.7, NS) as a result of the intervention. No intervention effects were found in boys or in girls for fruit (F = 0.5, NS), soft drinks (F = 2.6, NS) and water consumption (F = 0.3, NS).

CONCLUSIONS

Combining physical and social environmental changes with computer-tailored feedback in girls and their parents can induce lower fat intake in middle-school girls. However, to have an impact on the consumption of soft drinks and water, governmental laws that restrict the at-school availability of low-nutritive products may be necessary.

Effects of lifestyle on the onset of puberty as determinant for breast cancer

Breast cancer is more than ever the leading cause of death in women. In this article, we investigate the influence of lifestyle factors, and in particular nutrition (i.e. soft drinks), on physical development, puberty, breast growth and menarche to understand the potential impact of these environmental and lifestyle factors on the induction of breast cancer susceptibility. A questionnaire was obtained from 1146 girls of 10 schools in Belgian Limburg, attending the second year of secondary school. Their mean age was about 13 years. The analyses of the data were performed with 'survival analysis', in particular with the 'Cox regression' model for menarche. This project was conducted in the school year of 1999-2000. In the univariate and multivariate analysis investigating the most important variables of the period from birth to the age of menarche, there was clear evidence that lifestyle factors, including nutrition, have an effect on breast development and menarche. The following variables were significantly related to breast development and menarche: body mass index, drinking high-carbohydrate drinks, i.e. soft drinks, height of the father and the mother, weight of the mother at the start of pregnancy, history of mononucleosis, origin and education of the parents and physical activity. Lifestyle factors, including nutrition (i.e. soft drinks), affect the age at puberty and menarche. The same factors are known to be related to breast cancer risk. Better control of these variables during puberty might reduce breast cancer risk later in life.

Breakfast habits affect overall nutrient profiles in adolescents

Objective

To describe breakfast consumption patterns, on a nutrient and food item level, in Belgian adolescents.

Design

A 7-day estimated food record was administered in a cross-sectional survey.

Setting

Secondary schools in Ghent, Belgium.

Subjects

A total of 341 adolescents (13–18 years old), multistage clustered sampling.

Results

The energy contribution of breakfast to daily energy intake was on average 15.7% in boys and 14.9% in girls. Significantly more overweight girls and significantly more girls following vocational training were categorised as eating a low-quality breakfast. In boys, the energy contribution of polysaccharides was significantly higher in consumers of good-quality breakfasts. The intake of all selected micronutrients was significantly higher in consumers of good-quality breakfasts. In girls, the total energy intake and the proportional intake of proteins and polysaccharides were significantly higher in consumers of good-quality breakfasts, while the proportional contribution of total fat, monounsaturated and polyunsaturated fatty acids was significantly lower in these girls. The intake of all micronutrients was significantly higher in girls consuming a good-quality breakfast. In all adolescents, consumers of a good-quality breakfast had significantly higher intakes of bread, fruit, vegetables, milk and milk products, and fruit juice, while intake of soft drinks was significantly lower than in consumers of low-quality breakfasts.

Conclusions

Consumers of a good-quality breakfast had a better overall dietary pattern – on a nutrient and food group level – than consumers of a low-quality breakfast. A daily breakfast, including whole-grain products, fruit and (semi-) skimmed milk products or an alternative source of calcium, is recommended.

Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: Quantitative studies

BACKGROUND

In order to more effectively promote fruit and vegetable intake among children and adolescents, insight into determinants of intake is necessary. We conducted a review of the literature for potential determinants of fruit and vegetable intake in children and adolescents.

METHODS

Papers were identified from Medline and PsycINFO by using all combinations of the search terms: "fruit(s) or vegetable(s)" and "children or adolescents". Quantitative research examining determinants of fruit and/or vegetable intake among children and adolescents aged 6-18 years were included. The selection and review process was conducted according to a four-step protocol resulting in information on country, population, design, methodology, theoretical basis, instrument used for measuring intake, statistical analysis, included independent variables, and effect sizes.

RESULTS

Ninety-eight papers were included. A large number of potential determinants have been studied among children and adolescents. However, for many presumed determinants convincing evidence is lacking, mostly because of paucity of studies. The determinants best supported by evidence are: age, gender, socio-economic position, preferences, parental intake, and home availability/accessibility. Girls and younger children tend to have a higher or more frequent intake than boys and older children. Socio-economic position, preferences, parental intake, and home availability/accessibility are all consistently positively associated with intake.

CONCLUSION

The determinants most consistently supported by evidence are gender, age, socio-economic position, preferences, parental intake and home availability/accessibility. There is a need for internationally comparative, longitudinal, theory-based and multi-level studies taking both personal and environmental factors into account. This paper is published as part of the special Pro Children series in the International Journal of Behavioral Nutrition and Physical Activity. Please see [http://www.ijbnpa.org/content/3/1/26] for the relevant editorial.

Nutrition policy, food and drinks at school and after school care

OBJECTIVE

The purpose of the paper is to describe food and drinks available in food stands or cantina at Danish schools and food and drinks provided at after school care institutions in Denmark.

MATERIAL AND METHODS

The survey was performed in 1999 and self-administered postal questionnaires were sent to all private and public schools and all after school care institutions in Denmark. The participation rate was 70 at schools and 66 at after school care institutions.

RESULTS

In total, 3% of schools and 4% of after school care institutions have a written policy on nutrition. All Danish children have access to milk at school and they can choose between milk with low and high content of fat. Vending machines are rare at schools and are not present at all at after school care institutions. Only 10% of schools offer children sugared carbonated drinks at food stands. Fruit is available daily in 35% of schools, at food stands, and in 18% of the schools, fruit is available on prescription. In after school care institutions, sweets and sugared carbonated drinks are rare. However, juice is served daily in 47% of after school care institutions. Most schools run the food stand at school for profit.

CONCLUSION

The paper highlights the important aspects of the institutional level as one of six important levels as regards the prevention of obesity and an important level at which to act to increase nutrition habits in school children.