Fruit and vegetable intake in young children

Brassica vegetables-an undervalued nutritional goldmine

The genus Brassica includes six species and over 15 types of vegetables that are widely cultivated and consumed globally. This group of vegetables is rich in bioactive compounds, including glucosinolates, vitamins (such as vitamin C, folate, tocopherol, and phylloquinone), carotenoids, phenols, and minerals, which are crucial for enriching diets and maintaining human health. However, the full extent of these phytonutrients and their significant health benefits remain to be fully elucidated. This review highlights the nutrient compositions and health advantages of Brassica vegetables and discusses the impacts of various processing methods on their nutritional value. Additionally, we discuss potential strategies for enhancing the nutrition of Brassica crops through agronomic biofortification, conventional breeding, and biotechnological or metabolic engineering approaches. This review lays the foundation for the nutritional improvement of Brassica crops.

Overweight in childhood and consumer purchases in a Danish cohort

BACKGROUND

Prevention and management of childhood overweight involves the entire family. We aimed to investigate purchase patterns in households with at least one member with overweight in childhood by describing expenditure on different food groups.

METHODS

This Danish register-based cohort study included households where at least one member donated receipts concerning consumers purchases in 2019-2021 and at least one member had their Body mass index (BMI) measured in childhood within ten years prior to first purchase. A probability index model was used to evaluate differences in proportion expenditure spent on specific food groups.

RESULTS

We identified 737 households that included a member who had a BMI measurement in childhood, 220 with overweight and 517 with underweight or normal weight (reference households). Adjusting for education, income, family type, and urbanization, households with a member who had a BMI classified as overweight in childhood had statistically significant higher probability of spending a larger proportion of expenditure on ready meals 56.29% (95% CI: 51.70;60.78) and sugary drinks 55.98% (95% CI: 51.63;60.23). Conversely, they had a statistically significant lower probability of spending a larger proportion expenditure on vegetables 38.44% (95% CI: 34.09;42.99), compared to the reference households.

CONCLUSION

Households with a member with BMI classified as overweight in childhood spent more on unhealthy foods and less on vegetables, compared to the reference households. This study highlights the need for household/family-oriented nutrition education and intervention.

Process evaluation of the Centrally Procured School Food Program (CPSFP) in Ontario, Canada: school-level perspectives

This study explored the implementation of the Centrally Procured School Food Program (CPSFP)-a free, universal, volunteer-led snack program for elementary school children. To assess participants' perceptions and experiences with the CPSFP, interviews were conducted in school-level participants (n = 33) using a semi-structured interview guide. Fifteen on-site visits also were conducted at each school to observe implementation practices. Quantitative data were obtained through a general information form where participants provided school characteristics and weekly logbooks where they described program operations and food quality. Most participants expressed positive perceptions of the CPSFP, identifying it as a valuable program for their students. Successful program implementation was associated with an appreciation for the CPSFP and the participation of the school community. Challenges to program implementation included concerns with the volume and types of food provided, issues with classroom food delivery and distribution and communication challenges. Suggestions for improvement included building capacities and enhancing student engagement in the program. Participants provided an in-depth assessment of the implementation of the CPSFP. The lessons learned and suggestions provided may help not only enhance the reach, feasibility and fidelity of the CPSFP, but inform the best practices for similar programs.

The apparent inverse association between dietary carotene intake and risk of cardiovascular mortality disappeared after adjustment for other cardioprotective dietary intakes: The Japan collaborative cohort study

BACKGROUND AND PURPOSE

An effect of dietary carotenes on risk of cardiovascular disease (CVD) is uncertain. We aimed to investigate whether the association between dietary carotenes intake and risk of CVD mortality will persist after controlling for the intakes of potential cardioprotective dietary factors that correlate with dietary alpha- and/or beta-carotenes.

METHODS AND RESULTS

We followed up a total of 58,646 Japanese between 1988 and 1990 and 2009. We used a food frequency questionnaire (FFQ) to determine the dietary intakes of carotenes, and estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) of CVD mortality in relation to carotene intake by the proportional hazard regression developed by David Cox. During 965,970 person-years of follow-up (median 19.3 years), we identified 3388 total CVD deaths. After adjusting for demographic and lifestyle factors, dietary intakes of alpha-carotene were significantly associated with the reduced risk of mortality from coronary heart disease (CHD); adjusted HR (95% CI) in the highest versus lowest quintiles of intake was 0.75 (0.58-0.96; P-trend = 0.02) and dietary intakes of beta-carotene were significantly associated with the reduced risk of mortality from CVD, CHD, and other CVD; adjusted HRs (95% CIs) were 0.88 (0.79-0.98; P-trend = 0.04), 0.78 (0.61-0.99; P-trend = 0.01), and 0.81 (0.67-0.98; P-trend = 0.04), respectively. However, after further adjusting for the dietary intakes of potassium, calcium, vitamins C, E, or K, these associations disappeared.

CONCLUSIONS

-Dietary alpha- and beta-carotene intakes were not associated with risk of CVD mortality after controlling for intakes of other potential cardioprotective nutrients.

Outcome evaluation of fruits and vegetables distribution interventions in schools: a systematic review and meta-analysis

OBJECTIVE

Fruits and vegetables (FV) distribution interventions have been implemented as a public health strategy to increase children's intake of FV at school settings. The purpose of this review was to examine whether snack-based FV distribution interventions can improve school-aged children's consumption of FV.

DESIGN

Systematic review and meta-analysis of articles published in English, in a peer-reviewed journals, were identified by searching six databases up to August 2020. Standardised mean differences (SMD) and 95 % CI were calculated using a random effects model. Heterogeneity was quantified using I2 statistics.

SETTING

Population-based studies of interventions where the main focus was the effectiveness of distributed FV as snacks to schoolchildren in North America, Europe and Pacific were included.

RESULTS

Forty-seven studies, reporting on fifteen different interventions, were identified; ten studies were included in the meta-analysis. All interventions were effective in increasing children's consumption of FV, with only one intervention demonstrating a null effect. Pooled results under all classifications showed effectiveness in improving children's consumption of FV, particularly for multi-component interventions at post-intervention (SMD 0·20, 95 % CI 0·13, 0·27) and free distribution interventions at follow-up (SMD 0·19, 95 % CI 0·12, 0·27).

CONCLUSIONS

Findings suggest that FV distribution interventions provide a promising avenue by which children's consumption can be improved. Nonetheless, our results are based on a limited number of studies, and further studies should be performed to confirm these results. More consistent measurement protocols in terms of rigorous study methodologies, intervention duration and follow-up evaluation are needed to improve comparability across studies.

Estimates of Non-Alcoholic Food-Derived Ethanol and Methanol Exposure in Human

Food-derived alcohol is almost not in question due to its low concentration. Nevertheless, could it pose a problem for some risk groups and forensic cases? To answer this, we aimed to simultaneously evaluate ethanol and methanol ingredients of a variety of non-alcoholic foods in two different countries and estimate their possible health and forensic consequences. Alcohols in foods were analysed by headspace gas chromatography (HS-GC). Human average acute daily food consumptions and food-derived blood alcohol concentrations (BAC) were determined by using the data of the EFSA Nutrition Survey. Methanol and ethanol ingredients of similar foods varied between the two cities. Most foods produce higher methanol concentrations than the Maximum Allowable Dose Level (23 mg). Especially fruit juices lead to the critical level of ethanol for children (6.0 mg/kg bw). Based on the results, adult daily intake of selected food groups does not bear ethanol that exceeds the legal limit of BAC or the limit not allowed by the religious and does not lead to acute alcohol toxicity. But these low levels of ethanol and methanol consumed via non-alcoholic foods for life can raise the vulnerability to chronic health problems (cancer, liver cirrhosis, Alzheimer's disease, autism, ocular toxicity, alterations in fetal development), and may lead to positive ethanol metabolite results (e. g. Ethyl glucuronide) when a low cut-off level is used. Therefore, studies on the alcohol contents of various natural and processed non-alcoholic foods along with their effects on humans, and new regulations on labeling the food products and conscious food consumption are in particular importance. It would also be important to consider unintentional alcohol consumption via non-alcoholic foods in the evaluation of clinical and forensic cases.

Process evaluation of fruit and vegetables distribution interventions in school-based settings: A systematic review

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Assesses how school fruit & vegetable distribution interventions are implemented.

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Child fruit & vegetable intake is influenced by how intervention is implemented.

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Recommendations for implementing fruit & vegetable interventions in schools.

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Studies should also consider sustainability, cost-effectiveness and implementation.

Despite the importance of process evaluation in program evaluations, research has focused primarily on the effectiveness of fruit and vegetables (FVs) distribution interventions on children’s consumption, with little attention given to how these interventions achieve their outcomes. Five bibliographic databases (Embase, PubMed, ProQuest, Scopus, and Web of Science Core Collection) were searched in June 2019 for studies of interventions where the main focus was the implementation of distributed FVs to school-aged children as a snack. The Critical Appraisal Skills Programme (CASP) tool was used to appraise the risk of bias within included studies. Data were extracted based on study characteristics and findings. Results identified 24 studies reporting on 11 interventions and 1 policy. The findings of this systematic review indicate that the majority of the studies included limited references to implementation research. Recurring limitations include an absence of an evaluation theoretical framework and the data collection methods used. Also, several factors were identified as informing the success of snack-based FVs distribution programs, including participation of the school community, school characteristics, background knowledge, and parental engagement. Lack of timely FVs delivery, limited funding, inadequate awareness about the program, insufficient teachers’ time, and food waste were identified as challenges to successful programming. Findings indicate that distributing FVs to school-aged children as a snack can increase their consumption, but only with proper implementation. Further evaluative research is required to better inform future implementation of snack-based FV distribution interventions in school settings.

Association of fruit and vegetable intake with meal skipping in children and adolescents: the CASPIAN-V study

BACKGROUND

There are few studies on the association of main meal consumption with fruit and vegetable intake. This study aims to assess the relation between skipping main meals and fruit and vegetable intake in children and adolescents.

METHODS

This multi-centric cross-sectional study was conducted in 30 provinces of Iran. This study was conducted in the framework of the fifth survey of a national surveillance program entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease study (CASPIAN- V). 14,440 school students aged 7-18 years were assessed. Logistic regression analyses were used to evaluate the association between frequency of fruit and vegetable intake with skipping main meals.

RESULTS

Overall, 14,274 students completed the study (99% participation rate). Their mean (SD) age was 12.3 (3.2) (53% were aged 6-12), 50.6% of them were boys, and 71.3% lived in urban area. In multivariate logistic regression model, statistically significant associations were found between skipping main meals and low fruits and vegetables intake. Skipping breakfast was associated with vegetables intake [OR = 1.19(95% CI 1.02-1.38)] and fruits intake [OR = 5.33(95% CI 4.46-6.37)]. Skipping lunch was associated with vegetables intake [OR = 1.61(95% CI 1.29-1.96)] and fruit intake [OR = 9.11(95% CI 6.55-12.67)]. Skipping dinner was associated with vegetables intake [OR = 1.52 (95% CI 1.15-2.01)] and fruits intake [OR = 2.21(95% CI 1.64-2.97)].

CONCLUSIONS

In this study, low frequency of fruit and vegetable intake was associated with skipping main meals. The results highlight the importance of promoting regular meal consumption with increase in the intake of fruit and vegetables among children and adolescents.

LEVEL OF EVIDENCE

Level V.

Are Preschoolers Meeting the Mark? Comparing the Dietary, Activity, and Sleep Behaviors of Preschoolers With Obesity to National Recommendations

Objective

National health organizations and expert committees have issued recommendations for health behaviors related to obesity risk. Behavioral and family-based weight management interventions for preschoolers often target improving adherence to these recommendations, but it is unknown how the health behaviors of preschoolers with obesity enrolled in weight control treatments (WCTs) compare with these guidelines. In this study, the dietary intake, activity, and sleep behaviors of preschoolers with obesity enrolled in a family-based behavioral WCT are described and compared with national health behavior recommendations.

Methods

Health behaviors of 151 preschoolers with obesity (M age = 4.60, SD = 0.93) enrolled in a clinical trial of a weight management program were measured at baseline through caregiver-report questionnaires, three 24-hr dietary recalls, and accelerometers.

Results

In total, 70% of the sample exceeded daily caloric recommendations, only 10 and 5% met recommendations for fruit and vegetable intake, respectively, and only 30% met the recommendation of consuming no sugar-sweetened beverages. The majority of the sample met the daily recommendations for 60 min of moderate-to-vigorous activity (80%), < 2 hr of screen time (68%), and sleep duration (70%).

Conclusions

Behavioral weight management interventions for preschoolers with obesity should target the health behaviors where children are not meeting recommendations.

Healthy eating interventions delivered in the family home: A systematic review

Unhealthy eating habits have long term health implications and can begin at a young age when children still consume the majority of their meals at home. As parents are the principal agents of change in children's eating behaviours, the home environment is the logical location for the delivery of interventions targeting healthy family eating. Despite the recent proliferation of published studies of behaviour-change interventions delivered in the home, there has been little attempt to evaluate what makes such interventions successful. This review provides a systematic evaluation of all healthy eating interventions delivered to families in the home environment to date and seeks to identify the successful elements of these interventions and make recommendations for future work. Thirty nine studies are described, evaluated and synthesised. Results show that evidence- and theory-based interventions tended to be more successful than those that did not report detailed formative or evaluative work although details of theory application were often lacking. Careful analysis of the results did not show any further systematic similarities shared by successful interventions. Recommendations include the need for more clearly theoretically driven interventions, consistent approaches to measuring outcomes and clarity regarding target populations and desired outcomes.

Mediators of the effectiveness of a kindergarten-based, family-involved intervention on pre-schoolers' snacking behaviour: the ToyBox-study

OBJECTIVE

The present study aimed to explore the mediating role of family-related determinants on the effects of the ToyBox-intervention on pre-school children's consumption of healthy and unhealthy snacks.

DESIGN

The ToyBox-intervention was a kindergarten-based, family-involved intervention with a cluster-randomized design, aiming to promote healthy lifestyle behaviours to prevent obesity at pre-school age.

SETTING

Kindergartens (n 309) in six European countries.

SUBJECTS

A total of 6290 pre-schoolers and their families participated in the ToyBox-intervention in 2012-2013 and data from 5212 pre-schoolers/families were included in the current analyses.

RESULTS

Even though the total effect of the ToyBox-intervention on healthy and unhealthy snacking was not significant, the ToyBox-intervention significantly improved parental rule setting on children's unhealthy snack consumption (i.e. restriction of snacking while watching television and permission only at certain occasions) and parental consumption of unhealthy snacks, while it increased parental knowledge on snacking recommendations. Regarding healthy snacking, the ToyBox-intervention improved children's attitude towards fruit and vegetables (F&V). All previously mentioned family-related determinants mediated the intervention effects on pre-schoolers' consumption of healthy and unhealthy snacks. Almost all family-related determinants examined in the study were independently associated with pre-schoolers' consumption of healthy and unhealthy snacks.

CONCLUSIONS

The intervention was effective in improving relevant family-related determinants. Interventions aiming to promote F&V consumption and limit the consumption of unhealthy snacks in pre-schoolers should target on these mediators, but also identify new family-, school- or peer-related determinants, to enhance their effectiveness.

Effect of Taste Enhancement on Consumer Acceptance of Pureed Cucumber and Green Capsicum

Vegetables have low taste intensities, which might contribute to low acceptance. The aim of this study was to investigate the effect of taste (sweetness, sourness, bitterness, umami, and saltiness) and fattiness enhancement on consumer acceptance of cucumber and green capsicum purees. Three concentrations of sugar, citric acid, caffeine, mono-sodium glutamate, NaCl, and sunflower oil were added to pureed cucumber and green capsicum. Subjects (n = 66, 35.6 ± 17.7 y) rated taste and fattiness intensity. Different subjects (n = 100, 33.2 ± 16.5 years) evaluated acceptance of all pureed vegetables. Taste intensities of vegetable purees were significantly different (P < 0.05) between the three tastant concentrations except for umami in both vegetable purees, sourness in green capsicum puree, and fattiness in cucumber puree. Only enhancement of sweetness significantly (P < 0.05) increased acceptance of both vegetable purees compared to unmodified purees. In cucumber purees, relatively small amounts of added sucrose (2%) increased acceptance already significantly, whereas in green capsicum acceptance increased significantly only with addition of 5% sucrose. Enhancement of other taste modalities did not significantly increase acceptance of both vegetable purees. Enhancing saltiness and bitterness significantly decreased acceptance of both vegetable purees. We conclude that the effect of taste enhancement on acceptance of vegetable purees differs between tastants and depends on tastant concentration and vegetable type. With the exception of sweetness, taste enhancement of taste modalities such as sourness, bitterness, umami, and saltiness was insufficient to increase acceptance of vegetable purees. We suggest that more complex taste, flavor, or texture modifications are required to enhance acceptance of vegetables.

PRACTICAL APPLICATION

Results can be used by cultivators to select and grow vegetable varieties with enhanced taste and flavor. Especially for cucumber, relatively small sweetness enhancement is sufficient to increase acceptance.

Analysis of Current Status on a New Public Health Nutrition Service Pattern in China: A Nutrition Outpatient Clinic-Based Study

Background

Nutrition outpatient clinics were launched in some hospitals as a new pattern of public health nutrition service in recent years in China. The aim of this study was to review and analysis demographics and consultation spectrum in a single nutrition outpatient clinical center in China.

Methods

The retrospective study was performed in the nutrition outpatient clinical center launched by a comprehensive teaching hospital in Yiwu, Zhejiang Province (China). 1014 patients attending the clinic from August 2015 to February 2018 were included. The clinical records including relevant history and baseline data were reviewed and analyzed.

Results

Majority of the patients (41.9%) came to our clinical center for nutrition consultation of healthy dietary services, 32.1% for malnutrition, 6.7% for diabetes, 6.3% for neoplasms, 5.3% for digestive system diseases, and the last 7.6% for hypertension, hematologic diseases, thyroid diseases, and so on. More minor patients came for healthy dietary services compared with the population (P<0.001), and, on the contrary, more adult patients came for malnutrition service, especially obesity (P<0.05), while more elderly patients came for consultation services of diabetes, neoplasms, digestive system diseases, and hypertension (P<0.05).

Conclusion

Our study provided important data of the new public health nutrition service pattern in China which has never been reported yet. It indicated the huge demand of nutrition outpatient clinic, especially nutrition consultation services of healthy diet and malnutrition; further studies about the validity of the new pattern in improving public health nutrition status are expected in the future.

Influence of lifestyle factors on Body Mass Index in preschoolers in Behbahan city, southwest Iran, 2016

Background and aim

The body mass index (BMI) of Iranian preschoolers is noticeably increasing. Thus, studying the factors influencing BMI in preschool children is crucial. The purpose of this study was to identify the effects of lifestyle factors on BMI of preschool children, residing in Behbahan city, southwest Iran, in 2016.

Methods

A total of 120 preschool children, aged 4 to 6 years, participated in this cross-sectional study. Multi-stage random sampling was done. Using researcher-developed questionnaires whose validity and reliability was confirmed, demographic and lifestyle data were obtained, as the questionnaires were completed by the subject's mothers. Lifestyle factors included physical activity, fruit and vegetable consumption, sugar-free beverage intake, and screen time. Multiple logistic regression was conducted to analyze the influence of lifestyle-related behaviors on BMI. Data were analyzed by means of the SPSS 22 software and p<0.05 was resulted as the meaningful level of statistics.

Results

The average BMI values for children was 15.13±1.90 kg/m2. A total of 88.3% of children did not receive 5 cups of fruits and vegetables each day. Also, 12.5% consumed more than one serving of sweetened beverages per day. Only 2.5% engaged in 60 minutes of structured physical activity every day and 40% did not limit screen-time viewing to 2 hours per day or less. The findings indicated that the physical activity and screen time affected the BMI (p<0.05), and the duration of physical activity had inverse relationship with obesity, and screen time was directly related to obesity.

Conclusion

Understanding the factors affecting the BMI of preschool children can inform the development of interventions to impact children's weight-related behavior and it can be used as the basis for future healthy body weight policies. Efforts to lower the obesity rate of preschoolers should be focused on the lifestyle behaviors, especially on the physical activity and screen time.

The role of smell, taste, flavour and texture cues in the identification of vegetables

It has been shown that the identification of many foods including vegetables based on flavour cues is often difficult. The effect of providing texture cues in addition to flavour cues on the identification of foods and the effect of providing taste cues only on the identification of foods have not been studied. The aim of this study was to assess the role of smell, taste, flavour and texture cues in the identification of ten vegetables commonly consumed in The Netherlands (broccoli, cauliflower, French bean, leek, bell pepper, carrot, cucumber, iceberg lettuce, onion and tomato). Subjects (n = 194) were randomly assigned to one of four test conditions which differed in the sensory cues available for vegetable identification: taste, smell (orthonasal), flavour (taste and smell) and flavour-texture (taste, smell and texture). Blindfolded subjects were asked to identify the vegetable from a list of 24 vegetables. Identification was the highest in the flavour-texture condition (87.5%). Identification was significantly lower in the flavour condition (62.8%). Identification was the lowest when only taste cues (38.3%) or only smell cues (39.4%) were provided. For four raw vegetables (carrot, cucumber, onion and tomato) providing texture cues in addition to flavour cues did not significantly change identification suggesting that flavour cues were sufficient to identify these vegetables. Identification frequency increased for all vegetables when perceived intensity of the smell, taste or flavour cue increased. We conclude that providing flavour cues (taste and smell) increases identification compared to only taste or only smell cues, combined flavour and texture cues are needed for the identification of many vegetables commonly consumed in The Netherlands.

Dietary Intake of Trans Fatty Acids in Children Aged 4-5 in Spain: The INMA Cohort Study

Trans fatty acid (TFA) intake has been identified as a health hazard in adults, but data on preschool children are scarce. We analyzed the data from the Spanish INMA Project to determine the intake of total, industrial and natural TFA, their main sources and the associated socio-demographic and lifestyle factors in children aged 4–5 (n = 1793). TFA intake was estimated using a validated Food Frequency Questionnaire, and multiple linear regression was used to explore associated factors. The mean daily intakes of total, industrial and natural TFA were 1.36, 0.60, and 0.71 g/day, respectively. Ten percent of the children obtained >1% of their energy intake from TFA. The main sources of industrial TFA were fast food, white bread and processed baked goods. Milk, red and processed meat and processed baked goods were the main sources of natural TFA. Having parents from countries other than Spain was significantly associated with higher natural TFA (in mg/day) intake (β 45.5) and television viewing was significantly associated with higher industrial TFA intake (β 18.3). Higher fruits and vegetables intake was significantly associated with lower intakes of all TFAs, whereas higher sweetened beverages intake was significantly associated with lower total and natural TFA intake. Thus, total and industrial TFA intake was associated with less healthy food patterns and lifestyles in Spanish preschool children.

Mutually Responsive Orientation: A novel observational assessment of mother-child mealtime interactions

Mother-child mealtime interactions during preschool years is an important but overlooked factor when evaluating the influence of parent-child relationships on child eating and weight. This paper describes the validation of the Mutually Responsive Orientation (MRO) coding system adapted for assessing parent-child interactions during food preparation and consumption situations. Home-based mealtimes of 94 mothers and their children (3.03 ± 0.75 years) were filmed at two time points, 12-months apart. Filmed dimensions of mutual mother-child responsiveness, shared positive affect, maternal control relating to food and child compliance were assessed. Objective BMI and maternal reports of parenting, feeding, child eating, diet and child temperament were also collected. Correlations, repeated measures ANOVAs and regressions were performed to examine the validity of MRO variables and their stability across both time points. Validation analysis showed the MRO coding system performed as expected: dyads with higher MRO scores expressed lower control/power assertion, lower child non-compliance, and greater committed compliance. The measure demonstrated sensitivity to specific contexts: maternal responsiveness, mother and child positive affect were higher during food consumption compared to food preparation. Coded dimensions were stable across time points, with the exception of decreases in maternal responsiveness in food consumption and child non-compliance in food preparation. MRO and maternal dimensions were correlated with maternally reported parenting and feeding measures. Maternal responsiveness (inversely) and child responsiveness (positively) were concurrently associated with child fussy eating, and child refusal was prospectively and inversely associated with child fussy eating. Findings suggest the adapted MRO coding system is a useful measure for examining observed parent-child mealtime interactions potentially implicated in preschoolers' eating and weight development.

Estimates of Ethanol Exposure in Children from Food not Labeled as Alcohol-Containing

Ethanol is widely used in herbal medicines, e.g., for children. Furthermore, alcohol is a constituent of fermented food such as bread or yogurt and “non-fermented” food such as fruit juices. At the same time, exposure to very low levels of ethanol in children is discussed as possibly having adverse effects on psychomotoric functions. Here, we have analyzed alcohol levels in different food products from the German market. It was found that orange, apple and grape juice contain substantial amounts of ethanol (up to 0.77 g/L). Furthermore, certain packed bakery products such as burger rolls or sweet milk rolls contained more than 1.2 g ethanol/100 g. We designed a scenario for average ethanol exposure by a 6-year-old child. Consumption data for the “categories” bananas, bread and bakery products and apple juice were derived from US and German surveys. An average daily exposure of 10.3 mg ethanol/kg body weight (b.w.) was estimated. If a high (acute) consumption level was assumed for one of the “categories,” exposure rose to 12.5–23.3 mg/kg b.w. This amount is almost 2-fold (average) or up to 4-fold (high) higher than the lowest exposure from herbal medicines (6 mg/kg b.w.) suggested to require warning hints for the use in children.

Encouraging children to eat more fruit and vegetables: Health vs. descriptive social norm-based messages

Traditional intervention approaches to promote fruit and vegetable consumption outline the health benefits of eating fruit and vegetables. More recently, social norm-based messages describing the healthy eating habits of others have been shown to increase fruit and vegetable intake in adults. Here we report two experimental studies which investigated whether exposure to descriptive social norm-based messages about the behaviour of other children and health-based messages increased fruit and vegetable intake in young children. In both studies children were exposed to messages whilst playing a board-game. After exposure to the messages, children were able to consume fruit and vegetables, as well as high calorie snack foods. Although findings were inconsistent across the two individual studies, in a pooled analysis we found evidence that both health messages and descriptive social norm-based messages increased children's fruit and vegetable intake, relative to control condition messages (p < .05). Whether descriptive social norm-based messages can be used to promote meaningful changes to children's dietary behaviour warrants further study.

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Descriptive social norm-based and health messages were examined.

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Health messages increased fruit and vegetable intake.

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Descriptive social norm-based messages increased fruit and vegetable intake.

Imbalance in Resting State Functional Connectivity is Associated with Eating Behaviors and Adiposity in Children

Background and Hypothesis

Over the past 30 years, childhood obesity in the US has nearly doubled, while obesity has tripled among adolescents. Non-homeostatic eating, influenced by impulsivity and inhibition, may undermine successful long-term weight loss. We hypothesized that unhealthy eating habits and adiposity among children are associated with functional connectivity between brain regions associated with impulsivity, response inhibition, and reward.

Methods

We analyzed resting state functional magnetic resonance images from 38 children, ages 8–13. Using seed-based resting state functional connectivity, we quantified connectivity between brain regions associated with response inhibition (inferior parietal lobe [IPL]), impulsivity (frontal pole), and reward (nucleus accumbens [NAc]). We assessed the relationship of resting state functional connectivity with adiposity, quantified by BMI z-score, and eating behaviors, as measured by the Child Eating Behaviour Questionnaire (CEBQ). We computed an imbalance measure—the difference between [frontal pole:NAC] and [ipl:nac] functional connectivity—and investigated the relationship of this imbalance with eating behaviors and adiposity.

Results

As functional connectivity imbalance is increasingly biased toward impulsivity, adiposity increases. Similarly, as impulsivity-biased imbalance increases, food approach behaviors increase and food avoidance behaviors decrease. Increased adiposity is associated with increased food approach behaviors and decreased food avoidance behaviors.

Conclusions

In the absence of any explicit eating-related stimuli, the developing brain is primed toward food approach and away from food avoidance behavior with increasing adiposity. Imbalance in resting state functional connectivity that is associated with non-homeostatic eating develops during childhood, as early as 8–13 years of age. Our results indicate the importance of identifying children at risk for obesity for earlier intervention. In addition to changing eating habits and physical activity, strategies that normalize neural functional connectivity imbalance are needed to maintain healthy weight. Mindfulness may be one such approach as it is associated with increased response inhibition and decreased impulsivity.

Perceived eating norms and vegetable consumption in children

Background

Beliefs about the eating behaviour of others (perceived eating norms) have been shown to influence eating behaviour in adults, but no research has examined whether young children are motivated by perceived eating norms.

Findings

Here we investigated the effect on vegetable intake of exposing children to information about the vegetable intake of other children. One hundred and forty three children aged 6–11 years old took part in a between-subjects experiment. Children were exposed to information suggesting that other children had eaten a large amount of carrots, no carrots, or control information. Children ate more carrots when they believed that other children had eaten a large amount of carrots, compared to all other conditions.

Conclusions

Perceived eating norms can influence vegetable intake in young children and making use of eating norms to promote healthier eating in children warrants investigation.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-015-0296-z) contains supplementary material, which is available to authorized users.

Picky eating and child weight status development: a longitudinal study

BACKGROUND

Children's picky eating behaviour has been linked both to being overweight and underweight. However, the role of parenting practices in this relationship has rarely been investigated. The present study aimed to clarify the direction of the association between picky eating and weight status and to examine the moderating role of food parenting practices.

METHODS

The present study comprised a longitudinal study on the effects of picky eating on child weight status within the KOALA Birth Cohort Study, the Netherlands. Mothers and their children were included in the analyses. Children's picky eating behaviour and food parenting practices were assessed at baseline (child age 5 years). Their weight status was assessed repeatedly until age 9 years. Mixed effects linear and logistic regressions were used to compare picky eaters (n = 403) and non-picky eaters (n = 621) on changes in weight status over the years.

RESULTS

At baseline of age 5 years, picky eaters were slightly shorter, more often underweight and less often overweight than non-picky eaters, whereas energy intake in relation to body weight (kJ kg(-1)) was similar. Picky eaters with a normal weight at baseline had no increased risk of becoming underweight during follow-up until age 9 years, and were less likely to become overweight compared to non-picky eaters. There were no interactions with food parenting practices. The parents of picky eaters more often reported pressuring their child to eat and restrict unhealthy food intake compared to parents of non-picky eaters.

CONCLUSIONS

The association between picky eating and child weight status was not influenced by parenting practices.

Growth and development in Chinese pre-schoolers with picky eating behaviour: a cross-sectional study

Objective

To explore the associations between picky eating behaviour and pre-schoolers’ growth and development. Corresponding potential mechanisms, such as nutrient and food subgroup intake, as well as micronutrients in the blood, will be considered.

Methods

Picky eating behaviour was present if it was reported by parents. From various areas of China, 937 healthy children of 3-7 years old were recruited using a multi-stage stratified cluster sampling method. Children and their mothers’ socio-demographic information and children’s anthropometry, intelligence, blood samples, one 24-hour dietary intake record and food frequency questionnaire were collected. Z-scores and intelligence tests were used to evaluate growth and development (cognitive development). Multilevel models were employed to verify the associations between picky eating behaviour and growth and development.

Results

The prevalence of picky eating as reported by parents was 54% in pre-schoolers. Compared with the non-picky eaters, weight for age in picky eaters was 0.14 z-score (95% CI: -0.25, -0.02; p = 0.017) lower while no significant difference was found in intelligence (p > 0.05). Picky eating behaviour lasting over two years was associated with lower weight for age, as was nit-picking meat (the prevalence from parents’ perception was 23% in picky eaters) (p < 0.05). Picky eaters consumed fewer cereals, vegetables, and fish (p < 0.05), and had a lower dietary intake of protein, dietary fibre, iron, and zinc (p < 0.05). There were no differences in the concentrations of essential minerals in whole blood (p > 0.05).

Conclusions

Picky eating behaviour is reported by parents in half of the Chinese pre-schoolers, which is negatively associated with growth (weight for age). Lower protein and dietary fibre as well as lower iron and zinc intakes were associated with picky eating as were lower intakes of vegetables, fish and cereals.

Influence of choice on vegetable intake in children: an in-home study

Children's vegetable consumption is still far below that recommended, and stimulating their intake is a challenge for caregivers. The objective of this study was to investigate whether choice-offering is an effective strategy to increase children's vegetable intake in an in-home situation. Seventy children (mean age 3.7; SD 1) randomly assigned to a choice or a no-choice condition, were exposed 12 times to six familiar target vegetables at home during dinner. In the choice group, two selected vegetables were offered each time, whereas the no-choice group only received one vegetable. Vegetable intake was measured by weighing children's plates before and after dinner. A mixed linear model with age, gender, and baseline vegetable liking as covariates was used to compare intake between the choice and the no-choice group. Mixed linear model analysis yielded estimated means for vegetable intake of 48.5 g +/- 30 in the no-choice group and 57.7 g +/- 31 for the choice group (P = 0.09). In addition, baseline vegetable liking (P <0.001) and age (P = 0.06) predicted vegetable intake to be higher when the child liked vegetables better and with older age. These findings suggest that choice-offering has some, but hardly robust, effect on increasing vegetable intake in children. Other factors such as age and liking of vegetables also mediate the effect of offering a choice.

Brassica foods as a dietary source of vitamin C: a review

Brassica genus includes known horticultural vegetables with major economical importance worldwide, and involves vegetables of economical importance being part of the diet and source of oils for industry in many countries. Brassicales own a broad array of health-promoting compounds, emphasized as healthy rich sources of vitamin C. The adequate management of pre- and postharvest factors including crop varieties, growth conditions, harvesting, handling, storage, and final consumer operations would lead to increase or preserve of the vitamin C content or reduced losses by interfering in the catalysis mechanisms that remains largely unknown, and should be reviewed. Likewise, the importance of the food matrix on the absorption and metabolism of vitamin C is closely related to the range of the health benefits attributed to its intake. However, less beneficial effects were derived when purified compounds were administered in comparison to the ingestion of horticultural products such as Brassicas, which entail a closely relation between this food matrix and the bioavailability of its content in vitamin C. This fact should be here also discussed. These vegetables of immature flowers or leaves are used as food stuffs all over the world and represent a considerable part of both western and non-Western diets, being inexpensive crops widely spread and reachable to all social levels, constituting an important source of dietary vitamin C, which may work synergistically with the wealth of bioactive compounds present in these foods.

The influence of early feeding practices on fruit and vegetable intake among preschool children in 4 European birth cohorts

BACKGROUND

Fruit and vegetable intake in children remains below recommendations in many countries. The long-term effects of early parental feeding practices on fruit and vegetable intake are not clearly established.

OBJECTIVE

The purpose of the current study was to examine whether early feeding practices influence later fruit and vegetable intake in preschool children.

DESIGN

The study used data from 4 European cohorts: the British Avon Longitudinal Study of Parents and Children (ALSPAC), the French Etude des Déterminants pre et postnatals de la santé et du développement de l'Enfant study, the Portuguese Generation XXI Birth Cohort, and the Greek EuroPrevall study. Fruit and vegetable intake was assessed in each cohort by food-frequency questionnaire. Associations between early feeding practices, such as breastfeeding and timing of complementary feeding, and fruit and/or vegetable intake in 2-4-y-old children were tested by using logistic regressions, separately in each cohort, after adjustment for infant's age and sex and maternal age, educational level, smoking during pregnancy, and maternal fruit and vegetable intake.

RESULTS

Large differences in early feeding practices were highlighted across the 4 European cohorts with longer breastfeeding duration in the Generation XXI Birth Cohort and earlier introduction to complementary foods in ALSPAC. Longer breastfeeding duration was consistently related to higher fruit and vegetable intake in young children, whereas the associations with age of introduction to fruit and vegetable intake were weaker and less consistent across the cohorts. Mothers' fruit and vegetable intake (available in 3 of the cohorts) did not substantially attenuate the relation with breastfeeding duration.

CONCLUSION

The concordant positive association between breastfeeding duration and fruit and vegetable intake in different cultural contexts favors an independent specific effect.

The addition of a plain or herb-flavored reduced-fat dip is associated with improved preschoolers' intake of vegetables

This quasiexperimental study used a within-subjects experimental design to determine whether adding herbs and/or spices to a reduced-fat dip increased children's willingness to taste, liking of, and consumption of vegetables. Participants were preschool children aged 3 to 5 years who attended a child-care center in Central Pennsylvania in late 2008 and early 2009. First, children's familiarity with and liking of six raw vegetables and five dips (reduced-fat plain, herb, garlic, pizza, and ranch) were assessed. In Experiment 1 (n=34), children tasted a vegetable they liked, one they disliked, and one they refused, with a reduced-fat plain dip and their favorite reduced-fat herb-flavored dip. In Experiment 2 (n=26 or n=27), they rated their liking of celery and yellow squash, with and without their favorite reduced-fat herb dip (pizza or ranch), and their intake of those vegetable snacks was measured. In Experiment 1, the herb-flavored dip was preferred over the plain dip (P<0.01), and children were three times more likely to reject the vegetable alone, compared with eating the vegetable paired with an herb dip (P<0.001). In Experiment 2, children ate significantly more of a previously rejected or disliked vegetable (celery and squash) when offered with a preferred reduced-fat herb dip than when the vegetable was served alone (P<0.05). These findings suggest that offering vegetables with reduced-fat dips containing familiar herb and spice flavors can increase tasting and thereby promote liking, acceptance, and consumption of vegetables, including vegetables previously rejected or disliked.

Contributions of white vegetables to nutrient intake: NHANES 2009-2010

Vegetables, especially white potatoes, provide significant levels of key nutrients of concern, such as potassium and dietary fiber. Per capita availability (PCA) data for vegetables-often used as a proxy for vegetable consumption-show that vegetable consumption, including consumption of white potatoes, declined in the past decade. Using dietary data for participants in the NHANES 2009-2010, we examined total vegetable, white potato, and French-fried potato consumption among all age-gender groups as well as mean energy, potassium, and dietary fiber intakes. Mean total energy intake for the US population (≥2 y old) was 2080 kcal/d, with white potatoes and French-fried potatoes providing ∼4% and ∼2% of total energy, respectively. Individuals who consumed white potatoes had significantly higher total vegetable and potassium intakes than did nonconsumers. In addition, the proportion of potassium and dietary fiber contributed by white potatoes was higher than the proportion that they contributed to total energy. Among white potato consumers aged 14-18 y, white potatoes provided ∼23% of dietary fiber and ∼20% of potassium but only ∼11% of total energy in the diet. The nutrient-dense white potato may be an effective way to increase total vegetable consumption and potassium and dietary fiber intake.

Food consumption patterns in preschool children

PURPOSE

Healthy eating during early childhood is important for growth and development. Eating Well with Canada's Food Guide (CFG) provides dietary recommendations. We investigated patterns of food consumption among preschool children and attempted to determine whether these children's intakes met nutrition recommendations.

METHODS

Between 2005 and 2007, four- and five-year-old children (n=2015) attending 12 Edmonton-region public health units for immunization were recruited for a longitudinal study on determinants of childhood obesity. The children's dietary intake at baseline was assessed using parental reports.

RESULTS

Overall, 29.6%, 23.5%, 90.9%, and 94.2% of the children met recommendations for vegetables and fruit, grain products, milk and alternatives, and meat and alternatives, respectively. In addition, 79.5% consumed at least one weekly serving of foods in the "choose least often" group. Significant differences existed in consumption of food groups across socioeconomic and demographic groups. For example, 82.9%, 84.7%, and 75.9% of preschool children from neighbourhoods of low, medium, and high socioeconomic status, respectively, consumed at least one food in the "choose least often" group (χ² =16.2, p<0.001).

CONCLUSIONS

Consumption of vegetables and fruit and grain products was low among participants, and intake of "choose least often" foods was high. Consumption of foods also differed among socioeconomic and demographic groups. To encourage healthy eating among children, public health professionals should target groups who do not meet the CFG recommendations.

Study protocol of a parent-focused child feeding and dietary intake intervention: the feeding healthy food to kids randomised controlled trial

BACKGROUND

Poor childhood nutrition is a more pervasive and insidious risk factor for lifestyle-related chronic disease than childhood obesity. Parents find it difficult to address the reported barriers to optimal child feeding, and to improve child dietary patterns. To impact at the population level, nutrition interventions need to be easy to disseminate, have a broad reach and appeal to parents while overcoming the barriers parents face when trying to improve child feeding behaviours. The Feeding Healthy Food to Kids (FHFK) Randomised Control Trial (RCT) examines the impact of providing low cost, self-directed nutrition and parenting resources to rural parents, on child dietary intake and parent-child feeding practices.

METHODS/DESIGN

Up to 150 parents of two-to-five year old children will be recruited in five rural Australian towns. Eligible, consenting parents will be randomly allocated to intervention or 12-month wait-list control groups. Intervention group parents will receive an interactive nutrition CD and parenting DVD, and be provided with instructions for optimal resource utilisation. Intervention and control group participants will also receive a generic nutrition and physical activity brochure and a physical activity resource to blind participants to group allocation. Primary outcome measures are dietary intake of vegetables (serves/day), fruit and energy dense nutrient poor foods (serves/day and %Energy). Secondary outcome measures are total energy (kCal), other food groups (serves/day and %Energy), key nutrients (mg/day), child feeding domains and parenting style domains.Analysis of dietary outcome measures, child feeding and parenting domains will be conducted on an intention-to-treat basis and compared at baseline, three and 12 months using the random effects model, using STATA software. Details of the methodological aspects of recruitment, inclusion criteria, randomisation and statistical analysis are described.

DISCUSSION

This paper will add to existing research examining child feeding practices and dietary intake of young children, by specifically focusing on the efficacy of an RCT that has the potential to be implemented at a population level. The correlation of the RCT outcomes with parents' perceptions about child feeding practices and children's dietary intake of their children in a subsequent qualitative study will further contribute to this emerging area of research.

TRIAL REGISTRATION

Australian Clinical Trials Registration Number: ACTRN12609000356268.

Dietary and physical activity/inactivity factors associated with obesity in school-aged children

Diet and physical activity (PA) are essential components of nutritional status. Adequate nutrition and an active lifestyle are key factors during childhood, because food habits track into adulthood. Children spend more time in school than in any other environment away from home. Studying the diet factors and patterns of PA that affect obesity risk in children during school hours and the complete school day can help identify opportunities to lower this risk. We directly measured the time children spent performing moderate to vigorous PA (MVPA) at school, compared the amount and intensity of PA during school hours with after-school hours, and tried to determine if diet behaviors and PA or inactivity were associated with excess weight and body fat. This cross-sectional study included 143 normal-weight (NLW) and 48 obese children aged 8-10 y. Diet data were obtained from two 24-h recalls. Body composition was measured by bioimpedance. Screen time and sports participation data were self-reported. NLW children drank/ate more dairy servings than the obese children, who consumed more fruit-flavored water than the NLW group. Consumption of soft drinks, sugar-added juices, and fresh juices was low in both groups. Children were less active during school hours than after school. MVPA was lower during school hours in the obese group than in the NLW group. Schools, parents, and authorities should be more involved in promoting strategies to improve the dietary habits and PA levels of school-aged children, because this group is not achieving the recommended level of daily MVPA.

Childhood consumption of fruit and vegetables across England: a study of 2306 6-7-year-olds in 2007

The School Fruit and Vegetable Scheme (SFVS) provides children in government-run schools in England with a free piece of fruit or a vegetable each school day for the first 3 years of school. The present study examines the impact of the SFVS, in terms of its contribution towards the total daily intake of fruit and vegetables by children across England. Quantitative dietary data were collected from 2306 children in their third year of school, from 128 schools, using a 24 h food diary. The data were examined at different spatial scales, and variations in the impact of the scheme across areas with different socio-economic characteristics were analysed using a deprivation index and a geodemographic classification. The uptake of the SFVS and the total intake of fruit and vegetables by children varied across different parts of England. Participation in the SFVS was positively associated with fruit and vegetable consumption. That is, in any one area, those children who participated in the SFVS consumed more fruit and vegetables. However, children living in deprived areas still consumed less fruit and vegetables than children living in more advantaged areas: the mean daily frequency of fruit and vegetables consumed, and rates of consumption of fruit or vegetables five times or more per d, decreased as deprivation increased (r -0.860; P = 0.001; r -0.842; P = 0.002). So the SFVS does not eliminate the socio-economic gradient in fruit and vegetable consumption, but it does help to increase fruit and vegetable consumption in deprived (and affluent) areas.

Produce consumption in the United States: an analysis of consumption frequencies, serving sizes, processing forms, and high-consuming population subgroups for microbial risk assessments

A great variety of fruits and vegetables are available in the United States. These items are produced in various geographic regions by a diverse industry. Produce has been increasingly identified as a vehicle for disease outbreaks. Changes in consumption may explain this increase, but analyses of produce consumption are limited. Comprehensive assessments of the public health risks associated with produce depend on quantitative consumption data, including the population fractions and subgroups of consumers, the quantities consumed by these individuals, and the processing that occurs before consumption. Here, we provide an analysis of nationally representative consumption estimates by estimating consumption frequencies, serving sizes, and processing forms for a variety of produce commodities based on 1999 through 2006 data from "What We Eat in America," the dietary interview component of the National Health and Nutrition Examination Survey performed by the National Center for Health Statistics. Consumption patterns for fresh and heat-treated produce were assessed, compared with U.S. food availability estimates from the U.S. Department of Agriculture Economic Research Service (ERS), and combined with ERS data on temporal trends in food availability and nondomestic produce origins. To identify high-consuming population subgroups, we explored consumer habits and demographic predictors of fresh produce consumption (data available at www.foodrisk.org). Our analysis of common outbreak vehicles revealed limited temporal changes in food availability but frequent consumption as fresh commodities. In addition to providing quantitative consumption estimates for risk assessments, our data clearly show that produce consumption differs among fruits and vegetables, fresh and heat-treated foods, and demographic subgroups. These results are valuable for risk assessments and outbreak investigations and allow targeting of risk communication or interventions to those individuals at greatest risk.

Trying versus liking fruits and vegetables: correspondence between mothers and preschoolers

Extensive research indicates that a diet rich in fruits and vegetables (F&V) protects against numerous illnesses in adulthood, but that most individuals, including children, consume far fewer F&V per day than is recommended. Since evidence suggests that eating habits in childhood track into adulthood, more research is necessary to learn about how parental F&V intake and opportunities influence child F&V consumption. The purpose of this study was to examine the relationship between mothers' F&V preferences and those of their preschool-age children to determine if greater maternal "liking" of fruits and vegetables was associated with their reports of their children's "trying" more fruits and vegetables. Eighty-three mothers completed a questionnaire that assessed whether they and their preschoolers had tried or liked a variety of F&V. Mothers liked 86% of the fruits they tried, girls 76%, and boys 69%. Mothers liked 81% of the vegetables they tried; boys and girls liked 55%. Mothers' likes correlated with F&V that their children tried, but mothers' likes also limited the number of F&V that their children tried. Mothers reported preferences for F&V are associated with estimates of their preschoolers' preferences for F&V. Relative to girls, boys may need additional opportunities for F&V exposure.

Long-term changes in food consumption trends in overweight children in the HIKCUPS intervention

BACKGROUND AND AIM

Energy intake is a major contributor to energy imbalance and is a key modifiable factor for successful treatment of obesity. Long-term changes in dietary intake from pediatric obesity treatment programs are rarely reported. The aim of this study was to describe the changes in food intake of children from all intervention groups from baseline to 2-year follow-up after a 6-month obesity intervention.

SUBJECTS AND METHODS

Overweight children (n = 160, 5-9 years), 58% girls and body mass index z score (mean ± SD) 2.89 ± 0.79, were recruited to the Hunter Illawarra Kids Challenge using the Parent Support randomized controlled trial. Dietary intake was reported by parents for children at baseline and 2-year follow-up (n = 87) using a food frequency questionnaire. Linear mixed models were used to determine differences by time.

RESULTS

Parents reported decreases in total energy (total kcal, kcal/kg), child percentage of total energy from energy-dense, nutrient-poor foods (sweetened drinks, potato crisps, sweets, and carry-out foods) from 42% ± 1.0% at baseline to 34.8% ± 1.0% at 2 years (P < 0.001), with an increase in percentage of energy from nutrient-dense foods (fruits, vegetables, dairy, breads, and cereals) from 57% ± 0.9% at baseline to 65% ± 1.0% at 2 years (P < 0.001).

CONCLUSIONS

This is the only one of a few studies that report dietary data of overweight children who participated in a treatment program with long-term follow-up. It provides evidence that improvements in food intake can be sustained up to 2 years through decreased consumption of energy-dense, nutrient-poor foods, particularly sweetened drinks, and increased consumption of core foods following an intervention.

Children's understandings' of obesity, a thematic analysis

Childhood obesity is a major concern in today's society. Research suggests the inclusion of the views and understandings of a target group facilitates strategies that have better efficacy. The objective of this study was to explore the concepts and themes that make up children's understandings of the causes and consequences of obesity. Participants were selected from Reception (4-5 years old) and Year 6 (10-11 years old), and attended a school in an area of Sunderland, in North East England. Participants were separated according to age and gender, resulting in four focus groups, run across two sessions. A thematic analysis (Braun & Clarke, 2006) identified overarching themes evident across all groups, suggesting the key concepts that contribute to children's understandings of obesity are "Knowledge through Education," "Role Models," "Fat is Bad," and "Mixed Messages." The implications of these findings and considerations of the methodology are discussed in full.

Consumer segmentation based on the level and structure of fruit and vegetable intake: an empirical evidence for US adults from the National Health and Nutrition Examination Survey (NHANES) 2005-2006

OBJECTIVE

To identify consumption patterns of fruit and vegetables within a representative sample of US adults with a focus on degree of produce processing and to explore sociodemographic, lifestyle and nutritional profiles associated with these patterns.

DESIGN

Cross-sectional analysis. Fruit and vegetable (F&V) consumption data were collected using two non-consecutive 24 h recalls. For the purpose of the study, F&V intakes were aggregated into seven subgroups indicating degree of processing, which afterwards were used as inputs into cluster analysis.

SETTING

The 2005-2006 National Health and Nutrition Examination Survey.

SUBJECTS

The sample consisted of 2444 adults aged 20-59 years.

RESULTS

Total average F&V intake of the adults was below the recommended level. Thereby, 20 % of the respondents consumed fruit only in the form of juice. Three F&V consumption patterns were identified: 'low-intake F&V consumers' (74 % of respondents), 'consumers of healthier F&V options' (13 %) and 'intensive fruit juice consumers' (13 %). These groups differed markedly in terms of their sociodemographic, lifestyle and health characteristics, such as gender, age, race/ethnicity, education, smoking, weight status, etc. Differences in nutrient profiles were also found, with the 'consumers of healthier F&V options' showing better nutritional quality compared with other clusters.

CONCLUSIONS

Only a small share of US adults combines high F&V intakes with healthier F&V options that lead to a better nutritional profile. This raises discussion about a need to deliver more specific F&V promotion messages, including advice on healthier preparation methods, especially for the specific population groups.

Impact of commercials on food preferences of low-income, minority preschoolers

OBJECTIVE

To determine whether fruit and vegetable (FV) commercials have an impact on preschool children's preferences for specific FV.

DESIGN

A year of extensive formative assessment was conducted to develop 2 30-second commercials: "Judy Fruity" promoted apples and bananas and "Reggie Veggie" promoted broccoli and carrots. The commercials were embedded into a 15-minute TV program. Fruit and vegetable preferences were assessed before and after 4 exposures to each of the commercials.

SETTING

Four Head Start centers in Houston, Texas.

PARTICIPANTS

One hundred eighty-three preschool children (39% African American; 61% Hispanic American).

MAIN OUTCOME MEASURES

Assessment of whether FV preferences were significantly higher in the treatment group than the control group, controlling for baseline FV preferences, age, race, and intervention dose in the model.

ANALYSIS

A general linear model was used.

RESULTS

There was a significantly higher preference for broccoli and carrots (P = .02) in the intervention group compared to the control group after multiple exposures to the vegetable commercial.

CONCLUSIONS AND IMPLICATIONS

Data suggest that commercials promoting vegetables may be an effective strategy to influence young children's preferences for vegetables. This may not be the case with fruit preferences, which are already high in this age group.