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Research suggests that issue involvement moderates the efficacy of gain and loss frames, yet the extent to which this is true across behaviors and contexts is an open question. In this study, I examined the moderating role of issue involvement in the context of fruit and vegetable intake in Lima, Peru. Only 11.3% of the Peruvian population 15 years old or older consume five servings of fruits and vegetables every day, even though this health behavior prevents the onset of chronic diseases, including diabetes and hypertension. Guided by the Reasoned Action Approach and research about the effects of gain and loss frames, I conducted an experiment (N=253, three conditions: gain-framed messages condition; loss-framed messages condition; and no-message, control condition) to assess the effect of gain- and loss-framed messages on mothers' intentions to increase fruits and vegetables consumption among their 1- to 5-year-old children in Lima. Results indicated that mothers who saw gain-framed messages reported greater intentions than those who did not see any messages (control condition). However, issue involvement moderated the effect of gain frames, such that mothers low in issue involvement reported greater intentions after seeing the gain-framed messages. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Considering that nutrition plays a prominent role in the health of the elderly, oral health and the associated quality of life are very important for a healthy diet. The aim of this study was to investigate the association between the frequency of fruit and vegetable consumption and oral health-related quality of life (OHRQoL) among the elderly in Amirkola. Materials & Methods: This study was part of the second phase of the Amirkola elderly cohort study conducted on750 older people who underwent a special oral and dental examination in 2016-2020 using the Oral Health Questionnaire. The frequency of fruit and vegetable consumption was assessed with the Semi- Quantitative Food Frequency Questionnaire (SQFFQ), OHRQoL was assessed with the General Oral Health Assessment Index (GOHAI), and information on age, sex, history of systemic diseases, and the number of teeth was extracted from the full data set completed by specialists for each patient. Data were analyzed with SPSS 20 using the chi-square statistical test, ANOVA, and Pearson correlation coefficient. A value of p<0.05 was considered significant. Results: Non-smokers and people with a higher level of education had a better OHRQoL (P=0.022 and P=0.036, respectively). There was no significant relationship between the frequency of fruit and vegetable consumption and OHRQoL, but a significant relationship was found between the frequency of fresh herb consumption and OHRQoL (p=0.005). In men, there was a significant relationship between the number of teeth and frequency of vegetable consumption as well as between OHRQoL and frequency of fresh herb consumption in men (P=0.048, r=0.096). In women, a significant relationship was observed between the frequency of total vegetable consumption and OHRQoL (p=0.021, r=0.129). Conclusion: According to the results of the present study,it was found that the amount of fruit and vegetable consumption has no effect on improving the OHRQoL among the elderly of Amirkola city. [ABSTRACT FROM AUTHOR]

Background: Although nutrients in fruits and vegetables are necessary for proper development and disease prevention, most US children consume fewer servings than recommended. Prescriptions for fruits and vegetables, written by physicians to exchange for fresh produce, address access and affordability challenges while emphasizing the vital role of diet in health promotion and disease prevention. Michigan's first fruit and vegetable prescription program (FVPP) exclusively for children was introduced in 2016 at one large pediatric clinic in Flint and expanded to a second clinic in 2018. The program provides one $15 prescription for fresh produce to all pediatric patients at every office visit. Prescriptions are redeemable at a year-round farmers' market or a local mobile market. The current study will assess the impact of this FVPP on diet, food security, and weight status of youth.Methods: Demographically similar pediatric patient groups with varying levels of exposure to the FVPP at baseline will be compared: high exposure (> 24 months), moderate exposure (12-24 months), and no previous exposure. Data collection will focus on youth ages 8-16 years. A total of 700 caregiver-child dyads (one caregiver and one child per household) will be enrolled in the study, with approximately 200 dyads at clinic 1 (high exposure); 200 dyads at clinic 2 (moderate exposure), and 300 dyads at clinic 3 (no previous exposure). Children with no previous exposure will be introduced to the FVPP, and changes in diet, food security, and weight status will be tracked over two years. Specific aims are to (1) compare baseline diet, food security, and weight status between pediatric patients with varying levels of exposure to the FVPP; (2) measure changes in diet, food security, and weight status before and after never-before-exposed children are introduced to the FVPP; and (3) compare mean 12- and 24-month follow-up measures of diet, food security, and weight status in the initial no exposure group to baseline measures in the high exposure group.Discussion: Completion of study aims will provide evidence for the effectiveness of pediatric FVPPs and insights regarding the duration and intensity of exposure necessary to influence change.Trial Registration: The study was registered through clinicaltrials.gov [ID: NCT04767282] on February 23, 2021. [ABSTRACT FROM AUTHOR]

Background: This study aimed to describe the prevalence of metabolically healthy obesity (MHO) and metabolically unhealthy normal weight (MUNW) rural adults in Xinjiang and to explore their influencing factors.Methods: We selected 13,525 Uyghur, Kazakh and Han participants in Kashi, Yili and Shihezi areas in Xinjiang from 2009 to 2010. Weight status was classified according to body mass index. Metabolic phenotype was further defined based on the National Cholesterol Education Program Adult Treatment Panel III criteria.Results: The prevalence of normal weight, overweight, and obesity were 51.6, 30.2, and 14.4%, respectively. The mean age of the population was 45.04 years. The prevalence of MHO was 5.5% overall and was 38.5% among obese participants. The prevalence of MUNW was 15.5% overall and was 30.1% among normal weight participants. A metabolically healthy phenotype among obese individuals was positively associated with females and vegetable consumption ≥4 plates per week. However, this was inversely associated with higher age, red meat consumption ≥2 kg per week, and larger waist circumference (WC). Conversely, a metabolically unhealthy phenotype among normal-weight individuals was positively associated with higher age, red meat consumption ≥2 kg per week, and larger WC; this was however inversely associated with vegetable consumption ≥4 plates per week.Conclusions: The prevalence of MHO among obese adults in Xinjiang is higher than that of Han adults, while the prevalence of MUNW among normal weight adults is lower than that among Han adults. In obese and normal weight participants, higher age, more red meat consumption, and larger WC increase the risk of metabolic abnormality, and more vegetable consumption reduces the risk of metabolic abnormality. [ABSTRACT FROM AUTHOR]

Parents play a critical role in promoting fruit and vegetable consumption, for eating patterns established early in life tend to persist into adulthood. Despite this, the factors that facilitate or inhibit parents’ capacity to socialise fruit and vegetable consumption into their children’s daily diets remain poorly defined. Thirty-eight semi-structured interviews with residents, allied healthcare professionals, community leaders, community programme leaders and a local government leader living or working in two low socioeconomic suburbs were consequently conducted to ascertain factors exogenous and endogenous to the family unit that shaped parental food socialisation practices. Budgetary and time constraints emerged as exogenous factors that constrained fruit and vegetable socialisation. Constraining effects were also found for a range of endogenous factors, including commensal experiences, children’s food fussiness and the feeding styles employed by parents. As such, while many caregivers may wish to socialise fruit and vegetable consumption into their children’s daily diets, their capacity to do so is often inhibited by factors beyond their volitional control. Failure to take heed of these factors could therefore result in the development of social marketing campaigns that are ineffective at best or give rise to unintentionally harmful outcomes at worst. [ABSTRACT FROM PUBLISHER]

Feeding problems have been estimated to occur in approximately 25-45% of normally developing children. The aim of this study was to investigate the prevalence of feeding problems in typically developing young children in Greece. Child feeding behavior, parents' feelings about their child's feeding patterns, and parental feeding practices were also explored. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS). Data on 742 healthy, typically developing children aged two to seven years are presented. Overall, the majority of children in the sample showed high frequency of desirable mealtime behaviors and low frequency of undesirable mealtime behaviors. However, a significant proportion of the cohort presented with food neophobia and low consumption of vegetables. When applying test cut-off scores, it was found that 8.2% of the sample had abnormal Total Frequency Score (TFS) and 26.6% had abnormal Total Problem Score (TPS). The study showed that parent-reported feeding problems are quite common in children of typical development in Greece. Moreover, while the majority of the sample displayed a high frequency of favorable behaviors, specific child feeding behaviors are amenable to improvement. [ABSTRACT FROM AUTHOR]

Importance: Guidelines endorsing vegetable-enriched diets to improve outcomes for prostate cancer survivors are based on expert opinion, preclinical studies, and observational data.Objective: To determine the effect of a behavioral intervention that increased vegetable intake on cancer progression in men with early-stage prostate cancer.Design, Setting, and Participants: The Men's Eating and Living (MEAL) Study (CALGB 70807 [Alliance]) was a randomized clinical trial conducted at 91 US urology and medical oncology clinics that enrolled 478 men aged 50 to 80 years with biopsy-proven prostate adenocarcinoma (International Society of Urological Pathology grade group = 1 in those <70 years and ≤2 in those ≥70 years), stage cT2a or less, and serum prostate-specific antigen (PSA) level less than 10 ng/mL. Enrollment occurred from January 2011 to August 2015; 24-month follow-up occurred from January 2013 to August 2017.Interventions: Patients were randomized to a counseling behavioral intervention by telephone promoting consumption of 7 or more daily vegetable servings (MEAL intervention; n = 237) or a control group, which received written information about diet and prostate cancer (n = 241).Main Outcomes and Measures: The primary outcome was time to progression; progression was defined as PSA level of 10 ng/mL or greater, PSA doubling time of less than 3 years, or upgrading (defined as increase in tumor volume or grade) on follow-up prostate biopsy.Results: Among 478 patients randomized (mean [SD] age, 64 [7] years; mean [SD] PSA level, 4.9 [2.1] ng/mL), 443 eligible patients (93%) were included in the primary analysis. There were 245 progression events (intervention: 124; control: 121). There were no significant differences in time to progression (unadjusted hazards ratio, 0.96 [95% CI, 0.75 to 1.24]; adjusted hazard ratio, 0.97 [95% CI, 0.76 to 1.25]). The 24-month Kaplan-Meier progression-free percentages were 43.5% [95% CI, 36.5% to 50.6%] and 41.4% [95% CI, 34.3% to 48.7%] for the intervention and control groups, respectively (difference, 2.1% [95% CI, -8.1% to 12.2%]).Conclusions and Relevance: Among men with early-stage prostate cancer managed with active surveillance, a behavioral intervention that increased vegetable consumption did not significantly reduce the risk of prostate cancer progression. The findings do not support use of this intervention to decrease prostate cancer progression in this population, although the study may have been underpowered to identify a clinically important difference.Trial Registration: ClinicalTrials.gov Identifier: NCT01238172. [ABSTRACT FROM AUTHOR]

The aim of this study was to estimate the association between life habits and adequate consumption of fruits and vegetables (F&V) after four years of follow-up among elderly of a cohort in Florianópolis, Santa Catarina. This is a longitudinal population-based study, the sample being composed of individuals 60 years of age or older living in the urban area of the city of Florianópolis- SC. The baseline study took place in 2009-2010 and the second wave in 2013-2014. Adequate consumption was assessed by considering the frequency of ingestion of F&V at least five times a day at least five times a week. Life habits (smoking, alcohol consumption, physical activity and Internet use) and a biological variable (nutritional status) were associated. Multilevel logistic regression was used for the statistical analysis. There was a 5.23% increase in F&V consumption between evaluations. In the adjusted final models, internet use was associated with a greater chance of regular consumption of F&V (OR = 1.48, 95% CI: 1.09 - 2.01), while overweight was associated with a lower chance of outcome (OR = 0.76, 95% CI: 0.61 - 0.95). In conclusion, using the internet has proven to contribute significantly to a more adequate diet in F&V, as well as being overweight has shown to be a risk factor. [ABSTRACT FROM AUTHOR]

Background: Vegetable consumption reduces colon cancer risk when fed in the initiation stage of carcinogenesis; however, the effect of vegetable consumption during the post-initiation stage has rarely been examined.Objective: We investigated the chemopreventive effects of feeding apiaceous and cruciferous vegetables on colon cancer risk in the post-initiation stage.Methods: Thirty male Wistar rats (∼5 wk, 92 g) were subcutaneously injected with 1,2-dimethylhydrazine 1 time/wk for 2 wk. One week after the last dose, rats were randomly assigned to 3 groups: the basal diet, an apiaceous vegetable-containing diet (API; 21% fresh wt/wt), or a cruciferous vegetable-containing diet (CRU; 21% fresh wt/wt). All diets contained ∼20% protein, 7% fat, and 63% digestible carbohydrate. Experimental diets were fed for 10 wk, after which colons were harvested.Results: CRU reduced aberrant crypt foci (ACF) number compared to the basal group (P = 0.014) and API (P = 0.013), whereas API decreased the proportion of dysplastic ACF relative to the basal group (P < 0.05). Both CRU and API reduced doublecortin-like kinase 1-positive marker expression relative to basal by 57.9% (P = 0.009) and 51.4% (P < 0.02). The numbers of CD44-positive ACF did not differ between the groups. We identified 14 differentially expressed microRNAs (miRNAs). Of these, expression of 6 miRNAs were greater or tended to be greater (P ≤ 0.10) in one or both vegetable-containing groups compared to the basal group. Bioinformatic analysis of these expression changes in miRNA predicted a change in WNT/β-catenin signaling, indicating downregulation of β-catenin in the vegetable-fed groups. Consistent with this bioinformatics analysis, β-catenin-accumulated ACF were decreased in CRU (93.1%, P = 0.012), but not in API (54.4%, P = 0.125), compared to the basal group.Conclusion: Both apiaceous and cruciferous vegetables, fed post-initiation, reduce colonic preneoplastic lesions as well as cancer stem cell marker expression in rats, possibly by suppressing oncogenic signaling through changes in miRNA expression. [ABSTRACT FROM AUTHOR]

Objectives. To assess a healthy retail intervention in Tribal convenience stores in Oklahoma. Methods. We adapted healthy retail strategies to the context of 8 Tribally owned stores. We assessed individual- and store-level outcomes in a cluster-controlled intervention trial (April 2016–June 2017). We measured fruit and vegetable intake, store environment perceptions, and purchases before and after the intervention among a cohort of 1637 Native American shoppers. We used mixed-effects linear regression to estimate pre- to postintervention changes in and between groups. Results. We followed 74% of participants (n = 1204) 9 to 12 months. Intervention and control participants perceived healthier stores after intervention. Higher shopping frequency was related to purchases of fruits, vegetables, and healthy items. Conclusions. Intervention exposure was associated with healthy purchasing but not fruit and vegetable intake. Research is needed to further assess impacts of environmental interventions on intake. Public Health Implications. As the first healthy retail intervention in Tribally owned stores, our results contribute evidence for environmental and policy interventions to address obesity in Tribal Nations. Multicomponent interventions, led by Tribal leaders from diverse sectors, are needed to create healthy environments and sustainable improvements in Native American health. [ABSTRACT FROM AUTHOR]

For children it is important to consume enough vegetables to establish healthy dietary patterns. Taste acceptance is an important factor contributing to food choice and consumption. Sweetness and sourness enhancement can increase acceptance of specific foods in children. The aim of this study was to determine the effect of sweetness and sourness enhancement on acceptance of cucumber and green capsicum purees in 5-6-year-old children. Three concentrations of sucrose (2, 5 and 10%) and citric acid (0.05, 0.08 and 0.15%) were added to cucumber and green capsicum purees. Children (n = 70, 5.7 ± 0.5 yrs) assessed acceptance of the vegetable purees using a 5-point hedonic facial scale. Sweetness enhancement significantly increased acceptance of cucumber purees (5 and 10% sucrose) and green capsicum purees (2 and 10% sucrose) compared to unmodified purees. Sourness enhancement (0.05, 0.08 and 0.15% citric acid) did not significantly influence acceptance of cucumber and green capsicum purees compared to unmodified purees. Children differed in acceptance of vegetable purees with added sucrose and citric acid. Sweetness likers (cucumber 77.1%, green capsicum 58.6%) accepted sucrose concentrations better than sweetness non-likers in both vegetables. Sourness likers (cucumber 50.0%, green capsicum 44.3%) accepted medium and high concentrations of citric acid better than sourness non-likers in cucumber and all citric acid concentrations in green capsicum. We conclude that enhancement of sweetness increases acceptance of cucumber and green capsicum purees in most children whereas enhancement of sourness is better accepted by only a few children. This study highlights the challenge to get children to better accept vegetables, since only sweetness enhancement improved acceptance while addition of sucrose is undesirable. For a small subset of children enhancing sourness might be an alternative strategy to increase acceptance of vegetables. [ABSTRACT FROM AUTHOR]

Background: Fruits and vegetables, due to high antioxidant capacity, may protect the lung from oxidative damage caused by tobacco smoke and potentially prevent chronic obstructive pulmonary disease (COPD). Only one study based on baseline diet has examined fruit and vegetable consumption in relation to risk of COPD, and no previous studies have examined long-term diet.Methods: We investigated whether long-term fruit and vegetable consumption was associated with COPD incidence among 34 739 women (age 48-83 years) in the population-based prospective Swedish Mammography Cohort. Fruit and vegetable consumption was assessed twice (1987, 1997) with a self-administered questionnaire. Cases of COPD were identified by linkage to the Swedish health register. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).Results: During follow-up from 2002 to 2014, 1512 women were diagnosed with COPD. Long-term fruit was associated with lower risk of COPD; women in the highest vs lowest quintile of consumption (≥2.5 vs <0.8 servings/day) had a 37% lower risk of COPD (95% CI: 25-48%; P-trend < 0.0001). No association was observed with long-term vegetable intake. Current and ex-smokers with low long-term consumption of fruits (<1 serving/day) in comparison to never smokers with high consumption (≥3 servings/day) had a 38-fold (HR: 38.1; 95% CI: 20.2-71.7) and 13-fold (HR: 12.5, 95% CI: 6.5-24.1) higher risk of COPD, respectively. However, no significant interaction between smoking status and fruit intake in relation to COPD incidence was observed (P-interaction = 0.95).Conclusions: In this prospective cohort of middle-age and older women, long-term consumption of fruits but not vegetables was inversely associated with COPD incidence. [ABSTRACT FROM AUTHOR]

In the framework of the external factors that influence the growth/development of the students, sports activity and alimentation play an essential role. Material and method: The study was conducted on a batch of 98 teenagers from 2 highschools in Suceava. They filled in a questionnaire with questions relating to the time allotted for physical activity and dietary habits. Results and discussion: in most cases the students allocated daily physical activity between 15 and 60 minutes (54.08%). The dominant contribution of milk is 2-3 times per week (31.63%) and chicken meat (51.02%). The result is unsatisfactory, which highlight the problems related to the consumption of food products of animal origin. Cooked vegetables are present in the menus especially 4-7 times (36.73%) and bread (72.44%). Conclusions: the time allotted for daily activities is pretty modest and the intake of animal origin products is low. [ABSTRACT FROM AUTHOR]

At least 10% of children worldwide are diagnosed with overweight. Part of this problem is attributed to low vegetable intake, for which preference at a younger age is an indicator. Few studies examined long‐term effects of school garden interventions on the knowledge about and preference for vegetables. Therefore, in this study, an intervention period of 7 months (17 lessons) was organized for primary school students (n = 150) of age 10–12 years in the Municipality of Nijmegen (the Netherlands). Surveys were conducted before and after the intervention period to test the ability of students to identify vegetables, to measure their self‐reported preference for vegetables, and to analyze students' attitudes toward statements about gardening, cooking, and outdoor activity. The long‐term effects were measured by repeating the survey 1 year after the intervention (n = 52). Results were compared with a control group of students (n = 65) with similar background and tested for significance with α = 0.05. School gardening significantly increases the knowledge of primary schoolchildren on 10 vegetables as well as their ability to self‐report preference for the vegetables. The short‐term (n = 106) and long‐term (n = 52) preference for vegetables increased (p < 0.05) in comparison with the control group. The latter did not show a significant learning effect (p > 0.05). This implies that the exposure to vegetables generated by school gardening programs may increase willingness to taste and daily intake of vegetables on the long term. Students' attitudes toward gardening, cooking, and outdoor activity were unaffected by the intervention. Few studies examined long‐term effects of school garden interventions on the knowledge about and preference for vegetables. School gardening significantly increases the knowledge of primary schoolchildren on 10 vegetables (p < 0.001). Moreover, the short‐ and long‐term preference for vegetables on average increased for several vegetables. [ABSTRACT FROM AUTHOR]

This paper estimates the cost-effectiveness of a 20% price discount on healthy food and beverages with and without consumer nutrition education, as trialled in remote Northern Australia. Changes in actual store sales, from the pre-discount baseline period, were analysed for population impact on consumption of fruit and vegetables, water and artificially sweetened soft drinks, in addition with total dietary weight (grams), energy (Mega Joules), and sodium (milligrams). Disability Adjusted Life Years (DALYs), arising from changes in dietary risk factor prevalence in the population, were estimated as the primary health outcome in a multi health-state Markov model. The costs of the strategies were sourced from paid invoices and time estimates of staff providing store-based discount promotion and consumer education. The incremental cost-effectiveness ratio adopted a partial societal perspective, (including health and retail sector costs), as cost per DALY averted and was presented in 2011 Australian dollars. The price discount, helped address a gap in food price equity for residents of remote communities. However, the discount strategy, with or without consumer education led to a net loss of population health –36 95%CI (-47,-25) or -21(-28, -15) DALYs respectively, at increased cost to the retail and health sectors, of AUD860000 95%CI (710000, 1million) or AUD500000 (410000, 590000). The strategies trialled were thereby categorised as dominated by current practice while acknowledging considerable uncertainty surrounding the health outcome estimates. The 20% discount on limited targeted products appeared to need to be considered in conjunction with other marketing strategies to support healthy food choices, if remote Australian Indigenous population health is to be improved. [ABSTRACT FROM AUTHOR]

The article discusses research on the effects of elevated fruit and vegetable intake on serum bone turnover markers, and it mentions plasma carotenoid levels, bone resorption marker C-terminal telopeptide of type 1 collagen, and lower bone formation marker alkaline phosphatase.

Smoothies are popular dietary products. An online survey of Australian adults (n=833; 79% female) was used to explore patterns of smoothie consumption and individual motives for consuming these beverages. Participants commonly reported consuming fruit (98%), yoghurt (66%), milk (58%), honey (52%), fruit juice (46%), and nutritional supplements (46%) in smoothies. Compared to Infrequent Smoothie-Consumers (I-SC, <1·week-1; n=514), Frequent Smoothie-Consumers (F-SC, =1·week-1; n=269) were more likely to consume core-foods (e.g. vegetables, p<0.001) and less likely to consume discretionary items (e.g. honey or ice-cream, p's<0.020) in smoothies. It followed that F-SC typically cited "health-related reasons" for consuming these beverages (i.e. to increase fruit/vegetable [57%] or nutrient [50%] intake, and/or to be "healthy" [56%]) and perceived these products as "nutritious" (84%); whilst I-SC often perceived them as "indulgent" (62%). Smoothies may play a positive role in the diet. However, beverages incorporating discretionary choices may increase energy, saturated fat and/or sugar intakes, offsetting the benefits of fruit/vegetable consumption. [ABSTRACT FROM AUTHOR]

Fruit and vegetable consumption is on the rise as an increasing number of people recognize their health promoting effects, which are mediated through phytochemicals with disease combatting properties. The aim of this paper is to identify the potential benefits of fruits and vegetables in chronic diseases such as diabetes mellitus and hypertension. An electronic search of databases such as Pubmed Central, Science Direct and Web of Science from the last 5 years was conducted. Four commonly consumed edible fruit and vegetables, namely, Hypoxis hemmerocallidea (African potato), Moringa oleifera (Moringa), Persea americana (Avocado) and Psidium guajava (Guava) and their potential role in the prevention and management of metabolic syndrome and other disorders, are presented. In this narrative review plant uses extend beyond traditional medicine and include usage in food preparation, beverages, as part of fragrances, culinary flavouring, as well as cosmetic use, but more importantly have potential in contributing to the amelioration of the deleterious effects of diseases/health conditions. In addressing disease states, including metabolic syndrome and other disorders, the interest in medicinal plants continues to grow with the possibility of novel compounds and/or new drug discovery. Alternative and affordable methods of large scale harvesting of medicinal plants, as well as identification and specificity of bioactive compounds as future therapeutics are essential for sustainability. [ABSTRACT FROM AUTHOR]

Introduction: healthy eating habits, such as the consumption of fruits and vegetables, allow better health and, consequently, reduce the consumption of health resources. It is important to establish a relationship between fruit and vegetable consumption and the use of health services in the Spanish population to consider the need to intervene.Methods: the European Health Survey in Spain for 2014 was used, and the possible existence of differences in access and visit frequency to the family physician, specialist physician and emergency services depending on fruits and vegetables consumption habits was assessed through Hurdle models. Subsequently, two groups were generated through the propensity score matching technique in order to compare the differences in the frequenting of services depending on the consumption of fruits and/or vegetables and other adjustment covariates. Finally, the cost generated by such differences was estimated according to consumption groups.Results: there are differences in access to the emergency services, both in subjects who never consume fruit and in subjects who never consume vegetables. In the first case, there is an increase of 420 visits per year for every 1,000 persons with attributable costs of €75,000, whereas in the second case, an increase of 780 visits per year for every 1,000 persons, with a cost of €139,000, is observed.Conclusions: certain eating habits of the Spanish population, such as never consuming fruits or vegetables, produce important avoidable expenses in the health system. It would be of interest to implement prevention policies to reduce such costs and use resources appropriately. [ABSTRACT FROM AUTHOR]

Objective: To examine the trend in social inequality in low intake of vegetables among adolescents in Denmark from 2002 to 2014 using occupational social class (OSC) as socio-economic indicator.Design: Repeated cross-sectional school surveys including four waves of data collection in 2002-2014. The analyses focused on absolute social inequality (difference between high and low OSC in low vegetable intake) as well as relative social inequality (OR for low vegetable intake by OSC).Setting: The nationally representative Health Behaviour in School-aged Children (HBSC) study in Denmark.Subjects: The study population was 11-15-year olds (n 17 243).Results: Low intake of vegetables was defined as less than weekly intake measured by food frequency items. OSC was measured by student reports of parents' occupation. The proportion of participants who reported eating vegetables less than once weekly was 8·9 %, with a notable decrease from 11·9 % in 2002 to 5·9 % in 2014. The OR (95 % CI) for less than weekly vegetable intake was 2·28 (1·98, 2·63) in the middle compared with high OSC and 3·12 (2·67, 3·66) in the low compared with high OSC. The absolute social inequality in low vegetable intake decreased from 2002 to 2014 but the relative social inequality remained unchanged.Conclusions: The study underscores that it is important to address socio-economic factors in future efforts to promote vegetable intake among adolescents. The statistical analyses of social inequality in vegetable intake demonstrate that it is important to address both absolute and relative social inequality as these two phenomena may develop differently. [ABSTRACT FROM AUTHOR]

Objective: To examine the associations of vegetable and/or fruit consumption with metabolic syndrome (MetS).Design: Meta-analysis of observational studies.Setting: The electronic databases of PubMed, Web of Science and EMBASE were searched up to September 2017 for observational studies concerning the associations of vegetable and/or fruit consumption with MetS. The pooled relative risk (RR) of MetS for the highest v. the lowest category of vegetable and/or fruit consumption, as well as their corresponding 95 % CI, were calculated.Results: A total of twenty-six observational studies (twenty cross-sectional, one case-control and five cohort studies) were included in the meta-analysis. Specifically, sixteen studies were related to vegetable consumption and the overall multivariable-adjusted RR evidenced a negative association between vegetable consumption and MetS (RR=0·89, 95 % CI 0·85, 0·93; P<0·001). For fruit consumption, sixteen studies were included and the overall multivariable-adjusted RR demonstrated that fruit consumption was inversely associated with MetS (RR=0·81, 95 % CI 0·75, 0·88; P<0·001). For vegetable and fruit consumption, eight studies were included; the overall multivariable-adjusted RR showed that vegetable and fruit consumption was also negatively associated with MetS (RR=0·75, 95 % CI 0·63, 0·90; P=0·002).Conclusions: The existing evidence suggests that vegetable and/or fruit consumption is negatively associated with MetS. More well-designed prospective cohort studies are needed to elaborate the concerned issues further. [ABSTRACT FROM AUTHOR]

Objective: To assess the feasibility, reliability and validity of reflection spectroscopy (RS) to assess skin carotenoids in a racially diverse sample.Design: Study 1 was a cross-sectional study of corner store customers (n 479) who completed the National Cancer Institute Fruit and Vegetable Screener as well as RS measures. Feasibility was assessed by examining the time it took to complete three RS measures, reliability was assessed by examining the variation between three RS measures, and validity was examined by correlation with self-reported fruit and vegetable consumption. In Study 2, validity was assessed in a smaller sample (n 30) by examining associations between RS measures and dietary carotenoids, fruits and vegetables as calculated from a validated FFQ and plasma carotenoids.Setting: Eastern North Carolina, USA.Results: It took on average 94·0 s to complete three RS readings per person. The average variation between three readings for each participant was 6·8 %. In Study 2, in models adjusted for age, race and sex, there were statistically significant associations between RS measures and (i) FFQ-estimated carotenoid intake (P<0·0001); (ii) FFQ-estimated fruit and vegetable consumption (P<0·010); and (iii) plasma carotenoids (P<0·0001).Conclusions: RS is a potentially improved method to approximate fruit and vegetable consumption among diverse participants. RS is portable and easy to use in field-based public health nutrition settings. More research is needed to investigate validity and sensitivity in diverse populations. [ABSTRACT FROM AUTHOR]

Objective: To investigate socio-economic differences in changes in fruit and vegetable intake between 2004 and 2011 and explore the mediating role of financial barriers in this change.Design: Respondents completed a self-reported questionnaire in 2004 and 2011, including questions on fruit and vegetable intake (frequency per week), indicators of socio-economic position (education, income) and perceived financial barriers (fruits/vegetables are expensive, financial distress). Associations were analysed using ordinal logistic regression. The mediating role of financial barriers in the association between socio-economic position and change in fruit and vegetable intake was studied with the Baron and Kenny approach.Setting: Longitudinal GLOBE study.Subjects: A total of 2978 Dutch adults aged 25-75 years.Results: Respondents with the lowest income in 2004 were more likely to report a decrease in intake of cooked vegetables (P-trend<0·001) and raw vegetables (P-trend<0·001) between 2004 and 2011, compared with those with the highest income level. Respondents with the lowest education level in 2004 were more likely to report a decrease in intake of fruits (P-trend=0·021), cooked vegetables (P-trend=0·033), raw vegetables (P-trend<0·001) and fruit juice (P-trend=0·027) between 2004 and 2011, compared with those with the highest education level. Financial barriers partially mediated the association between income and education and the decrease in fruit and cooked vegetable intake between 2004 and 2011.Conclusions: These results show a widening of relative income and educational differences in fruit and vegetable intake between 2004 and 2011. Financial barriers explained a small part of this widening. [ABSTRACT FROM AUTHOR]

Objective: Previous research indicates that low-income individuals often struggle to consume the recommended amount of fruits and vegetables (F&V). LINK Up Illinois is a farmers' market incentive programme that aims to increase F&V consumption among Supplemental Nutrition Assistance Program (SNAP) recipients by improving access to and affordability of locally grown foods. The present research aimed to identify barriers to F&V consumption that exist among users of the LINK Up Illinois programme.Design: Cross-sectional.Setting: Farmers' markets in Chicago, Springfield, Northbrook, Woodstock, Aurora and Urbana, IL.Subjects: In 2016, a volunteer sample of 140 LINK Up Illinois users (mean age 42·5 years; 81·7 % female; 28·7 % African American; 44·0 % obese) completed a survey at participating farmers' markets across the state. Information on demographics, food shopping behaviours, programme satisfaction, barriers to F&V consumption and frequency of F&V consumption was collected and examined.Results: Approximately 23 % of survey participants reported consuming F&V ≥3 times/d. The barriers to F&V consumption most often reported by survey participants were the cost of F&V (29·5 %), spoilage (18·6 %), knowing how to cook F&V (8·7 %) and not thinking about F&V when hungry (8·6 %). Results from multivariable-adjusted logistic regression models suggested that reporting one or more barriers was associated with reduced odds of consuming vegetables ≥3 times/d, but not fruits.Conclusions: Cost, spoilage and knowledge of cooking are key barriers to F&V consumption that exist among LINK Up Illinois users. Strategies are needed to mitigate these barriers and increase F&V consumption in this population. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to examine the effectiveness of two different implementation forms of the EU School Fruit and Vegetable Scheme (SFVS).Design: A quasi-experimental design was applied including a thrice as well as a twice weekly intervention group. Repeated 24 h dietary recalls were used to measure children's fruit and vegetable (F&V) intake. Effects were analysed on days with and without F&V deliveries using hierarchical linear regression models.Setting: Twelve primary schools in North Rhine-Westphalia, Germany.Subjects: Third and fourth graders (n 664).Results: Average daily F&V intake at pre-intervention was 0·84 frequencies in the thrice weekly intervention group, 0·90 frequencies in the twice weekly intervention group and 1·25 frequencies in the control group. Providing children thrice weekly with F&V increased children's F&V intake on average by 0·96 (P<0·001) frequencies/d. The effects were higher on days with (1·07; P<0·001) than on days without (0·75; P<0·001) F&V deliveries. Distributing F&V twice weekly resulted in an increase of 0·75 (P<0·001) frequencies/d on average, again with higher effects on days with (1·30; P<0·001) than without (0·48; P<0·003) F&V deliveries. Subgroup analysis revealed some indications for differential effectiveness only in the twice weekly intervention group.Conclusions: The SFVS with thrice or twice weekly deliveries of F&V led to a significant increase in children's F&V intake on days with and without deliveries. The latter might provide an indication of positive long-term effects of the scheme. The scheme shows equal efficiency for almost all subgroups. [ABSTRACT FROM AUTHOR]

ObjectiveTo study the associations between home food availability and dietary patterns among pre-school children.DesignCross-sectional study in which parents of the participating children filled in an FFQ and reported how often they had certain foods in their homes. We derived dietary pattern scores using principal component analysis, and composite scores describing the availability of fruits and vegetables as well as sugar-enriched foods in the home were created for each participant. We used multilevel models to investigate the associations between availability and dietary pattern scores.SettingThe DAGIS study, Finland.SubjectsThe participants were 864 Finnish 3–6-year-old children recruited from sixty-six pre-schools. The analyses included 711 children with sufficient data.ResultsWe identified three dietary patterns explaining 16·7 % of the variance. The patterns were named ‘sweets-and-treats’ (high loadings of e.g. sweet biscuits, chocolate, ice cream), ‘health-conscious’ (high loadings of e.g. nuts, natural yoghurt, berries) and ‘vegetables-and-processed meats’ (high loadings of e.g. vegetables, cold cuts, fruit). In multivariate models, the availability of fruits and vegetables was inversely associated with the sweets-and-treats pattern (β=−0·05, P<0·01) and positively associated with the health-conscious (β=0·07, P<0·01) and vegetables-and-processed meats patterns (β=0·06, P<0·01). The availability of sugar-enriched foods was positively associated with the sweets-and-treats pattern (β=0·10, P<0·01) and inversely associated with the health-conscious pattern (β=−0·03, P<0·01).ConclusionsConsidering dietary patterns, the availability of sugar-enriched foods in the home seems to have a stronger role than that of fruits and vegetables. Parents should restrict the availability of unhealthy foods in the home. [ABSTRACT FROM PUBLISHER]

Objective: To assess the influence of a mobile produce market (MPM) on fruit and vegetable access.Design: Novel application of a structured assessment (five dimensions of access framework) to examine fruit and vegetable access through self-administered surveys on shopping behaviours, and perceptions and experiences of shopping at the MPM.Setting: Low-income neighbourhoods with limited access to fruits and vegetables.Subjects: Older (≥60 years) and younger (18-59·9 years) shoppers.Results: Participants were more likely to be women and non-White, one-third lived alone and nearly half were older adults. Compared with younger, older participants had different shopping behaviours: tended to purchase food for one person (P < 0·001), be long-term shoppers (P=0·002) and use electronic benefit transfer (EBT) cards (P=0·012). Older adults were more likely to like the market location (P=0·03), while younger adults were more likely to want changes in location (P=0·04), more activities (P=0·04), taste sampling (P=0·05) and nutritional counselling (P=0·01). The MPM captured all dimensions of access: availability, indicated by satisfaction with the produce variety for nearly one-third of all participants; accessibility, indicated by participants travelling <1 mile (<1·6 km; 72·2 %) and appreciation of location (72·7 %); affordability, indicated by satisfaction with price (47·6 %); acceptability, indicated by appreciation of produce quality (46·2 %); and accommodation, indicated by satisfaction with safety of location (30·1 %) and high EBT use among older adults (41·8 %).Conclusions: MPM may influence fruit and vegetable access in low-income urban neighbourhoods by facilitating the five dimensions of access and may especially benefit older adults and individuals living alone. [ABSTRACT FROM AUTHOR]

Purpose Young adults frequently engage in sub-optimal dietary behaviours, such as inadequate intakes of fruits and vegetables and excessive consumption of take-out meals. Theory-based interventions are suggested to promote dietary change. The transtheoretical model is an example that stages an individual’s readiness to change behaviours as precontemplation, contemplation, preparation, action and maintenance, and includes a series of processes that help people move between stages. The purpose of this study is to investigate whether self-reported usual dietary intakes of fruits and vegetables and take-out foods differ by reported stage-of-change.Design/methodology/approach Cross-sectional data from 250 overweight young adults, aged 18-35 years, who enrolled in a lifestyle intervention to prevent weight gain are analysed. Participant’s stage-of-change for increasing fruit and vegetable intakes and reducing take-out foods is determined using staging algorithms. This is compared with self-reported dietary intakes over the past month using a food frequency questionnaire. Differences in intakes and variety by stage-of-change are compared for fruits, vegetables and take-out foods.Findings Take-out foods differed between stages (p < 0.0001), with lower weekly intakes in action (309 g) and maintenance (316 g) compared with preparation (573 g). Daily fruit intakes and variety scores varied by stage-of-change (p < 0.0001), being highest for action and maintenance (261 g and 263 g, respectively, and variety scores of 1 and 2) compared with precontemplation, contemplation and preparation (all = 100 g and 0 for variety). Daily vegetable consumption and variety scores differed by stage (p = 0.009 and p = 0.025, respectively) being highest for action/maintenance (204 g and 2 for variety) versus precontemplation and preparation (<110 g daily and Variety 1).Practical implications The finding of no differences in intakes between precontemplation, contemplation or preparation stages implies that the adoption of the dietary behaviours is not a continuum but a move from pre-action to actioning the target intakes. This means that for planning health promotion and dietary counselling, assigning people to the three different pre-action stages may be unnecessary.Originality/value This study is the first to examine the congruence of self-reported readiness to change behaviour with dietary intakes of take-out foods as well as variety of fruit and vegetables in overweight young adults. [ABSTRACT FROM AUTHOR]

Abstract: Adequate nutrition is an important factor for health and well‐being in adolescents and later years. Fruits and vegetables are part of a healthy diet as important source of nutrients, but their intakes are lower than the recommendations in European countries. This study aimed to compare the choices made by adolescents and older people between three similar dishes, one based on meat, one on fish and one on vegetables, in two different conditions: a neutral (control) situation and an intervention situation in which the vegetable‐based meal was designated ‘dish of the day’. The comparisons of choices will be made within the same age group (adolescents in the control group vs. adolescents in the intervention group; older people in the control group vs. older people in the intervention group). A quasi‐randomised field trial design was used with a sample of 94 adolescents (aged 10–19 years) and 97 older people (aged ≥65 years), who were randomly allocated to intervention or control groups. In the control situation participants were asked to choose between three similar meals, one meat, one fish and one the VeggiEat dish. In the intervention, the VeggiEat dish was labelled the ‘Dish of the day’. All dishes were provided free of charge, displayed side by side in the same order and served in same portions. The dish choices showed no differences between the control and intervention groups in both age groups, and no differences were found among the other variables analysed. This nudging strategy, ‘dish of the day’, seems not to work for the Danish sample of adolescents and older people. Future nudging studies with these populations are needed in order to find the best strategy to move adolescents' and older people's food habits toward a healthier pattern. [ABSTRACT FROM AUTHOR]

Background: We investigated whether BCMO1 variants and dietary patterns are associated with lung cancer risk.Methods: Case-control study including 1166 lung cancer cases and 1179 frequency matched controls was conducted for three BCMO1 variants (rs6564851, rs12934922, and rs7501331) and four dietary patterns were investigated. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs).Results: The rs6564851, rs12934922, and rs7501331 were not found to be associated with lung cancer risk (P > 0.05). In multivariable-adjusted models, compared to the lowest quartile of the score on the "fruits and vegetables" pattern, the highest quintile was associated with a 78.4% decreased risk (OR Q4 vs. Q1 = 0.216; 95% CI, 0.164-0.284; P for trend < 0.001). Other patterns were not found the association. The "fruits and vegetables" pattern was associated with a reduced risk of lung cancer with all 3 SNPs irrespective of genotypes (all P for trend< 0.001). The association for the "Frugal" pattern was associated with increased risk of lung cancer among smokers (P for interaction = 0.005). The protective effects of the "cereals/wheat and meat" pattern was more evident for squamous cell carcinoma and other histological type.Conclusions: We did not observe associations of BCMO1 variants and lung cancer. Diets rich in fruits and vegetables may be protective against lung cancer. [ABSTRACT FROM AUTHOR]

Vegetable fields have a high risk of heavy metal contamination from pollution sources in suburban and industrial areas of cities. Eighty-seven soil samples, 106 leafy vegetables and 48 road dust samples were collected from industrial areas of Shanghai, China. We studied the levels of heavy metals, health risk through consumption of leafy vegetables, and sources of Pb in soils, road dust and leafy vegetables. Soil Cd, Zn, Pb, Cu, Hg and As concentrations exceeded the soil background values in 73.6%, 97.7%, 52.3%, 37.8%, 95.1% and 20.2% soil samples, respectively, but were below the criteria for agricultural soil in China, with the exception of Hg. The concentrations of Cd, Zn, Pb, Cu and As in road dust were significantly higher than concentrations in soils, while Hg concentration in road dust was lower. Cd, Zn, Pb, Hg and Cu concentrations in soils and Zn, Pb and Cu concentrations in road dust were greatest near the municipal solid waste incineration power plant. Heavy metal concentrations in the edible tissues of vegetables were not correlated with their total values in soils and varied among vegetable species. The trends in transfer factors (TFs) in different vegetables were Cd > Zn > Cu > As > Hg > Pb. There was low health risk from heavy metal exposure by consumption of vegetables based on Hazard Quotients (HQ M ): As was the major contributor to HQ M , followed by Cd and Pb. Parent material of the Yangtze River Estuary was the major source of Pb in soils, while coal-fired, stationary industrial emissions and municipal waste incineration emissions were the major sources of Pb in dust and vegetables based on use of the lead isotopic tracing method. Accumulation of Pb in leafy vegetables was through foliar uptake and directly related to atmospheric Pb. [ABSTRACT FROM AUTHOR]

Discrete choice models estimated over a large household database, show the impacts of demographics, household behavior, health status, obesity issues and prices on household servings of fruits and vegetables. These impacts are ranked from the most to least effects on daily servings. A major result is the importance of obesity and calorie issues relative to other major demand drivers. [ABSTRACT FROM PUBLISHER]

Traditional African vegetables have recently received considerable attention for their contribution to food and nutrition security and opportunities for enhancing smallholder livelihoods. Promoting the production and consumption of traditional vegetables is expected to enhance household nutrition among urban and rural households. The Good Seed Initiative (GSI) program promoted production and consumption of nutrient-dense traditional African vegetables in Arusha region in Tanzania to reduce malnutrition through diet diversification. We estimated the impact of promotion activities on households, women, and children's dietary diversity. The study used cross-sectional data from 258 and 242 households in intervention and control regions, respectively, and applied matching techniques and inverse probability weighting to control for unobserved heterogeneity and selection bias, which could otherwise bias the outcome estimates. We found that households benefiting from traditional vegetable promotion and demand creation activities had significantly higher dietary diversity of children under 5 yr and women in reproductive age. We found no significant impact of promotion activities on households’ dietary diversity. The policy implication is that scaling up promotional and demand creation activities to encourage consumers to grow and eat traditional African vegetables would be an important element in initiatives to increase dietary diversity, particularly for children under 5 and women in Tanzania. [ABSTRACT FROM PUBLISHER]

Context: Increased intake of fruits and vegetables (FV) may be useful for weight loss. Objective: This study was designed to evaluate the effects of changes in FV intake on the overall diet and to determine if selfregulation affects the association between changes in FV intake and weight. Methods: Women with obesity (N = 74, mean age = 47.7 years) participating in a year-long behavioral weight-loss treatment were assessed regarding changes in consumption of various food groups, physical activity, and eating self-regulation over 6, 12, and 24 months. Results: FV intake change significantly predicted changes in weight and consumption of dairy and bread products and sweets. The only other notable relationships were among changes in sweets, bread, and dairy consumption over 24 months. Over 6, 12, and 24 months, changes in self-regulation significantly mediated the FV intake-weight change relationship. The overall mediation models were significant (R2 values = 0.19, 0.13, and 0.32, respectively). A reciprocal relationship between changes in FV intake and self-regulation also was found. Significant increases in physical activity outputs did not influence weight changes. Conclusion: Findings supported a relationship between FV intake and weight loss occurring through self-regulatory skills. Associations between FV intake and reduced consumption of other food groups provided data useful for improving the architecture of behavioral weight-loss treatments and the foci of medical practitioners' helping methods. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of a peer facilitator (PF) approach for improving mothers' knowledge and practices relating to maternal and child nutrition.Design: A quasi-experimental design nested within a large-scale integrated nutrition programme, Suaahara, in Nepal. Suaahara interventions were implemented in all study sites, but peer facilitators were used in only half of the study sites.Setting: Rural, disadvantaged villages in three districts of Nepal: Bhojpur, Bajhang and Rupandehi.Subjects: Mothers of children aged 6-23·9 months (n 1890).Results: Differences over time between comparison (C) and intervention (I) groups show that the PF approach had a significant positive impact on several indicators of mothers' knowledge and practices relating to maternal and child nutrition: (i) knowing that fruits and vegetables are good for children 6-23·9 months (C: -0·7, I: 10·6; P=0·03); (ii) child dietary diversity (C: 0·02, I: 0·04; P=0·02); (iii) child minimum dietary diversity (≥4 of 7 food groups; (C: 6·9, I: 16·0; P=0·02); (iv) maternal dietary diversity (C: 0·1, I: 0·4; P=0·01); and (v) maternal minimum dietary diversity (≥4 food groups; C: 3·6, I: 14·0; P=0·03). Additionally, exposure to a PF three or more times in the past 6 months was positively associated with a small improvement in maternal (β=0·06, P=0·04) and child (β=0·06, P=0·02) dietary diversity scores. Improvements were not observed in maternal health-seeking behaviours such as number of antenatal care visits.Conclusions: Peer mobilization is a potential approach for improving health- and nutrition-related knowledge and behaviours among women in hard-to-reach communities of Nepal. [ABSTRACT FROM AUTHOR]

Objective: To identify individual and contextual socio-economic factors associated with an increase in fruit and vegetable (F&V) consumption over a 12-year period and evaluate if some socio-economic factors were differentially associated with the change in consumption of some types of F&V.Design: Associations between increased F&V consumption and socio-economic factors were studied with multivariate logistic regression.Setting: E3N, a French prospective cohort study of 98 995 women.Subjects: E3N participants (n 58 193) with information on diet in 1993 and 2005, and numerous individual and contextual socio-economic factors available.Results: Associations between some individual socio-economic factors and changes in F&V consumption were observed. For instance, women who lived in a large household (>3 children v. no child) had higher probability of increasing their vegetable consumption (OR=1·33; 95 % CI 1·24, 1·42). This association was driven by higher consumption of courgette and raw cucumber. Living with a partner was associated with higher odds of increasing consumption of fruits (OR=1·07; 95 % CI 1·02, 1·13) such as pear, peach and grape.Conclusions: Certain individual socio-economic factors, but none of the contextual socio-economic factors examined, were associated with an increase in F&V consumption. Factors associated with an increase in total F&V consumption were not necessarily associated with an increase in fruit or vegetable consumption separately, or with an increase in each subtype of fruit or vegetable. Magnitudes of the different associations observed also differed when F&V were considered together, separately or by subtype. Increases in F&V consumption were mostly observed in women with high socio-economic position. To develop effective nutritional interventions and policies that take the socio-economic environment of individuals into account, we recommend future research to further focus on (i) pathways through which population characteristics might influence changes in F&V consumption and (ii) existing interactions between individual and contextual socio-economic factors. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we examined the role of socio-demographic (race/ethnicity, sex, grade, nativity, literacy, body mass index) and individual-level (normative beliefs, knowledge, perceived barriers, food preference, self-efficacy) factors on US adolescent fruit and vegetable consumption. Methods: We conducted hierarchical multiple regression analysis to determine the influence of factors on adolescent fruit and vegetable consumption in a nationally representative sample of 795 adolescents from the National Cancer Institute's 2014 Family Life, Activity, Sun, Health and Eating (FLASHE) study. Results: Socio-demographic variables explained little variance (1.7%) whereas individual-level factors explained approximately 29% of the variance in adolescent fruit and vegetable consumption. Statistically significant (p < .001) predictors of adolescent fruit and vegetable consumption were food preference (β = .253), self-efficacy (β = .184), perceived barriers (β = -.139) and normative beliefs (β = .134). After controlling for sex, food preference and normative beliefs were stronger predictors of male and perceived barriers was a stronger predictor of female, adolescent fruit and vegetable consumption. Conclusions: Understanding the predictive strength and sex-specific differences of intrapersonal variables on male and female adolescent fruit and vegetable consumption informs health promotion efforts to increase intake to recommended amounts. [ABSTRACT FROM AUTHOR]

Unlike fast and restaurant food, diet rich in fibre is known to contribute significantly to health. The aim of our study was to assess eating habits such as consumption of fibre-rich, fast, and restaurant food of the general population in Croatia. For this purpose we used a validated survey designed by the Polytechnic Institute Viseu in Portugal, which includes questions about demographics, good eating habits related to the consumption of the main sources of dietary fibre (fruit, vegetables, and whole grains), and unhealthy eating habits related to the consumption of fast food and restaurant meals. Between October 2014 and March 2015 we received answers from 2,536 respondents aged between 18-70 years, of whom 67.4 % were women and 32.6 % were men. Most respondents reported consuming one serving of vegetables and one piece of fruit a day, and whole grains every other day. Women and urban residents reported consuming larger amounts of fruit, vegetables, and whole grains than men (p<0.001). Men, in turn, reported eating out and eating fast food more often than women (p<0.001). Eating out highly correlated with eating fast food, which translates to lower consumption of dietary fibre (p<0.001). Higher education correlated positively with the consumption of fibre-rich food, but it also correlated positively with the consumption of fast and restaurant food (p<0.001). While eating fast food is not the predominant dietary practice in Croatia, over 50 % of respondents have reported eating fast food at least once a week. Our data also indicate that consumption of fruit, vegetables, and whole grains falls below the national and international dietary recommendations. [ABSTRACT FROM AUTHOR]

Objective: Evidence suggests that improvements to the childcare nutrition environment can have a positive impact on child dietary intake. The primary aim of the present study was to assess, relative to usual care, the effectiveness of a multi-strategy implementation intervention in improving childcare compliance with nutrition guidelines. As a secondary aim, the impact on child dietary intake was assessed.Design: Parallel-group, randomised controlled trial design. The 6-month intervention was designed to overcome barriers to implementation of the nutrition guidelines that had been identified by applying the theoretical domains framework.Setting: Hunter New England region, New South Wales, Australia.Subjects: Forty-five centre-based childcare services.Results: There were no differences between groups in the proportion of services providing food servings (per child) compliant with nutrition guideline recommendations for all five (5/5) food groups at follow-up (i.e. full compliance). Relative to control services, intervention services were more likely to be compliant with guidelines (OR; 95 % CI) in provision of fruit (10·84; 1·19, 551·20; P=0·0024), meat and meat alternatives (8·83; 1·55, -; P=0·023), dairy (8·41; 1·60, 63·62; P=0·006) and discretionary foods (17·83; 2·15, 853·73; P=0·002). Children in intervention services consumed greater servings (adjusted difference; 95 % CI) of fruit (0·41; 0·09, 0·73; P=0·014) and vegetables (0·70; 0·33, 1·08; P<0·001).Conclusions: Findings indicate that service-level changes to menus in line with dietary guidelines can result in improvements to children's dietary intake. The study provides evidence to advance implementation research in the setting as a means of enhancing child public health nutrition. [ABSTRACT FROM AUTHOR]

Objective: Limited research is available on whether participation in healthy food incentive programmes is associated with higher fruit and vegetable intake. The objective of the present study was to determine fruit and vegetable intake among participants in the Produce Plus Program, a farmers' market-based healthy food incentive programme in Washington, DC, and identify demographic and behavioural factors associated with higher fruit and vegetable intake.Design: Using a cross-sectional survey, programme participants were interviewed at markets across DC between June and September 2015. Questions included the Behavioral Risk Factor Surveillance System (BRFSS) fruit and vegetable module. Fruit and vegetable intake among 2013 DC BRFSS participants reporting annual household incomes of ≤$US 35 000 was calculated for context.Setting: Washington, DC, USA.Subjects: Participants (n 288) in the Produce Plus Program.Results: On average, participants reported consuming both fruits (interquartile range: 1·0-3·0) and vegetables (interquartile range: 1·3-3·5) two times/d. Participants who reported eating home-cooked meals ≥3 times/week also reported higher median fruit (2·0 v. 0·8) and vegetable (2·3 v. 1·3) intake compared with those eating home-cooked meals less frequently. No statistically significant differences in reported median fruit or vegetable intake were observed over the course of the farmers' market (June v. August/September) season.Conclusions: Produce Plus Program participants reported higher median fruit and vegetable intake compared with DC BRFSS respondents with similar incomes, but still below recommended levels. More frequent home-cooked meals were associated with higher fruit and vegetable intake. Thus, efforts to increase home cooking may represent an opportunity to increase fruit and vegetable intake among healthy food incentive participants. [ABSTRACT FROM AUTHOR]

Objectives: Due to growing health disparities, federal and philanthropic agencies have emphasized reducing health disparities in their preventive health efforts. This study determined the status of disparities in health behaviors in the last 13 years in the United States. Methods: Data were obtained from the Behavioral Risk Factor Surveillance Systems in odd years (2003-2015). Health behaviors were dichotomized to reflect met fruit and vegetable (FV) consumption and physical activity (PA) recommendations, non-cigarette smoking, non-heavy drinking, and nonbinge drinking. Overall and sociodemographic characteristic-specific disparities ratios for each behavior were calculated. Linear trend analyses were calculated to determine disparities change across the years. Results: Overall disparities fluctuated across the years. Linear trend analyses confirmed that education-specific and income-specific disparities' contribution to overall disparities increased for all behaviors. Sex-specific disparities' contribution decreased for all behaviors except non-cigarette smoking. Age-specific disparities' contribution decreased for all behaviors except non-binge drinking. Race/ethnicity-specific disparities' contribution to overall disparities increased for FV and non-cigarette smoking, but decreased for the other behaviors. Conclusions: The results suggest health disparities in preventive health behaviors in the last 13 years have not improved. Tailored interventions, systemic and policy changes, and/or inclusive population efforts should be initiated to reduce disparities in preventive health for the mostdivergent groups identified in the results. [ABSTRACT FROM AUTHOR]

Background Evidence on the effects of ambient PM 2.5 on lung function is limited among adults and the effect modification by dietary fruit and vegetables remains largely unknown. Methods We interviewed 29,032 participants aged 50 years and older from the WHO Study on global AGEing and adult health. Annual average PM 2.5 levels were estimated for each community using satellite data. We applied multi-level linear regressions to examine the association between ambient PM 2.5 and lung function (forced vital capacity (FVC), forced expiratory volume in 1-sec (FEV 1 ), FEV 1 /FVC ratio, peak expiratory flow (PEF), and forced expiratory flow between 25th and 75th percentiles of FVC (FEF 25–75 )). Results We found that ambient PM 2.5 was associated with lower lung functions. Each 10 μg/m 3 increase in PM 2.5 corresponded to reductions of 123.58 ml in FVC (95% CI: −185.21, −61.95), 126.64 ml in FEV 1 (95% CI: −186.04, −67.23) and 178.93 ml/s FEV 25–75 (95% CI: −249.20, −108.66). Lower effect estimates were observed among those with higher consumption of fruit and vegetables. Conclusion Our study suggests that exposure to ambient PM 2.5 might be one risk factor of reduced lung function in adults and that higher consumption of fruit and vegetables may mitigate this effect. [ABSTRACT FROM AUTHOR]

Abstract: The American diet is lacking in plant‐based foods and vegetables, higher in protein than necessary, and too centered on meat and poultry. Two major dietary shifts recommended by the 2015‐2020 U.S. Dietary Guidelines are to increase vegetable intake and to increase the variety of protein food sources. One suggested strategy for doing this is to partially replace meat and poultry with vegetables and plant‐based ingredients in mixed dishes. This research tested the potential of flavor modalities (taste, aroma, trigeminal, and their combination) as strategies to increase the sensory appeal of plant‐forward dishes. Consumer testing (n = 141) was conducted in a cross‐sectional design in a laboratory setting on 24 recipe variations. Three factors were tested: cuisine (Latin American, Mediterranean, and Asian), meat proportion (high‐meat/low‐vegetable versus low‐meat/high‐vegetable), and flavor strategy (taste, aroma, trigeminal, and a reduced‐intensity trimodal combination). Statistical analysis was performed in R and XLSTAT‐Sensory® 2017. Four consumer preference segments were uncovered. The low‐meat dishes achieved parity or higher in consumer acceptance across all recipes and flavor strategies. The taste and trigeminal strategies both had higher overall acceptability scores than the aroma strategy, and the differences were significant (P < 0.05) in some consumer preference segments. The consumers successfully characterized the samples using a Check‐All‐That‐Apply task, verifying the flavor strategy design. This research provides insight into consumer preferences regarding flavor strategies to partially replace meat with vegetables in mixed dishes. The trigeminal and trimodal combination strategies were found to be the most promising flavor modalities to use to implement this shift. Practical Application: There is little knowledge of American consumer preferences regarding vegetables in mixed dishes. Mixed dishes are a strategy recommended by the U.S. Dietary Guidelines to increase vegetable consumption and variety of protein sources. This research explores various flavor and culinary strategies with which to carry out the mixed dish meat‐vegetable swap and to test the potential of the Flexitarian Flip™ (the shift from meat‐centric to plant‐centric diets). This research shows that individuals have different preferences regarding the type of flavor they prefer in mixed dishes (for example, some consumers prefer salty and some prefer spicy), so if the dietitian can recommend recipes that cater to that client's food and flavor preferences, the client will be more likely to adhere to their diet. [ABSTRACT FROM AUTHOR]

Purpose: EHealth interventions are effective in changing health behaviours, such as increasing physical activity and altering dietary habits, but suffer from high attrition rates. In order to create interventions that are adapted to end-users, in-depth investigations about their opinions and preferences are required. As opinions and preferences may vary for different target groups, we explored these in two groups: the general population and a clinical sample. Methods: Twenty adults from the general population (mean age = 42.65, 11 women) and twenty adults with type 2 diabetes (mean age = 64.30, 12 women) performed ‘MyPlan 1.0’, which is a self-regulation-based eHealth intervention designed to increase physical activity and the intake of fruit and vegetables in the general population. The opinions and preferences of end-users were explored using a think aloud procedure and a questionnaire. During a home visit, participants were invited to think aloud while performing ‘MyPlan 1.0’. The thoughts were transcribed verbatim and inductive thematic analysis was applied. Results: Both groups had similar opinions regarding health behaviours and ‘MyPlan 1.0’. Participants generally liked the website, but often experienced it as time-consuming. Furthermore, they regularly mentioned that a mobile application would be useful to remind them about their goals on a daily basis. Finally, users’ ideas about how to pursue health behaviours often hindered them to correctly use the website. Conclusions: Although originally created for the general population, ‘MyPlan 1.0’ can also be used in adults with type 2 diabetes. Nevertheless, more adaptations are needed to make the eHealth intervention more convenient and less time-consuming. Furthermore, users’ ideas regarding a healthy lifestyle should be taken into account when designing online interventions. [ABSTRACT FROM AUTHOR]

Paraoxonase 1 gene (PON1) polymorphisms and dietary vegetable and fruit intake are both established determinants of ischemic stroke (IS). However, little is known about whether these factors jointly influence the risk of IS. We analyzed the main effects of PON1, as well as the interactions between PON1 and dietary vegetable or fruit intake with the risk of total IS and its subtypes in a family-based case-control study conducted among 2158 Chinese participants (1007 IS cases and 1151 IS-free controls) from 918 families. Conditional logistic regression models, with each family as a stratum, were used to examine the association between rs662 and IS. Gene-diet interactions were tested by including a cross-product term of dietary vegetable or fruit intake by rs662_G allele count in the models. Each copy of the PON1 rs662_G allele was associated with 28% higher risk of total IS (p = 0.008) and 32% higher risk of large artery atherosclerosis subtype (LAA) (p = 0.01). We observed an interaction between rs662 and vegetable intake for both total IS (p = 0.006) and LAA (p = 0.02) after adjustment for covariates. Individuals who carry the rs662_A allele may benefit to a greater extent from intake of vegetables and thus be more effectively protected from ischemic stroke, whereas carriers of the G allele may still remain at greater risk for ischemic stroke due to their genetic backgrounds even when they consume a high level of vegetables. More studies are needed to replicate our findings among other populations. [ABSTRACT FROM AUTHOR]