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Objective: To assess the evidence of the impact of new food store (supermarket/grocery store) interventions on selected health-related outcomes. Design: A systematic review following the Effective Public Health Practice Project guidelines. All quantitative studies were assessed for their methodological quality. Results were synthesized narratively. Setting: Eight electronic databases - MEDLINE, EMBASE, CINAHL, ProQuest Public Health, Web of Science, Scopus, PsycINFO and Cochrane Library - were searched to identify relevant records. Subjects: Peer-reviewed scholarly journal articles on new grocery store/supermarket interventions with adult study populations, published in the English language after 1995. Results: Eleven records representing seven new grocery store interventions were identified. Six were assessed having 'weak' methodological quality, one as 'moderate' and two as 'strong'. All studies reported fruit and vegetable consumption but results were not consistent, some studies reporting significantly more and others no increase in consumption. BMI and self-rated health did not show significant improvements. Perceptions of food access, neighbourhood satisfaction and psychological health showed significant improvements. Conclusions: Improved food access through establishment of a full-service food retailer, by itself, does not show strong evidence towards enhancing health-related outcomes over short durations. Presently the field is developing and the complex linking pathways/mechanisms are yet to be elucidated. Further evidence, in the form of high-quality research in different communities with longer follow-up periods, is needed to inform policy decisions. [ABSTRACT FROM AUTHOR]

There is an emerging use of brief dietary questionnaires to investigate diet-health relation. We prospectively assess the association between eating attitudes (yes/no) and incident cardiovascular disease (CVD) in 19,138 participants of the Seguimiento Universidad de Navarra (SUN) Cohort. We calculated a baseline healthy-eating attitudes score (in quartiles), positively weighting answers on more fruit, vegetables, fish and fiber and less meat, sweets and pastries, fat, butter, fatty meats and added sugar in drinks. We observed 139 incident cases of CVD. A higher score was associated with a lower risk of CVD [3-5 points Hazard Ratio (HR): 0.38 (95% confidence interval: 0.18-0.81); 6-8 points: 0.57 (0.29-1.12); 9-10 points: 0.31 (0.15-0.67), compared to 0-2 points]. Key contributors were the attitude to increase fruit [HR: 0.59 (0.40-0.87)], vegetables [HR: 0.57 (0.29-1.12)] and fiber intake [HR: 0.69 (0.48-0.98)]. Brief questionnaire on attitudes towards healthy-eating may be a useful tool for the primary prevention of CVD. [ABSTRACT FROM AUTHOR]

Measuring the dietary intake of large samples of children is a challenge. This article describes a protocol for capturing a large number of digital images of lunch trays in a school cafeteria environment, addresses some of the advantages and challenges of this procedure, and examines the validity of Digital Food Image Analysis (DFIA; beta version) as a tool to quantify the amount of fruits and vegetables (FV) that elementary schoolchildren are served and that they consume. The beta version of DFIA is a valid method for assessing fruit and vegetable consumption and, with modest correction, the amount of FV served. [ABSTRACT FROM AUTHOR]

Background: Dietary patterns provide a summary of dietary intake, but to our knowledge, few studies have assessed trends in dietary patterns in the population. Objective: The aim was to assess 20-y trends in dietary patterns in a representative sample of the Geneva, Switzerland, population with the consideration of age, sex, education, and generation. Design: Repeated, independent cross-sectional studies were conducted between 1993 and 2014. Dietary intake was assessed by using a validated food-frequency questionnaire. Dietary patterns were assessed by using principal components analyses. Results: Among 18,763 adults, 1 healthy ("fish and vegetables") and 2 unhealthy ("meat and chips" and "chocolate and sweets") patterns were identified. Scores for the "fish and vegetables" pattern increased, whereas the "meat and chips" and "chocolate and sweets" pattern scores decreased in both sexes and across all age groups. The stronger increase in the "fish and vegetables" pattern score among the less well-educated participants led to a narrowing of educational differences (mean ± SD scores in 1993: -0.56 ± 1.39 compared with -0.05 ± 1.58 in low- compared with highly educated groups, respectively; P < 0.001; scores in 2014: 0.28 ± 1.64 compared with 0.24 ± 1.83, respectively; P = 0.772). Generational analysis showed that older age groups tended to show smaller changes than younger age groups: the yearly score change in "chocolate and sweets" was -0.021 (95% CI: -0.027, -0.014; P < 0.001) for the 35-to 44-y cohort compared with 20.002 (95% CI: -0.009, 0.005; P = 0.546) for the 45-to 54-y cohort. Conclusions: Three dietary patterns were identified; scores for the "fish and vegetables" pattern increased, whereas the "meat and chips" and the "chocolate and sweets" pattern scores decreased. The stronger increases in the "fish and vegetables" pattern score among the less well-educated participants led to a smaller difference in dietary intake across the different educational levels. [ABSTRACT FROM AUTHOR]

Background: Nitrate-rich vegetables lower blood pressure and improve endothelial function in humans. It is not known, however, whether increased consumption of nitrate-rich vegetables translates to a lower risk of atherosclerotic vascular disease (ASVD) mortality. Objective: The objective was to investigate the association of nitrate intake from vegetables with ASVD mortality. Design: A total of 1226 Australian women aged 70-85 y without prevalent ASVD and/or diabetes were recruited in 1998 and were studied for 15 y. We assessed demographic and ASVD risk factors at baseline (1998), and we used a validated food-frequency questionnaire to evaluate dietary intake. Nitrate intake from vegetables was calculated by use of a newly developed comprehensive database. The primary outcome was any death attributed to ASVD ascertained by using linked data that were provided via the Western Australian Data Linkage system. We used Cox proportional hazards modeling to examine the association between nitrate intake and ASVD mortality before and after adjustment for lifestyle and cardiovascular disease risk factors. Results: During a follow-up period of 15,947 person-years, 238 of 1226 (19.4%) women died of ASVD-related causes. The mean 6 SD vegetable nitrate intake was 67.0 6 29.2 mg/d. Each SD higher vegetable nitrate intake was associated with a lower risk of ASVD mortality in both unadjusted [HR: 0.80 (95% CI: 0.70, 0.92), P = 0.002] and multivariable-adjusted [HR: 0.79 (95% CI: 0.68, 0.93), P = 0.004] analyses. This relation was attenuated after further adjustment for diet quality [HR: 0.85 (95% CI: 0.72, 1.01), P = 0.072]. Higher vegetable nitrate intake (per SD) also was associated with a lower risk of all-cause mortality [multivariableadjusted HR: 0.87 (95% CI: 0.78, 0.97), P = 0.011]. Conclusions: Nitrate intake from vegetables was inversely associated with ASVD mortality independent of lifestyle and cardiovascular disease risk factors in this population of older adult women without prevalent ASVD or diabetes. These results support the concept that nitrate-rich vegetables may reduce the risk of age-related ASVD mortality. This trial was registered at www. anzctr.org.au as ACTRN12617000640303. [ABSTRACT FROM AUTHOR]

Background: What lactating mothers eat flavors breast milk and, in turn, modifies their infants' acceptance of similarly flavored foods. Objective: We sought to determine the effects of the timing and duration of eating a variety of vegetables during breastfeeding on the liking of vegetables in both members of the dyad. Design: We conducted a randomized controlled study of 97 motherinfant dyads. Lactating mothers drank vegetable, beet, celery, and carrot juices for 1 mo beginning at 0.5, 1.5, or 2.5 mo postpartum or for 3 mo beginning at 0.5 mo postpartum. The control group drank equal volumes of water and avoided drinking the juices. Mothers rated the tastes of the juices and self-reported dietary intakes at each monthly visit (0.5-4.5 mo). After weaning, when 7.9 mo of age, infants' acceptance of plain, carrot-flavor (exposed flavor), and broccoliflavor (nonexposed flavor) cereals was assessed on separate days. Results: The timing of exposure affected the acceptance of the carrot flavor that did not generalize to the novel broccoli flavor. A relatively brief experience (1 mo) with vegetable flavors in mothers' milk, starting at 0.5 mo postpartum, was sufficient to shift the hedonic tone, which resulted in a faster rate of eating carrot-flavored cereal than that in infants who were exposed during subsequent months or not at all. One month of exposure had a greater effect than 3 mo of exposure or no exposure. Regardless of when exposure occurred, infants were less likely to display facial expressions of distaste initially when eating the carrot cereal. Over time, mothers liked the tastes of carrot, beet, and celery juices more, but no changes in dietary intake of vegetables were observed. Conclusions: Early life may be an optimum time for both infants and their mothers to learn to like the taste of healthy foods. More research is needed to facilitate the liking and eating of these foods by mothers, which will, in turn, increase the likelihood of their feeding these foods to their children. This trial was registered at clinicaltrials.gov as NCT01667549. [ABSTRACT FROM AUTHOR]

Background: Although substantial evidence supports a 20-30% risk reduction of colon cancer, breast cancer, and endometrial cancer by physical activity (PA), the evidence for head and neck cancer (HNC) is limited. Three published studies on the association between PA and HNC have generated inconsistent results. The current study examined the association between recreational PA (RPA) and HNC risk with a more detailed assessment on the intensity, frequency, duration, and total years of RPA.Methods: Data on RPA were collected from 623 HNC cases and 731 controls by in-person interview using a standardized questionnaire. The association between RPA and HNC risk was assessed using unconditional logistic regression, adjusted for sex, age, educational level, use of alcohol, betel quid, and cigarette, and consumption of vegetables and fruits.Results: A significant inverse association between RPA and HNC risk was observed in a logistic regression model that adjusted for sex, age, and education (odds ratio (OR) = 0.65, 95% confidence interval (CI): 0.51-0.82). However, after further adjustment for the use of alcohol, betel quid, and cigarette, and consumption of vegetables and fruits, RPA was no longer associated with HNC risk (OR =0.97, 95% CI: 0.73-1.28). No significant inverse association between RPA and HNC risk was observed in the analysis stratified by HNC sites or by the use of alcohol, betel quid, or cigarette.Conclusion: Results from our study did not support an inverse association between RPA and HNC risk. The major focus of HNC prevention should be on cessation of cigarette smoking and betel chewing, reduction of alcohol drinking, and promotion of healthy diet that contains plenty of fruits and vegetables. [ABSTRACT FROM AUTHOR]

Implementation of vegetable and fruit programs in schools is less than optimal. This study aimed to identify, using a theoretical framework, factors associated with implementation of a school vegetable and fruit program; that provides a time in class for children to consume a piece of vegetable or fruit they have brought from home. Three hundred and three randomly selected school principals across the state of New South Wales, Australia responded to a 25-min telephone survey. Principals were asked if their school had implemented a vegetable and fruit program, and which of 12 factors from Damschroder's consolidated framework for implementation research had facilitated or impeded implementation. Multiple logistic regression models examined the association between such factors and program implementation. Seventyeight percent of schools had a vegetable and fruit program. Schools were significantly more likely to implement the program if the principal believed that: the program was effective (OR = 2.97; P < 0.02); they had sufficient resources to implement the program (OR = 4.22; P < 0.0001); the program would not be difficult to implement (OR = 10.16; P < 0.0001) and that the program was as important as other school priorities (OR = 2.45; P < 0.02). Realizing the intended benefits of vegetable and fruit programs requires widespread implementation by schools. Consideration of principal beliefs about the program effectiveness, resources, difficultly and relative importance in program implementation strategies appear key to increasing program implementation. [ABSTRACT FROM AUTHOR]

Introduction: Carotenoids are plant pigment with important biological activities in humans, such as provitamin-A among others. At present, there are no individual carotenoid intake data in the Dominican population, which is at risk of vitamin A deficiency and has an important percentage of overweight and obese individuals .Objective: To assess the individual components of vitamin A intake (retinol, α-carotene, β-carotene and β-cryptoxanthin) and that of other relevant dietary carotenoids like lutein, zeaxanthin and lycopene of Dominican daily food intake.Methods: Fifty overweigth and obese subjects (22-69 y). Individual carotenoid intake, from whole diet and from the ingestion of fruits and vegetables, was determined using three 24 h diet recalls and a specific carotenoid database. Retinol, macronutrient and energy intake were calculated using DIAL® software.Results: The total carotenoid intake was 6363.2 µg/day, 56. 1% corresponding to provitamin A carotenoids (74.3% β-carotene). Vitamin A intake was supplied by retinol (40%) and by provitamin A carotenoids (60%); vegetables contributed more than fruits (39.2% and 19.2%, respectively). Non-provitamin A carotenoid intake represents 43.9% of the total intake and is supplied by lycopene and lutein plus zeaxanthin in similar percentages (52.3% and 47.7%, respectively).Conclusions: The diet of these Dominican subjets met the recommended vitamin A intake, when expressed as retinol equivalents, 59% of which was supplied by provitamin-A carotenoids from plant sources, mainly by red/orange and white/yellow foods. Individual carotenoid intake is an aspect of great interest for issuing dietary recommendations in the public health setting. [ABSTRACT FROM AUTHOR]

Background: Web-based nutritional education programmes appear to be comparable to those delivered face-to-face. However, no existing web-based nutrition education or similar programme has yet been evaluated with consideration of socio-economic status. The objective of a nutritional education programme of promoting vegetable intake designed a randomized controlled trial (RCT) is to evaluate the results of intervention and to determine how socio-economic status influences the programme effects.Methods/design: Participants will be randomly sampled individuals (aged 30-59) stratified according national population statistics for sex, age, and household income. Participants were consented to survey participation (n = 1500), and will be randomly divided into intervention and control groups. The intervention period is 5 weeks with one step of diet-related education per week. The main outcome of the programme is dietary behaviour as eating vegetable (350 g per day, five small bowl). To encourage behavioural changes, the programme contents are prepared using behavioural theories and techniques tailored to the assumed group stages of behavioural change. In the first step, we employ the health belief model to encourage a shift from the pre-contemplative to the contemplative phase; in the second and third steps, social cognitive theory is used to encourage transition to the preparatory phase; in the fourth step, social cognitive theory and strengthening social support are used to promote progression to the execution phase; finally, in the fifth step, strengthening social capital and social support are used to promote the shift to the maintenance phase. The baseline, post intervention and follow-up survey was assessed using a self-administered questionnaire. For process evaluation, we use five items relating to programme participation and satisfaction. A follow-up survey of participants will be carried out 3 months after intervention completion.Discussion: The fact that this study is an RCT with an established control group is a strong advantage. Information and communications technology is not limited by time or place. If we could show this web-based nutrition education programmes has a positive effect, it may be an appropriate tool for reaching individuals in lower socio-economic state.Trial Registration: Current Controlled Trials UMIN-ICDR UMIN 000019376 (Registered October 16, 2015). [ABSTRACT FROM AUTHOR]

This study was carried out to determine the some nutritional and seed properties of three wild edible plants, namely, Malva neglecta (common mallow), Polygonum cognatum (knotweed) and Trachystemon orientalis (Abraham-Isaac-Jacob), consumed as vegetable in the Middle Black Sea Region of Turkey. In this study, the plants were collected from five different localities in four different provinces (Amasya, Ordu, Samsun and Tokat) of the region. As a result, the nutritional and seed properties of wild edible plants varied considerably depending on the species and locality. Nutritional analysis showed that the wild edible plants contained important levels of protein (15.71 to 19.96%), potassium (1219.19–1867.47 mg/100 g), phosphorus (56.89–195.86 mg/100 g), calcium (282.96–688.32 mg/100 g) and magnesium (112.54–165.79 mg/100 g). The length, width, thickness, geometric mean diameter, sphericity, surface area, volume, 1000 seed weight and bulk density of wild edible plant seeds varied from 1.71 to 3.11 mm, 1.37 to 1.83 mm, 1.00 to 1.61 mm, 1.41 to 2.06 mm, 0.60 to 0.85, 6.27 to 13.29 mm 2 , 1.20 to 3.17 mm 3 , 1.40 to 3.41 g and 532.3 to 680.9 kg/m 3 , respectively. The germination rate and mean germination time of seeds changed from 36.33 to 64.67% and 7.00 to 12.67 day, respectively. The results clearly revealed that these wild plants had important nutritional properties. Thus, these wild plant species could serve as good and cheap food sources in human diet. Additionally, the findings of this study may provide useful information on nutritional composition and seed properties of these wild plants for researchers. [ABSTRACT FROM AUTHOR]

Objectives: To develop and test the effectiveness of a mobile-phone based ecological momentary intervention (EMI) to increase fruit and vegetable (FV) consumption in low-consuming young adults.Methods: A two-week randomised controlled trial of low-FV consuming young adults ages 18-25 years (n = 171) compared three conditions: ecological momentary intervention (EMI), fruit and vegetable intervention (FVI), and a diet-as-usual control (ANZCTRN12615000183583). Participants in the EMI condition were sent two targeted text messages a day for 13 days and were asked to increase daily FV consumption to at least five servings. These messages were designed, using the Health Action Process Approach, to address salient beliefs identified as effective in a preliminary focus group investigation. Participants in the FVI condition were provided two servings of FV a day (carrots, kiwifruit or oranges, and apples) to eat in addition to their current diet. Control participants ate their normal diet. Participants reported their daily servings of FV each evening during the study using a smartphone-delivered survey. Blood samples testing plasma vitamin C and total carotenoids were taken pre- and post-intervention as an objective biomarker of FV intake.Results: Participants in the EMI and FVI conditions reported higher daily servings of FV - approximately +1 serving per day more compared to control (EMI = 3.7 servings/day; FVI = 3.7 servings/day; Control = 2.8 servings/day) and approximately +1.2 servings compared to baseline. Increases in objective biomarkers for the experimental conditions supported the validity of self-reported FV consumption.Conclusions: Our results provide initial proof of concept that EMI strategies (with minor financial assistance) are as effective as giving FV in increasing FV consumption in educated, low-consuming young adults. [ABSTRACT FROM AUTHOR]

Objectives: We studied the association between the number of fruits and vegetables (F/V) offered and appearance of salad bars with student F/V consumption at lunch and overall diet quality using the Healthy Eating Index-2010 (HEI-2010). Methods: This was a cross-sectional study assessing student-level dietary intake (N = 2048) and school salad bar characteristics at 39 elementary schools in California during 2011 and 2012. Results: Students who were in schools with visually appealing salad bars (ie, extremely inviting) had the highest mean (M) HEI-2010 greens and beans score (M=0.52, SD=1.32) compared to students in schools with plain-looking salad bars (M=0.35, SD =1.11, p = .009). Conclusions: This result suggests that school salad bar appearance may play a positive role in students' vegetable diet quality. Intervention strategies that improve the attractiveness of salad bar offerings should be considered to promote vegetable consumption in schoolchildren. [ABSTRACT FROM AUTHOR]

Objective: Using a taste-test competition in an elementary school lunchroom, researchers sought to increase consumption of select vegetables. Methods: Overall, 1030 students in a large urban school district participated in the study. The percentage of students who consumed the target vegetable was measured and compared between the experimental and control schools using a logistic regression framework. Results: There was a significant increase for all 3 vegetables in schools that conducted the taste-test competition. An odds ratio demonstrated that after the second follow-up, students were 2 to 7.2 times more likely to consume the vegetables. Conclusion: Using a taste-test competition may be a feasible and sustainable approach to engage students in their food selection. [ABSTRACT FROM AUTHOR]

Young children are not meeting recommendations for vegetable intake. Our objective is to provide evidence of validity and reliability for a pictorial vegetable behavioral assessment for use by federally funded community nutrition programs. Parent/child pairs (n=133) from Head Start and the Special Supplemental Nutrition Program for Women, Infants and Children [WIC] provided parent-administered vegetable tools, three child 24-hour diet recalls, child blood sample and measured heights/weights. The 10-item Focus on Veggies scale, with an alpha of .83 and a stability reliability coefficient of .74, was positively related to vegetables in cup equivalents [p≤.05]; dietary intakes of folate, vitamin C, β-carotene, potassium and magnesium [p≤.05-.01]; and soluble fiber [p≤.001]. The child vegetable scores were related to the parent's mediators [p≤.00001] and vegetable behaviors [p≤.00001]. Children's plasma inflammatory markers were negatively related to the 10 item scale [p≤.05] and are indicators of the child's health status. The positive relationship between the serum carotenoid index and a sub-scale of child vegetable behaviors offered additional support for criterion validity [p≤.05]. Finally, the inverse relationship of BMI-for-age percentile one year post baseline and a sub-scale of child vegetable behaviors supported the predictive validity [p≤.05]. Focus on Veggies, a simple assessment tool, can inform practitioners about the child's health status. A child with a high score, shows a healthful profile with a lower inflammation index, higher carotenoid index, lower BMI and higher vegetable intake. In conclusion, validity of Focus on Veggies has been demonstrated using vegetable cup equivalents and micronutrient intakes, anthropometry and blood biomarkers. [ABSTRACT FROM AUTHOR]

Background: Australian and most international Dietary Guidelines recommend people consume more fruits and vegetables (F&V) to maintain a healthy weight and reduce chronic disease risk. Previous Australian and international surveys have shown sub-optimal consumption of F&V.Objectives: This study aimed to assess adults' F&V consumption, knowledge of recommended servings, readiness to change, barriers/enabling factors, so that this knowledge might be used for campaigns that support improved consumption.Material and Methods: An online survey of a representative sample of adults living in New South Wales, Australia (n = 2474) measuring self-reported F&V consumption; attitudes towards F&V consumption; stage of change for increasing F&V; barriers to consumption; and knowledge of cancer-health benefits.Results: F&V consumption was below recommendations, with vegetable consumption notably low. Only 10% of participants ate at least five servings of vegetables/day (median intake was two daily servings), and 57% consumed two servings fruit/day. There was poor recognition that intake of vegetables was inadequate and this was a barrier to improving vegetable consumption; with preferences for other foods, habit and cost also important barriers. Key barriers to increasing fruit intake were habit, preferences for other foods, perishability, and cost. For vegetable consumption, 49% of participants were in the pre-contemplation stage of change, whereas for fruits 56% were in the action/maintenance stage. Sixty-four percent of respondents believed that eating F&V would protect against cancer, with 56% reporting they thought not eating enough F&V would cause cancer.Implications: Understanding what motivates and prevents people from consuming F&V is important for developing effective health promotion programs. Similar to previous surveys, there has been little shift in F&V consumption. Social marketing campaigns have been shown to improve health-related behaviours, and this study may assist in identifying audience segmentation for better targeted campaigns. [ABSTRACT FROM AUTHOR]

There is a relationship between hepatic encephalopathy (HE) protein malnutrition and muscle wasting. Muscle may play an alternative role in ammonia detoxification. Molecular mechanisms responsible for muscle depletion are under investigation. Specific nutrients may interact to reverse the molecular pathways involved in muscle wasting at an early stage. Training exercises have also been proposed to improve skeletal muscle mass. However, these data refer to small groups of patients. The amelioration of muscle mass may potentially help to prevent HE. The pathogenesis of HE is associated with modifications of the gut microbiota and diet is emerging to play a relevant role in the modulation of the gut milieu. Vegetarian and fibre-rich diets have been shown to induce beneficial changes on gut microbiota in healthy people, with reduction of Bacteroides spp., Enterobacteriaceae, and Clostridium cluster XIVa bacteria. By way of contrast, it has been suggested that a high-fat or protein diet may increase Firmicutes and reduce Bacteroidetes phylum. Milk-lysozyme and milk-oligosaccharides have also been proposed to induce a 'healthy' microbiota. At present, no studies have been published describing the modification of the gut microbiota in cirrhotic patients with HE as a response to specific diets. New research is needed to evaluate the potentiality of foods in the modulation of gut microbiota in liver disease and HE. [ABSTRACT FROM AUTHOR]

Objectives. To describe time trends in the availability of healthier children's menu items in the top selling quick service restaurant (QSR) chains. Methods. We used Technomic Inc.'s MenuMonitor to construct a data set of side and beverage items available on children's menus from 2004 to 2015 at 20 QSR chains in the United States. We evaluated the significance of time trends in the average availability of healthier fruit and nonfried vegetable sides and nonsugary beverages offered as options and by default in children's meal bundles. Results. Healthier sides and beverages offered as options increased by 57.5 and 25.0 percentage points, respectively, from 2004 to 2015 but leveled off starting in 2013. Healthier items bundled by default also increased during this time frame, with most adoption occurring after 2010. However, these items remain relatively uncommon, with less than 20% of meal bundles including healthier items by default. All tests evaluating time trends in the availability of healthier items in meal bundles were significant at P <.001. Conclusions. The QSRs evaluated made improvements in the quality of sides and beverages offered on children's menus from 2004 to 2015. Additional efforts are needed to increase the percentage of healthier options offered by default. [ABSTRACT FROM AUTHOR]

Objectives: We examined changes in fruit and vegetable consumption and diet quality within a weight loss intervention. Methods: Calorie intake and servings of fruits and vegetables were assessed in 151 overweight/obese women. Calories consumed per serving of fruits and vegetables represented diet quality. Results: Fruit and vegetable intake increased from baseline to 6 and 12 months (p < .001). Calories/serving of fruits and vegetables decreased from baseline to 6 and 12 months (p < .001). Fruit and vegetable intake and diet quality were not correlated with 6- or 12-month weight change. Conclusions: A prescribed calorie-restricted diet resulted in increased fruit and vegetable consumption and diet quality, but these were not associated with weight loss. [ABSTRACT FROM AUTHOR]

Background: Dietary energy density (ED) is a measure of diet quality that estimates the amount of energy per unit of food (kilocalories per gram) consumed. Low-ED diets are generally high in fiber and fruits and vegetables and low in fat. Dietary ED has been positively associated with body mass index (BMI) and other risk factors for postmenopausal breast cancer.Objective: We evaluated the associations of total dietary ED and energy-dense (high-ED) foods with postmenopausal breast cancer incidence.Methods: Analyses included 56,795 postmenopausal women from the Cancer Prevention Study II Nutrition Cohort with no previous history of breast or other cancers and who provided information on diet, lifestyle, and medical history in 1999. Multivariable-adjusted breast cancer incidence rate ratios (RRs and 95% CIs) were estimated for quintiles of total dietary ED and for the consumption of high-ED foods in Cox proportional hazards regression models.Results: During a median follow-up of 11.7 y, 2509 invasive breast cancer cases were identified, including 1857 estrogen receptor-positive and 277 estrogen receptor-negative tumors. Median dietary ED was 1.5 kcal/g (IQR: 1.3-1.7 kcal/g). After adjusting for age, race, education, reproductive characteristics, and family history, high compared with low dietary ED was associated with a statistically significantly higher risk of breast cancer (RR for fifth quintile compared with first quintile: 1.20; 95% CI: 1.05, 1.36; P-trend = 0.03). The association between the amount of high-ED foods consumed and breast cancer risk was not statistically significant. We observed no differences by estrogen receptor status or effect modification by BMI, age, or physical activity.Conclusion: These results suggest a modest positive association between total dietary ED and risk of postmenopausal breast cancer. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity prevalences in Mexico are among the highest in the world, with dietary factors being the third-leading category of risk contributing to the burden of disease. Consequently, studying the compliance of the Mexican population to food-based dietary recommendations is essential for informing nutritional policies.Objectives: We described the energy contribution of food groups to total dietary energy intake of the Mexican population and by sociodemographic subgroups and compared these results with Mexican dietary recommendations.Methods: Twenty-four-hour dietary recalls for participants aged ≥5 y (n = 7983) from the 2012 Mexican National Health and Nutrition Survey were used. Foods and beverages were classified into 8 groups (the first 6 were called "basic foods" and the last 2 "discretionary foods"), as follows: 1) cereals, 2) legumes, 3) milk and dairy, 4) meat and animal products, 5) fruit and vegetables, 6) fats and oils, 7) sugar-sweetened beverages (SSBs), and 8) products high in saturated fat and/or added sugar (HSFAS). Recommendations were based on the Mexican Dietary Guidelines (MDG). Energy contributions from the food groups by age, sex, region, residence (rural or urban), and socioeconomic status (SES) were estimated.Results: The highest contribution to total energy intake came from cereals (33%) followed by HSFAS (16%), meat and animal products (14%), and SSBs (9.8%). Fruit and vegetables (5.7%) and legumes (3.8%) had the lowest contribution. Energy contribution of several food groups differed significantly between population subgroups. Overall, discretionary foods contributed more than one-quarter of total energy intake (26%) and were 13 percentage points above the maximum allowed by the recommendations, whereas the intakes of legumes and fruit and vegetables were much lower than recommended.Conclusions: Our results show the need to generate a food environment conducive to a healthier diet in the Mexican population. [ABSTRACT FROM AUTHOR]

In this manuscript, we present the protocol for a study that applies incentive sensitization theory to improve vegetable intake in overweight and obese adults. This 8-week, randomized, controlled, community-based feeding study with an 8-week follow-up seeks to use repeated exposure to amounts of vegetables recommended by federal guidance to increase the primary outcome of the relative reinforcing value of vegetables compared to a snack food. A community-based design is used to give participants autonomy in choosing their method of exposure. Secondary outcomes include: 1) Determine potential moderators of incentive sensitization of vegetables, including genetic polymorphisms associated with food reinforcement and obesity, 6-n-propylthiouracil tasting status, and delay discounting. 2) Determine whether adding vegetables to the diet results in participants substituting low-energy-dense vegetables for energy-dense foods or whether energy-dense food consumption is independent of vegetable consumption. 3) Determine whether reductions in adiposity are associated with substitution of vegetables in the diet. 4) Determine if markers of bone turnover change. 5) Assess changes in self-reported secondary outcomes measured by questionnaire such as self-efficacy to eat vegetables. The results of this study will provide information about the drivers of individual choice to consume recommended amounts of vegetables. The understanding gained will help increase the effectiveness and sustainability of behavior-based interventions focused on improving vegetable intake. This information may also be used to assist in setting dietary guidance targets for the amounts and types of vegetables Americans can, and should, consume. [ABSTRACT FROM AUTHOR]

Background Cancer survivors suffer from long-term adverse effects that reduce health-related quality of life (QOL) and physical functioning, creating an urgent need to develop effective, durable, and disseminable interventions. Harvest for Health, a home-based vegetable gardening intervention, holds promise for these domains. Methods This report describes the methods and recruitment experiences from two randomized controlled feasibility trials that employ a waitlist-controlled design. Delivered in partnership with Cooperative Extension Master Gardeners, this intervention provides one-on-one mentorship of cancer survivors in planning and maintaining three seasonal vegetable gardens over 12 months. The primary aim is to determine intervention feasibility and acceptability; secondary aims are to explore effects on objective and subjective measures of diet, physical activity and function, and QOL and examine participant factors associated with potential effects. One trial is conducted exclusively among 82 female breast cancer survivors residing in the Birmingham, AL metropolitan area (BBCS); another broadly throughout Alabama among 46 older cancer survivors aged > 60 (ASCS). Results Response rates were 32.6% (BBCS) and 52.3% (ASCS). Both trials exceeded 80% of their accrual target. Leading reasons for ineligibility were removal of > 10 lymph nodes (lymphedema risk factor), lack of physician approval, and unwillingness to be randomized to the waitlist. Conclusion To date, recruitment and implementation of Harvest for Health appears feasible. Discussion Although both studies encountered recruitment challenges, lessons learned can inform future larger-scale studies. Vegetable gardening interventions are of interest to cancer survivors and may provide opportunities to gain life skills leading to improvements in overall health and QOL. [ABSTRACT FROM AUTHOR]

Fresh fruit and vegetable consumption (FFV) is integral to a healthy diet and increased longevity, yet 25.8 million Americans live in areas of restricted access, with under-resourced communities particularly vulnerable. To consider how immediate environment influences FFV, this study uses the Behavioral Risk Factor Surveillance System (BRFSS) survey (N = 122,265) to examine the influence of sprawl on FFV consumption. Findings indicate that higher sprawl relates to lower FFV consumption, and this relationship persists net of demographic covariates. Implications offer that social work's person-in-environment approach can increase FFV access in under-resourced communities. [ABSTRACT FROM AUTHOR]

Background: Dietary nitrate is receiving increased attention due to its reported ergogenic and cardioprotective properties. The extent to which ingestion of various nitrate-rich vegetables increases postprandial plasma nitrate and nitrite concentrations and lowers blood pressure is currently unknown.Objective: We aimed to assess the impact of ingesting different nitrate-rich vegetables on subsequent plasma nitrate and nitrite concentrations and resting blood pressure in healthy normotensive individuals.Methods: With the use of a semirandomized crossover design, 11 men and 7 women [mean ± SEM age: 28 ± 1 y; mean ± SEM body mass index (BMI, in kg/m(2)): 23 ± 1; exercise: 1-10 h/wk] ingested 4 different beverages, each containing 800 mg (∼12.9 mmol) nitrate: sodium nitrate (NaNO3), concentrated beetroot juice, a rocket salad beverage, and a spinach beverage. Plasma nitrate and nitrite concentrations and blood pressure were determined before and up to 300 min after beverage ingestion. Data were analyzed using repeated-measures ANOVA.Results: Plasma nitrate and nitrite concentrations increased after ingestion of all 4 beverages (P < 0.001). Peak plasma nitrate concentrations were similar for all treatments (all values presented as means ± SEMs: NaNO3: 583 ± 29 μmol/L; beetroot juice: 597 ± 23 μmol/L; rocket salad beverage: 584 ± 24 μmol/L; spinach beverage: 584 ± 23 μmol/L). Peak plasma nitrite concentrations were different between treatments (NaNO3: 580 ± 58 nmol/L; beetroot juice: 557 ± 57 nmol/L; rocket salad beverage: 643 ± 63 nmol/L; spinach beverage: 980 ± 160 nmol/L; P = 0.016). When compared with baseline, systolic blood pressure declined 150 min after ingestion of beetroot juice (from 118 ± 2 to 113 ± 2 mm Hg; P < 0.001) and rocket salad beverage (from 122 ± 3 to 116 ± 2 mm Hg; P = 0.007) and 300 min after ingestion of spinach beverage (from 118 ± 2 to 111 ± 3 mm Hg; P < 0.001), but did not change with NaNO3 Diastolic blood pressure declined 150 min after ingestion of all beverages (P < 0.05) and remained lower at 300 min after ingestion of rocket salad (P = 0.045) and spinach (P = 0.001) beverages.Conclusions: Ingestion of nitrate-rich beetroot juice, rocket salad beverage, and spinach beverage effectively increases plasma nitrate and nitrite concentrations and lowers blood pressure to a greater extent than sodium nitrate. These findings show that nitrate-rich vegetables can be used as dietary nitrate supplements. This trial was registered at clinicaltrials.gov as NCT02271633. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have shown that occupational or environmental pesticide exposure can affect male fertility. There is less evidence, however, regarding any potentially adverse effects of pesticide residues in foods on markers of male fertility potential.Objectives: We examined the relations between fruit and vegetable intake, considering pesticide residue status, and semen quality and serum concentrations of reproductive hormones in healthy young men.Methods: The Rochester Young Men's Study is a cross-sectional study that recruited men aged 18-22 y (n = 189) in Rochester, New York. Participants completed a questionnaire, provided a semen sample, had a blood sample drawn, and underwent a physical examination at enrollment. Semen samples were analyzed for total sperm count, sperm concentration, morphology, motility, ejaculate volume, total motile count, and total normal count. Dietary intake during the previous year was assessed by a validated food-frequency questionnaire. Fruit and vegetables were categorized as having high [Pesticide Residue Burden Score (PRBS) ≥4] or low-to-moderate (PRBS <4) pesticide residues on the basis of data from the USDA Pesticide Data Program. Linear regression models were used to analyze the associations of fruit and vegetable intake with semen variables and reproductive hormones while adjusting for potential confounding factors.Results: The total intake of fruit and vegetables was unrelated to semen quality. However, the intake of fruit and vegetables with low-to-moderate pesticide residues was associated with a higher total sperm count and sperm concentration, whereas the intake of fruit and vegetables with high pesticide residues was unrelated to semen quality. On average, men in the highest quartile of low-to-moderate-pesticide fruit and vegetable intake (≥2.8 servings/d) had a 169% (95% CI: 45%, 400%) higher total sperm count and a 173% (95% CI: 57%, 375%) higher sperm concentration than did men in the lowest quartile (<1.1 servings/d; P-trend = 0.003 and 0.0005, respectively). The intake of fruit and vegetables, regardless of pesticide-residue status, was not associated with reproductive hormone concentrations.Conclusions: The consumption of fruit and vegetables with low-to-moderate pesticide residues was positively related to sperm counts in young men unselected by fertility status. This suggests that pesticide residues may modify the beneficial effects of fruit and vegetable intake on semen quality. [ABSTRACT FROM AUTHOR]

Objective: To assess the relative validity and reproducibility of the semi-quantitative FFQ (SFFQ) applied in the evaluation of a community intervention study, SoL-Bornholm, for estimating food intakes.Design: The reference measure was a 4 d estimated food record. The SFFQ was completed two times separated by a 1-month period in order to test reproducibility.Setting: The Capital Region and the Regional Municipality of Bornholm, Denmark.Subjects: A total of fifty-four children aged 3-9 years were enrolled in the study.Results: In terms of validity, the SFFQ generally overestimated intakes compared with the food records, especially for vegetables. For most intakes, the mean difference increased with increasing intake. Gross misclassification was on average higher for energy and nutrients (17%) than for foods (8%). Spearman correlation coefficients were significant for twelve out of fourteen intakes, ranging from 0·29 to 0·63 for foods and from 0·12 to 0·48 for energy and nutrients. Comparing the repeated SFFQ administrations, the intakes of the first SFFQ were slightly higher than those of the second SFFQ. Gross misclassification was low for most intakes; on average 6% for foods and 8% for energy and nutrients. Intra-class correlations were significant for all intakes, ranging from 0·30 to 0·82 for foods and from 0·46 to 0·81 for energy and nutrients.Conclusions: The results indicate that the SFFQ gives reproducible estimates. The relative validity of the SFFQ was low to moderate for most intakes but comparable to other studies among children. [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between dietary cruciferous vegetable intake and selected tumour biomarkers for histone acetylation (H3K9ac, H3K18ac, HDAC3 and HDAC6), proliferation (Ki-67) and cell-cycle regulation (p21) from breast tissue.Design: The study used baseline data of women recruited to participate in a clinical trial of sulforaphane supplement. Dietary cruciferous vegetable intake was collected through a validated Arizona Cruciferous Vegetable Intake Questionnaire. Breast tissue was obtained from biopsy samples. Spearman correlations were calculated between intake of specific cruciferous vegetables and biomarkers. Tissue biomarkers were log2-transformed to obtain approximate normality. Linear regression analyses were conducted to examine associations between cruciferous vegetable intake and biomarkers adjusting for age and use of non-steroidal anti-inflammatory drugs. False discovery rate (FDR) was used to account for multiple comparisons.Setting: Clinical trial baseline.Subjects: Fifty-four women who had abnormal mammogram findings and were scheduled for breast biopsy.Results: Mean intake of total cruciferous vegetables from all food sources was 81·7 (sd 57·3) g/d. Mean urinary total sulforaphane metabolites was 0·08 (sd 0·07) µm/mm creatinine. Total cruciferous vegetable intake was inversely associated with Ki-67 protein expression in breast ductal carcinoma in situ (DCIS) tissue (β=-0·004; se=0·001; FDR q value=0·03), but not in benign or invasive ductal carcinoma (IDC) tissue. No association was found for other biomarkers measured (HDAC3, HDAC6, H3K9, H3K18 and p21) in all tissues examined (benign, DCIS and IDC).Conclusions: The present study sought to provide additional evidence for the potential role of sulforaphane in histone acetylation and cell proliferation. Here, we report that total cruciferous vegetable intake is associated with decreased cell proliferation in breast DCIS tissue. [ABSTRACT FROM AUTHOR]

This study examined father and child sociodemographic characteristics in relation to fathers’ feeding-related parenting strategies and whether their parenting strategies were associated with children’s reported fruit and vegetable (FV), weekly fast-food, and daily sugar-sweetened beverage intake among 81 Latino father-child pairs. Father’s employment status, acculturation, number of children in the home, and child’s age and weight status were associated with the use of different parenting strategies. More control was associated with less FV intake, but more reinforcement was associated with more FV intake by children. Fathers play a role in their children’s diet and should be considered in future interventions. [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between the local retail food environment and consumption of fruits and vegetables (FV) and sugar-sweetened beverages (SSB) in São Paulo, Brazil, as well as the moderation effects of income in the studied relationships.Design: Cross-sectional study design that drew upon neighbourhood- and individual-level data. For each participant, community (density and proximity) and community food environment (availability, variety, quality and price) measures of FV and SSB were assessed in retail food stores and specialized fresh produce markets within 1·6 km of their homes. Poisson generalized estimating equations (GEE) were used to model the associations of food consumption with food environment measures, adjusted by individual-level characteristics.Setting: São Paulo, Brazil.Subjects: Adults (n 1842) residing in the same census tracts (n 52) in São Paulo, Brazil as those where the neighbourhood-level measures were taken.Results: FV availability in neighbourhoods was associated with regular FV consumption (≥5 times/week; prevalence ratio=1·41; 95 % CI 1·19, 1·67). Regular FV consumption prevalence was significantly lower among lower-income individuals living in neighbourhoods with fewer supermarkets and fresh produce markets (P-interaction <0·05). A greater variety of SSB was associated with a 15 % increase in regular SSB consumption (≥5 times/week) prevalence, after adjustment for confounding variables.Conclusions: Our findings suggest that the local retail food environment is associated with FV and SSB consumption in a Brazilian urban sample. [ABSTRACT FROM AUTHOR]

A number of school-based programmes have shown positive effects on children's dietary behaviour. Some of these have focused broadly on nutrition, physical activity, and heart health, whilst others have focused more specifically on the consumption of fruit and vegetables. Despite some successes in this field, however, the consumption of fruit and vegetables among adolescents is generally below recommended levels, supporting a need to identify effective strategies for promoting fruit and vegetable consumption, among other healthful dietary patterns. Several states are now implementing programmes in which they provide free fresh fruit and vegetable snacks to students during the school day. This paper aims to analyse what are the determinants of the consumption of fruit and vegetables for children, putting them in relation with the different educational and promotional actions implemented in Italy in the last few years with the European programme "School Fruit". The objective is to identify information that would be useful for the construction of a model of nutritional education to be implemented through a campaign for the promotion and enhancement of fruit and vegetables. Consumers have forgotten what lies behind every fruit, so starting from the consumption of local products, it is necessary to clarify the significance that fruit and vegetables have in terms of their environmental, social, and ethical aspects. The determinants of the consumption of fruit and vegetables are to be found amongst a wide range of factors: gender, age and socio-economic status; accessibility and availability; composition and habits of the household; individual preferences; knowledge; psychological factors, attitudes, beliefs and perceived barriers. This contribution defines what are the key elements of education programmes and the didactic approach employed, evaluating the overall results and the role of the determinants in the education process to encourage the consumption of fruit and vegetables by children. [ABSTRACT FROM AUTHOR]

A virtual pet in the form of a mid-sized dog was developed based on the framework of social cognitive theory and tested as a vehicle for promoting fruit and vegetable (F&V) consumption in children. Three groups of children ( N = 68) between the ages of 7 and 13 years were studied: baseline (no treatment), computer only, and virtual dog. Children in the virtual dog condition interacted with the virtual dog for 3 days, setting F&V consumption goals and receiving evaluation and reinforcement based on whether they met their self-set goals. Children vicariously experienced future health outcomes of F&V consumption by seeing, hearing, and feeling their virtual dog's physical and mental health improve or deteriorate based on their F&V consumption in the physical world. Children in the computer only condition interacted with a computer system that presented equivalent features, but without the virtual dog. Children in the baseline condition did not receive any experimental treatment. Results indicated that children in the virtual dog condition chose to be served significantly more F&V than those in the computer only or baseline conditions did. However, children in the virtual dog condition were unable to consume significantly more F&V than those in the computer only condition, although children in those two conditions consumed more F&V than the baseline condition. Food preferences did not differ significantly across the three conditions before and after the experimental treatments. Theoretical and practical potentials of using a virtual pet to promote F&V consumption systematically in children are discussed. [ABSTRACT FROM AUTHOR]

Health messages are a commonly used way to promote changes in dietary habits but their efficacy could be enhanced by strategies such as the way in which the presented arguments are framed. This study aimed to test the effectiveness of framed messages (gain vs. loss) on behavioural intention and fruit and vegetable (FV) intake, comparing predictions based on prominent theoretical perspectives on message framing (function of the health behaviour and recipients' motivational orientation) and by further exploring the role of baseline intentions as a potential moderator of the framing effects. Undergraduate students (N = 180) completed the three assessment points in time. At baseline, individual moderators (motivational orientation and intentions) and fruit and vegetable intake were assessed. One week later, participants were randomly assigned to the loss or gain-framed message and indicated their intentions for FV intake the following week. A week later, FV intake over the previous week was assessed. The gain-frame was not conducive, per se, to higher intentions or behaviour. Having intention as the outcome, only baseline intentions moderated the effects of message frame. When considering FV intake as the outcome, both motivational orientation and baseline intentions moderated the effects of message frame, with the loss-frame promoting higher FV intake among individuals who were prevention-oriented and had higher baseline intentions. Findings suggest that the success of framed messages for FV intake depends upon the recipient's characteristics, such as motivational orientation, baseline intentions, and cultural background, with implications for health communication interventions. [ABSTRACT FROM AUTHOR]

Background and Objectives: Overweight and obesity increase the risk of hypertension, type 2 diabetes, and other metabolic disorders and are increasing in Japan, particularly among men. Several prospective studies have suggested that high vegetable intake is inversely associated with weight gain. Here, the association between vegetable consumption and weight gain in a group of food manufacturing workers over the course of one year was investigated.Methods and Study Design: The study was a one-year cohort study of the nutrition and lifestyle survey. The study population consisted of 900 and 910 Japanese employees (aged 19-60 years) from a manufacturing company located in Musashino City, Tokyo, Japan, that were administered the same validated brief self-administered diet history and dietary lifestyle questionnaire in 2006 and 2007, respectively. Clinical examinations of body weight were also performed to assess changes in weight. We analyzed participants who responded in both 2006 and 2007 (n=478).Results: Risk of weight gain of more than 3 kg was significantly lower in the group consuming the most vegetables than in the group consuming the least, and this difference remained significant after adjustment for baseline age, sex, and consumption of other foods (p for trend=0.028).Conclusions: Weight gain was inversely associated with high consumption of vegetables. Encouraging Japanese employees to consume more vegetables may be an important strategy in controlling weight gain and preventing metabolic syndrome. [ABSTRACT FROM AUTHOR]

Objectives: Dietary intentions are supposed to engender planning processes, which in turn stimulate dietary behaviour change. However, some studies failed to find such mediation effects, which suggest more complex and not yet unravelled relationships between these factors. One explanation may be that mediation works better under certain circumstances or only for specific subgroups. This study addresses this reasoning by examining autonomy beliefs and sex as putative moderators of the hypothesized mediation chain.Design and Methods: In a longitudinal design with three measurement points in time (1 week and 1 month apart), 912 women and 214 men were surveyed. Planning, intention, dietary autonomy beliefs, and sex were used to predict fruit and vegetable intake within a conditional process model designed to identify mechanisms of change.Results: The intention-planning-behaviour chain was qualified by a triple interaction involving autonomy beliefs and sex as moderators between intention and planning. Higher dietary autonomy resulted in higher levels of planning fruit and vegetable intake. For men, even in case of higher intention, at least medium levels of autonomy beliefs were necessary to facilitate planning processes. For women, already lower levels of autonomy beliefs can engender postintentional planning strategies and seem to even compensate lower intention.Conclusions: Intention and planning are key predictors of dietary change. However, these variables work better under specific conditions (with a sufficient level of autonomy), and differently in subgroups (men vs. women). These results may explain the inconsistent findings of previous studies on the mediating effect of planning and allow for a better description of the mechanisms by which intentions may influence behaviour. Statement of contribution What is already known on this subject? The adoption of health-enhancing dietary behaviours can be facilitated by intentions and planning. Planning to eat more fruit and vegetable helps to translate intentions into actual consumption. Fruit and vegetable intake levels are higher in women than in men. What does this study add? Dietary intentions engender more likely planning processes when perceived autonomy concerning food consumption is high. Dietary autonomy beliefs and sex moderate the intention-planning-behaviour chain. Among men, dietary planning is highest when both intentions and autonomy are high. [ABSTRACT FROM AUTHOR]

Background: Randomized controlled trials provide conflicting results on the effects of increased fruit and vegetable consumption on changes in body weight. We aimed to perform a systematic review and meta-analysis of prospective cohort studies on fruit and vegetable consumption in relation to changes in anthropometric measures. Methods: PubMed and EMBASE were searched up to July 2015 for prospective studies reporting on habitual fruit and/or vegetable consumption in relation to changes in body weight or waist circumference or to risk of weight gain/overweight/obesity in adults. Random-effects meta-analysis was applied to pool results across studies. Findings: Seventeen cohort studies (from 20 reports) including 563,277 participants met our inclusion criteria. Higher intake of fruits was inversely associated with weight change (decrease) (beta-coefficient per 100-g increment, -13.68 g/year; 95% CI, -22.97 to -4.40). No significant changes could be observed for combined fruit and vegetable consumption or vegetable consumption. Increased intake of fruits was inversely associated with changes (decrease) in waist circumference (beta: -0.04 cm/year; 95% CI, -0.05 to -0.02). Comparing the highest combined fruit & vegetable, fruit, and vegetable intake categories were associated with a 9%, 17%, and 17% reduced risk of adiposity (odds ratio [OR]: 0.91, 95% CI, 0.84 to 0.99), (OR: 0.83, 95% CI, 0.71 to 0.99), and (OR: 0.83, 95% CI, 0.70 to 0.99), respectively. Conclusion: This meta-analysis showed several inverse associations between fruit and vegetable intake and prospective improvements in anthropometric parameters, and risk of adiposity. The present meta-analysis seems to be limited by low study quality. Nevertheless, when combined with evolutionary nutrition and epidemiological modeling studies, these findings have public health relevance and support all initiatives to increase fruit and vegetable intake. [ABSTRACT FROM AUTHOR]

Objective: To identify determinants of fruit and vegetable (F&V) consumption among school-aged children.Design: A survey study was conducted in October 2010. The questionnaire contained questions concerning social and demographic data, lifestyle and dietary habits, particularly the frequency of F&V consumption, availability of F&V and knowledge about recommended amounts of F&V intake.Setting: Polish primary schools.Subjects: Children (n 1255) aged 9 years from randomly selected primary schools and their parents.Results: The children's consumption of fruit and of vegetables was influenced by the fruit consumption and vegetable consumption of their parents (r=0·333 and r=0·273, respectively; P=0·001), parents encouraging their children to eat F&V (r=0·259 and r=0·271, respectively; P=0·001), giving children F&V to take to school (r=0·338 and r=0·321, respectively; P=0·001) and the availability of F&V at home (r=0·200 and r=0·296, respectively; P=0·001). Parental education influenced only the frequency of fruit consumption (r=0·074; P=0·01). A correlation between parents' knowledge of the recommended intakes and the frequency of vegetable and fruit consumption by children was noticed (r=0·258 and r=0·192, respectively, P=0·001).Conclusions: Factors within the family environment such as parents' dietary habits and F&V availability had the greatest influence on the F&V consumption by children. Educational activities aimed at parents are crucial to increase the consumption of F&V among children. [ABSTRACT FROM AUTHOR]

Objective: People eat more unhealthy foods when served more (portion size effect) and when the food is served in larger units (unit size effect). The present study aimed to examine whether these effects can be used for the good: to increase vegetable consumption among children.Design: A 2×2 between-subjects experiment was conducted at two schools. Pupils were presented in class with cucumber that varied both in unit size (one piece v. pre-sliced) and portion size (one-third v. two-thirds of a cucumber). Children ate ad libitum during the morning break and filled in a survey.Setting: Primary schools in the centre of the Netherlands.Subjects: Primary-school pupils (n 255) aged 8-13 years.Results: Children ate 54 % more cucumber when served a large compared with a smaller portion (difference of 49 g; P<0·001). Large units did not impact consumption (P=0·58), but were considered as less convenient to eat than small units (P=0·001).Conclusions: Findings suggest that children's vegetable intake can be improved by serving larger portions in smaller-sized pieces. [ABSTRACT FROM AUTHOR]

Objective: To examine characteristics potentially associated with school lunch fruit and vegetable waste, both overall and pre/post implementation of the Healthy, Hunger-Free Kids Act.Design: Multi-year (2010-2013) cross-sectional study using pre- and post-meal digital photographs of students' school lunch trays to estimate fruit and vegetable availability and consumption. Fruit and vegetable items were categorized for factors suspected to impact waste: prior farm to school years, placement (main menu, salad bar), procurement (local, conventional), preparation (cooked, raw) and meal component (entrée, side, topping). Analyses to assess within-category differences in waste volume were performed using a Tobit model.Setting: Wisconsin elementary schools participating in farm to school programmes, USA.Subjects: Children in third to fifth grade.Results: Many within-factor differences were detected overall and/or across time. Cooked fruits were wasted less than raw, while cooked vegetables were wasted more than raw. Where identified, locally sourced items were wasted more than conventionally sourced (+0·1 cups, P<0·0001) and salad bar items more than main menu items (+0·01 cups, P<0·0001). Increasing prior farm to school years decreased waste (-0·02 cups, P<0·0001). Items previously tried were wasted at the same volume whether reported as liked or not. New school lunch meal pattern requirement implementation did not uniformly impact fruit and vegetable waste across all categories and there was no change in waste for seven of fifteen assessed categories.Conclusions: Many factors impact elementary students' school lunch waste. These factors may be helpful for school food-service authorities to consider when planning school menus. [ABSTRACT FROM AUTHOR]

Objective: To explain patterns of fruit and vegetable consumption in nine former Soviet Union countries by exploring the influence of a range of individual- and community-level determinants.Design: Cross-sectional nationally representative surveys and area profiles were undertaken in 2010 in nine countries of the former Soviet Union as part of the Health in Times of Transition (HITT) study. Individual- and area-level determinants were analysed, taking into account potential confounding at the individual and area level.Setting: Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine.Subjects: Adult survey respondents (n 17 998) aged 18-95 years.Results: Being male, increasing age, lack of education and lack of financial resources were associated with lower probability of consuming adequate amounts of fruit or vegetables. Daily fruit or vegetable consumption was positively correlated with the number of shops selling fruit and vegetables (for women) and with the number of convenience stores (for men). Billboard advertising of snacks and sweet drinks was negatively related to daily fruit or vegetable consumption, although the reverse was true for billboards advertising soft drinks. Men living near a fast-food outlet had a lower probability of fruit or vegetable consumption, while the opposite was true for the number of local food restaurants.Conclusions: Overall fruit and vegetable consumption in the former Soviet Union is inadequate, particularly among lower socio-economic groups. Both individual- and community-level factors play a role in explaining inadequate nutrition and thus provide potential entry points for policy interventions, while the nuanced influence of community factors informs the agenda for future research. [ABSTRACT FROM AUTHOR]