Systematic review and meta-analysis of school-based interventions to improve daily fruit and vegetable intake in children aged 5 to 12 y

Objectives: To examine fruit and vegetable intake among children aged 1-5 years old and associations with household food assistance program (FAP) participation and food sufficiency. Methods: We used data from the 2021-2022 National Survey of Children’s Health (n=36,641). We defined FAP as participation in the Supplemental Nutrition Assistance Program (SNAP) or Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and food sufficiency as ability to afford needed food during the past 12 months. Separate logistic regression models estimated the associations between FAP (vs. income eligible [≤185% federal poverty level] or income ineligible [≥186% federal poverty level] nonparticipants), food sufficiency (vs. marginal/low food sufficiency) and (1) daily fruit intake [does not include fruit juice] and (2) daily vegetable intake [not including French fries, fried potatoes, or potato chips] after adjusting for child age, child race/ethnicity, maternal age, primary caregiver education level, and primary household language. Results: Caregivers report that 68% and 51% of children ate a fruit or vegetable at least daily in the last week, respectively; 29% of households participated in WIC or SNAP; and 72% of households were food sufficient. Caregivers from households with FAP participation reported 59% of children ate a daily fruit vs. 63% in eligible nonparticipating households and 73% in ineligible nonparticipating households; the respective daily vegetable intake was 45%, 52%, and 54%. Caregivers from food sufficient households reported 71% of children ate a daily fruit vs. 60% in food insufficient; 53% ate a daily vegetable vs. 47%, respectively. In adjusted analyses, FAP participation was not associated with either daily fruit or vegetable intake, whereas household food sufficiency was: food insufficient households were less likely to report daily fruit (odds ratio: 0.76 [95% CI: 0.67, 0.87]) or vegetable (0.87 [0.77, 0.97]) intake compared with food sufficient households. Conclusions: Food sufficiency appears to be a stronger predictor of daily fruit and vegetable intake than FAP participation. Increasing food sufficiency could improve fruit and vegetables intakes in early childhood. Funding Sources: This study used publicly available data.

Substantial scientific evidence firmly advocates consumption of vegetables and fruits for maintenance of overall health and protection against chronic diseases, such as obesity. However, prevalence of fruit and vegetable intake among adolescents in Malaysia remains low, whereas the data on factors associated with vegetable and fruit intake among adolescents were limited. This study aims to determine the prevalence of fruit and vegetable intake and the factors that influence the Malaysian adolescents' consumption of fruits and vegetables. A cross-sectional study was conducted from November 2021 to August 2022 by distribution of an online validated questionnaire on various platforms to recruit school-going adolescents aged 13 to 17 years old (Form 1-5) in Selangor. Respondents were screened and data of eligible participants were included as subjects. Descriptive statistics, chi square analysis, and generalized linear model with Poisson-loglinear distribution and the robust estimator were employed for data analysis. A total of 277 adolescents participated in this study. Overall, low prevalence of adequate vegetable consumption was observed (23.5%). Of the participants surveyed, 14.8% of adolescents with thinness, 25.2% and 15.0% of adolescents with overweight and obesity, and 27.1% of normal-weight adolescents met the recommended daily intake (>3 servings), whereas 64.1% of adolescents with overweight and obesity and 65% of normal-weight participants consumed at least two servings of fruits a day. The findings revealed significant association between BMI-for-age (X 2 (1, N = 277) = 5.236, p = 0.022) and adolescent fruit intake. On the other hand, overweight and obese adolescents reporting positive intention (PR: 1.146, 95% CI: 1.002, 1.310, p = 0.047) and parental allowance (PR: 1.125, 95% CI: 1.011, 1.252, p = 0.030) were observed to have 14.6% and 12.5% higher prevalence of fruit consumption, respectively, while availability at home (PR: 0.849, 95% CI: 0.731, 0.987, p = 0.033) showed significantly lower prevalence of fruit intake with more reports of home availability. The study suggests that personal, social-environmental, and physical-environmental factors influence vegetable and fruit intake among adolescents, particularly fruit intake consumption behaviors among overweight and obese adolescent population in Selangor. The enunciation of these intake correlates could potentially be incorporated in future development of intervention strategies to effectively promote fruit and vegetable intake.

The relationship between Fruit and vegetable intake and frailty: Data from NHANES 2007–2018

Fruits and vegetables are known for their beneficial effects on chronic diseases. The purpose of the present study was to investigate the protective effect of a diet rich in fruits and vegetables on total stroke mortality and its 2 main subtypes in men and women separately. A prospective cohort study of 40 349 Japanese men and women was initiated in 1980-1981 and followed until 1998. Fruit and vegetable intake was assessed at baseline on the basis of the response to a food frequency questionnaire. During the 18-year follow-up period, deaths from stroke were registered. A total of 1926 stroke deaths were identified during the follow-up period. An increasing frequency of intake of green-yellow vegetables and fruit was associated with a reduced risk of death from intracerebral hemorrhage and cerebral infarction. Daily intake of green-yellow vegetables was associated with a significant 26% reduction in the risk of death from total stroke in men and women compared with an intake of once or less per week. The protective effect associated with daily fruit and vegetable intake was observed for both cerebral infarction and intracerebral hemorrhage mortality but was slightly stronger and clearer for infarction than for hemorrhage, with a 32% reduction in men and a 30% reduction in women. Daily fruit intake was associated with a significant 35% reduction in risk of total stroke in men and a 25% reduction in women and was equally strong for both intracerebral hemorrhage and cerebral infarction. Daily consumption of green-yellow vegetables and fruits is associated with a lower risk of total stroke, intracerebral hemorrhage, and cerebral infarction mortality. The protective effects are similar in both men and women.

BackgroundAfrican Americans continue to have suboptimal cardiovascular health (CVH) related to diet and physical activity (PA) behaviors compared with White people. Mobile health (mHealth) interventions are innovative platforms to improve diet and PA and have the potential to mitigate these disparities. However, these are understudied among African Americans.ObjectiveThis study aims to examine whether an mHealth lifestyle intervention is associated with improved diet and PA-related psychosocial factors in African Americans and whether these changes correlate with diet and PA behavioral change.MethodsThis study is a retrospective analysis evaluating changes in diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors (daily fruit and vegetable intake and moderate-intensity PA [MPA] per week) in 45 African American adults (mean age 48.7 years, SD 12.9 years; 33/45, 73% women) enrolled in the FAITH! (Fostering African American Improvement in Total Health) app pilot study. The intervention is a 10-week, behavioral theory–informed, community-based mHealth lifestyle intervention delivered through a mobile app platform. Participants engaged with 3 core FAITH! app features: multimedia education modules focused on CVH with self-assessments of CVH knowledge, self-monitoring of daily fruit and vegetable intake and PA, and a sharing board for social networking. Changes in self-reported diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors were assessed by electronic surveys collected at baseline and 28 weeks postintervention. Changes in diet and PA-related psychosocial factors from pre- to postintervention were assessed using paired 2-tailed t tests. The association of changes in diet and PA-related psychosocial variables with daily fruit and vegetable intake and MPA per week was assessed using Spearman correlation. Associations between baseline and 28-week postintervention changes in diet and PA-related psychosocial measures and CVH behaviors with covariates were assessed by multivariable linear regression.ResultsParticipants reported improvements in 2 subscales of diet self-regulation (decrease fat and calorie intake, P=.01 and nutrition tracking, P<.001), one subscale of social support for healthy diet (friend discouragement, P=.001), perceived barriers to healthy diet (P<.001), and daily fruit and vegetable intake (P<.001). Improvements in diet self-regulation (increase fruit, vegetable, and grain intake, and nutrition tracking) and social support for healthy diet (friend encouragement) had moderate positive correlations with daily fruit and vegetable intake (r=0.46, r=0.34, and r=0.43, respectively). A moderate negative correlation was observed between perceived barriers to healthy diet and daily fruit and vegetable intake (r=−0.25). Participants reported increases in PA self-regulation (P<.001). Increase in social support subscales for PA (family and friend participation) had a moderate positive correlation with MPA per week (r=0.51 and r=0.61, respectively).ConclusionsOur findings highlight key diet and PA-related psychosocial factors to target in future mHealth lifestyle interventions aimed at promoting CVH in African Americans.

Background: The Malaysian Dietary Guidelines recommended that at least two servings of fruits and three servings of vegetables be consumed daily. However, is there a relationship between daily fruit and vegetable intake and body mass index (BMI)? The aim of this study was to identify the relationship between fruit and vegetable intake and BMI among postgraduate students in the health sciences. Methodogy: A cross-sectional study was conducted at the Faculty of Health Sciences, Universiti Kebangsaan Malaysia. 44 postgraduate students from the 2019/2020 batch of health sciences took partn in this study. Respondents were asked to complete three parts of the questionnaire: socio-demographic data, anthropometric measurements, and self-administered questions. Results: The majority of respondents are female (n=44, 77.3%), and they are mainly Malay (n=22, 50.0%). The average BMI of all respondents is 23.76±4.83. This study found that majority of respondents did not meet the recommended daily fruit (n=31, 70.5%) and vegetable intake (n=23, 52.3%). Discussion: The study discovered a significant relationship (p&lt;0.05) between age and daily vegetable intake. However, there was no significant relationship (p&gt;0.05) between gender, age, BMI, waist circumference, and daily fruit intake. Moreover, neither daily fruit nor vegetable intake predicted changes in BMI. Conclusion: This study found that the consumption of fruits and vegetables among postgraduate students was unsatisfactory and lower than recommended guidelines.

Background: The Malaysian Dietary Guidelines recommended that at least two servings of fruits and three servings of vegetables be consumed daily. However, is there a relationship between daily fruit and vegetable intake and body mass index (BMI)? The aim of this study was to identify the relationship between fruit and vegetable intake and BMI among postgraduate students in the health sciences. Methodogy: A cross-sectional study was conducted at the Faculty of Health Sciences, Universiti Kebangsaan Malaysia. 44 postgraduate students from the 2019/2020 batch of health sciences took partn in this study. Respondents were asked to complete three parts of the questionnaire: socio-demographic data, anthropometric measurements, and self-administered questions. Results: The majority of respondents are female (n=44, 77.3%), and they are mainly Malay (n=22, 50.0%). The average BMI of all respondents is 23.76±4.83. This study found that majority of respondents did not meet the recommended daily fruit (n=31, 70.5%) and vegetable intake (n=23, 52.3%). Discussion: The study discovered a significant relationship (p&lt;0.05) between age and daily vegetable intake. However, there was no significant relationship (p&gt;0.05) between gender, age, BMI, waist circumference, and daily fruit intake. Moreover, neither daily fruit nor vegetable intake predicted changes in BMI. Conclusion: This study found that the consumption of fruits and vegetables among postgraduate students was unsatisfactory and lower than recommended guidelines.

Home environment predictors of vegetable and fruit intakes among Australian children aged 18 months

Fruit and vegetable campaigns have been widely conducted in countries with school-based intervention programs as a promising strategy to improve eating habits, but no reviews have assessed the effectiveness of multicomponent home-school-based programs on daily fruit and vegetable intake. Through a systematic review of the literature, this study aims to determine the effectiveness of a home-school-based nutrition intervention program on children's and teenagers' consumption of fruits and vegetables. This research identified randomized controlled trials based in primary, middle, and high schools designed to increase daily fruit and vegetable intake. PubMed, Google Scholar, and Crossref were searched from 2013 to 2024. The six studies met all inclusion criteria. Three of the six studies’ findings indicate that home-school-based nutrition intervention programs significantly increase fruit and vegetable intake among children and adolescents. The amount of FV consumed by teenagers at follow-up was significantly correlated with the level of parental participation in the Boost intervention. Adolescents' consumption of fruits and vegetables increased significantly during the BALANCE program intervention. The three-year school-based multicomponent intervention group's children's daily intake of fruits and vegetables increased significantly. However 3 other literature studies did not increase fruit and vegetable consumption. This study references the best approaches and strategies to prevent non-communicable diseases. Multicomponent interventions with specific duration and sustainability in the future may have the potential to be effectively implemented.

Fruit and Vegetable Intake in Adults with Sickle Cell Disease

The purposes of this study were to assess the average daily intakes of fruits and vegetables (IFV) of Chinese immigrants comparing to the USDA recommendations for American; and to evaluate the influence of acculturation on IFV in Chinese immigrants. Foreign‐born Chinese immigrants were invited by emails to participate an online survey, which assess their sociodemographic, acculturation, and dietary intake characteristics. The questionnaires assessing IFV was adopted from a validated instrument developed by the National Cancer Institute. A total of 134 Chinese immigrants responded to the invitation, although only 102 of them qualified and completed the survey. The average daily intakes of fruits were 1.21 cups; while the average intakes of vegetables were 1.93 cups. Thus the average daily IFV were 3.14 cups. There was no significant difference in the intakes of fruits and/or vegetables between male and female subjects. We failed to find significant difference in the intakes of fruits and/or vegetables between three age groups (ages 19–30, 31–40, and 41–50). However, the intakes of vegetable and IFV depended on the years‐of‐living in US. The longer the immigrants stayed in US, the greater their intakes of vegetables and total IFV were. The level of education didn't seem to have an impact on the intakes of fruits and/or vegetables. According to USDA, the recommended daily intakes of fruits and vegetables should be two cups and two and half cups, respectively. Based on our survey, Chinese immigrants did not meet the recommendations, especially those that just migrated to this country.

ObjectiveThe aims of the review were to identify school-based randomised and non-randomised controlled trials to increase daily or lunchtime fruit and vegetable intake in children and to determine the impact...

This is a cross-sectional school-based study that evaluated the prevalence and associated factors of the daily intake of fruit and vegetables by adolescents at public schools in Caruaru, Pernambuco. Poisson regression with a hierarchical model, including sociodemographic variables in the first hierarchical level, behavioral variables in the second and diet-related variables in the third was used to assess the factors associated with fruit and vegetable intake. The results showed that of the 600 adolescents interviewed, 10% reported never eating fruit and 30.7% mentioned not eating vegetables. Prevalence of fruit intake was 32.9% and vegetables 29.0%. Only 6.5% reported eating both kinds of food daily. Merely the daily vegetable intake showed a significant difference according to sex (higher among girls). Daily fruit intake was 63% higher among adolescents living in urban areas. Not consuming alcohol was associated with higher fruit intake, though not to vegetable intake. Daily intake of fruits and vegetables was 2.4 times higher among adolescents who consumed rice and beans daily. Daily fruit and vegetable intake among adolescents in Caruaru is below the recommendations, and was associated with gender, residence area, consumption of alcoholic beverages and consumption of rice and beans.

OBJECTIVE: Thhis study aimed to investigate the reason why people choose to consume less vegetable and fruit through examining how the stage of change and psycho-social parameters relate to vegetable and fruit intake.&#x0D; &#x0D; METHODS: We carried out a cross-sectional study in 4 regions of Japan in which 2308 individuals (1012 men and 1296 women) aged 18 years or older who completed the questionnaires were included in the study.&#x0D; &#x0D; RESULTS: The results showed 56% of the participants were in the precontemplation stage (not thinking about consuming recommended amount of fruit and vegetable) and their average amounts of vegetable and fruit intake were far below the level of current recommendations, and subjects in the precontemplation stage showed lower scores of attitude and self efficacy. Men were more likely to be in precontemplation (67.7%) and less likely to be in action/maintenance stage (7.9%) than women (46.9%, 12.1%, respectively) (p &amp;lt; 0.001). We also observed the scores of attitude (p = 0.06) and self-efficacy (p &amp;lt; 0.01) rose as the stage went up from the precontemplation to action/maintenance for increasing vegetable and fruit intake. Moreover, a linear trend was found toward higher vegetable (p &amp;lt; 0.05) and fruit (p = 0.121) intake from precontemplation to action/maintenance stage.&#x0D; &#x0D; CONCLUSION: The present evidence suggests more attention should be focused on strategy for perceptions of personal need for recommended amount of vegetable and fruit intake for those who are in the precontemplation stage. Moreover, effective programs on enhancement of self-efficacy and attitude toward vegetable and fruit consumption are needed for increasing the vegetable and fruit intake.

To investigate potential personal, social and physical environmental predictors of daily fruit intake and daily vegetable intake in 11-year-old boys and girls in nine European countries. The total sample size was 13 305 (90.4% participation rate). Overall, 43.2% of the children reported to eat fruit every day, 46.1% reported to eat vegetables every day. Daily fruit intake and daily vegetable intake was mainly associated with knowledge of the national recommendations, positive self-efficacy, positive liking and preference, parental modeling and demand and bringing fruit to school (odds ratio between 1.40 and 2.42, P<0.02). These factors were associated fairly consistently with daily fruit intake across all nine European countries, implying that a rather uniform intervention strategy to promote fruit can be used across Europe. For vegetables, the pattern was, however, less consistent. Differences between countries in cooking and preparing vegetables might be responsible for this larger diversity. This study showed that especially a combination of personal and social factors is related to daily fruit and vegetable intake in schoolchildren. This shows that a comprehensive multilevel intervention strategy based upon a series of individual and social correlates will be most promising in the promotion of daily fruit and vegetable intake in children.