Children 's Fruit And Vegetable Intake Research Articles

SNAP Participation Moderates Fruit and Vegetable Intake Among Minority Families With Low Income

ObjectiveTo examine the moderation effect of Supplemental Nutrition Assistance Program (SNAP) participation on the baseline fruit and vegetable (FV) intake of Hispanic/Latino and African American children and parents participating in the Brighter Bites program. DesignCross-sectional. SettingHouston, Austin, and Dallas, TX; Washington, DC; and Southwest Florida. ParticipantsSelf-reported surveys (n = 6,037) of Hispanic/Latino and African American adult-child dyads enrolled in Brighter Bites in Fall 2018. Variables MeasuredDependent variable, child FV intake; Independent variable, parent FV intake, and FV shopping behavior; Effect Measure Modifier, SNAP participation. AnalysisQuantitatively used mixed effects linear regression models to test if the effect of parental baseline FV intake and shopping behavior on a child's baseline FV intake differed by SNAP participation. Analyses were performed using STATA with significance set at P < 0.05 and 95% confidence intervals (CIs). ResultsFor parents that consumed FV ≥ 2 times/d at baseline, there was a 0.1 times increase in child FV intake at baseline among those who participated in SNAP as compared with those who did not participate in SNAP (ß = 0.1; 95% CI, 0.1–0.2; P = 0.001), and for parents who shopped at convenience stores ≥ 2 times/wk for FV, there was 0.6 times increase in child FV intake at baseline for those who participated in SNAP as compared with those that did not participate in SNAP (ß = 0.6; 95% CI, 0.3–0.9; P < 0.001). Conclusions and ImplicationsSupplemental Nutrition Assistance Program participation moderated the associations between FV intake among African American and Hispanic/Latino parents and children and FV shopping at convenience stores and child FV intake. Findings indicate a need for future interventions to promote SNAP participation among those eligible and improve access to FV.

Associations of parent dietary role modeling with children's diet quality in a rural setting: Baseline data from the NU-HOME study

These analyses examined associations of parent dietary role modeling with diet quality among school-age children in a rural community. Past research has found protective associations between parent role modeling and children's dietary intake; however, there is a gap in understanding these associations for families in rural communities. Baseline data (2017 -2018) were drawn from the New Ulm at Home (NU-HOME) randomized controlled trial, conducted in the United States. The trial recruited 114 children (7–10 years old) and parents. Parents self-reported dietary intake [fruit and vegetable (FV), sugar-sweetened beverage (SSB), fast food (FF)] and frequency of sitting and eating with their child. Children reported parent role modeling of healthful eating (FV and salad at the evening meal; FV as snacks). Two 24-h dietary recalls assessed child diet quality indicators [Healthy Eating Index-2015 (HEI-2015) total scores, FV intake, SSB intake]. General linear models (GLM) and logistic regression analyzed associations of child diet quality (HEI score, FV intake, SSB intake) with parent dietary intake, parent sitting and eating the evening meal with their child, and child perceptions of parent role modeling healthful eating, adjusted for highest level of education in the home. Higher child HEI-2015 scores were positively associated with more frequent parent role modeling of fruit intake at meals, and inversely associated with more frequent parent role modeling of fruit as a snack; no significant associations of child FV intake with parent role modeling were observed. Higher child SSB intake was positively associated with parent FF intake. In this rural community, parents play significant roles in shaping children's dietary quality and intake, though more work needs to be done to address optimal intervention strategies to promote parent role modeling of healthful eating.

P25 Fruit and Vegetable Intake, Intention, and Healthy Food Choice Self-Efficacy Among Second and Third Grade EFNEP Youth in Guam

<h3>Objective</h3> To examine the effectiveness of the Health Kids Club (HKC) curriculum on fruit and vegetable (FV) intake and dietary behaviors among the Expanded Food and Nutrition Education Program (EFNEP) youth participants in Guam. <h3>Use of Theory or Research</h3> Guam EFNEP implements the HKC curriculum and applies the Experiential Learning Model; therefore, the constructs of the Social Cognitive Theory is the framework to evaluate this study's objective. <h3>Target Audience</h3> Study participants were Guam EFNEP youth in grades 3-5 (N = 2,569) during 2015-2019 from different community-based sites throughout Guam. Majority of youth were Asian and/or Native Hawaiian or Other Pacific Islander race and males (53%). <h3>Program Description</h3> The HKC curriculum consists of 6 interactive lessons on food safety, diet quality, portion control, and moving more and each has 2 activities. A lesson is added to gather exit data and celebrate program completion. <h3>Evaluation Methods</h3> Only data from youth who self-reported dietary behaviors using the nutrition education survey at entry and exit were analyzed (N = 1,714). Surveys consisted of 14 total questions for both periods 2015-2017 (n = 776) and 2017-2019 (n = 938). A paired <i>t</i> test and Wilcoxon signed rank test were performed to determine program effectiveness. Questions from each survey period were selected to examine FV intake, FV intention, and healthy food choice (HFC) self-efficacy behavior categories. <h3>Results</h3> Youth reported a significantly higher exit score for all behavior categories in both study periods. In 2015-2017, the mean increase in FV intake, FV intention, and HFC self-efficacy scores at exit were 0.45 (95% CI: 0.35-0.55), 0.18 (95% CI: 0.10-0.27), and 0.55 (95% CI: 0.45-0.65), respectively. In 2017-2019, the mean increase in FV intake and HFC self-efficacy scores at exit were 0.20 (95% CI: 0.05-0.35) and 0.37 (95% CI: 0.29-0.45), respectively, and a statistically significant median increase in FV intention score, z=2.27, <i>P</i> = 0.023. <h3>Conclusion</h3> Guam EFNEP youth curriculum is effective in improving children's FV intake, FV intention, and HFC self-efficacy.

Fruit and vegetable intake at and away from school during participation in the FIT Game.

The FIT Game is a multicomponent school-based incentive program aimed at increasing children's fruit and vegetable (FV) intake. There has been no previous report on how playing the game at school influences FV intake away from school. To examine children's (n=37) FV intake away from school while participating in the FIT Game program at school. FV intake away from school was assessed using the ASA24-Kids-2014 Dietary Assessment Tool. Paired samples t-tests and the generalized linear model repeated measures analysis of variance were used to examine the difference in children's mean FV intake away from school. During the final three days of the FIT Game intervention, we observed no change in FV consumption away from school (p=0.30). Similarly, no differences were observed between FV intake away from school before the implementation of the FIT Game and during the final three days (p=0.81). The FIT Game modestly decreased the children's FV intake in a nonstatistically significant manner away from school. Our previous report showed an increase in children's FV intake at school; thus, the net effect of the game was a significant increase in total daily FV intake.

Role of Organizational Support on Implementation of an Environmental Change Intervention to Improve Child Fruit and Vegetable Intake: a Randomized Cross-Over Design.

Little is known about the role of organizational or administrative support in implementation of health promotion interventions, particularly outside of school settings. The purpose was to determine the change in fruit and vegetable (FV) intake among children living in residential children's homes (RCHs) and assess the relationships among change in organizational support, intervention implementation, and child nutrition outcomes. Data were collected from 29 RCHs and 614 children living in RCHs, as part of a group randomized design with delayed intervention, at three cross-sectional waves: 2004, 2006, and 2008. RCH staff made environmental changes to increase intake of FV. Implementation and organizational support data were collected from staff at the RCHs. Child FV intake were measured via 24-h dietary recalls. A two-way (condition by time) repeated measures ANOVA was conducted to test whether FV intake increased in response to the intervention. A two-level path analysis with a robust maximum likelihood estimator was used to explore the relationships among organizational support, intervention implementation fidelity, and child FV intake. There was a significant increase in FV intake within all RCHs from 2004 to 2006 (P = 0.022 for the intervention group, P = 0.015 for the control group). This increase was maintained in both groups from 2006 to 2008 (post-intervention mean servings: intervention = 3.2 vs control = 3.4). Increases in organizational support resulted in greater overall implementation fidelity. When RCH staff, supervisors, and the RCH CEO were perceived to be supportive of the intervention, more environmental changes were made to encourage eating FV. Fostering organizational support may improve implementation of interventions.

The baseline characteristics of parents and African American girls in an online obesity prevention program: A feasibility study.

The objective of this paper was to identify the relationships and associations between child and parent characteristics with child fruit and vegetable (FV) consumption in an online obesity prevention program for 8–10 year old African American girls. Girls and a parent (n = 342 child-parent pairs) in the southwestern US completed baseline data collection from 2012 to 2014. Girls and a parent completed self-report questionnaires online. Girls also completed two unannounced 24 hour telephone-based dietary recalls. The relationships of parent demographic characteristics, child FV intake, and psychosocial variables (child and parent) were examined by analysis of variance. Pearson correlation coefficients were calculated to determine the relationships between psychosocial variables and child FV intake. Child FV intake was significantly greater in the highest household education (p = 0.001) and income groups (p = 0.004). FV home availability was higher with older parents (p = 0.007) and two-parent households (p = 0.033). Child FV intake was positively related to child FV preferences (p < 0.001), FV home availability (p = 0.022), and FV home accessibility (p = 0.002) but was negatively related to family barriers to FV consumption (p = 0.000). The study highlighted significant findings between child FV consumption and parent psychosocial variables and demographic characteristics that may offer insights for the design of effective obesity prevention interventions for 8–10 year old African American girls.ClinicaTrials.gov (NCT01481948).

The effectiveness of asking behaviors among 9\u201311 year-old children in increasing home availability and children\u2019s intake of fruit and vegetables: results from the Squire\u2019s Quest II self-regulation game intervention

BackgroundHome environment has an important influence on children’s fruit and vegetable (FV) consumption, but children may in turn also impact their home FV environment, e.g. by asking for FV. The Squire’s Quest II serious game intervention aimed to increase asking behaviors to improve home FV availability and children’s FV intake. This study’s aims were to assess: 1) did asking behaviors at baseline predict home FV availability at baseline (T0) (RQ1); 2) were asking behaviors and home FV availability influenced by the intervention (RQ2); 3) did increases in asking behaviors predict increased home FV availability (RQ3); and 4) did increases in asking behaviors and increases in home FV availability mediate increases in FV intake among children (RQ4)?MethodsThis is a secondary analysis of a study using a randomized controlled trial, with 4 groups (each n = 100 child–parent dyads). All groups were analyzed together for this paper since groups did not vary on components relevant to our analysis. All children and parents (n = 400 dyads) received a self-regulation serious game intervention and parent material. The intervention ran for three months. Measurements were taken at baseline, immediately after intervention and at 3-month follow-up. Asking behavior and home FV availability were measured using questionnaires; child FV intake was measured using 24-h dietary recalls. ANCOVA methods (research question 1), linear mixed-effect models (research question 2), and Structural Equation Modeling (research questions 3 and 4) were used.ResultsBaseline child asking behaviors predicted baseline home FV availability. The intervention increased child asking behaviors and home FV availability. Increases in child asking behaviors, however, did not predict increased home FV availability. Increased child asking behaviors and home FV availability also did not mediate the increases in child FV intake.ConclusionsChildren influence their home FV environment through their asking behaviors, which can be enhanced via a serious game intervention. The obtained increases in asking behavior were, however, insufficient to affect home FV availability or intake. Other factors, such as child preferences, sample characteristics, intervention duration and parental direct involvement may play a role and warrant examination in future research.Trials RegistrationClinicalTrials.gov NCT01004094. Date registered 10/28/2009

Impact evaluation of Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial.

The family and home environment is an influential antecedent of childhood obesity. The purpose of this study was to pilot test The Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) intervention; a newly developed, theory-based, online program for prevention of childhood obesity. The two-arm, parallel group, randomized, participant-blinded trial targeted mothers with children between 4 and 6 years of age. Measures were collected at baseline, 4 weeks, and 8 weeks to evaluate programmatic effects on constructs of social cognitive theory (SCT) and obesity-related behaviors. Process evaluation transpired concurrently with each intervention session. Fifty-seven participants were randomly assigned to receive either experimental EMPOWER (n = 29) or active control Healthy Lifestyles (n = 28) intervention. Significant main effects were identified for child physical activity, sugar-free beverage consumption, and screen time, indicating that both groups improved in these behaviors. A significant group-by-time interaction was detected for child fruit and vegetable (FV) consumption as well as the SCT construct of environment in the EMPOWER cohort. An increase of 1.613 cups of FVs (95% confidence interval = [0.698, 2.529]) was found in the experimental group, relative to the active control group. Change score analysis found changes in the home environment accounted for 31.4% of the change in child FV intake for the experimental group. Child physical activity, sugar-free beverage consumption, and screen time improved in both groups over the course of the trial. Only the theory-based intervention was efficacious in increasing child FV consumption. The EMPOWER program was robust for inducing change in the home environment leading to an increase in child FV intake (Cohen's f = 0.160).

Child Care Nutrition Environment: Is it related to children's fruit and vegetable intake?

Objectives To assess the impact of child care nutrition environment on children's fruit and vegetable (FV) intake among preschool children. Methods The study sample consisted of cohort of 425 preschool-aged children enrolled in 29 child care centers participating in the STRONG Kids program. Child care nutrition environments (CCNE) were measured by trained observers using the modified Environment and Policy Assessment and Observation. Hierarchical regressions were performed to evaluate whether CCNE and parent FV intake are associated with children's FV intake after controlling for primary caregiver's and child's characteristics. Results Results of the correlation analysis between CCNE and children's FV intake indicated that both Total Nutrition Environment (TNE) and Fruit/Vegetable environment (FVE) were positively correlated with vegetable intake and FV intake, while there was no relationship for fruit and 100% fruit juice intake. From the hierarchical regression analysis, both child care FVE and primary caregivers' fruit intake were independently associated with children's FV intake. Conclusion This study identified the significant role of child care FV environment when we promote FV intake among preschool children.

Associations between school meals offered through the National School Lunch Program and the School Breakfast Program and fruit and vegetable intake among ethnically diverse, low-income children.

Despite evidence in support of the health benefits associated with fruit and vegetable (FV) intake, national data indicate that FV consumption among school-aged children is below recommended levels, particularly among low-income children. School meals offered through the School Breakfast Program and National School Lunch Program can provide an important contribution to child FV intake. This study examines the proportion of fruits and vegetables consumed from school meals programs among ethnically diverse, low socioeconomic status children. Participants (n = 103) included fourth to sixth grade boys and girls from 4 urban elementary schools in St. Paul, Minnesota serving primarily low-income populations. Research staff interviewed children during school hours and recorded dietary intake via 24-hour recall. Analysis included descriptive statistics using cross tabulations and means. Average reported mean (SD) daily FV intake was 3.6 (2.5) servings, with 80% of children consuming fewer than 5 daily servings of FV. On average, children consumed over half of their daily FV intake within school. Children with low FV intake (<5 FV servings daily) consumed a higher proportion of their daily intake at school than children with higher FV intake (≥5 FV servings daily) (39% vs 59%; p = .002). Child FV intake is below recommended levels. School meals provide an important contribution to the daily FV intake among ethnically diverse, low socioeconomic status children, particularly among those with the lowest FV intake. School meals programs promoting FV intake within the school environment may provide an opportunity to encourage increased FV consumption.

Fruits and Vegetables at Home: Child and Parent Perceptions

Objective Examine child and parent perceptions of home food environment factors and associations with child fruit and vegetable (FV) intake. Design Research staff administered surveys to children during after-school sessions, and parents completed surveys by mail or over the phone. Setting Four urban elementary schools in St. Paul, Minnesota, serving primarily low-income populations. Participants Seventy-three children (55 girls, 18 boys) and 1 parent/guardian per child participated in a theater-based intervention aimed at obesity prevention. Main Outcome Measures Perceptions of home food environment factors (home FV availability, home FV accessibility; parental encouragement to eat FV; family meal frequency). Analysis Descriptive statistics and paired t tests. Results On average, child and parent perceptions of the home food environment were similar. When comparing child-parent dyad perceptions of home food environment, a moderate to high level of agreement (56%-86%) was found. Child report of home FV availability, home FV accessibility, parental encouragement to eat FV, and family meal frequency explained 26.7% of the variance in child FV intake, whereas parent report of these factors explained 4.9% of the variance. Conclusions and Implications It is important to understand both child and parent perceptions of the home food environment when developing interventions aimed at increasing child FV intake.