Persistent social inequality in low intake of vegetables among adolescents, 2002-2014

Parental intentions to implement vegetable feeding strategies at home: A cross sectional study

In order to increase vegetable intake by children, parents are encouraged to implement strategies that promote trying and eating vegetables at mealtimes. Qualitative studies have previously highlighted barriers parents face in implementing healthy eating practices, such as time, monetary costs and child factors (e.g. fussy eaters). This study aimed to specify the relationships between child and parent factors and their effects on parental intentions to implement vegetable feeding strategies at mealtimes. Parental intentions to implement meal service (serving larger portions, offering variety, serving vegetables first) and experiential learning (repeated exposure, games, sensory play) strategies were examined. Parents (N = 302, 73 male, Mage = 33.5) also explained reasons why certain strategies may or may not work for their child (4-7y). For both types of strategy, higher food fussiness of the child predicted higher parental intentions to implement strategies at home. However, this was competitively mediated by low beliefs that the strategy would work for their child, resulting in weaker overall positive effects on intentions. In the meal service model, parental beliefs that healthy eating is important for their child had a positive, indirect effect on higher intentions, through involved parental feeding practices. However, this was not significant in the experiential learning strategies model. Written parental responses suggest that this may be due to meal service approaches being viewed as easier to implement, with little additional effort required. Increasing parental confidence to implement strategies successfully and managing expectations around successful outcomes of strategies (e.g. tasting, eating) may be important focuses of future interventions to support parents implementing vegetable feeding strategies at mealtimes.

Satisfaction with Food: Profiles of Two-Parent Families with Adolescent Children

The objectives of this study were to distinguish family profiles based on the level of satisfaction with food-related life (SWFoL) of mothers, fathers, and adolescents, and to characterize the profiles based on the three family members' diet quality and nutritional status, family's eating habits, parental feeding practices, parent's nutritional knowledge, and sociodemographic characteristics. Questionnaires were applied to a sample of 300 two-parent families with adolescent children, aged between 10 and 17 years, in Temuco, Chile. The questionnaires used were: satisfaction with food-related life (SWFoL); adapted healthy eating index (AHEI); family eating habits questionnaire (FEHQ); and the nutritional knowledge subscale. They also answered questions about eating habits and provided data to determine BMI and sociodemographic characteristics. Four different profiles were identified with respect to SWFoL: "Families satisfied with their food" (50.6%); "Fathers and mothers moderately satisfied with their food, children satisfied" (23.2%); "Families extremely satisfied with their food" (16.6%); and "Fathers and mothers satisfied with their food, children extremely dissatisfied" (9.7%). The profiles demonstrated heterogeneity in SWFoL. Higher levels of SWFoL (mothers, fathers and adolescents) were associated with healthier eating habits. These results contribute to new studies that enable understanding of how families' healthy eating habits are part of improving quality of life.

The diverging patterns of life satisfaction between families: A latent profile analysis in dual-earner parents with adolescents

This study identifies family profiles based on the level of life satisfaction (LS) in mothers, fathers and adolescents, and variables related to their family, food, and work life. The sample was composed of 303 families of dual-earner parents (mothers’ mean age = 40.9 years, SD = 7.4, fathers’ mean age = 43.2 years, SD = 7.2) and one of their children aged between 10 and 17 years (mean age 13.3, SD = 2.4, 51.5% female). A Latent Profile Analysis (LPA) was used to identify five family profiles. Profiles differed in LS, satisfaction with family life (SWFaL), satisfaction with food-related life (SWFoL), family functioning, both parents’ work-life balance and their perception of the financial situation of the household. Balanced and imbalanced families in terms of LS differed in the three family members’ LS and SWFaL, mothers’ and children’ SWFoL and family functioning, and both parents’ perception of financial situation. These results contribute to understanding the heterogeneity of life satisfaction dynamics between and within dual-earner families.

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

OBJECTIVE

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

DESIGN

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

SETTING

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

RESULTS

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

CONCLUSIONS

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

Ten-year changes in diet quality among adolescents and young adults (Food Consumption Survey 2004 and 2014, Belgium)

PURPOSE

To estimate the 10-year change in the overall nutritional quality of adolescent and young adult's diet, as measured by the modified Nutrient Profiling System of the British Food Standards Agency individual Dietary Index (FSAm-NPS-DI) which funds the Nutri-Score development, and in different components of this score, overall and according to the individual characteristics.

METHODS

Two 24-h dietary recalls were carried out in 15- to 39-year-old respondents included in the Belgian Food Consumption Surveys in 2004 (n = 1186) and 2014 (n = 952). The weighted mean individual FSAm-NPS-DI was computed from all foods and beverages consumed, converted into a scale from 0 to 100 (from the poorest to the most favorable diet), and compared between survey years. Subject characteristics associated with the score, along with the mean daily intake of food groups, energy, and nutrients were explored in multiple linear regressions stratified by survey year and age group.

RESULTS

The weighted mean daily FSAm-NPS-DI significantly increased between 2004 and 2014 [2004: 55.3 (SEM: 0.2) vs. 2014: 57.4 (0.5), P < 0.001 in 15- to 18-year olds; 55.0 (0.6) vs. 58.1 (0.4), P < 0.001 in 19- to 25-year olds; 57.1 (0.4) vs. 58.5 (0.3), P < 0.01 in 26- to 39-year olds]. SFA intake decreased in all age groups, and sugar-sweetened beverage, sugar, sodium, and fiber intakes decreased among 15‒18-year olds. The nutritional quality changed unevenly according to sociocultural characteristics, levels of education and regions being the main sources of disparities.

CONCLUSION

The quality of diet improved overall between 2004 and 2014 among young people in Belgium, an uneven change that need to be confirmed in future surveys, following the implementation of the Nutri-Score.

Family structure and affluence in adolescent eating behaviour: a cross-national study in forty-one countries

OBJECTIVE

To investigate the family structure and affluence-related inequality in adolescent eating behaviour.

DESIGN

Multivariate binary logistic regression and path analyses were employed to evaluate the impact of family structure and affluence on the consumption of fruits, vegetables, sweets and soft drinks among adolescents.

SETTING

The cross-national Health Behaviour in School-aged Children study in 2013/2014 across forty-one countries.

PARTICIPANTS

Adolescents aged 11-15 years old (n 192 755).

RESULTS

Adolescents from a non-intact family were less likely to eat daily fruits (OR 0·82; 95 % CI 0·80, 0·84), vegetables (OR 0·91; 95 % CI 0·89, 0·93) and sweets (OR 0·96; 95 % CI 0·94, 0·99), but were more likely to consume soft drinks (OR 1·14; 95 % CI 1·11, 1·17), compared with their counterparts from an intact family. Adolescents who had the lowest family affluence scores (FAS) were less likely to eat daily fruits (OR 0·51; 95 % CI 0·49, 0·53), vegetables (OR 0·58; 95 % CI 0·56, 0·60) and sweets (OR 0·94; 95 % CI 0·90, 0·97), but were more likely to consume soft drinks (OR 1·25; 95 % CI 1·20, 1·30), compared with their counterparts who had the highest FAS. Across countries, a wide range of social inequality in daily consumption of foods was observed.

CONCLUSIONS

Among adolescents in Europe, Canada and Israel, there was a high level of family structure and family affluence inequalities in daily food consumption. Different aspects of family socio-economic circumstances should be considered at the national level designing effective interventions to promote healthy eating among adolescents.

State-level income inequality and the odds for meeting fruit and vegetable recommendations among US adults

Background

Previous research indicates that income inequality is associated with risk for mortality, self-rated health status, chronic conditions, and health behavior, such as physical activity. However, little is known about the relationship between income inequality and dietary intake, which is a major risk factor for common chronic diseases including heart disease, stroke, diabetes, and certain types of cancers. The objective of this study is to determine the association between US state income inequality and fruit and vegetable consumption among adults.

Methods

Cross-sectional data on 270,612 U.S. adults from the U.S. 2013 Behavioral Risk Factor Surveillance System was used. Fruit and vegetable consumption was assessed from the six-item fruit and vegetable frequency questionnaire, which is part of the Behavioral Risk Factor Surveillance System. Multilevel modeling was used to determine whether US state-level income inequality (measured by the z-transformation of the Gini coefficient) was associated with fruit and vegetable consumption adjusting for individual-level and state-level covariates.

Results

In comparison to men, women were more likely to consume fruits and vegetables ≥5 times daily, fruits ≥2 times daily, vegetables ≥3 times of daily, and less likely to consume fruit juice daily. Among both men and women, a standard deviation increase in Gini coefficient was associated with an increase in consuming fruit juice daily (OR = 1.07, 95% CI = 1.03, 1.11). However, among women, a standard deviation increase in Gini coefficient was associated with a decreased likelihood in meeting daily recommended levels of both fruits and vegetables (OR = 0.93; 0.87–0.99), fruits only (OR = 0.95; 95% CI, 0.92–0.99) and vegetables only (OR = 0.92; 95% CI, 0.89–0.96).

Conclusions

This study is one of the first to show the relationship between income inequality and fruit and vegetable consumption among U.S. adults empirically. Women’s health is more likely to be detrimentally affected when living in a state with higher income inequality.

Progress and setbacks in socioeconomic inequalities in adolescent health-related behaviours in Brazil: results from three cross-sectional surveys 2009-2015

OBJECTIVES

Despite some progress, Brazil is still one of the most unequal countries, and the extent of socioeconomic inequalities in adolescent health is unclear. We assessed trends in socioeconomic inequalities in adolescent's health-related behaviours in Brazil between 2009 and 2015.

DESIGN

We used cross-sectional data from the Brazilian National Survey of School Health carried out in 2009, 2012 and 2015.

SETTING

Brazilian state capitals.

PARTICIPANTS

Students attending ninth grade from public and private schools in Brazilian state capitals in 2009 (60 973 students), 2012 (61 145 students) and 2015 (51 192 students).

MAIN OUTCOME MEASURE

We assessed 12 health-related behaviours (irregular fruit, vegetables and bean consumption; regular soft drink consumption; irregular physical activity; alcohol, drug and tobacco use; unsafe sex; involvement in gun fights; bullying victimisation and domestic violence victimisation), under the broad domains of lifestyle risk behaviours, engagement in risky activities and exposure to violence. Socioeconomic status was assessed through an asset-based wealth index derived from principal component analysis. Absolute and relative inequalities in these health behaviours and inequalities trends were investigated.

RESULTS

From 2009 to 2015, prevalence of certain harmful health-related behaviours increased, such as unsafe sex (21.5% to 33.9%), domestic violence (9.5% to 16.2%), bullying victimisation (14.2% to 21.7%) and irregular consumption of beans (37.5% to 43.7%). Other indicators decreased: alcohol use (27.1% to 23.2%), irregular physical activity (83.0% to 75.6%) and consumption of soft drinks (37.2% to 28.8%). Over the period, we found consistent evidence of decreasing health inequalities for lifestyle behaviours (fruit, bean and soft drink consumption) and alcohol use, set against increasing inequalities in violence (domestic violence, fights using guns and bullying victimisation).

CONCLUSION

Socioeconomic inequality increased in the violence domain and decreased for lifestyle behaviours among Brazilian adolescents. Widening gaps in violence domain urge immediately policy measures in Brazil.