Children's consumption of energy dense nutrient poor foods, fruit and vegetables; are they related? An analysis of data from a cross sectional survey

Issue addressed: Many children consume excessive amounts of energy-dense, nutrient-poor (EDNP) or 'extra' foods and low intakes of fruit and vegetables. The aim of this study was to examine the associations between EDNP foods and ascertain whether certain EDNP foods and beverages are more likely to be eaten in association with other EDNP foods.

Methods: A cross-sectional representative population survey of children in preschool (n=764), and of school students in Years K, 2 and 4 (n=1,560) and in Years 6, 8 and 10 (n=1,685) residing in the Hunter New England region of New South Wales, Australia. Dietary data were collected using a short food frequency questionnaire. Multivariate logistic regression models examined the association between EDNP foods and fruit and vegetable intake. Data were stratified by sex and age cohort.

Results: More frequent consumption of some EDNP food types was significantly associated with more frequent consumption of other EDNP foods. Fast food and soft drinks consumption were associated with each other as well as with fried potato and salty snacks; and with lower intakes of fruit and vegetables in some but not all age groups.

Conclusion: The positive associations found between EDNP foods point towards the existence of a high-risk group of children who frequently consume a variety of EDNP foods and drinks.

Perceived quality and availability of fruit and vegetables are associated with perceptions of fruit and vegetable affordability among socio-economically disadvantaged women

Objective Perceptions that fruit and vegetables are expensive have been found to be associated with lower consumption of fruit and vegetables among disadvantaged women; however, the determinants of these perceptions are relatively unknown. The purpose of the current paper is to examine whether perceived availability and quality of fruit and vegetables, and social support for healthy eating, are associated with perceptions of fruit and vegetable affordability among women residing in disadvantaged neighbourhoods.

Design Cross-sectional self-report survey.

Setting The study was conducted in Melbourne, Australia.

Subjects An Australian sample of 4131 women, aged 18–45 years, residing in neighbourhoods ranked in the lowest Victorian tertile of relative disadvantage by the Australian Bureau of Statistics, an index that considers aspects of disadvantage such as residents’ income, education, motor vehicle access and employment.

Results Results showed that irrespective of education, income and other key covariates, women who perceived poor availability and quality of fruit and vegetables in their local neighbourhood were more likely to perceive fruit and vegetables as expensive.

Conclusions Our results suggest that perceptions of fruit and vegetable affordability are not driven exclusively by lack of financial or knowledge-related resources, but also by women's psychological response and interpretation of their local nutrition environment.

Perceptions of fruit and vegetable dietary guidelines among Australian young adults

Aim:  Regular consumption of fruit and vegetables has been associated with a decreased risk of a number of chronic diseases. An appropriate level of knowledge is important to successfully adhere to the dietary guidelines for eating fruit and vegetables. However, there is little research about the level of knowledge that young adults have about fruit and vegetable consumption. The current study aimed to investigate the recall and understanding of Australian dietary guidelines, food product and serving size knowledge in a population of young adults. Methods:  One hundred and six undergraduate students completed online questionnaires regarding (1) knowledge of dietary recommendations; (2) knowledge of serving size information; and (3) foods that could be included as part of fruit and vegetable intake. Results:  The results showed that the sample had significant knowledge gaps in all three areas. Approximately half (54%) of participants correctly reported the recommended daily intake of fruit and vegetables, the majority were not able to correctly report serving sizes (correct responses were 30–61%) and were not able to identify all ingredients from a recipe that counted towards fruit and vegetable intake. Conclusions:  Past interventions have not tended to focus on the fruit and vegetable knowledge, or behaviours, of Australian young adults. On the basis of findings from this study, it appears that more work is needed to develop messages to effectively target this important group.

ShopSmart 4 Health - protocol of a skills-based randomised controlled trial promoting fruit and vegetable consumption among socioeconomically disadvantaged women

Background
There is a need for evidence on the most effective and cost-effective approaches for promoting healthy eating among groups that do not meet dietary recommendations for good health, such as those with low incomes or experiencing socioeconomic disadvantage. This paper describes the ShopSmart 4 Health study, a randomised controlled trial conducted by Deakin University, Coles Supermarkets and the Heart Foundation, to investigate the effectiveness and cost-effectiveness of a skill-building intervention for promoting increased purchasing and consumption of fruits and vegetables amongst women of low socioeconomic position (SEP).

Methods/design
ShopSmart 4 Health employed a randomised controlled trial design. Women aged 18–60 years, holding a Coles store loyalty card, who shopped at Coles stores within socioeconomically disadvantaged neighbourhoods and met low-income eligibility criteria were invited to participate. Consenting women completed a baseline survey assessing food shopping and eating habits and food-related behaviours and attitudes. On receipt of their completed survey, women were randomised to either a skill-building intervention or a wait-list control condition. Intervention effects will be evaluated via self-completion surveys and using supermarket transaction sales data, collected at pre- and post-intervention and 6-month follow-up. An economic evaluation from a societal perspective using a cost-consequences approach will compare the costs and outcomes between intervention and control groups. Process evaluation will be undertaken to identify perceived value and effects of intervention components.

Discussion
This study will provide data to address the currently limited evidence base regarding the effectiveness and cost-effectiveness of skill-building intervention strategies aimed at increasing fruit and vegetable consumption among socioeconomically disadvantaged women, a target group at high risk of poor diets.

Associations between neighbourhood and household environmental variables and fruit consumption : exploration of mediation by individual cognitions and habit strength in the GLOBE study

Objective The present study examined associations of several home and neighbourhood environmental variables with fruit consumption and explored whether these associations were mediated by variables derived from the Theory of Planned Behaviour (TPB) and by habit strength.

Design Data of the Dutch GLOBE study on household and neighbourhood environment, fruit intake and related factors were used, obtained by self-administered questionnaires (cross-sectional), face-to-face interviews and audits.

Setting The city of Eindhoven in the Netherlands

Subjects Adults (n 333; mean age 58 years, 54 % female).

Results Multiple mediation analyses were conducted using regression analyses to assess the association between environmental variables and fruit consumption, as well as mediation of these associations by TPB variables and by habit strength. Intention, perceived behaviour control, subjective norm and habit strength were associated with fruit intake. None of the neighbourhood environmental variables was directly or indirectly associated with fruit intake. The home environmental variable ‘modelling behaviour by family members’ was indirectly, but not directly, associated with fruit intake. Habit strength and perceived behaviour control explained most of the mediated effect (71·9 %).

Conclusions Modelling behaviour by family members was indirectly associated with fruit intake through habit strength and perceived behaviour control. None of the neighbourhood variables was directly or indirectly, through any of the proposed mediators, associated with adult fruit intake. These findings suggest that future interventions promoting fruit intake should address a combination of the home environment (especially modelling behaviour by family members), TPB variables and habit strength for fruit intake.

Cost of reproduction in the Queensland fruit fly: Y-model versus lethal protein hypothesis

The trade-off between lifespan and reproduction is commonly explained by differential allocation of limited resources. Recent research has shown that the ratio of protein to carbohydrate (P : C) of a fly's diet mediates the lifespan–reproduction trade-off, with higher P : C diets increasing egg production but decreasing lifespan. To test whether this P : C effect is because of changing allocation strategies (Y-model hypothesis) or detrimental effects of protein ingestion on lifespan (lethal protein hypothesis), we measured lifespan and egg production in Queensland fruit flies varying in reproductive status (mated, virgin and sterilized females, virgin males) that were fed one of 18 diets varying in protein and carbohydrate amounts. The Y-model predicts that for sterilized females and for males, which require little protein for reproduction, there will be no effect of P : C ratio on lifespan; the lethal protein hypothesis predicts that the effect of P : C ratio should be similar in all groups. In support of the lethal protein hypothesis, and counter to the Y-model, the P : C ratio of the ingested diets had similar effects for all groups. We conclude that the trade-off between lifespan and reproduction is mediated by the detrimental side-effects of protein ingestion on lifespan.