Fruits and vegetables:measuring intake and encouraging increased consumption

A high intake of fruit and vegetables (FV) is associated with reduced risk of chronic disease, although the evidence base is mostly observational. Blood biomarkers offer an objective indicator of FV intake, potentially improving estimates of intakes based on traditional methods. A valid biomarker of overall FV intake would be able to confirm population intakes, more precisely evaluate the association between intakes and health outcomes and confirm compliance in FV interventions. Several substances have been proposed as biomarkers of FV intake: vitamin C, the carotenoids and polyphenols. Certain biomarkers are strong predictors of single FV; however, the proposed single biomarkers of FV consumption are only modestly predictive of overall FV consumption. This is likely to be due to the complexity of the FV food group. While accurately measuring FV intake is important in nutrition research, another critical question is: how best can an increase in FV intake be achieved? Increased FV intake has been achieved in efficacy studies using intensive dietary advice. Alternative, less intensive methods for encouraging FV consumption need to be developed and tested for population level intervention. Systematic reviews suggest peer support to be an effective strategy to promote dietary change. This review will describe the evidence for a link between increased FV intake and good health, outline possible novel biomarkers of FV consumption, present the most recently available data on population intake of FV and examine the usefulness of different approaches to encourage increased consumption of FV.

Seafood consumption in Portugal : patterns, drivers and sustainability

Tese de doutoramento, Ciências do Mar, Universidade de Lisboa, Faculdade de Ciências, 2014

Food habits and sport activity during adolescence: differences between athletic and non-athletic teenagers in Switzerland.

OBJECTIVE: To describe food habits and dietary intakes of athletic and non-athletic adolescents in Switzerland. SETTING: College, high schools and professional centers in the Swiss canton of Vaud. METHOD: A total of 3,540 subjects aged 9-19 y answered a self-reported anonymous questionnaire to assess lifestyles, physical plus sports activity and food habits. Within this sample, a subgroup of 246 subjects aged 11-15 also participated in an in-depth ancillary study including a 3 day dietary record completed by an interview with a dietician. RESULTS: More boys than girls reported engaging in regular sports activities (P<0.001). Adolescent food habits are quite traditional: up to 15 y, most of the respondents have a breakfast and eat at least two hot meals a day, the percentages decreasing thereafter. Snacking is widespread among adolescents (60-80% in the morning, 80-90% in the afternoon). Food habits among athletic adolescents are healthier and also are perceived as such in a higher proportion. Among athletic adolescents, consumption frequency is higher for dairy products and ready to eat (RTE) cereals, for fruit, fruit juices and salad (P<0.05 at least). Thus the athletic adolescent's food brings more micronutrients than the diet of their non-athletic counterparts. Within the subgroup (ancillary study), mean energy intake corresponds to requirements for age/gender group. CONCLUSIONS: Athletic adolescents display healthier food habits than non-athletic adolescents: this result supports the idea that healthy behavior tends to cluster and suggests that prevention programs among this age group should target simultaneously both sports activity and food habits.

Associations between fruit and vegetable consumption and psychological distress: results from a population-based study.

BACKGROUND: Several studies observed associations of various aspects of diet with mental health, but little is known about the relationship between following the 5-a-day recommendation for fruit and vegetables consumption and mental health. Thus, we examined the associations of the Swiss daily recommended fruit and vegetable intake with psychological distress. METHODS: Data from 20,220 individuals aged 15+ years from the 2012 Swiss Health Survey were analyzed. The recommended portions of fruit and vegetables per day were defined as 5-a-day (at least 2 portions of fruit and 3 of vegetables). The outcome was perceived psychological distress over the previous 4 weeks (measured by the 5-item mental health index [MHI-5]). High distress (MHI-5 score ≤ 52), moderate distress (MHI-5 > 52 and ≤ 72) and low distress (MHI-5 > 72 and ≤ 100) were differentiated and multinomial logistic regression analyses adjusted for known confounding factors were performed. RESULTS: The 5-a-day recommendation was met by 11.6 % of the participants with low distress, 9.3 % of those with moderate distress, and 6.2 % of those with high distress. Consumers fulfilling the 5-a-day recommendation had lower odds of being highly or moderately distressed than individuals consuming less fruit and vegetables (moderate vs. low distress: OR = 0.82, 95 % confidence interval [CI] 0.69-0.97; high vs. low distress: OR = 0.55, 95 % CI 0.41-0.75). CONCLUSIONS: Daily intake of 5 servings of fruit and vegetable was associated with lower psychological distress. Longitudinal studies are needed to further determine the causal nature of this relationship.

Consumption of Bias and Reptition as a Revisionary Strategies in Palace of the Peacock and in the Thought of Wilson Harris

Wilson Harris créée dans son roman Le palace du paon un espace de transformation intellectuelle d’une nature inédite. Cet espace se confond avec la matrice narrative de son roman. Celle-ci permet la génèse de l’identité guyanaise, non pas à partir des vestiges pré-coloniaux, ni grâce aux récits des historiens des vainqueurs mais avec des ingrédients philosophiques et littéraires de nature à transformer l’étoffe même de notre imaginaire et énergie créative. Il utilise pour ce faire la répétition comme stratégie narrative permettant de rompre la linéarité chronologique qui joint passé, présent et avenir. Ainsi faisant, il déjoue toutes les attentes de ses lecteurs les habituant ainsi à ce que Derrida appelle la logique spectrale qui permet l’influence mutuelle entre passé et présent. Ce travail est l’exploration des mécanismes de ce lâcher prise imaginatif mais aussi de toutes les voix qui répètent, à travers le temps et les continents, cet appel à l’hospitalité inconditionnelle envers l’Autre, c'est-à-dire une ouverture envers le paradoxal, le multiple, le différent en soi et en dehors de soi.

A DSGE model with loss aversion in consumption and leisure: an explanation for business cycles asymmetries

In this chapter, an asymmetric DSGE model is built in order to account for asymmetries in business cycles. One of the most important contributions of this work is the construction of a general utility function which nests loss aversion, risk aversion and habits formation by means of a smooth transition function. The main idea behind this asymmetric utility function is that under recession the agents over-smooth consumption and leisure choices in order to prevent a huge deviation of them from the reference level of the utility; while under boom, the agents simply smooth consumption and leisure, but trying to be as far as possible from the reference level of utility. The simulations of this model by means of Perturbations Method show that it is possible to reproduce asymmetrical business cycles where recession (on shock) are stronger than booms and booms are more long-lasting than recession. One additional and unexpected result is a downward stickiness displayed by real wages. As a consequence of this, there is a more persistent fall in employment in recession than in boom. Thus, the model reproduces not only asymmetrical business cycles but also real stickiness and hysteresis.

Identifying behavioural predictors of small power electricity consumption in office buildings

It is widely accepted that there is a gap between design energy and real world operational energy consumption. The behaviour of occupants is often cited as an important factor influencing building energy performance. However, its consideration, both during design and operation, is overly simplistic, often assuming a direct link between attitudes and behaviour. Alternative models of decision making from psychology highlight a range of additional influential factors and emphasise that occupants do not always act in a rational manner. Developing a better understanding of occupant decision making could help inform office energy conservation campaigns as well as models of behaviour employed during the design process. This paper assesses the contribution of various behavioural constructs on small power consumption in offices. The method is based upon the Theory of Planned Behaviour (TPB) which assumes that intention is driven by three factors: attitude, subjective norms, and perceived behavioural control, but we also consider a fourth construct: habit measured through the Self- Report Habit Index (SRHI). A questionnaire was issued to 81 participants in two UK offices. Questionnaire results for each behavioural construct were correlated against each participant’s individual workstation electricity consumption. The intentional processes proposed by TPB could not account for the observed differences in occupants’ interactions with small power appliances. Instead, occupants were interacting with small power “automatically”, with habit accounting for 11% of the variation in workstation energy consumption. The implications for occupant behaviour models and employee engagement campaigns are discussed.

Nutrition knowledge and food consumption: can nutrition knowledge change food behaviour?

The status and explanatory role of nutrition knowledge is uncertain in public health nutrition. Much of the uncertainty about this area has been generated by conceptual confusion about the nature of knowledge and behaviours, and, nutrition knowledge and food behaviours in particular. So the paper  describes several key concepts in some detail. The main argument is that 'nutrition knowledge' is a necessary but not sufficient factor for changes in consumers' food behaviours. Several classes of food behaviours and their causation are discussed. They are influenced by a number of environmental and intra-individual factors, including motivations. The interplay between motivational factors and information processing is important for nutrition promoters as is the distinction between declarative and procedural  knowledge. Consideration of the domains of nutrition knowledge shows that their utility is likely to be related to consumers' and nutritionists' particular goals and viewpoints. A brief survey of the recent literature shows that the evidence for the influence of nutrition knowledge on food behaviours is mixed. Nevertheless, recent work suggests that nutrition knowledge may play a small but pivotal role in the adoption of healthier food habits. The implications of this overview for public health nutrition are: (i) We need to pay greater attention to the development of children's and adults' knowledge frameworks (schema building); (ii) There is a need for a renewed proactive role for the education sector; (iii) We need to take account of consumers' personal food goals and their acquisition of procedural knowledge which will enable them to attain their goals; (iv) Finally, much more research into the ways people learn and use food-related knowledge is required in the form of experimental interventions and longitudinal studies.

Benefits and barriers to the consumption of a vegetarian diet in Australia

Objective: The aim of this study was to examine consumers' perceived benefits and barriers to the consumption of a vegetarian diet.

Design: Survey (written questionnaire) that included questions on perceived benefits and barriers to the consumption of a vegetarian diet.

Setting: South Australia.

Subjects: Six hundred and one randomly selected South Australians.

Results: The main perceived barriers to adopting a vegetarian diet were enjoying eating meat and an unwillingness to alter eating habits. This was the case for men, women and all age groups, although there were sex and age differences present in over half of the barrier items. For example, family food preferences were a greater problem for women than for men, while the oldest group was more likely to agree that humans are ‘meant’ to eat meat than the younger groups. The main benefits associated with vegetarian diets were health benefits: increased fruit and vegetable intake, decreased saturated fat intake, weight control. Animal welfare-related benefits and disease prevention were also important. Age and sex differences were apparent, although age differences were more important than sex differences.

Conclusions: The majority of respondents perceived there to be health benefits associated with the consumption of a vegetarian diet, but also, predictably, enjoyed eating meat. Given this, it is likely that interest in plant-based diets that contain some meat is higher than that in no-meat diets. An understanding of the perceived benefits and barriers of consuming a vegetarian diet will allow the implementation of strategies to influence meat and vegetarianism beliefs, dietary behaviour and, hence, public health.

The behavioural and demographic contexts of white bread consumption

The aim of this study was to examine the demographic, health habits and personal values associations of white bread use. A total of 474 randomly selected consumers completed a questionnaire about bread consumption, health habits and personal values. The findings showed that compared with non-consumers white bread users were younger, less educated, more likely to have children and to be smokers. They were less likely to follow vegetarian, low fat or special diets or use alternative therapies. Non-consumers were more likely to hold pro-nature universalistic values. This suggests that the use of this staple food is associated with demographic, behavioural and ideological domains. Their causal inter-relationships require further investigation.

Effect of migration on food habits of Somali women living as refugees in Australia

This study aimed to assess the dietary changes that occur for migrants moving from a low-income to a high-income country. The sample included 45 females who had migrated to Australia from Somalia within the past 5years (1996-2001). The data for the study was derived from structured interviews conducted by a bilingual interviewer and anthropometry. Usual dietary intake and frequency of consumption of 54 foods were determined both for Australia (current home) and for Somalia (previous home). In Australia, subjects maintained the structure of the diet from their country of birth. They did increase their consumption of some processed food, such as instant noodles, crisps, and pizza. However, there was little evidence that the subjects adopted ready or partially prepared meals or takeaway meals. A significant addition to the diet in Australia was the use of breakfast cereals. Significant substitutions were of ready-baked bread for traditional bread and lamb for camel meat. The mean BMI of the sample was 27.4kg/m². Sixty percent of the sample were overweight or obese (BMI>25). Some of the dietary changes observed may be consistent with increased energy intake and altered nutrient density. Given the association between transition to a high-income diet and obesity, it is important that migrants are encouraged to retain the best of their traditional diet while adopting healthy foods from host country.

A family-based intervention to increase fruit and vegetable consumption in adolescents : a pilot study

Objective: To evaluate the feasibility and effectiveness of a pilot family-based newsletter intervention to increase fruit and vegetable (FV) consumption among adolescents.
Design: Family-based, two-group randomised control trial with baseline, postintervention and follow-up measures. The intervention group received two FV newsletter packs over a 1 month period by postal mail. Social cognitive and behavioural choice theories provide the theoretical framework for the design and development of intervention materials. Control families were provided with all intervention materials at the end of the study. Adolescent FV consumption was assessed by an FFQ. Adolescent-reported barriers to eating FV, FV habits and preferences were the secondary outcomes, along with parent FV consumption, and parents reported knowledge, encouragement, home availability and accessibility of FV. Repeated-measures ANOVA was used to detect differences in behavioural and psychosocial outcomes between groups, time and group-by-time.
Setting: East Midlands, UK.
Subjects: Forty-nine parents and adolescents aged 12–14 years.
Results: Process evaluation indicated high reach, dose acceptability and fidelity of the intervention. At post-intervention and 6 weeks later at follow-up, adolescents in the intervention group had significantly higher fruit: (P0<·01) and vegetable (P<0·05) consumption and higher preferences for vegetables (P<0·01), compared with the control group. At post-intervention and follow-up, parents in the intervention group had significantly higher fruit (P<0·001) and vegetable (P<0·01) consumption and reported higher accessibility of fruit and vegetables (P<0·001), compared with those in the control group.
Conclusions: Family-based, newsletter interventions promoting FV consumption to adolescents appear to be feasible and effective at increasing FV consumption.

A cluster randomised trial of a telephone-based intervention for parents to increase fruit and vegetable consumption in their 3-to 5-year-old children : study protocol

Background: Inadequate fruit and vegetable consumption in childhood increases the risk of developing chronic disease. Despite this, a substantial proportion of children in developed nations, including Australia, do not consume sufficient quantities of fruits and vegetables. Parents are influential in the development of dietary habits of young children but often lack the necessary knowledge and skills to promote healthy eating in their children. The aim of this study is to assess the efficacy of a telephone-based intervention for parents to increase the fruit and vegetable consumption of their 3- to 5-year-old children.
Methods/Design: The study, conducted in the Hunter region of New South Wales, Australia, employs a cluster randomised controlled trial design. Two hundred parents from 15 randomly selected preschools will be randomised to receive the intervention, which consists of print resources and four weekly 30-minute telephone support calls delivered by trained telephone interviewers. The calls will assist parents to increase the availability and accessibility of fruit and vegetables in the home, create supportive family eating routines and role-model fruit and vegetable consumption. A further two hundred parents will be randomly allocated to the control group and will receive printed nutrition information only. The primary outcome of the trial will be the change in the child's consumption of fruit and vegetables as measured by the fruit and vegetable subscale of the Children's Dietary Questionnaire. Pre-intervention and post-intervention parent surveys will be administered over the telephone. Baseline surveys will occur one to two
weeks prior to intervention delivery, with follow-up data collection calls occurring two, six, 12 and 18 months following baseline data collection.
Discussion: If effective, this telephone-based intervention may represent a promising public health strategy to increase fruit and vegetable consumption in childhood and reduce the risk of subsequent chronic disease.
Trial registration: Australian Clinical Trials Registry ACTRN12609000820202

A cluster randomized controlled trial of a telephone-based parent intervention to increase preschoolers’ fruit and vegetable consumption

Background: Inadequate fruit and vegetable consumption is associated with increased chronic disease risk and represents a considerable global health burden. Despite evidence that dietary habits track from early childhood, there are few published trials of interventions attempting to increase preschoolers’ fruit and vegetable consumption.

Objective: The Healthy Habits trial aimed to assess the efficacy of a telephone-based intervention for parents to increase the fruit and vegetable consumption in their 3–5-y-old children.

Design: A cluster randomized controlled trial was conducted involving 394 parents of children aged 3–5 y recruited through local preschools. Parents allocated to the intervention received printed resources plus four 30-min telephone calls targeting aspects of the home food environment associated with children's fruit and vegetable consumption. Parents allocated to the control group received generic printed nutrition information. Children's fruit and vegetable consumption was assessed by using the Fruit and Vegetable Subscale of the Children's Dietary Questionnaire, which was administered via telephone interview at baseline and 2 and 6 mo later.

Results: Analysis of all available data showed that children's fruit and vegetable scores were significantly higher in the intervention group than in the control group at 2 mo (P < 0.001) and at 6 mo (P = 0.021). Sensitivity analysis using baseline observation carried forward showed an intervention effect at 2 mo (P = 0.008) but not at 6 mo (P = 0.069).

Conclusions: Telephone-delivered parent interventions may be an effective way of increasing children's fruit and vegetable consumption in the short term. Further investigation to determine whether the intervention effect is maintained in the longer term is recommended.