Promotion of Fruits and Vegetables Consumption: Results of a School-Based Intervention in a Sample of 13-15 Years Old Italian Students
DOI:
https://doi.org/10.6000/1929-4247.2013.02.04.6Keywords:
School based intervention, Italian students, healthy vending machines, availability, accessibilityAbstract
Background: The …e vai con la frutta (let’s go with fruit) project was designed to respond to the worrying low consumption of fruits and vegetable in the large portion of population, especially in youth. The main objective was to increase fruit and vegetable consumptions at school level.
Methods: In 2010/11, we randomly selected subjects from middle and high schools in five Italian regions. The subjects were randomly divided into two groups: intervention (I) and control (C). A questionnaire on fruits and vegetables consumption was administered, at the baseline as well as at end of the period. The sample size was evaluated on the expected frequency of 0.5 for a binomial random variable, of ± 1.54% with IC of 95%.
Results: These results confirmed that adolescent students at baseline survey eat less than the amount of fruits and vegetables consumption recommended by the International guidelines. After the intervention time, we observed an increment in fruits and vegetables consumptions both in middle and high school students. Regarding the impact of the intervention on the factors like knowledge, attitudes and behaviour, there was a positive change in the behaviour only in the intervention group, in coherence with the consumption variations examined.
Conclusions: This study is the first time that fruits and vegetables were offered at such a large scale through vending machines at schools in five regions. Several vending companies under this project agreed to revise the list of healthy snacks offered to eliminate those clearly classified as junk foods.
References
Ludwig DS, Pereira MA, Kroenke CH, Hilner JE, Van Horn L, Slattery ML, et al. Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. JAMA 1999; 282: 1539-46. http://dx.doi.org/10.1001/jama.282.16.1539
Howarth NC, Saltzman E, Roberts SB. Dietary fiber and weight regulation. Nutr Rev 2001; 59: 129-39. http://dx.doi.org/10.1111/j.1753-4887.2001.tb07001.x
Cullen KW, Baranowski T, Klesges LM, Watson K, Sherwood NE, Story M, et al. Anthropometric, parental, and psychosocial correlates of dietary intake of African-American girls. Obes Res 2004; 12: 20S-31S. http://dx.doi.org/10.1038/oby.2004.265
Roseman MG, Yeung WK, Nickelsen J. Examination of weight status and dietary behaviors of middle school students in Kentucky. J Am Diet Assoc 2007; 107(7): 1139-45. http://dx.doi.org/10.1016/j.jada.2007.04.015
St John M, Durant M, Campagna PD, Rehman LA, Thompson AM, Wadsworth LA, et al. Overweight Nova Scotia children and youth: the roles of household income and adherence to Canada's Food Guide to Healthy Eating. Can J Public Health 2008; 99(4): 301-6.
Wang Y, Ge K, Popkin BM. Why do some overweight children remain overweight, whereas others do not? Public Health Nutr 2003; 6: 549-58. http://dx.doi.org/10.1079/PHN2003470
Ledoux TA, Hingle MD, Baranowski T. Relationship of fruit and vegetable intake with adiposity: a systematic review. Obes Rev 2011; 2(5): 43-50.
Diet, nutrition and the prevention of chronic diseases. Geneva, World Health Organization and Food and Agricultural Organization, 2003. WHO Technical Report Series, No. 916; 2003.
Diethelm K, Jankovic N, Moreno LA, Huybrechts I, De Henauw. Food intake of European adolescents in the light of different food-based dietary guidelines: results of the HELENA (Healthy Lifesyle in Europe by Nutrition in Adolescence) Study. Public Health Nutr 2011; 15(3): 386-98. http://dx.doi.org/10.1017/S1368980011001935
Yngve A, Wolf A, Poortvlient E, Elmadafa I, Brug J, Ehrenblad B, et al. Fruit and vegetable intake in a sample of 11-year-old children in 9 European countries: The Pro-Children cross-sectional study. Ann Nutr Metab 2005; 49: 236-45. http://dx.doi.org/10.1159/000087247
Guenther PM, Dood KW, Reedy J, Krebs Smith MS. Most Americans eat much less than recommended amounts of fruits and vegetables. J Am Diet Assoc 2006; 106: 1511-21. http://dx.doi.org/10.1016/j.jada.2006.06.002
Population-based approaches to childhood obesity prevention. Geneva, World Health Organization 2012.
Pomerleau J. Effectiveness of interventions and programmes promoting fruit and vegetable intake. Background paper for the joint FAO/WHO Workshop on fruit and vegetables for Health; 2004: 1-3 September, Kobe, Japan. Geneva, World Health Organization 2005.
Knai C, Pomerleau J, Lock K, et al. Getting children to eat more fruit and vegetables: a systematic review. Prev Med 2006; 42: 85-95. http://dx.doi.org/10.1016/j.ypmed.2005.11.012
Krølner R, Suldrup Jørgensen T, Aarestrup AK, Hjøllund Christiansen A, Christensen AM, Due P. The Boost study: design of a school- and community-based randomised trial to promote fruit and vegetable consumption among teenagers. BMC Public Health 2012; 12: 191. http://dx.doi.org/10.1186/1471-2458-12-191
Ganann R, Fitzpatrick-Lewis D, Ciliska D, Peirson L. Community-based interventions for enhancing access to or consumption of fruit and vegetables among five to 18-year olds: a scoping review. BMC Public Health 2012; 12: 711. http://dx.doi.org/10.1186/1471-2458-12-711
De Sa J, Lock K. Will European agricultural policy for school fruit and vegetables improve public health? A review of school fruit and vegetable programmes. Eur J Public Health 2008; 18(6): 558-68. http://dx.doi.org/10.1093/eurpub/ckn061
Krølner R, Rasmussen M, Brug J, Klepp KI, Wind M, Due P. Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies. Int J Behav Nutr Phys Act 2011; 8: 112. http://dx.doi.org/10.1186/1479-5868-8-112
Rasmussen M, Krølner R, Klepp KI, Lytle L, Brug J, Bere E, Due P. Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: Quantitative studies. Int J Behav Nutr Phys Act 2006; 11: 3-22.
Blanchette L, Brug J. Determinants of fruit and vegetable consumption among 6-12-year-old children and effective interventions to increase consumption. J Hum Nutr Diet 2005; 18(6): 431-43. http://dx.doi.org/10.1111/j.1365-277X.2005.00648.x
Reinaerts E, de Nooijer J, Candel M, De Vries N. Explaining school children's fruit and vegetable consumption: the contributions of availability, accessibility, exposure, parental consumption and habit in addition to psychosocial factors. Appetite 2007; 48(2): 248-58. http://dx.doi.org/10.1016/j.appet.2006.09.007
Wechsler H, Devereaux RS, Davis M, Collins J. Using the School Environment to Promote Physical Activity and Healthy Eating. Prev Med 2000; 31(2): 121-37. http://dx.doi.org/10.1006/pmed.2000.0649
French SA, Stables G. Environmental interventions to promote vegetable and fruit consumption among youth in school settings. Prev Med 2003; 37(6): 593-10. http://dx.doi.org/10.1016/j.ypmed.2003.09.007
Davis EM, Cullen KW, Watson KB, Konarik M, Radcliffe J. A fresh fruit and vegetable program improves high school students’ consumption of fresh produce. J Am Diet Assoc 2009; 109: 1227-31. http://dx.doi.org/10.1016/j.jada.2009.04.017
Wells L, Nelson M. The National School Fruit Scheme produces short-term but not longer-term increases in fruit consumption in primary school children. Br J Nutr 2005; 93: 537-42. http://dx.doi.org/10.1079/BJN20051393
Nicklas TA, Johnson CC, Myers L, Farris RP, Cunningham A. Outcomes of a high school program to increase fruit and vegetable consumption: Gimme 5-a fresh nutrition concept for students. J Sch Health 1998; 68(6): 248-53. http://dx.doi.org/10.1111/j.1746-1561.1998.tb06348.x
Øverby NC, Klepp KI, Bere E. Introduction of a school fruit program is associated with reduced frequency of consumption of unhealthy snacks. Am J Clin Nutr 2012; 96(5): 1100-3. http://dx.doi.org/10.3945/ajcn.111.033399
Tak NI, Te Velde SJ, Singh AS, Brug J. The effects of a fruit and vegetable promotion intervention on unhealthy snacks during mid-morning school breaks: results of the Dutch Schoolgruiten Project. J Hum Nutr Diet 2010; 23(6): 609-15. http://dx.doi.org/10.1111/j.1365-277X.2010.01090.x
WHO Regional Office for Europe editor. Gaining health. The European Strategy for the Prevention and Control of Noncommunicable Diseases. World Health Organization; 2006: Available from: http://www.euro.who.int/__data/assets/ pdf_file/0008/76526/E89306.pdf
Currie C, Zanotti C, Morgan A, et al. editors. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe 2012: Available from: http://www.euro.who.int/_data/assets/pdf_file/0003/163857/Social-determinants-of-health-and-well-being-among-young-people.pdf
Lazzeri G, Giacchi MV, Dalmasso P, Vieno A, Nardone P, Lamberti A, Spinelli A, Cavallo F and the Italian HBSC 2010 group: The methodology of the Italian HBSC 2010 study (Health Behaviour in School-aged Children). Ann Ig 2013; 25(3): 225-33.
Binkin N, Fontana G, Lamberti A, Cattaneo C, Baglio G, Perra A, Spinelli A. A national survey of the prevalence of childhood overweight and obesity in Italy. Obes Rev 2010; 11(1): 2-10. http://dx.doi.org/10.1111/j.1467-789X.2009.00650.x
French SA. Pricing Effects on Food Choices. J Nutr 2003; 133: 841S-843S.
Mytton OT, Clarke D, Rayner M. Taxing unhealthy food and drinks to improve health. BMJ 2012; 15: 344.
Vereecken CA, De Henauw S, Maes L. Adolescents’ food habits: results of the Health Behaviour in School-aged Children survey. Br J Nutr 2005; 94: 423-31. http://dx.doi.org/10.1079/BJN20051513
Evans CE, Christian MS, Cleghorn CL, Greenwood DC, Cade JE. Systematic review and meta-analysis of school-based interventions to improve daily fruit and vegetable intake in children aged 5 to 12 y. Am J Clin Nutr 2012; 96(4): 889-901. http://dx.doi.org/10.3945/ajcn.111.030270
Callaghan C, Mandich G, He M. Healthier snacks in school vending machines: a pilot project in four Ontario high schools. Can J Diet Pract Res 2010; 71(4): 186-91. http://dx.doi.org/10.3148/71.4.2010.186
Ciliska D Miles E, O’brien MA, Turl C, Tomasik HH, Donovan Ursula, et al. Effectiveness of community-based interventions to increase fruit and vegetable consumption. J Nutr Educ 2000; 32(6): 341-52. http://dx.doi.org/10.1016/S0022-3182(00)70594-2
Downloads
Published
How to Cite
Issue
Section
License
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .