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BACKGROUND: Although dietary guidelines recommend that vegetables and fruits make up half the diet, it is unclear whether serving vegetables and fruits in larger portions will have sustained effects on children's intake over multiple days. OBJECTIVES: This study tested the effects on children's intake of 2 strategies for increasing the proportion of vegetables and fruits: either adding or substituting extra portions as side dishes at meals and snacks over 5 d. METHODS: In a cluster-randomized crossover design with 3 periods, we provided all meals and snacks for 5 d to 53 children aged 3–5 y in classrooms in their childcare centers. In the Control condition, we served typical portions for all food groups. In the Addition condition we increased portions of low-energy-dense vegetables and fruits by 50%, and in the Substitution condition we increased portions of vegetables and fruits by 50% and also reduced portions of other foods by an equivalent weight. RESULTS: For vegetables, the Addition strategy increased daily intake compared with Control by 24% (mean ± SEM = 12 ± 3 g/d; P = 0.0002), and the Substitution strategy increased intake compared with Control by 41% (22 ± 3 g/d; P < 0.0001). For fruits, consumption increased by similar amounts: Addition by 33% (60 ± 6 g/d) and Substitution by 38% (69 ± 8 g/d; both P < 0.0001). Both strategies increased vegetable and fruit intakes compared with Control across all 5 days (all P < 0.004), although the increase in fruit consumption with Addition declined over time (P < 0.0001). Daily energy intake compared with Control increased by 5% with Addition (57 ± 17 kcal; P = 0.001) but decreased by 6% with Substitution (−64 ± 21 kcal; P = 0.004). CONCLUSIONS: Both the Addition and Substitution strategies promoted increases in vegetable and fruit intake over 5 d in preschool children. When excess energy intake is a concern, substituting vegetables and fruits for other foods is a better option than simply serving more. This trial was registered at http://www.clinicaltrials.gov as NCT03242863 (https://clinicaltrials.gov/ct2/show/NCT03242863), where the protocol is available.

RATIONALE Extensive interdependencies exist between dietary intake, metabolic dysregulation, and asthma; however, the dietary pattern in adults with asthma remains unknown. OBJECTIVES To evaluate the association between dietary patterns and asthma ER visits and explore the effect of the interaction between race and diet on asthma. METHODS Using NHANES data, we compared dietary patterns between adults with asthma with and without asthma-related emergency room (ER) visits in the previous year, and between subjects of different races. The 2015 Healthy Eating Index (HEI-2015) was used to assess alignment between dietary patterns and the 2015-2020 Dietary Guideline for Americans. RESULTS Among 1681 individuals included in the study, 193 reported asthma-related ER visit. Patients with asthma had low fruit and vegetable intake, and a low mean (SE) HEI-2015 score [52.6 (0.53)]. Individuals with asthma-related ER visits had lower vegetable consumption compared to those without (median 0.61 vs. 0.85 cup equivalents). Furthermore, non-Hispanic Blacks (NHB) reported lower amount of vegetable (median cup equivalent 0.58 vs. 0.89) and fruit intake (0.17 vs. 0.39) and had a lower HEI-2015 score (49.9 vs. 52.9) comparing to non-Hispanic Whites. No association was discovered between dietary patterns and ER visits in multivariable analysis, or significant interactions between diet and race in predicting the need for ER visits. CONCLUSIONS Dietary patterns in adult with current asthma are frequently misaligned with current dietary guidelines. Patients with asthma-related ER visits and of NHB race had lower vegetable consumption; however, the associations disappeared in multivariable analysis. The impact of diet on asthma is not straightforward and deserves further investigation. Supplemental data for this article is available online at at www.tandfonline.com/ijas.

Background: This study aimed to explore the relationship between fruit intake, changes in fruit intake, and changes in cardiometabolic factors in people with obesity. Methods: A total of 21,270 subjects (8,718 men, 12,552 women) aged 40 years and over, from the Korean-based Genome and Epidemiology Study, were followed up for an average of 4.4 years. Fruit intake was assessed using a food frequency questionnaire at baseline and the second follow-up. The beta coefficient and confidence intervals for changes in cardiometabolic risk factors according to fruit consumption were calculated using a linear regression model. Results: In men, the abdominal circumference decreased with changes in fruit intake (P=0.029). Fruit intake and increased fruit intake in men were associated with a lower systolic blood pressure (P=0.012 and P=0.02, respectively) and lower triglyceride levels (P=0.002 and P

Objective Characterize vegetable and fruit (VF) intake in a Yup'ik community using self-reported intake and skin carotenoid status (SCS) and evaluate the relationship between SCS and fish intake. Methods Self-reported VF intake was measured using the 24-hour recall, SCS was measured by reflection spectroscopy via the Veggie Meter (Longevity Link Corporation), and fish intake was estimated by the nitrogen isotope ratio (NIR) for 80 participants in a remote community in Southwestern Alaska. Bivariate correlations were used to assess the relationship between self-reported VF intake, SCS, and NIR. Results Intake of all VF subgroups was low. The SCS was higher for males (262.7 vs 185.3; P = 0.002) and participants consuming more than 1 VF serving (232.5 vs 183.0; P = 0.02). It was not associated with the NIR. Conclusions and Implications Increasing VF intake is a way to improve diet in Yup'ik communities and the Veggie Meter is a simple and noninvasive tool to facilitate surveillance efforts.

The COVID-19 pandemic has shaken the globe and remains a threat to the food and nutrition security of vulnerable communities due to the disruptions of the food system. This study assessed the impact of COVID-19 on food and nutrition security at the household level in eight Caribbean countries. The findings revealed that 16% of households reported that their diet was suboptimal during the crisis; among the households severely affected, rice and egg consumption increased whereas the utilization of meats, fish, chicken, vegetables, and fruit intake declined; 40% of households experienced some form of hunger and 42% of them reported that they were moderately to severely affected. As countries aim to recover and regain stability, households remain at risk and the situation on the ground may worsen and therefore the findings of this study may be modest. As such, food security should be an integral part of the policy framework to address immediate needs and the imperatives for long-term resilience.

We aimed to describe associations between diet quality in adolescence and adulthood and knee symptoms in adulthood. Two hundred seventy-five participants had adolescent diet measurements, 399 had adult diet measurements and 240 had diet measurements in both time points. Diet quality was assessed by Dietary Guidelines Index (DGI), reflecting adherence to Australian Dietary Guidelines. Knee symptoms were collected using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were analysed using zero-inflated negative binomial regressions. The overall adolescent DGI was not associated with adult knee symptoms, although lower intake of discretionary foods (e.g. cream, alcohol, bacon and cake) in adolescence was associated with lower pain (mean ratio (MR) 0·96) and dysfunction (MR 0·94). The overall adult DGI was not associated with knee symptoms; however, limiting saturated fat was associated with lower WOMAC (Pain: MR 0·93; stiffness: MR 0·93; dysfunction: MR 0·91), drinking water was associated with lower stiffness (MR 0·90) and fruit intake was associated with lower dysfunction (MR 0·90). Higher DGI for dairy products in adulthood was associated with higher WOMAC (Pain: MR 1·07; stiffness: MR 1·13; dysfunction: MR 1·11). Additionally, the score increases from adolescence to adulthood were not associated with adult knee symptoms, except for associations between score increase in limiting saturated fat and lower stiffness (MR 0·89) and between score increase in fruit intake and lower dysfunction (MR 0·92). In conclusion, the overall diet quality in adolescence and adulthood was not associated with knee symptoms in adulthood. However, some diet components may affect later knee symptoms.

Objectives:Fruit intake may influence gestational diabetes mellitus (GDM) risk. However, prospective evidence remains controversial and limited. The current study aimed to investigate whether total fruit and specific fruit intake influence GDM risk.Design:A prospective cohort study was conducted. Dietary information was collected by a 3-d 24-h dietary recall. All participants underwent a standard 75-g oral glucose tolerance test at 24–28 gestational weeks. Log-binomial models were used to estimate the association between fruit intake and GDM risk, and the results are presented as relative risks (RR) and 95 % CI.Setting:Southwest China.Participants:Totally, 1453 healthy pregnant women in 2017.Results:Total fruit intake was not associated with lower GDM risk (RR of 1·03 (95 % CI 0·83, 1·27) (Ptrend = 0·789)). The RR of GDM risk was 0·73 for the highest anthocyanin-rich fruit intake quartile compared with the lowest quartile (95 % CI 0·56, 0·93; Ptrend = 0·015). A higher grape intake had a linear inverse association with GDM risk (Q4 v. Q1: RR = 0·65; 95 % CI 0·43, 0·98; Ptrend = 0·044), and after further adjustment for anthocyanin intake, the inverse association tended to be non-linear (Q4 v. Q1: RR = 0·65; 95 % CI 0·44, 0·98; Ptrend = 0·079). However, we did not find an association between glycaemic index-grouped fruit, glycaemic load-grouped fruit or other fruit subtype intake and GDM risk.Conclusions:In conclusion, specific fruit intake (particularly anthocyanin-rich fruit and grapes) but not total fruit intake was inversely associated with GDM risk.

Supa Pengpid,1,2 Karl Peltzer3,4 1ASEAN Institute for Health Development, Mahidol University, Salaya, Nakhon Pathom, Thailand; 2Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa; 3Department of Psychology, University of the Free State, Bloemfontein, South Africa; 4Department of Psychology, College of Medical and Health Science, Asia University, Taichung, TaiwanCorrespondence: Karl PeltzerDepartment of Psychology, University of the Free State, PO Box 339 (40), Bloemfontein, 9300, South AfricaEmail kfpeltzer@gmail.comBackground: This study aimed to estimate the trends of 20 health risk behaviours among adolescents in Morocco.Methods: Cross-sectional data from 13,109 adolescents (14 years median age) that took part in three waves (2006, 2010, and 2016) of the “Morocco Global School-Based Student Health Survey (GSHS)” were analysed.Results: Among both boys and girls, five health risk behaviours (being physically attacked, annual injury, passive smoking, zero days walking or biking to school, and poor hand hygiene after toilet use) significantly declined over time, as well as among boys the involvement in physical fighting. Inadequate fruit intake and current tobacco use increased among both boys and girls over time, and among girls bullying victimization and among boys poor hand hygiene prior to eating increased over time.Conclusion: More health risk behaviours decreased than increased in this study of three cross-sectional surveys over a period of 10 years. Additional school health promotion is needed.Keywords: tobacco use, sedentary behaviour, nutrition, injury, psychological health, hygiene behaviour, protective indicators, interpersonal violence

Worldwide, adherence to national guidelines for physical activity (PA), and fruit and vegetable consumption is recommended to promote health and reduce the risk for (chronic) disease. This study reports on the effectiveness of various social-cognitive interventions to improve adherence to guidelines and the revealed adherence predictors. Participants (n = 1,629), aged 45–70 years, randomly selected and recruited in 2005–2006 from 23 Dutch general practices, were randomized (centralized stratified allocation) to four groups to receive a 12-month lifestyle intervention targeting guideline adherence for PA and fruit and vegetable consumption. Study groups received either four computer-tailored print communication (TPC) letters (n = 405), four telephone motivational interviewing (TMI) sessions (n = 407), a combined intervention (two TPC letters and two TMI sessions, n = 408), or no intervention (control group, n = 409). After the baseline assessment, all parties were aware of the treatment groups. Outcomes were measured with self-report postal questionnaires at baseline, 25, 47 and 73 weeks. For PA, all three interventions were associated with better guideline adherence than no intervention. Odds ratios for TPC, TMI and the combined intervention were 1.82 (95% CI 1.31; 2.54), 1.57 (95% CI 1.13; 2.18), and 2.08 (95% CI 1.50; 2.88), respectively. No pedometer effects were found. For fruit and vegetable consumption, TPC seemed superior to those in the other groups. Odd ratio for fruit and vegetable consumption were 1.78 (95% CI 1.32; 2.41) and 1.73 (95% CI 1.28; 2.33), respectively. For each behaviour, adherence was predicted by self-efficacy expectations, habit strength and stages of change, whereas sex, awareness and the number of action plans predicted guideline adherence for fruit and vegetable intake. The season predicted the guideline adherence for PA and fruit consumption. The odds ratios revealed were equivalent to modest effects sizes, although they were larger than those reported in systematic reviews. This study indicated that less resource intensive interventions might have the potential for a large public health impact when widely implemented. The strengths of this study were the participation of lower educated adults and evaluation of maintenance effects. (Trial NL1035, 2007-09-06).

Fruit, but not fruit juice, intake is inversely associated with type 2 diabetes mellitus (T2DM). However, questions remain about the mechanisms by which fruits may confer protection.The aims of this work were to examine associations between intake of fruit types and 1) measures of glucose tolerance and insulin sensitivity and 2) diabetes at follow-up.Among participants of the Australian Diabetes, Obesity and Lifestyle Study, fruit and fruit juice intake was assessed by food frequency questionnaire at baseline. Associations between fruit and fruit juice intake and 1) fasting plasma glucose, 2-hour postload plasma glucose, updated homeostasis model assessment of insulin resistance of β-cell function (HOMA2-%β), HOMA2 of insulin sensitivity (HOMA2-%S), and fasting insulin levels at baseline and 2) the presence of diabetes at follow-up (5 and 12 years) were assessed using restricted cubic splines in logistic and linear regression models.This population of 7675 Australians (45% males) had a mean ± SD age of 54 ± 12 years at baseline. Total fruit intake was inversely associated with serum insulin and HOMA2-%β, and positively associated with HOMA2-%S at baseline. Compared to participants with the lowest intakes (quartile 1), participants with moderate total fruit intakes (quartile 3) had 36% lower odds of having diabetes at 5 years (odds ratio, 0.64; 95% CI, 0.44-0.92), after adjusting for dietary and lifestyle confounders. Associations with 12-year outcomes were not statistically significant.A healthy diet including whole fruits, but not fruit juice, may play a role in mitigating T2DM risk.

Purpose Whether the association between fruit and type 2 diabetes (T2D) is modified by the genetic predisposition of T2D was yet elucidated. The current study is meant to examine the gene–dietary fruit intake interactions in the risk of T2D and related glycemic traits. Methods We performed a cross-sectional study in 11,657 participants aged ≥ 40 years from a community-based population in Shanghai, China. Fruit intake information was collected by a validated food frequency questionnaire by asking the frequency of consumption of typical food items over the previous 12 months. T2D-genetic risk score (GRS) was constructed by 34 well established T2D common variants in East Asians. The risk of T2D, fasting, 2 h-postprandial plasma glucose, and glycated hemoglobin A1c associated with T2D-GRS and each individual single nucleotide polymorphisms (SNPs) were tested. Results The risk of T2D associated with each 1-point of T2D-GRS was gradually decreased from the lower fruit intake level ( 3 times/week) [the corresponding ORs and 95% CIs were 1.08 (1.05–1.10) and 1.07 (1.05–1.08); P for interaction = 0.04]. Analyses for associations with fasting, 2 h-postprandial plasma glucose and glycated hemoglobin A1c demonstrated consistent tendencies (all P for interaction ≤ 0.03). The inverse associations of fruit intake with risk of T2D and glucose traits were more prominent in the higher T2D-GRS tertile. Conclusions Fruit intakes interact with the genetic predisposition of T2D on the risk of diabetes and related glucose metabolic traits. Fruit intake alleviates the association between genetic predisposition of T2D and the risk of diabetes; the association of fruit intake with a lower risk of diabetes was more prominent in population with a stronger genetic predisposition of T2D.

Objective:Evaluate associations between orange juice (OJ) consumption and anthropometric parameters.Design:Prospective cohort study assessing the association between OJ intake and changes in BMI and height-for-ageZ-score (HAZ) using mixed linear regression.Setting:2004–2008, USA.Participants:Children from the Growing Up Today Study II (n7301), aged 9–16 years at enrollment.Results:OJ consumption was positively associated with 2-year change in HAZ in girls (mean (se)): 0·03 (0·01) for non-consumers, 0·03 (0·02) for 1–3 glasses/month, 0·06 (0·01) for 1–6 glasses/week and 0·09 (0·02) for ≥1 glass/d after full adjustment (Ptrend= 0·02). However, OJ consumption was not associated with 2-year change in BMI percentile (kg/m2, mean (se)): –0·44 (0·36) for non-consumers, 0·20 (0·41) for 1–3 glasses/month, –0·04 (0·34) for 1–6 glasses/week and –0·77 (0·62) for ≥1 glass/d in girls,Ptrend= 0·81; –0·94 (0·53) for non-consumers, –1·68 (0·52) for 1–3 glasses/month, –0·81 (0·38) for 1–6 glasses per week and –1·12 (0·61) for ≥1 glass/d in boys,Ptrend= 0·49.Conclusion:OJ consumption was favourably associated with height growth but unrelated to excess weight gain. OJ may be a useful alternative to whole fruit in the event that whole fruit intake is insufficient.

Objective:To examine core and discretionary food and beverage intake at eating occasions, and to explore the variation in consumption by age and gender in Australian adults and children.Design:The study utilised one 24-h dietary recall with self-reported eating occasions from a nationally representative sample of Australians. Average servings of each food group for age and gender subpopulations were compared with the Australian Dietary Guidelines. The percentage contribution of each eating occasion to total daily food group intake and typical composition of eating occasions were described. Frequently consumed discretionary foods were reported for eating occasions by age and gender.Setting:2011–2012 Australian National Nutrition and Physical Activity Survey.Participants:12 153 Australian people aged 2 years and above.Results:Grains were consumed in equal proportions throughout the day across all age and gender subgroups, while remaining core food groups were unequally distributed, featuring more prominently at specific eating occasions. Children consumed two-thirds of their fruit intake as snacks, and up to three quarters of adults’ vegetable and meat intake was consumed at dinner. Children consumed more of their discretionary intake at mid-meals, while adults consumed a greater proportion as part of a main meal.Conclusions:The present study provides a detailed understanding about when food groups are consumed, the ‘typical’ meal composition across the day, and how consumption patterns and compliance with dietary guidelines differ by age group and gender. These findings can assist in developing more specific nutrition messages which may help to achieve greater improvements in population dietary intake.

Objective This study investigated the association between fruit and vegetable intake and stomach cancer, with considering the impacts of Helicobacter pylori (H. pylori) infection and tobacco smoking. Methods A case-control study featuring 80 male incident stomach-cancer cases and 146 male controls was conducted in a general hospital in Viet Nam. A semi-quantitative food frequency and demographic lifestyle questionnaire were used; and venous blood samples were collected to determine H. pylori status by IgG ELISA. The respective associations between fruit and vegetable intake and stomach cancer were examined using unconditional logistic regression analysis with adjustments for possible cofactors. Results Fruit intake and stomach cancer showed a weak inverse association when this became non-significant after adjusting for H. pylori infection (OR = 0.50, 95%CI: 0.22-1.12, p trend = 0.094). Stratifying by H. pylori status returned a negative trend for fruit intake and stomach cancer among H. pylori-negative participants (OR = 0.21, 95%CI: 0.06-0.69, p trend = 0.010), but no significant interaction for H. pylori-positive participants (OR = 0.76, 95%CI: 0.21-2.68, p trend = 0.670). Vegetable intake and stomach cancer showed no association, regardless of H. pylori status. Compared to ever-smokers with low intake, never-smokers with high vegetable (OR = 0.25, 95% CI: 0.06-0.95) and fruit intake (OR = 0.20, 95%CI: 0.06-0.65) showed the lowest odds of stomach cancer. Conclusions Fruit, but not vegetable, intake showed a weak inverse association with stomach cancer. H. pylori infection and tobacco-smoking status may influence the protective effects of fruit and vegetable intake on stomach cancer. .

Purpose Fruits and vegetables (FVs) are a good source of substances that contributed to bone health. However, the relation of FVs consumption with inflammation and bone biomarkers is inconsistent. Thus, this paper aims to assess the association of FVs intake with inflammation and bone biomarkers in older adults. Design/methodology/approach This cross-sectional study was performed on 178 older adults in Tehran, with a mean age of 67.04. Biochemical measurements including serum osteocalcin, high sensitivity c-reactive protein, 25-hydroxyvitamin D 25(OH) D, parathormone and urine terminal telopeptide of Type I collagen (u-CTx) was done. The intake of FVs was calculated using a validated quantitative food frequency questionnaire. Findings Pearson correlation coefficients showed a positive relation between serum osteocalcin and total vegetables (r = 0.167, p = 0.026), juices group (r = 0.155, p = 0.035), starchy vegetables (r = 0.205, p = 0.006) and other vegetable group (r = 0.161, p = 0.032) even after controlling of potential confounders. Analysis of covariance showed that total vegetable were significantly associated with serum osteocalcin (p = 0.041) and PTH levels (p = 0.028). Additionally, no evidence of a significant relationship between total fruit intake and test variables was observed. However, subgroup analyses demonstrated a significant association between citrus fruits and serum 25(OH) D (p = 0.017). A significant relation between starchy vegetable and urine CTx-I was reported (p = 0.016). Moreover, other vegetable subgroup was strongly associated with serum osteocalcin (p = 0.003). Originality/value The results of this paper may provide insight for clinical interventions and also important to make policy for prevention or easing bone disorders and general inflammation related to fruit and vegetable intake.

The detrimental impact of currently disproportionate amounts of digital food advertising for processed foods high in sugar, salt, and fat (HSSF) on children's food intake and dietary health is well-documented. The potential of digital healthy food advertising to encourage healthy eating in children is much less researched. A pre-test post-test control group design was used to compare the effect of specifically designed, television-style advertisements for healthy food versus toys on 172 three-to seven-year-old children's exclusively healthy food intake (vegetable, fruit, whole-grain) in five nurseries in Germany. Within- and between-group comparisons demonstrated the effectiveness of healthy food advertising exposure to increase children's healthy food intake. Three exposures to a 1-min-advertisement for healthy food were sufficient to increase children's healthy food intake by as much as three portions. Children in the control condition ate less healthy foods following viewing of a control advertisement (a matched toy advertisement). We concluded that digital healthy food advertising is likely to increase children's healthy food intake sufficiently to help children meet daily recommended amounts of vegetables, fruit, or whole-grain bread, and that this encouragement may be required as decreases in healthy food intake were found when healthy foods were merely available.

Background Biological markers of vegetable and fruit (VF) intake are needed both for nutrition surveillance and for the evaluation of nutrition interventions. Optically assessed skin carotenoid status (SCS) has been proposed as a marker of intake but there are few published validity studies to date. Therefore, the objective of the study was to examine the concurrent validity of multiple methods of assessing VF intake cross-sectionally and seasonally over one year and to discuss the relative merits and limitations of each method. Methods Fifty-two 40–60 y old women completed a 1-year longitudinal study that included 1) SCS assessment using resonance Raman spectroscopy (RRS) and using pressure-mediated reflection spectroscopy (RS) at 12 timepoints, 2) thirty-six 24-h recalls using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24; total 1866 recalls), and 3) plasma carotenoid concentrations measured every 3 months. Pearson correlation coefficients and mixed linear models were used to estimate pairwise correlations between RRS, RS, ASA24, and plasma carotenoids. Results RS and RRS were strongly correlated at baseline and over the year (r = 0.86 and 0.76; respectively, P r = 0.70) and moderately across the year (r = 0.65), as was RRS (r = 0.77 and 0.69, respectively, all P r = 0.33; P = 0.016), but not with RS or plasma carotenoids. Across the year, self-reported VF intake was weakly correlated with both RS (r = 0.37; P = 0.008), RRS (r = 0.37; P = 0.007), and with plasma carotenoids (r = 0.36; P Conclusions SCS as measured by RS and RRS is moderately to strongly correlated with plasma carotenoid concentrations both cross-sectionally and longitudinally, indicating that it can be a powerful tool to assess carotenoid-rich VF intake in populations. Clinical trial registry This trial was registered at ClinicalTrials.gov as NCT01674296.

Glycosylated haemoglobin (HbA1c) is a form of haemoglobin that is measured primarily to identify the average plasma blood glucose concentration prolonged periods previous 120 days. Cardiologist used to treat patients generally when glucose level is over 1.26g/l. Unfortunately, Haemoglobin A1c was seldom controlled. The objective of this study was to detect persons with type 2 diabetes risks by the correlation between HbA1c levels and random glucose one and propose a good management by lifestyles. Methods: This descriptive study included 216 patients selected randomly with cardiovascular complications and ocular diseases but none diabetes diagnosed. Glycaemia and HbA1c measurement were done. Results: All the patients were not diabetes diagnosed. There was a low correlation between the blood glucose levels and the glycated haemoglobin r=0.2761). Hypocaloric diet applied to type 2 diabetes management decreased glycaemia and Haemoglobin Hba1c. The decreasing of Hba1c was estimated from 14% to 17% of the initial values. Conclusions: Glycaemia must not only be considered to manage cardiovascular complications at Cardiology Institute of Abidjan. The contribution of hypocaloric diet with high vegetable and one fruit intake a day lead to better type 2 diabetes management.

Mere exposure is an often-described strategy to increase children’s food familiarity, preferences, and intake. Research investigating this method in less controlled settings is scarce. This study investigates the effects of repeated fruit and vegetable (FV) exposure through the Healthy Primary School of the Future (HPSF) on children’s FV familiarity, preferences, and intake. The study had a longitudinal quasi-experimental design comparing two full HPSFs (focus: nutrition and physical activity) with two partial HPSFs (focus: physical activity) in the Netherlands. Annual measurements (child-reported questionnaires) were conducted during 2015–2019 in 833 7–12-year-old children. The study was registered on ClinicalTrials.gov (NCT02800616). After correction for baseline, full HPSFs had, on average, a lower number of unfamiliar vegetable items after one (effect size (ES) = −0.28) and three years (ES = −0.35) and a higher number of disliked vegetable items after one year (ES = 0.24) than partial HPSFs. Unfavorable intervention effects were observed for fruit intake after one (odds ratio (OR) = 0.609) and four years (OR = 0.451). Repeated FV exposure had limited effects on children’s FV familiarity, preferences, and intake, likely due to insufficient taste exposure. Considering the widespread implementation of school-based mere exposure efforts, it is highly relevant to further investigate under which circumstances mere exposure effectively contributes to improvements in (determinants of) FV intake.

Objectives:Hispanic adults in the USA tend to have a disproportionate prevalence of metabolic syndrome (MetS) as compared to other races.Design:We examined whether the association between acculturation and MetS and its components are mediated by the intake of fruit in Hispanics.Setting:Data from the National Health and Nutrition Examination Surveys 2009–2016 were used in this study.Participants:A total of 2078 Hispanics aged ≥ 20 years were included in this analysis.Results:The mediating role of total fruit intake was assessed using multivariable-adjusted logistic structural equation models with the bootstrapping method by estimating indirect (IE) and direct (DE) effects from acculturation to MetS. High acculturation was associated with increased odds of MetS (adjusted OR = 1·20, 95 % CI 1·04, 1·39), central obesity (OR = 1·24, 95 % CI 1·07, 1·44) and high blood pressure (OR = 1·16, 95 % CI 1·02, 1·32) among Hispanic adults. Total fruits intake partially mediated the associations of acculturation with MetS (ORIE = 1·02, 95 % CI 1·00, 1·03) and central obesity (ORIE = 1·02, 95 % CI 1·00, 1·03), whereas fully mediated the association between acculturation and high blood pressure (ORIE = 1·03, 95 % CI 1·01, 1·06). Moreover, intake of total fruits fully mediated the acculturation–MetS association among Mexican Americans (ORIE = 1·02, 95 % CI 1·00, 1·05).Conclusions:Our findings suggested that increasing fruit consumption may reduce the impact of high acculturation on MetS development in Hispanic adults. Further studies are needed to confirm these findings.

OBJECTIVES: Community-based intervention studies that aim at developing cooking skills have increased in the scientific literature and are related to healthier food practices. We conducted this pilot study to investigate the effect of a combined curriculum of nutrition education and hands-on cooking skills on the consumption of fruits and vegetables, nutrition knowledge, and self-efficacy in families with low-income status. METHODS: This pilot intervention study was designed with a two-month follow-up. The intervention was based on a combined curriculum of nutrition education and cooking skills. The study group participated in eight weekly hands-on cooking/nutrition sessions. Pre- and post-surveys were conducted to assess changes for five primary outcome measures: 1) nutrition knowledge, 2) fruit and vegetable intake, 3) self-efficacy toward fruit and vegetables, 4) perceived benefits of fruit and vegetable consumption; and 5) perceived barriers of fruit and vegetable consumption. Paired samples t-tests were used to assess the change outcomes from baseline to post-intervention. RESULTS: A sample of 38 participants were included in the study. The mean age of the intervention group was 38 (89% female, 65.7% Hispanic). Compared to the baseline, there was an increase in nutrition knowledge score from 7.17 to 8.05 (P = 0.032) after the intervention. Participants reported higher self-efficacy (21 vs. 23.6, P = 0.013) and lower perceived barrier (19 vs. 17, P = 0.03) scores post-intervention. Fruit intake increased (1.2 vs.1.6 cups, P = 0.01) after the intervention. CONCLUSIONS: Cooking and nutrition interventions may be a feasible approach to improving attitudes and behaviors related to vegetable consumption in families with low-income status. Future studies are needed that rigorously evaluate the long-term impact on cooking skills, dietary intake, and health outcomes. FUNDING SOURCES: Health Care Foundation of Kansas City, Crosslines, Inc, and Department of Dietetics and Nutrition

Background: The Malaysian Dietary Guidelines recommended that at least two servings of fruits and three servings of vegetables be consumed daily. However, is there a relationship between daily fruit and vegetable intake and body mass index (BMI)? The aim of this study was to identify the relationship between fruit and vegetable intake and BMI among postgraduate students in the health sciences. Methodogy: A cross-sectional study was conducted at the Faculty of Health Sciences, Universiti Kebangsaan Malaysia. 44 postgraduate students from the 2019/2020 batch of health sciences took partn in this study. Respondents were asked to complete three parts of the questionnaire: socio-demographic data, anthropometric measurements, and self-administered questions. Results: The majority of respondents are female (n=44, 77.3%), and they are mainly Malay (n=22, 50.0%). The average BMI of all respondents is 23.76±4.83. This study found that majority of respondents did not meet the recommended daily fruit (n=31, 70.5%) and vegetable intake (n=23, 52.3%). Discussion: The study discovered a significant relationship (p0.05) between gender, age, BMI, waist circumference, and daily fruit intake. Moreover, neither daily fruit nor vegetable intake predicted changes in BMI. Conclusion: This study found that the consumption of fruits and vegetables among postgraduate students was unsatisfactory and lower than recommended guidelines.

Background: A single-item self-rated diet measure (SRD) may provide a quick, low-burden screener. However, assessment of its validity is limited. This study aimed to evaluate the association of an SRD construct with measured diet quality among adults in Puerto Rico (PR).Methodology: Participants (30–75 years old; n = 247) of the PR Assessment of Diet, Lifestyle, and Diseases (PRADLAD) cross-sectional study reported SRD with a single question (“How would you describe your current dietary habits and diet quality?”) with a five-point scale: excellent to poor. More complete diet quality was calculated using the Alternate Healthy Eating Index-2010 (AHEI), with 11 food and nutrient components assessed by the food frequency questionnaire. Multivariable general linear models were used to test associations between SRD with AHEI and its components. Associations were also tested between recall SRD in youth and current AHEI.Results: Most participants (35.2%) self-rated diet as “good,” 13.8% as “excellent,” and 4.1% as “poor,” with the remainder split between middle scale points. SRD was not significantly associated with AHEI, although participants with “excellent” vs. “poor” SRD had marginally higher AHEI (P = 0.07). SRD was significantly associated with higher fruit intake (P = 0.02) and marginally associated with intakes of vegetables (P = 0.07) and long-chain fatty acids (P = 0.07). Unexpectedly, AHEI was significantly higher among those reporting “poor” SRD in young adulthood (P = 0.01) or childhood (P = 0.05).Conclusions: SRD may capture current diet quality at extreme intakes. Larger studies should confirm these findings and replicate them in other underrepresented populations. Further research should clarify the inverse associations between adult AHEI and earlier reported SRD.

To examine the association of FVI and frailty in Chinese elders. A sectional study was conducted in three cities (Shanghai, Zhengzhou, and Baoji) in China from June 2017 to June 2018. A total of 5699 participants from 49 districts were included in the current study by two-stage sampling methods. Frailty was measured by a validated Chinese version of the FRAIL scale. FVI per day was measured by two single questions The sample proportion with sufficient fruit intake was 36.7%, and 44.7% reported sufficient vegetable intake. The sample proportions that were robust, pre-frail, and frail were 43.6%, 38.3%, and 18.1%, respectively. Compared with low FVI, after including covariates, the odds ratio (OR) of frailty was 0.84 (95% CI: 0.73–0.97) for moderate fruit intake and 0.81 (95% CI: 0.70–0.94) for enough fruit intake; the OR of frailty was 0.83 (95% CI: 0.68–0.91) for moderate vegetable intake and 0.77 (95% CI: 0.64–0.93) for enough vegetable intake. High FVI was negatively associated with the OR of frailty in Chinese elders. This finding implies it is important to promote FVI among adults to prevent frailty.

ObjectiveTo investigate fruit and vegetable (F&V) intakes of university students and associated demographic and lifestyle characteristics, and students’ perceptions of F&V availability and F&V intervention strategies in the university environment.DesignCross-sectional questionnaire data were collected; F&V intakes were measured using a food frequency tool. Multivariable linear regression analyses were used to analyse the associations between demographic and lifestyle characteristics and F&V intakes.SettingUniversities in the Netherlands.SubjectsUniversity students (n 717).ResultsThe majority of students did not adhere to Dutch F&V guidelines (71 % and 93 %, respectively). Fruit intake was lower among students who were male, living independently, enrolled in a technical study, not adhering to physical activity guidelines, and heavy to excessive alcohol drinkers. Vegetable intake was lower among students who were non-Dutch, living with their parents, not adhering to physical activity guidelines, and moderate and heavy to excessive alcohol drinkers. Most students perceived that their university environment offers sufficient healthy foods (60 %) and F&V (65 %), but also indicated that their F&V intakes would increase with interventions concerning affordable F&V in the university canteen (64 %) or university supermarket (60 %). Students were less disposed to indicate that weekly local farmers’ markets, vegetable parcels or a vegetable garden would increase their F&V intakes.ConclusionsDutch university students do not consume enough F&V. Future efforts that aim to promote students’ F&V intakes should consider the differences between subgroups based on demographic and lifestyle characteristics and that affordable F&V in the university environment might be an effective strategy.

Objective:To examine the frequency of shopping at different food sources and the associations between shopping at different food sources and fruit and vegetable (FV) intake among upstate New York rural residents.Design:Cross-sectional study. Descriptive statistics and linear mixed models were used.Setting:Eighty-two rural communities in upstate New York, USA.Participants:Adults (n 465; 82·3 % female, mean age 51·5 years, mean BMI 31·7 kg/m2).Results:Within one’s community, the majority of participants reported often going to supermarkets (73·1 %). Many participants sometimes or occasionally shopped at superstores (48·0 %), convenience stores (57·9 %), small grocery stores or local markets (57·2 %), farmers’ markets or FV stores (66·6 %), dollar stores (51·5 %), pharmacies (46·0 %), or farm stands or community-supported agriculture (56·8 %). Most participants had never utilized food banks or food pantries (94·0 %), community gardens (92·7 %) or home food delivery (91·9 %). While frequent visits to farmers’ markets or farm stands were associated with higher fruit intake (P < 0·001), frequent visits to food co-ops or food hubs were associated with lower fruit intake (P = 0·004). Frequent visits to convenience stores (P = 0·002) and dollar stores (P = 0·004) were associated with lower vegetable intake. When FV intakes were combined, frequent visits to farmers’ markets or farm stands (P < 0·001) were associated with higher FV intake, and frequent visits to convenience stores (P = 0·005) were associated with lower FV intake.Conclusions:Findings from the present study provide important insight for informing future food environment interventions related to helping rural residents consume adequate FV.

Background Two important components of a healthy diet are fruits and vegetables (F&V), which are essential for maintaining physical health. The aim of the present study was to assess the prevalence and correlates of F&V intake among high school adolescents in the city of Tabriz. Methods The Global School-based Student Health Survey self-administered questionnaire was used for data collection among 1517 adolescents. Results The prevalence of fruit intake was 76.1% (≥ 2 times/day) and vegetable intake 23% (≥ 3 times/day). Being at the third level of high school and having sedentary behavior, low intake of vegetables, low or lack of parental support, lack of peer support and lack of enough food at home were significantly associated with low consumption of fruit among students. Also, being overweight or obese and having low intake of fruit, low or lack of peer support, and being physically inactive were significantly associated with low intake of vegetables. Conclusion Results suggest that interventions targeting personal, interpersonal and environmental factors for increased F&V consumption should be given more priority by the public health authorities.

There are few studies on the association of main meal consumption with fruit and vegetable intake. This study aims to assess the relation between skipping main meals and fruit and vegetable intake in children and adolescents. This multi-centric cross-sectional study was conducted in 30 provinces of Iran. This study was conducted in the framework of the fifth survey of a national surveillance program entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease study (CASPIAN- V). 14,440 school students aged 7–18 years were assessed. Logistic regression analyses were used to evaluate the association between frequency of fruit and vegetable intake with skipping main meals. Overall, 14,274 students completed the study (99% participation rate). Their mean (SD) age was 12.3 (3.2) (53% were aged 6–12), 50.6% of them were boys, and 71.3% lived in urban area. In multivariate logistic regression model, statistically significant associations were found between skipping main meals and low fruits and vegetables intake. Skipping breakfast was associated with vegetables intake [OR = 1.19(95% CI 1.02–1.38)] and fruits intake [OR = 5.33(95% CI 4.46–6.37)]. Skipping lunch was associated with vegetables intake [OR = 1.61(95% CI 1.29–1.96)] and fruit intake [OR = 9.11(95% CI 6.55–12.67)]. Skipping dinner was associated with vegetables intake [OR = 1.52 (95% CI 1.15–2.01)] and fruits intake [OR = 2.21(95% CI 1.64–2.97)]. In this study, low frequency of fruit and vegetable intake was associated with skipping main meals. The results highlight the importance of promoting regular meal consumption with increase in the intake of fruit and vegetables among children and adolescents. Level V.

The healthy index is a tool for evaluation of nutrition recommendation aimed at prevention of chronic diseases. A lot of studies have been devoted to HEI of different aged groups of people but dates about Slovak population have been still missed. The goal of the study was to evaluate the Healthy Eating Index (HEI) in nutrition of adult female, determine their components in relation of parameters of anthropometry and body composition. Secondly, the research work was also aimed at the comparison of partial score HEI among groups of female with different fruit intake. Daily nutrition was evaluated by 24 hours dietary recalls. In set of female (average age 31.1 ±9.1 years) the average HEI index reached up 53.0 ±8.8 points in accord with medium degree of diet, it means dietary improvement has been highly recommended. In respect of all assayed components of index the best results achieved the variety of diet (8.8 ±1.3 points) and the worst the natrium intake (0.7 ±2.0 points). The average score for the individual components pointed to neccesary of increase in the grain intake and vegetable, on the other hand the intake of cholesterol, saturated fats and especially natrium should be decreased. The differences between groups with various intake of fruit (with recommended intake and insufficient intake) in the rest 9 components have not been proved as significant. The occurrence of risk values of body index, body fats determined by bioelectric impedance and android risk based on circumference of hips can not be considered between groups as significant. Average HEI has been in significance correlation with age (r = 0.240; p

Food parenting practices (FPPs) have an important role in shaping children’s dietary behaviors. This study aimed to investigate cross-sectional and longitudinal associations over a two-year follow-up between FPP and dietary intake and compliance with current recommendations in 6- to 11-year-old European children. A total of 2967 parent-child dyads from the Feel4Diabetes study, a randomized controlled trial of a school and community-based intervention, (50.4% girls and 93.5% mothers) were included. FPPs assessed were: (1) home food availability, (2) parental role modeling of fruit intake, (3) permissiveness, (4) using food as a reward. Children’s dietary intake was assessed through a parent-reported food frequency questionnaire. In regression analyses, the strongest cross-sectional associations were observed between home availability of 100% fruit juice and corresponding intake (β = 0.492 in girls and β = 0.506 in boys, p &lt, 0.001), and between parental role modeling of fruit intake and children’s fruit intake (β = 0.431 in girls and β = 0.448 in boys, p &lt, 0.001). In multilevel logistic regression models, results indicated that improvements in positive FPPs over time were mainly associated with higher odds of compliance with healthy food recommendations, whereas a decrease in negative FPP over time was associated with higher odds of complying with energy-dense/nutrient-poor food recommendations. Improving FPPs could be an effective way to improve children’s dietary intake.

Introduction The association of fruit and vegetables with functional dyspepsia (FD) has been less studied, especially in Middle Eastern populations. This study investigated the relationship between fruit and vegetable consumption with FD and its related symptoms among a large group of Iranian adults. Methods and materials This cross-sectional research was conducted on 3362 middle-age participants. Usual dietary intakes, including fruit and vegetable intake, during the last year were assessed using a validated 106-item dish-based food frequency questionnaire (FFQ). A modified Persian version of the Rome III questionnaire was used for assessment of FD. Results The prevalence of FD among study participants was 14.5%. After adjustment for confounders, the highest energy-adjusted tertile of fruit consumption was related to 32% lower risk of FD, compared to the lowest intake (OR = 0.68, 95% CI:0.51-0.90). Fruit consumption was also significantly related to lower risk of early satiation (OR = 0.67, 95% CI:0.54-0.85) and post-prandial fullness (OR = 0.75, 95% CI:0.61-0.92). Vegetable consumption was not related to the risk of FD in all models. Men who were in the third tertile of fruit and the third tertile vegetable consumption had lower risk of FD compared to the first tertile; but, in women, just fruit consumption was related to the reduced risk of FD, after adjustment for all confounders. Conclusion We found an inverse association between fruit intake and dyspepsia symptoms. In addition, high consumption of fruit was related to lower odds of early satiation and post-prandial fullness. Higher intake of vegetables was associated with lower risk of FD, only in men.

The diet of Danish children is often not in accordance with dietary guidelines. We aimed to evaluate changes in the intake of selected foods and beverages during a multi-component school-based physical activity intervention, and to investigate if changes were modified by socioeconomic status (SES). The study included 307 children (intervention group: 184, comparison group: 123) with information on dietary intake pre- and post-intervention as well as on SES. Linear regression models were conducted to assess the effect of the intervention on changes in dietary factors. Children from the intervention group increased their intake of whole-grain bread during the intervention (group means: 6.1 g/d (95% CI: 2.2 to 10.0) vs. 0.3 g/d (95% CI: −3.1 to 3.7) in the comparison group, p = 0.04). A significant interaction between SES and group allocation was observed to change in fruit intake (p = 0.01). Among children from low SES families, only those from the comparison group decreased their fruit intake (group means: −40.0 g/d (95% CI: −56.0 to −23.9) vs. 9.3 g/d (95% CI: −16.1 to 94) in the intervention group, p = 0.006). The present study found no convincing effect of introducing a multi-component intervention on dietary intake except a small beneficial effect on whole-grain bread consumption. However, beneficial intervention effects in fruit intake were found particularly among children from low SES families.

This study aimed to examine the relationship between one&rsquo, s physical status related to non-communicable diseases (NCDs) and social isolation, and to identify lifestyle behaviors for the prevention of NCDs associated with social isolation among community-dwelling older adults in Japan. A cross-sectional study was conducted to investigate lifestyle behaviors for NCD prevention associated with social isolation in Japanese adults aged 60 years and above in a community setting. Out of 57 participants, 17.5% were not socially participative, 66.7% hardly ever, 29.8% sometimes, and 3.5% often felt loneliness. Non-social participation and loneliness were negatively related to the frequency of vegetable and fruit intake. Additionally, loneliness was positively associated with one&rsquo, s duration of smoking and current smoking habits, and negatively associated with the frequency of moderate-intensity activities, with marginal significance. Those with non-social participation or loneliness were less likely to eat a healthy diet and live a smoke-free lifestyle. The findings of this study suggest that a mutual health support system in the community and the development of community-based approaches for the prevention of NCDs among Japanese older adults are needed.

Fruits are considered healthy because of their high antioxidant, vitamin, mineral, fiber, and phytochemical contents. However, their high sugar content is a concern for glucose, lipid, and uric acid metabolism. We reviewed related articles published in the last 10 years and summarized evidence that relates fruit intake to the prevention and control of hypertension and diabetes mellitus. Clinicians should familiarize themselves with appropriate fruit intake to counsel at-risk patients on hypertension and diabetes.

Observational studies in Ethiopia have identified a positive association between hot wheat porridge consumption and oesophageal carcinoma. However, a single dietary intake cannot be a sufficient predictor of cancer among populations that have diverse dietary practices. The present study was carried out to explore the community's perspectives on the role of hot foods in the pathogenesis of oesophageal cancer in Ethiopia. Focus group discussions were conducted from May to August 2019 among purposefully selected 112 participants. Data were collected by using open-ended questions; memo writing, audio recordings and photo pictures. All tape-recorded interviews were transcribed verbatim and inductively coded using Atlas.ti Version 7.0.71 software. Finally, the analysis was performed according to the standard thematic framework analysis techniques. The finding showed that hot foods (porridge, coffee and soup) consumption patterns were perceived as the principal dietary risk of oesophageal cancer. Cooking in unventilated rooms, monotonous cereal-based foods, poor vegetable, and fruit intake, not taking milk with porridge, eating fast, swallowing large bolus of hot porridge and exposure to carcinogens in foods were regarded as predisposing dietary practices to oesophageal carcinoma. Socio-demographic, economic and cultural backgrounds were reported as the underlying risk factors associated with oesophageal cancer. There was a strong perception within the community that oesophageal cancer is linked to several but sequentially interlinked dietary and related practices. Cumulative thermal injuries from the consumptions of hot food could be the immediate dietary risk factors associated with increased risk of oesophageal cancer.

Increased intake of vegetables and fruits has been associated with reduced risk of tuberculosis infection. Vegetables and fruits exert immunoregulatory effects; however, it is not clear whether vegetables and fruits have an adjuvant treatment effect on tuberculosis. Between 2009 and 2013, a hospital-based cohort study was conducted in Linyi, Shandong Province, China. Treatment outcome was ascertained by sputum smear and chest computerised tomography, and dietary intake was assessed by a semi-quantitative FFQ. The dietary questionnaire was conducted at the end of month 2 of treatment initiation. Participants recalled their dietary intake of the previous 2 months. A total of 2309 patients were enrolled in this study. After 6 months of treatment, 2099 patients were successfully treated and 210 were uncured. In multivariate models, higher intake of total vegetables and fruits (OR 0·70; 95 % CI 0·49, 0·99), total vegetables (OR 0·68; 95 % CI 0·48, 0·97), dark-coloured vegetables (OR 0·61; 95 % CI 0·43, 0·86) and light-coloured vegetables (OR 0·67; 95 % CI 0·48, 0·95) were associated with reduced failure rate of tuberculosis treatment. No association was found between total fruit intake and reduced failure rate of tuberculosis treatment (OR 0·98; 95 % CI 0·70, 1·37). High intake of total vegetables and fruits, especially vegetables, is associated with lower risk of failure of tuberculosis treatment in pulmonary tuberculosis patients. The results provide important information for dietary guidelines during tuberculosis treatment.

In this paper, we hypothesized that the gap between estimated cardiovascular age (eCV-age) and chronological age had a gender-wise correlation with the Korean Healthy Eating Index (KHEI). We tested the hypothesis in adults aged 20&ndash, 64 years old using the KNHANES 2013&ndash, 2017 data. eCV-age was estimated based on the designated risk factors of cardiovascular disease (CVD) and age-gap was calculated by subtracting the eCV-age from the chronological age in 12,317 adults. Adjusted odds ratios for the age-gap were measured according to KHEI, while controlling for covariates to influence risk factors of CVD, using logistic regression analysis with the complex sample survey design. Age-gaps were divided into four groups: &gt, 4 (High), 0&ndash, 4 (Moderate), &minus, 4&ndash, 0 (Mild), and &lt, &minus, 4 years (Low). The higher the age-gap, the lower the cardiovascular risk. Persons included in the following categories belonged to the high and moderate age-gap groups: young (&lt, 40 years), women, urban living, better than high school education, higher income, lean, mild drinking, and exercising regularly. KHEI scores were overall higher in women than men (p &lt, 0.01). Having breakfast and saturated fat intake were primary factors that influenced the age-gap for men, whereas fresh fruit intake and carbohydrate intake influenced the age-gap in women. The KHEI scores positively correlated with nutrient intake, especially fiber and vitamin C intake in women (p &lt, 0.05). Participants with high KHEI scores increased their chances of belonging to the high age-gap group by 2.16 times for men and 2.10 for women after adjusting for covariates of sex, age, and residence. However, after adding the covariates of education, income, marriage, and obesity, in conjunction with smoking, alcohol, and regular exercise, this reduced to 1.34 times in women. In conclusion, both genders had a positive correlation between age-gap and overall KHEI scores.

AIM To investigate associations between changes in vegetable and fruit (V&F) intakes and anthropometric indices (weight, BMI, % body fat, waist circumference), including differences by sex, during a dietary weight-loss intervention. METHODS Adults (18-45 years) with overweight/obesity (BMI 25-35 kg/m2 ) entered a 10-week pre-post study, receiving individualised consults with an Accredited Practising Dietitian targeting increased V&F intakes. Dietary intake was assessed using 24-hour recalls and food frequency questionnaires. Linear mixed models were used to examine how much of the changes in anthropometric indices were explained by changes in V&F intakes. Sex differences were assessed by Wilcoxon rank sum tests. RESULTS Of the 43 participants enrolled, 34 completed the study (53% female). Significant differences in energy intake and anthropometric indices were observed between males and females at baseline. After 10 weeks, females significantly reduced their weight (-2.9%, P

Background and Aims Constipation is a multifactorial gastrointestinal disorder commonly found in hemodialysis (HD) patients. In this multi-centre cross-sectional study, we aimed to evaluate the prevalence and factors associated with constipation, including the frequency of dietary fiber sources intake. Method Prevalent HD patients from four dialysis clinics in Southern Brazil were invited to participate (at least 80% of eligible patients from each clinic). Patients were interviewed by the researchers and answered a questionnaire that comprised ROMA III criteria questions to assess constipation status, use of medications and life habits. A food frequency questionnaire (FFQ) with the main dietary fiber sources (fruits, vegetables, legumes, whole grains cereals and seeds) was applied with seven frequency possibilities (from never to more than twice a day). To estimate the weekly frequency of intake, answers were transformed into a score. Every score point corresponded to one time per week (ex.: score 7 = seven times per week). Demographical and laboratory data were obtained from medical records. Univariate analysis was used to compare participants according to constipation status and variables with P Results 305 HD patients were included (male: 51%; age: 52.2 ± 14.7 years old; HD vintage: 46 (19 – 82) months). Ninety-three participants had constipation (30.5%). Median (interquartile) FFQ scores were: fruits: 6 (2-14); vegetables: 6 (3-10); legumes: 3 (1-7); whole-grain: 0 (0-1) and seeds: 0 (0-0). In univariate analysis, participants with constipation were significantly older (55.1 ± 14.8 versus 51.0 ± 14.5 years old; P=0.02), had lower literacy (5 (5-11) versus 8 (4-13) years at school; P=0.007), higher prevalence of diabetes (41 versus 23%; P=0.002) and lower total beverage intake (15 (12-20) versus 17 (12-24) ml/kg/day; P=0.04). The logistic regression analysis model also included body mass index; wheelchair need; sedentarism; fruits score and seeds score (all with P Conclusion Almost one-third of participants had constipation, and usual intake of fiber food sources was low. The independent determinants of constipation were diabetes and a lower frequency of fruit intake. Nutritional counselling to increase fiber intake sources can potentially decrease the prevalence of constipation of this population.

Background: Childhood blood pressure (BP) is known to be associated with weight status. However, the association between BP and adiposity and lifestyle behaviors in normal-weight (NW) versus overweight/obese (OW/OB) schoolchildren should be further explored. Objective: To determine the association between schoolchildren’s BP with adiposity and lifestyle behaviors. Methods: Data for age, sex, BMI, waist circumference (WC), and BP were recorded. OW/OB was defined as a BMI > 85%ile or > 95%ile respectively. A 5-level index that ranked participants’ daily consumption of vegetables or fruits, milk, sweetened beverages, and TV viewing were performed. Results: Schoolchildren (n = 1249, 554M) aged 9.4 ± 2.1 years from 9 elementary schools in five states of Argentina were examined. The prevalence of OW was 265 (21.2%) o and OB 265 (21.2%). All came from a low socio-economic background; 62% of the parents had an elementary school education or less. Children were divided into NW and OW/OB. Systolic BP was significantly associated with age (r=0.18), WC (r=0.17), and BMI (r=0.34) in NW children. However, systolic BP was significantly associated with age (r=0.37), WC (r=0.42), WC/height (r=0.24), BMI (r=0.19), low fruit intake (r=0.14), and TV watching (r=0.12) in OW/OB children. Diastolic BP was significantly associated with age (r=0.40), WC (r=0.37), WC/height (r=0.18), and BMI (r=0.33) in OW/OB children. Multiple linear regression analyses showed that systolic BP was only significantly associated with age in NW children (R2=0.02); but with age, WC, and TV watching (R2=0.22) in OW/OB children. In addition, diastolic BP was significantly associated with age and WC (R2=0.17) in OW/OB children but no association was found in NW children. Conclusion: These results suggest that BP levels in schoolchildren were associated with adiposity and unhealthy lifestyle behaviors. Future longitudinal studies should be performed to confirm these findings. Disclosure V. Hirschler: None. C. Molinari: None. S. Lapertosa: None. C. Garcia: None.

BackgroundThe role of fruit juice in pediatric dietary guidelines continues to be controversial, particularly with respect to concerns about unhealthy dietary habits and the potential promotion of excessive weight gain. The objective of the current study was to determine the association between preschool fruit juice consumption and the following outcomes during childhood and adolescence: whole and total fruit intake, diet quality, likelihood of meeting current dietary recommendations, and BMI change.MethodsThe data were previously collected from 100 children enrolled in the Framingham Children’s Study at 3–6 years of age and subsequently followed for 10 years. Dietary data were collected annually using multiple sets of 3-day diet records. Compliance with dietary recommendations was estimated based on2015–2020 Dietary Guidelines for Americansand diet quality was measured using the associated Healthy Eating Index (HEI). Mixed linear and logistic regression models were used for statistical analyses.ResultsPreschool children (3–6 years) who drank ≥1.0 (vs. p p p = 0.0044). Preschoolers consuming Dietary Guidelinesfor whole fruit intake during adolescence (p ConclusionThese data suggest that preschool consumption of 100% fruit juice is associated with beneficial effects on whole fruit intake and diet quality without having any adverse effect on BMI during childhood and into middle adolescence.

The objective of the NEKST (Nutrition Environmental Kibbutzim Study), a nonrandomized interventional study, was to evaluate the effect of an integrated intervention program on participants&rsquo, lunch quality and diversity in two communal dining rooms (intervention n = 58 vs. control n = 54). The intervention included recipe modification, environmental changes, and an education program. The outcomes included simple healthy meal index (SHMI), lunch quality (LQS), and diversity scores (LDS) calculated based on photographs of lunch trays. A nutrition questionnaire assessed the changes in fruit and vegetable intake at baseline and 3 months following the intervention. The mean SHMI, LQS, and LDS increased in the intervention group (0.51, p &lt, 0.001, 0.27, p = 0.045, 0.95, p &lt, 0.001, respectively) but not in the control group (p = 0.865, p = 0.339, p = 0.354, respectively). Multivariable linear models demonstrate an increase in the SHMI (&beta, = 0.26, 95% CI [0.12&ndash, 0.76], p = 0.015), LQS (&beta, = 0.23, 95% CI [0.06&ndash, 0.83], p = 0.024), and LDS (&beta, = 0.34, 95% CI [0.41&ndash, 1.39], p &lt, 0.001) of the participants in the intervention group. More participants in the intervention group raised their daily fruit intake compared with the control. We conclude that this integrated intervention program was effective in improving lunch healthy meal index, quality, and diversity in a communal dining room, with a modest halo effect of the intervention throughout the day.

Vegetable and fruit consumption in childhood remains below recommendations in many countries. As the intake of fruit and/or vegetables during childhood in a few studies was associated with breastfeeding, it may be suggested as a serious interfering factor while analyzing the association between breastfeeding and its long-term health effects. Thus, it may be important for creation and implementation of effective public health programs. The aim of this study was to evaluate the association between breastfeeding and consumption of fruit or vegetables in later childhood. The study was conducted within the Project &ldquo, ABC of Healthy Eating&mdash, ABC of Kids and Parents&rdquo, among a representative sample of 703 pairs of mothers and children aged 7&ndash, 12 years in Poland. A systematic purposive-quota selection according to gender, age, place of residence, and region of Poland was applied. The study was conducted by interviewers in the respondents&rsquo, homes in 2017. Logistic regression analysis was conducted, and models adjusted for children&rsquo, s age, BMI centile and gender, maternal education, employment status, and economic situation, as well as for EU&ndash, 28 average Gross Domestic Product (GDP) region. Almost 86% of children were ever breastfed. Vegetables for breakfast, second breakfast, dinner, supper, and between meals were consumed by 23.9%, 18.6%, 47.4%, 26.7%, and 4.0% of children, whereas fruit was consumed by 13.9%, 46.1%, 7.7%, 12.9%, and 59.7% of children, respectively. Breastfeeding for a period of 4&ndash, 6 months increased the chance of vegetable consumption for breakfast in the whole group (aOR 3.80, 95%CI 1.90&ndash, 7.59, p &le, 0.001) and particularly in girls (aOR 4.60, 95%CI 1.43&ndash, 14.75, p &le, 0.01) when compared to boys (aOR 3.17, 95%CI 1.32&ndash, 7.63, p &le, 0.01). Longer duration of breastfeeding (over 12 months) increased the chance of vegetable consumption for dinner in the total group (aOR 2.36, 95%CI 1.30&ndash, 4.26, p &le, 0.01) and particularly in girls (aOR 3.04, 95%CI 1.24&ndash, 7.46, p &le, 0.01) when compared to boys (aOR 2.20, 95%CI 1.01&ndash, 4.95, p &le, 0.05). We showed a positive association between breastfeeding and vegetable consumption for breakfast and dinner among children aged 7&ndash, 12 years. These associations were gender-specific (stronger among girls) and were not diminished by socio-demographic factors.

Background: In the United States, only about 15% of individuals meet daily fruit intake recommendations of 2 cups per day and only 10% meet the vegetable intake recommendations of 3 cups per day. African American women are a high-risk group. In this study, a fourth-generation multi-theory model (MTM) of health behavior change was used to design and evaluate a Sisters Adding Fruits and Vegetables for Optimal Results (SAVOR) intervention for AA women. Methods: The study utilized a randomized controlled trial (RCT) with measurements taken at pretest, posttest (after the three-week intervention) and follow-up (at the end of eight weeks). SAVOR (n=26) was compared to an equivalent knowledge-based intervention (n=28). Process evaluation was done for program fidelity and satisfaction. A validated 38-item self-reported questionnaire was used to measure changes in MTM constructs and past 24-hour consumption of fruits and vegetables. Results: The SAVOR intervention resulted in improvement of mean consumption of fruits and vegetables in the experimental group from pre-test (2.78) to posttest (4.77) to recommended levels at follow-up (5.04) while in the comparison group they remained at around 3 (PPConclusion: The SAVOR intervention was found to be efficacious and established the robustness of MTM. SAVOR can be replicated for future effectiveness trials.

Objective:To investigate the effects of providing free fruit and snack vegetables at a university on students’ fruit intake, snack vegetable intake and total vegetable intake.Design:Free fruit and raw snack vegetables (e.g. bite-sized tomatoes) were provided in a stand in the form of a miniature wooden house located in the central hall of the university’s main building, which students regularly pass through on their way to lectures and the cafeteria. Three interventions tested with a pre-test/post-test design were performed. In these three interventions, small changes to the appearance of the stand were made, such as placing potted plants around it. Demographic characteristics and fruit and vegetable intakes were assessed with questionnaires.Setting:A Dutch university of applied science.Participants:Intervention 1 included 124 students; Intervention 2 included ninety-two students; Intervention 3 included 237 students.Results:Longitudinal linear regression analyses showed that post-test snack vegetable intake was consistently higher compared with pre-test. In the three interventions, post-test snack vegetable intakes were between 11 and 14 g/d higher than at the pre-test, which is comparable to three bite-sized tomatoes. No differences in fruit intake or total vegetable intake were found. Subgroup analyses showed that, in all three interventions, students with the lowest pre-test fruit intake and total vegetable intake reported the largest increase in fruit intake and snack vegetable intake after the interventions.Conclusions:Providing free fruit and vegetables to students at their university might be beneficial for those with low habitual intakes.

Introduction:Since food banks have a strong influence on recipients’ diets, and seem to have difficulties in supporting healthy diets, improving the dietary quality of food parcels is important. Therefore, we aimed to assess whether improving the dietary quality of food parcels, using different strategies, can positively impact the actual dietary intake of Dutch food bank recipients.Materials and methods:This randomized cross-over controlled trial with four intervention conditions [1) Control (standard food parcel), 2) Snacks– (standard food parcel with replacement of snacks by staple foods), 3) FV + (standard food parcel plus the recommended daily amount of fruit and vegetables), 4) Snacks– + FV (standard food parcel with replacement of snacks by staple foods plus the recommended daily amount of fruit and vegetables)] included food bank recipients from three food banks. In total, 199 recipients were randomly allocated. At baseline, participants filled in a questionnaire and underwent anthropometric measurements. Dietary intake data were collected through 24-hour recalls after both intervention conditions at 4 and 8 weeks follow-up. Primary outcome was fruit and vegetable intake, secondary outcomes were dietary intakes of food groups and nutrients.Results:Multi-level linear regression analysis, using a two-level model showed a higher mean fruit intake in participants in the FV + condition than in participants in the Control condition (δ: 74 [40.3;107.6] g). Both mean fruit and mean vegetable intake were higher in participants in the Snacks– + FV + condition than in participants in the Control condition (fruit δ: 81.3 [56.5;106.2] g; vegetable: δ: 46.2 [17.5;74.9] g), as well as in the Snacks– condition (fruit: δ: 70.0 [38.8;101.1] g; vegetable δ: 62.2 [26.2; 98.2] g).Discussion:This study shows that improving the dietary content of food parcels can positively impact the dietary intake of Dutch food bank recipients. With this we can further develop effective strategies to improve dietary intake of food bank recipients.