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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.

Repeated presence of strawberries amongst produce with pesticide residues results in questionings related to the risks involved by its consumption. Deterministic and probabilistic risk assessment methods might be used depending on the available data. In the present study, both methods were used to estimate risks of pesticide intake by strawberry consumption. Strawberry samples along two years were analyzed via the multiresidue method. Results of active ingredients (a.i.) concentrations were organized and used for calculations for intake estimates. On the deterministic method, intake was calculated based on the data of a.i. concentration and consumption data coming from an online questionnaire and body weight between 5 and 70 kg. On the probabilistic method, the concentrations of a.i. and body weight of 60 kg were evaluated in two scenarios: a) consumption data from an online questionnaire or b) consumption data retrieved from Family Budget Survey of the Brazilian Institute of Geography and Statistics. In the 62 strawberry samples, 38 a.i. were quantified and in 25 samples the residue analyses were considered satisfactory and 37 had an unsatisfactory outcome. In the deterministic approach, 23% of the a.i. had a calculated intake higher than the acceptable daily intake (ADI) and risk concentrated in body weights between 5 and 30 kg. The risk is low when considering a body weight of 60 kg. All a.i. tested in the first scenario of the probabilistic method pointed towards some possibility of intake being higher than the ADI. In the second scenario, only the a.i. procymidone exceeded the ADI. RESUMO: A frequente presença do morango entre os alimentos com resíduos de agrotóxicos acima do limite máximo ou não autorizados gera uma série de questionamentos em relação aos riscos envolvidos no seu consumo. Nos processos de avaliação do riscopodemserutilizadosmétodosdeterminísticos e probabilísticosdependendo dos dados disponíveis. O objetivodestetrabalhofoiconduzirumaavaliaçãodeterminística e probabilística do risco de ingestão de agrotóxicosatravés do consumo de morangos. Para tanto, 62 amostras de morangosforamanalisadasatravés do método de multiresíduos entre osanos de 2018 e 2019. Osresultados de concentração dos ingredientesativosforamorganizados e utilizados para oscálculos de estimativa da ingestão. No métododeterminísticoaingestãofoicalculada com base nos dados de concentração dos ingredientesativos das amostras de morangos, dados de consumoprovenientes de um questionário online e pesos corporais entre 5 e 70 kg. No métodoprobabilísticoforamutilizadosos dados de concentração dos ingredientesativos das amostras e peso corporal de 60 kg noscenários um e dois, onde, no primeiro, os dados de consumoutilizadosforamos dados do questionário e no segundoos dados de consumo de morangoprovenientes da Pesquisa de OrçamentosFamiliares. Nas 62 amostras de morangoanalisadasforamdetectados 38 ingredientesativos, sendo 25 amostrasconsideradassatisfatórias, e 37 insatisfatórias. Entre osingredientesativosdetectados, 40% nãotêmseuusoautorizado para a cultura. Na avaliaçãodeterminística, 23% dos ingredientesativosapresentaramingestãocalculada superior a ingestãodiáriaaceitávelempelomenos um cenário, estando o riscoconcentradonos pesos corporais entre 5 e 30 kg, sendo o riscobaixoquandoconsiderado o peso corporal de 60 kg. Todososingredientesativostestados no primeirocenário da avaliaçãoprobabilísticaapresentaramalgumapossibilidade de aingestãoser superior a ingestãodiáriaaceitável, enquanto que para o segundocenárioapenas o ingredienteativoprocimidonasuperou a ingestãodiáriaaceitável. Entre osmodelosestudados, o primeirocenário da avaliaçãoprobabilísticafoi o que apresentou a maiorprobabilidade de provocarintoxicação e procimidonafoi o ingredienteativomaisfrequentementedetectadonasamostras, e que apresentou as maiores chances de oferecerrisco à saúde.

Importance of daily fruit and vegetables consumption is well known for maintaining weight status in adults. Therefore, the aim of this study was to estimate the longitudinal relationship between change in weight status and change in fruit and vegetable intake in healthy primary school children. The study was conducted on 139 children (52% boys) aged 8 years from primary schools in the city of Zagreb. 53.2% of children participated in the three-year school-based multicomponent intervention aimed at increasing fruit and vegetable acceptance and consumption. Fruit and vegetable (FV) intake and anthropometric measurements were conducted before (2018/2019 school year) and after the intervention (June 2020/2021 school year). FV intake was measured using a validate food frequency questionnaire. Anthropometric measurements were performed according to the standard protocol and z-scores for body mass index (BMI) were obtained using AnthroPlus software. Children in the intervention group (Δ98.8 g vs. Δ-31.7 g ; p < 0.001) had a significant increase (p=0.018) in FV intake and a significant decrease in BMI z-scores (Δ-0.26 vs. Δ-0.19 ; p < 0.001) after the intervention compared with the control group. In the intervention group, the change in BMI was weakly correlated with the change in FV intake (r=-0.173 ; p < 0.01), while this correlation was not found in the control group (r=0.088 ; p=0.491). In conclusion, increased fruit and vegetable intake over time may influence the change in the weight status of children. Therefore, it is necessary to establish proper eating habits in children, with emphasis on sufficient fruit and vegetable intake.

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.

BACKGROUND Most children do not eat enough fruits and vegetables (FV). Schools are a critical setting for supporting children to consume FV. To fill a gap in available materials, a classroom curriculum was developed and evaluated to determine impacts on student FV-related knowledge, attitudes, and behaviors. METHODS A pre-/post-intervention survey was administered to 4th-6th grade students in 3 intervention and one comparison schools. Post-intervention student focus groups, parent/guardian surveys, and teacher surveys provided complementary information. RESULTS Intervention students had a significantly greater increase in total FV intake, fruit intake, and 100% juice consumption, and preference for several types of FV relative to comparison group students. Students, teachers, and parents reported overall high levels of satisfaction with the curriculum. CONCLUSIONS The Harvest of the Month curriculum is effective at increasing fruit intake among a low-income, diverse student population in grades 4-6, is acceptable to students, teachers, and parents, and is feasible to implement. Findings suggest this impact is the result of changes in preferences, skills, and motivation but not self-efficacy or perceived social norms. Some tailoring of the curriculum may be needed to increase its appropriateness for 6th-grade students, increase the impact on vegetable intake, and limit intake of juice.

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.

This study investigated the influence of descriptive norm messages that either communicated that university students eat a sufficient amount of fruit and vegetable (F&V) or that they do not, on F&V consumption, and whether or not any effects are moderated by student identification. An online 2 (Norm: “Sufficient”/“Insufficient”) × 2 (Identification: “Low”/“High”) experimental design was employed. Infographics containing “sufficient”/“insufficient” F&V intake descriptive norms were presented. An identification manipulation was employed to create “high”/“low” student identifiers. F&V intake intentions were assessed after the manipulations; self-reported F&V intake was reported at 2 days post-intervention. Undergraduate students in the United Kingdom (N = 180) reported their intake intentions, of which 112 (62%) completed the behavioral follow-up. Participants were predominantly white female students from Scottish universities, mean age 20.4 (±1.6) years. Baseline mean F&V consumption was high (4.5 ± 2.8). There were no significant main effects of Norm or Identification manipulations on F&V intentions and intake. Significant norm × identification interactions were revealed for fruit intake intentions and vegetable intake at follow-up, indicating half-portion differences (~40 g) between groups. Ironic effects were observed for “high” identifiers, who neither intended to, nor acted in accordance with group norms; “low” student identifiers intended to and followed group norms, whereby the “sufficient”/“low” group intended to consume significantly more fruit portions and consumed more vegetables than the “insufficient”/“low” group. Given the half-portion differences between groups resulting from the norm × identification interactions, future research on a larger sample of young adults with low F&V intake is warranted to further explore the conditions under which moderating effects of identification are observed and the underlying mechanisms.

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. .

Objective:Despite extensive research on framing effects in public health communication, there is still a lack of knowledge on how gain framesv. loss frames can encourage healthy eating behaviour among children.Design:Drawing on the Prospect Theory as well as on the Reactivity of Embedded Food Cues in Advertising Model, an experiment exposed children to an audio-visual cartoon movie with gain-framed nutritional messages about eating fruit (gain condition), loss-framed nutritional messages about eating fruit (loss condition) or a message without any food (control group). Children’s fruit intake was measured as the dependent variable. Children’s awareness of gain- and loss-framed arguments was treated as mediators, while children’s age and parents’ self-reported food-related mediation styles were modelled as moderators.Setting:Vienna, Austria, in 2018.Participants:Children aged 6–10 years (N161).Results:Children in the gain frame group were more aware of gain-framed arguments, and children in the loss frame group were more aware of loss-framed arguments than those in the control group. However, only the mediator awareness of gain-framed arguments increased fruit intake. Additionally, there was a direct effect of the gain-framed message on fruit intake compared to the control group. The loss condition did not reveal such an effect. Neither parent’s food-related mediation styles nor children’s age moderated those results.Conclusion:Gain-framing seems to be more effective in influencing children’s healthy food choices compared to loss-framing. Implications for health communication strategies aimed at children are discussed.

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.

Worldwide, a large proportion of children consume suboptimal amounts of fruit and vegetables. In response, numerous intervention studies have been conducted to promote fruit and vegetable consumption. To increase the effectiveness of the intervention, it is necessary to identify the factors that most influence children's fruit and vegetable consumption in their socio-cultural environment. Indeed, according to Bronfenbrenner's bioecological model of human development, many factors (preferences, education, family, peers, school environment, availability of food, etc.) can influence children's fruit and vegetable consumption, with availability and preferences appearing to be the most prominent. Therefore, the aim of this study was to investigate whether the consumption of fruit and vegetables is related to the following factors: (1) children's preferences, (2) frequency of consumption, and (3) variety of fruit and vegetables among primary school children in Croatia. The study involved 195 (52.3% boys) school-aged children (8.9 ± 0.5 years) from 14 primary schools in the city of Zagreb. Dietary records for three non-consecutive days were used to estimate fruit and vegetable intake, frequency of fruit and vegetable servings, fruit and vegetable variety score, and food variety score. The food variety score was calculated as the average number of different food items eaten by each child during the recording of the 3-day dietary records. The fruit and vegetable variety score was calculated as the total variety score for fruit and vegetables only. Children's preference for fruit (26 species) and vegetables (28 species) was determined using a questionnaire that included a 5-point hedonic scale, where 1 meant ‘I dislike it a lot’ and 5 meant ‘I like it a lot’. Children consumed an average of 304.0 g (198.9 - 412.4 g) of fruit and vegetables daily. Only 28.2% of the children met the World Health Organization recommendations for daily consumption of 400 g of fruit and vegetables. The calculated value for fruit and vegetable variety score shows that children consumed average 3.3 (2.7 - 4.0) different fruit and vegetables daily, which is on average 24% (19 - 28%) of the food variety score. The amount of fruit and vegetables consumed was positively correlated with the fruit and vegetable variety score (r = 0.567 ; p < 0.001) and the proportion of the fruit and vegetable variety score to the food variety score (r = 0.621 ; p < 0.001). In terms of frequency of consumption, children consumed fruit and vegetables on average 4.7 (3.7 - 6.3) times per day. The daily frequency of fruit and vegetable consumption was positively correlated with the amount of fruit and vegetables consumed (r = 0.518 ; p < 0.001). Overall, the children rated 54 different fruit and vegetables with an average score of 3.3 (2.6 - 3.8). According to Spearman's rank correlation coefficient, the amount of fruit and vegetables consumed was not related to the children's fruit and vegetable preferences (r = 0.130 ; p = 0.069). In conclusion, most school-aged children do not consume enough fruit and vegetables on a daily basis and a strategy needs to be developed to increase children's intake of fruit and vegetables in children. The results of this study highlight the importance of frequency and variety of fruit and vegetable consumption in explaining fruit and vegetable consumption among primary school children. As frequency and variety of consumption appears to be a more important factor than preferences for higher fruit and vegetable consumption, an effective strategy to promote fruit and vegetable consumption among primary school children in Croatia could be to include more fruits and vegetables in school meals and meals prepared at home.

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.