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      Determinants of Fruit, Vegetable, and Dairy Consumption in a Sample of Schoolchildren, Northern Serbia, 2012

      research-article
      , MSc, RN , , PhD
      Preventing Chronic Disease
      Centers for Disease Control and Prevention

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          Abstract

          Introduction

          Insufficient intake of fresh fruits, vegetables, and dairy products among children is a serious nutrition-related concern. The aim of our study was to determine behavioral and environmental factors that influence fruit, vegetable, and dairy consumption among Serbian schoolchildren.

          Methods

          We used 24-hour recall to measure fruit, vegetable, and dairy intake of schoolchildren (N = 212) aged 8 to 11 years from 2 elementary schools in a local community in Serbia. We evaluated potential determinants of intake by using a 48-item questionnaire that asked about children’s behaviors, perceptions of others’ expectations and behaviors, reinforcement of children’s behaviors, and availability of fruits, vegetables, and dairy at home and school. Children completed written questionnaires during 1 school class under teacher supervision. Binary logistic regression was used to analyze determinants of fruit, vegetable, and dairy intake.

          Results

          Negative predictors of fruit intake were expectations from teacher and parents ( P <.001) to eat fruit and availability of fruit in school. Vegetable intake was positively related to paternal modeling behavior ( P <.001) and availability of vegetables at home ( P = .04). Dairy intake was positively influenced by parental reinforcement ( P = .03).

          Conclusion

          Various personal and environmental factors are associated with children’s intake of fruits, vegetables, and dairy. Interventions to promote fruit, vegetable, and dairy consumption in Serbian schoolchildren should focus on modeling and reinforcement by parents and teachers and increasing availability at school and at home.

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          Most cited references18

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          Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: quantitative studies

          Background In order to more effectively promote fruit and vegetable intake among children and adolescents, insight into determinants of intake is necessary. We conducted a review of the literature for potential determinants of fruit and vegetable intake in children and adolescents. Methods Papers were identified from Medline and PsycINFO by using all combinations of the search terms: "fruit(s) or vegetable(s)" and "children or adolescents". Quantitative research examining determinants of fruit and/or vegetable intake among children and adolescents aged 6–18 years were included. The selection and review process was conducted according to a four-step protocol resulting in information on country, population, design, methodology, theoretical basis, instrument used for measuring intake, statistical analysis, included independent variables, and effect sizes. Results Ninety-eight papers were included. A large number of potential determinants have been studied among children and adolescents. However, for many presumed determinants convincing evidence is lacking, mostly because of paucity of studies. The determinants best supported by evidence are: age, gender, socio-economic position, preferences, parental intake, and home availability/accessibility. Girls and younger children tend to have a higher or more frequent intake than boys and older children. Socio-economic position, preferences, parental intake, and home availability/accessibility are all consistently positively associated with intake. Conclusion The determinants most consistently supported by evidence are gender, age, socio-economic position, preferences, parental intake and home availability/accessibility. There is a need for internationally comparative, longitudinal, theory-based and multi-level studies taking both personal and environmental factors into account. This paper is published as part of the special Pro Children series in the International Journal of Behavioral Nutrition and Physical Activity. Please see [] for the relevant editorial.
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            Youth risk behavior surveillance - United States, 2011.

            Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, and are interrelated and preventable. September 2010-December 2011. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies. This report summarizes results from the 2011 national survey, 43 state surveys, and 21 large urban school district surveys conducted among students in grades 9-12. Results from the 2011 national YRBS indicated that many high school students are engaged in priority health-risk behaviors associated with the leading causes of death among persons aged 10-24 years in the United States. During the 30 days before the survey, 32.8% of high school students nationwide had texted or e-mailed while driving, 38.7% had drunk alcohol, and 23.1% had used marijuana. During the 12 months before the survey, 32.8% of students had been in a physical fight, 20.1% had ever been bullied on school property, and 7.8% had attempted suicide. Many high school students nationwide are engaged in sexual risk behaviors associated with unintended pregnancies and STDs, including HIV infection. Nearly half (47.4%) of students had ever had sexual intercourse, 33.7% had had sexual intercourse during the 3 months before the survey (i.e., currently sexually active), and 15.3% had had sexual intercourse with four or more people during their life. Among currently sexually active students, 60.2% had used a condom during their last sexual intercourse. Results from the 2011 national YRBS also indicate many high school students are engaged in behaviors associated with the leading causes of death among adults aged ≥ 25 years in the United States. During the 30 days before the survey, 18.1% of high school students had smoked cigarettes and 7.7% had used smokeless tobacco. During the 7 days before the survey, 4.8% of high school students had not eaten fruit or drunk 100% fruit juices and 5.7% had not eaten vegetables. Nearly one-third (31.1%) had played video or computer games for 3 or more hours on an average school day. Since 1991, the prevalence of many priority health-risk behaviors among high school students nationwide has decreased. However, many high school students continue to engage in behaviors that place them at risk for the leading causes of morbidity and mortality. Variations were observed in many health-risk behaviors by sex, race/ethnicity, and grade. The prevalence of some health-risk behaviors varied substantially among states and large urban school districts. YRBS data are used to measure progress toward achieving 20 national health objectives for Healthy People 2020 and one of the 26 leading health indicators; to assess trends in priority health-risk behaviors among high school students; and to evaluate the impact of broad school and community interventions at the national, state, and local levels. More effective school health programs and other policy and programmatic interventions are needed to reduce risk and improve health outcomes among youth.
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              Determinants of fruit and vegetable consumption among 6-12-year-old children and effective interventions to increase consumption.

              To review the current literature about potential determinants of fruit and vegetable intakes and effective intervention strategies to increase the consumption of fruits and vegetables among 6-12-year-old children. A structured review of literature located in PubMed and Psychinfo electronic literature databases. Of all determinants, the availability and accessibility of fruit and vegetables and taste preferences were most consistently and most positively related to consumption. There was some evidence that parental fruit and vegetable intakes, knowledge of intake recommendations and skills had a positive association with children's intakes, whereas television viewing, exposure to television advertisement, and having a snack bar at school were associated with lower intakes of fruit and vegetables. Multi-component school-based interventions that combined classroom curriculum, parent and food service components showed the greatest promise for fruit and vegetable promotion among children. School fruit and vegetable subscription programmes, scout-based interventions, and fruit and vegetables education via computer multi-media channels also appear promising. Interventions should improve the availability and accessibility of fruit and vegetables to children, and should aim to improve their taste preferences for them. Such interventions should be of a multi-component nature, school-based or use other social channels and may include multi-media channels.
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                Author and article information

                Journal
                Prev Chronic Dis
                Prev Chronic Dis
                PCD
                Preventing Chronic Disease
                Centers for Disease Control and Prevention
                1545-1151
                2013
                31 October 2013
                : 10
                : E178
                Affiliations
                [1]Author Affiliation: Budimka Novaković, University of Novi Sad, Novi Sad, Serbia.
                Author notes
                Corresponding Author: Sanja Šumonja, MSc, RN, University of Novi Sad, Podgorička 4 25000 Sombor, Novi Sad, Serbia. Telephone: 38-1-63-88-20-270. E-mail: sanjasumonja@ 123456gmail.com .
                Article
                13_0072
                10.5888/pcd10.130072
                3816602
                24176082
                b7e09215-51cb-4131-9d6b-43e34633e20e
                History
                Categories
                Original Research
                Peer Reviewed

                Health & Social care
                Health & Social care

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