Promoting sufficient fruit and vegetable intake among teachers: An intervention using the Solomon Four Group Design

Background@#Majority of recent deaths in the Philippines were attributed to noncommunicable diseases. While adequate consumption of fruits and vegetables can potentially decrease the burden of some of these noncommunicable diseases, health promotion and education interventions have also shown to increase the fruit and vegetable intake that will help prevent certain heart diseases and cancer.@*Objective@#This study aimed to evaluate the impact of a self-management intervention on psychosocial variables and fruit and vegetable intake (FVI) of public school teachers in Negros Oriental, Philippines.@*Methodology@#The study utilized the Solomon Four Group Design. The psychosocial variables were derived from Bandura's Social Cognitive Theory and Ajzen's Theory of Planned Behavior. FVI was measured using a food frequency questionnaire. An assessment of interaction between the intervention and pretest, group comparison tests, and nested ANOVA approach was performed.@*Results@#Teachers from 44 schools were included in the analysis; 112 were in the intervention group and 116 in the control group. Results indicate no significant interaction between treatment and pre-test group (F[1,224]=0.15, p=0.703) and no significant differences in the psychosocial variables scores and FVI of the intervention and control groups (p=>0.05). Significant findings in two of four psychosocial variables, particularly diet-related attitude (t=2.412, p=0.009) and knowledge regarding the recommended FVI (Fisher's exact test p=0.010), and mean FVI (t=1.898, p=0.031) were only found using data from the posttest-only intervention group who were able to attend the lecture-workshop and control group. Conclusion: The study found no evidence of pretest sensitization. There was insufficient evidence to conclude that there were differences in FVI and psychosocial variables of the intervention and control groups postintervention.

The role of emotional states in fruit and vegetable consumption in Brazilian adults / O papel dos estados emocionais no consumo de frutas e vegetais em adultos brasileiros

Abstract The objective was to investigate the association between emotional states with adequate fruit and vegetable consumption (FVC). This is a population-based cross-sectional study with 1,100 adults from a medium-sized city in Southern Brazil. Adequate FVC was defined as concomitant intake ≥ 3 fruits and ≥ 5 tablespoons of vegetables per day. Exposures were self-perception of nervousness/stress and minor psychiatric disorders (MPD). Data analysis used logistic regression. After controlling for demographic, socioeconomic and behavioral variables, adults reporting lack of nervousness/stress were twice more likely to report adequate FVC than those who reported it. Similarly, those reporting not having MPD symptoms were 52% more likely to have adequate FVC than those who did not. These effects increased and remained significant among women.

Resumo O objetivo foi verificar a associação entre a autopercepção do estado emocional com o consumo adequado de frutas, verduras e legumes (FVL). Este é um estudo transversal de base populacional com uma amostra probabilística de 1100 adultos residentes na zona urbana de um município de médio porte do Brasil. Considerou-se como consumo adequado uma ingestão ≥ 3 frutas concomitante com ≥ 5 colheres de verduras/legumes ao dia. O estado emocional foi avaliado através da autopercepção do nervosismo/stress e distúrbios psiquiátricos menores (DPM). Potenciais fatores de confundimento incluíam variáveis demográficas, socioeconômicas e comportamentais. Foram observadas associações significativas entre a autopercepção de nervosismo/stress e DPM com o consumo adequado de FVL. Após o controle de fatores de confusão, adultos relatando ausência de nervosismo/stress possuíam uma chance de apresentar um consumo adequado duas vezes maior do que aqueles relatando nervosismo/stress. Similarmente, participantes com ausência de distúrbios psiquiátricos possuíam uma chance de consumo adequado FVL 52% mais elevada quando comparados àqueles que relataram presença desses sintomas. Quando estratificada por gênero, esse efeito aumentou e manteve-se com significância estatística apenas entre as mulheres.

Food environment and family support in relation to fruit and vegetable intake in pregnant women

The aim of the study was to investigate predictor factors related to self-perceived food environment, food practices, and family support and fruit and vegetable intake during pregnancy. A cross-sectional study was conducted among 282 pregnant women at the second trimester of pregnancy living in the city of Ribeirão Preto, Brazil. A food frequency questionnaire, and two 24-hour dietary recalls were obtained, and the Multiple Source Method was used to estimate the usual intake. Self-perceived food environment, food practice and family support were assessed by structured questionnaires. Logistic regression models adjusted for education, age, socioeconomic class, and BMI by gestational age were used to evaluate the relationship between self-perceived food environment, food practice and family support and fruit and vegetable intake. No association between self-perceived food environment and fruit and vegetable intake was found. However, the women who reported a greater number of meals per day (OR 1.95 (95% CI = 1.06; 3.56), p = 0.03), those who believed they consumed enough fruit and vegetable (3.71 (2.23; 6.20), p < 0.001), and who reported to have family support for a healthy diet (3.16 (1.78; 5.60), p < 0.001), were more likely to consume greater amounts of these foods. Our data suggests that the family support and a higher number of meals per day might be relevant to achieve a higher fruit and vegetable intake among pregnant women(AU)

A relação entre o ambiente alimentar e o suporte familiar e o consumo de frutas, verduras e legumes em gestantes. O objetivo do presente estudo foi investigar fatores preditores relacionados à percepção do ambiente alimentar, práticas alimentares e suporte familiar e o consumo de frutas, verduras e legumes durante a gestação. Trata-se de um estudo transversal, conduzido entre 282 gestantes residentes em Ribeirão Preto, SP, Brasil, durante o segundo trimestre gestacional. O consumo alimentar foi avaliado por meio de um questionário de frequência alimentar e dois recordatórios de 24 horas. Para estimar o consumo usual de alimentos foi utilizado o Multiple Source Method. A percepção do ambiente alimentar, práticas alimentares e suporte familiar foram avaliados por meio de um questionário estruturado. Modelos de regressão logística ajustados por escolaridade, idade, classe social e IMC por idade gestacional foram utilizados para avaliar a relação entre a percepção do ambiente alimentar, práticas alimentares e suporte familiar com o consumo de frutas, verduras e legumes. Nenhuma relação foi encontrada entre a percepção do ambiente alimentar e o consumo de frutas, verduras e legumes. Por outro lado, as gestantes que relataram um maior número de refeições ao dia (OR 1,95 (95%IC = 1,06; 3,56), p = 0,03), aquelas que consideravam que consumiam uma quantidade suficiente de frutas, verduras e legumes (3,71 (2,23; 6,20), p < 0,001), e aquelas que relataram suporte familiar para ter uma alimentação saudável (3,16 (1,78; 5,60), p < 0,001), apresentaram maior chance de consumir uma maior quantidade destes alimentos. Os resultados sugerem que o suporte familiar e um maior número de refeições sejam relevantes para o alcance do maior consumo de frutas, verduras e legumes entre gestantes(AU)

Comparison of Fruits and Vegetables Intake and Physical Activity between Hypercholesterolemic Adults and Nonhypercholesterolemic Adults in Malaysia

Hypercholesterolemia is an important modifiable risk factor for coronary heart disease. Lifestyle changes in diet and physical activity can improve cholesterol levels. This study aimed to compare the fruits and vegetables (FV) intake and physical activity (PA) between hypercholesterolemic adults and nonhypercholesterolemic adults in Malaysia, and to investigate factors associated with meeting the recommended levels of FV intake and PA in a hypercholesterolemic population. Methods: This study was based on 17,988 participants (response rate 98.7%) aged 18 years and above who responded to the hypercholesterolemia questionnaire in the 2011 Malaysian National Health and Morbidity Survey (NHMS), a cross-sectional study with two-stage stratified sampling design. Data were obtained by trained enumerators via face-to-face interviews and were analysed by descriptive analysis, chi-square test, and univariable and multivariable logistic regression. Results: Out of the total population assessed, 39.0% had hypercholesterolemia. The prevalence of consuming five or more servings of FV per day is low (7.8%) while 36.0% were physically inactive among the hypercholesterolemic adults. No significant differences were observed in FV intake and PA between hypercholesterolemic and non-hypercholesterolemic populations. Gender, age and educational levels were associated with FV intake and PA among hypercholesterolemic adults. Hypercholesterolemic adults who were underweight or obese were less likely to consume FV, while those who were former smokers and those who had diabetes and heart disease were less likely to be physically active. Conclusion: These findings are relevant for future health promotion strategies, suggesting that more intensive interventions are needed to increase FV intake and PA level in hypercholesterolemic population and in the general population.

Consumo de frutas e hortaliças por idosos de baixa renda na cidade de São Paulo / Fruit and vegetable intake among low income elderly in the city of São Paulo, Southeastern Brazil

OBJETIVO: Estimar os fatores socioeconômicos e sociodemográficos associados ao consumo diário de cinco porções de frutas e hortaliças por idosos residentes em áreas de baixa renda, identificando as principais frutas e hortaliças que compõem a dieta desta população. MÉTODOS: Estudo transversal de base populacional com 2.066 idosos (>60 anos) de baixa renda residentes na cidade de São Paulo, SP, em 2003-2005. Para a avaliação do consumo de frutas e hortaliças foi aplicado questionário de freqüência alimentar. As respostas foram transformadas em consumo diário e comparadas às recomendações da Organização Mundial da Saúde (consumo de cinco ou mais porções diárias). A relação entre consumo recomendado de frutas e hortaliças e variáveis socioeconômicas foi avaliada mediante modelos de regressão logística. RESULTADOS: Dos participantes, 60,5 por cento eram mulheres e 39,5 por cento homens. Cerca de um terço dos idosos (n=723; 35,0 por cento) não consumia diariamente nenhum tipo de fruta ou hortaliça e 19,8 por cento relataram consumo diário de cinco ou mais porções de frutas e hortaliças. Este consumo esteve positivamente associado à renda e à escolaridade. CONCLUSÕES: O consumo de frutas e hortaliças de idosos de baixa renda do município de São Paulo mostrou-se insuficiente em relação às recomendações da Organização Mundial da Saúde e está associado a condições socioeconômicas desfavoráveis.

OBJECTIVE: To estimate the socioeconomic and sociodemographic factors associated with the daily intake of five servings of fruit and vegetables by elderly individuals living in low income areas, identifying the main fruits and vegetables which compose the diet of this population. METHODS: This is a cross-sectional population-based study with 2,066 low income elderly individuals (>60 years) living in the city of São Paulo, Southeastern Brazil, in 2003-2005. To assess the fruit and vegetable intake a Food Frequency Questionnaire was administered. The answers were transformed into daily intake and compared with the recommendations of the World Health Organization (five or more servings per day). The relationship between recommended fruit and vegetable intake and socioeconomic variables was analyzed using logistic regression models. RESULTS: Of the participants, 60.5 percent were women and 39.5 percent were men. Approximately one third of the elders (n=723; 35.0 percent) did not consume any kind of fruit or vegetable on a daily basis and 19.8 percent reported a daily intake of five or more servings of fruits and vegetables. This intake was positively associated with income and years of schooling. CONCLUSIONS: The fruit and vegetable intake of low income elderly individuals in the city of São Paulo was insufficient according to the recommendations of the World Health Organization and is associated with unfavorable socioeconomic conditions.