Improving low fruit and vegetable intake in children: Findings from a system dynamics, community group model building study.

Many children globally do not meet government guidelines for daily fruit and vegetable intake, and in New Zealand, adherence to the vegetable intake recommendation is declining. This study aimed to identify systemic barriers to children meeting fruit and vegetable (FV) guidelines and generate sustainable actions within a local community to improve children's FV intake. A qualitative system dynamics method of community group model building was used. The research team partnered with Healthy Families Waitakere, a Ministry of Health funded prevention initiative, to recruit 17 participants (including students, parents, teachers, community leaders, local retailers and health promoters) from a low-income, ethnically-diverse community in West Auckland, New Zealand. Three group model building workshops were held during which a systems map was created and used to identify actions by considering causal pathways and reinforcing loops in the system. Barriers to children's FV intake identified by participants were the saturation of fast-food outlets in the community and ubiquitous marketing of these products, the high cost of fresh produce compared to fast food, and parents having little time for food preparation plus declining cooking skills and knowledge. Several actions to improve children's FV intake by improving the local food environment were identified, which will be co-designed further and tested by a collaborative group involving community leaders. This project highlights the effectiveness of group model building for engaging a local community in systems change to improve child nutrition, and supplies a blueprint for future qualitative system dynamics research.

New Zealand women have suboptimal intakes of long chain omega-3 polyunsaturated fatty acids during pregnancy-a cross sectional study.

AIM: To investigate dietary intakes and food sources of polyunsaturated fatty acids in New Zealand pregnant women. METHOD: Women (n=596) 16 years plus in trimester three of pregnancy completed an online food frequency questionnaire validated for omega-3 and omega-6 polyunsaturated fatty acids. RESULTS: Estimated median [25th, 75th percentile] intakes of omega-3 polyunsaturated fatty acids were: 1,300 [790, 2,120] mg/d alpha-linolenic acid (adequate intake 1,000mg/d); 220 [120, 520] mg/d total long chain omega-3 polyunsaturated fatty acids (adequate intake 115mg/d); and 110 [50, 250] mg/d docosahexaenoic acid (recommended 200mg/d). Only 30.9% of participants consumed more than 200mg/d docosahexaenoic acid. Participants taking omega-3 supplements (19.6%) were 16.5 times more likely to meet recommendations for docosahexaenoic acid. Fish and seafood were the main contributors to docosahexaenoic acid (84.8%) intakes, yet only 21.7% of women consumed fish at least twice per week. Intakes of omega-6 polyunsaturated fatty acids were 11,580 [8,840, 15,760] mg/d linoleic acid (adequate intake 10,000mg/d) and 90 [60, 110] mg/d arachidonic acid (upper limit 800mg/d). CONCLUSION: Most participants did not meet recommended intakes for docosahexaenoic acid, which may be partly due to low intakes of fish, seafood and omega-3 supplements.