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Role of free school lunch in the associations between family-environmental factors and children's fruit and vegetable intake in four European countries.
MedLine Citation:
PMID:  22974579     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To determine whether an association exists between different clusters of fruit- and vegetable-specific family-environmental factors and children's daily fruit and vegetable intake, and whether these associations differ between countries with different school lunch policies. DESIGN: Cross-sectional data from four European countries participating in the Pro Greens project in 2009. These countries have different school food policies: two serve free school lunches and two do not. Self-administered data were used. Food frequency questions served to assess fruit and vegetable intakes. The study assessed sixteen children-perceived family-environmental factors, which were clustered based on principal component analysis into five sum variables: fruit and vegetable encouragement; vegetable modelling, family routine and demand; fruit modelling; fruit and vegetable snacking practices; and fruit and vegetable allowing. SETTING: Schools in Finland, Germany, Sweden and the Netherlands. SUBJECTS: Schoolchildren aged 11 years (n 3317). RESULTS: Multilevel logistic regression analyses revealed positive associations between nearly all clustered family-environmental factors and daily fruit and vegetable intake. The study tested a moderation effect between family-environmental factors and school lunch policy. In five out of twenty models significant interactions occurred. In the stratified analyses, most of the associations between family-environmental factors and raw and cooked vegetable intake were stronger in Germany and the Netherlands, neither of which provided free school lunches. CONCLUSIONS: Children reporting more fruit- and vegetable-promoting family-environmental factors had a more frequent intake of fruits and vegetables; the associations were stronger for vegetable intakes in countries providing no free school lunches, suggesting that parental involvement is crucial when schools offer no vegetables.
Carola Ray; Eva Roos; Johannes Brug; Isabel Behrendt; Bettina Ehrenblad; Agneta Yngve; Saskia J Te Velde
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Type:  JOURNAL ARTICLE     Date:  2012-9-14
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Languages:  ENG     Pagination:  1-9     Citation Subset:  -    
1 Folkhälsan Research Center, Paasikivenkatu 4, 00250 Helsinki, Finland.
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