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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Household, psychosocial, and individual-level factors associated with fruit, vegetable, and fiber intake among low-income urban African American youth

Authors: Angela Cristina Bizzotto Trude, Anna Yevgenyevna Kharmats, Kristen Marie Hurley, Elizabeth Anderson Steeves, Sameera A. Talegawkar, Joel Gittelsohn

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV) are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors influencing FV and fiber consumption in low-income African-American (AA) youth in Baltimore, MD.

Methods

Cross-sectional analysis of data collected from 285 low-income AA caregiver-youth (age range: 10–14 y) dyads participating in the baseline evaluation of the B’More Healthy Communities for Kids obesity prevention trial. The Kid's Block FFQ was used to estimate daily intakes of FV (including 100 % fruit juice) and dietary fiber. Questionnaires were used to assess household socio-demographics, caregiver and youth food purchasing and preparation behavior, and youth psychosocial information. Ordered logit regression analyses were conducted to examine psychosocial and food-related behavior associated with FV and dietary fiber intake (quartile of intake) controlling for youth age, sex, BMI percentile, total calorie intake and household income.

Results

On average, youth consumed 1.5 ± 1.1 (M ± SD) servings of fruit, 1.8 ± 1.7 serving of vegetables, and 15.3 ± 10.9 g of fiber/day. There were no differences by gender, age or household income. Greater youth’s healthy eating intentions and self-efficacy scores were associated with greater odds ratio for higher intake of FV and fiber (Intention: ORfruit 1.22; 95 % CI: 1.06–1.41, ORvegetable 1.31; 1.15–1.51 and ORfiber 1.46; 1.23–1.74, Self-efficacy: ORfruit 1.07; 1.03–1.12, ORvegetable 1.04; 1.01–1.09, ORfiber 1.10; 1.04–1.16). Youth receiving free/low-cost breakfast were more than twice as likely to have higher fiber intake than those who did not receive free breakfast (OR 2.7; 1.10; 6.9). In addition, youth shopping more frequently at supermarkets were more likely to have greater vegetable and fiber intake (OR 1.26; 1.06–1.50; OR 1.28; 1.03–1.58, respectively). Also, youth with parents who shopped more frequently at fast-food stores had 7 % lower odds for higher vegetable intake (95 % CI: 0.88–0.99).

Conclusion

In this study, both, youth and household factors were associated with youth FV and fiber intake, underscoring the need for a multi-level approach to increasing youths’ diet quality. These results will inform and shape an effective intervention program for improving youth dietary intakes.
Appendix
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Literature
1.
Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, Singh GM, Gutierrez HR, Lu Y, Bahalim AN, Farzadfar F, Riley LM, Ezzati M. National, regional, and global trends in body-mass index since 1980. Lancet. 2011;377:557–67.CrossRefPubMedPubMedCentral
2.
Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, Gortmaker SL. The global obesity pandemic: Shaped by global drivers and local environments. Lancet. 2011;378:804–14.CrossRefPubMed
3.
4.
World Health Organization. Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser. 2003;916:i - viii, 1-149, backcover. ISBN 92 4120916 X ISSN 0512-3054 (NLM classification: QU 145).
5.
Boeing H, Bechthold A, Bub A, Ellinger S, Haller D, Kroke A, Leschik-Bonnet E, Müller MJ, Oberritter H, Schulze M, Stehle P, Watzl B. Critical review: vegetables and fruit in the prevention of chronic diseases. Eur J Nutr. 2012;51:637–63.CrossRefPubMedPubMedCentral
6.
Guenther PM, Kirkpatrick SI, Reedy J, Krebs-Smith SM, Buckman DW, Dodd KW, Casavale KO, Carroll RJ. The Healthy Eating Index-2010 is a valid and reliable measure of diet quality according to the Dietary Guidelines for Americans. J Nutr. 2010;2014(144):399–407.
7.
Vadiveloo M, Dixon LB, Mijanovich T, Elbel B, Parekh N. Development and evaluation of the US Healthy Food Diversity index. Br J Nutr. 2014;112:1562–74.CrossRefPubMed
8.
Haack SA, Byker CJ. Recent population adherence to and knowledge of United States federal nutrition guides, 1992–2013: a systematic review. Nutr Rev. 2014;72:613–26.CrossRefPubMed
9.
Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance - United States. Surveill Summ. 2007;57(4):1–36.
10.
Krølner R, Rasmussen M, Brug J, Klepp K-I, Wind M, Due P. Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies. Int J Behav Nutr Phys Act. 2011;8:112.CrossRefPubMedPubMedCentral
11.
Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.CrossRefPubMed
12.
Lotrean LM, Tutui I. Individual and familial factors associated with fruit and vegetable intake among 11- to 14-year-old Romanian school children. Health Soc Care Community. 2015;23(5):541-49.
13.
Shaikh AR, Yaroch AL, Nebeling L, Yeh M-C, Resnicow K. Psychosocial predictors of fruit and vegetable consumption in adults a review of the literature. Am J Prev Med. 2008;34:535–43.CrossRefPubMed
14.
Franko DL, Cousineau TM, Rodgers RF, Roehrig JP, Hoffman JA. Social-cognitive correlates of fruit and vegetable consumption in minority and non-minority youth. J Nutr Educ Behav. 2013;45:96–101.CrossRefPubMed
15.
Chee Yen W, Mohd Shariff Z, Kandiah M, Mohd Taib MN. Stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake and related psychosocial factors. Nutr Res Pract. 2014;8:297–303.CrossRefPubMedPubMedCentral
16.
Di Noia J, Byrd-Bredbenner C. Determinants of fruit and vegetable intake in low-income children and adolescents. Nutr Rev. 2014;72:575–90.CrossRefPubMed
17.
Rasmussen M, Krølner R, Klepp K-I, Lytle L, Brug J, Bere E, Due P. Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: Quantitative studies. Int J Behav Nutr Phys Act. 2006;3:22.CrossRefPubMedPubMedCentral
18.
Pearson N, Ball K, Crawford D. Parental influences on adolescent fruit consumption: the role of adolescent self-efficacy. Health Educ Res. 2012;27:14–23.CrossRefPubMed
19.
De Jong E, Visscher TLS, Hirasing RA, Seidell JC, Renders CM. Home environmental determinants of children’s fruit and vegetable consumption across different SES backgrounds. Pediatr Obes. 2015;10(2):134-40.
20.
Smith LP, Ng SW, Popkin BM. Trends in US home food preparation and consumption: analysis of national nutrition surveys and time use studies from 1965–1966 to 2007–2008. Nutr J. 2013;12:45.CrossRefPubMedPubMedCentral
21.
Hawkes C, Smith TG, Jewell J, Wardle J, Hammond RA, Friel S, Thow AM, Kain J. Smart food policies for obesity prevention. Lancet. 2015;385:2410–21.CrossRefPubMed
22.
Morland K, Wing S, Diez Roux A, Poole C. Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med. 2002;22:23–9.CrossRefPubMed
23.
Berge JM, Wall M, Larson N, Forsyth A, Bauer KW, Neumark-Sztainer D. Youth dietary intake and weight status: healthful neighborhood food environments enhance the protective role of supportive family home environments. Health Place. 2014;26:69–77.CrossRefPubMed
24.
Vereecken C. Inequalities in Young People’s Health. Health Behaviour in School-Aged Children International Report from the 2005/2006 Survey. Copenhagen: WHO; 2008.
25.
Peltzer K, Pengpid S. Fruits and vegetables consumption and associated factors among in-school adolescents in five Southeast Asian countries. Int J Environ Res Public Health. 2012;9:3575–87.CrossRefPubMedPubMedCentral
26.
Gittelsohn J, Steeves E, Mui Y, Kharmats A, Hopkins L, Dennis D. B’More Healthy Communities for Kids: Design of a Multi-Level Intervention for Obesity Prevention for Low-Income African American Children. BMC Public Health. 2014:1–9. doi:10.​1186/​1471-2458-14-942.
27.
Gittelsohn J, Laska M, Karpyn A, Klingler K, Ayala G. Lessons learned from small store interventions to increase access to healthy foods. Submitt to Am J Heal Behav. 2013;38:307–15.CrossRef
28.
Walker RE, Keane CR, Burke JG. Disparities and access to healthy food in the United States: A review of food deserts literature. Health Place. 2010;16:876–84.CrossRefPubMed
29.
Cullen KW, Watson K, Zakeri I. Relative reliability and validity of the Block Kids Questionnaire among youth aged 10 to 17 years. J Am Diet Assoc. 2008;108:862–6.CrossRefPubMed
30.
Sattler M, Hopkins L, Anderson Steeves E, Cristello A, Mccloskey M, Gittelsohn J, Hurley K. Characteristics of Youth Food Preparation in Low-Income, African American Homes: Associations with Healthy Eating Index Scores. Ecol Food Nutr. 2015:1–17.
31.
Smith C, Fila S. Comparison of the Kid’s Block Food Frequency Questionnaire to the 24-h recall in urban Native American youth. Am J Hum Biol. 2006;18:706–9.CrossRefPubMed
32.
Gittelsohn J, Kim EM, He S, Pardilla M. A food store-based environmental intervention is associated with reduced BMI and improved psychosocial factors and food-related behaviors on the Navajo nation. J Nutr. 2013;143:1494–500.CrossRefPubMedPubMedCentral
33.
Gittelsohn J, Anliker JA, Sharma S, Vastine AE, Caballero B, Ethelbah B. Psychosocial determinants of food purchasing and preparation in American Indian households. J Nutr Educ Behav. 2006;38:163–8.CrossRefPubMed
34.
Suratkar S, Gittelsohn J, Song H-J, Anliker JA, Sharma S, Mattingly M. Food insecurity is associated with food-related psychosocial factors and behaviors among low-income African American adults in Baltimore City. J Hunger Environ Nutr. 2010;5:100–19.CrossRef
35.
Kramer RF, Coutinho AJ, Vaeth E, Christiansen K, Suratkar S, Gittelsohn J. Healthier home food preparation methods and youth and caregiver psychosocial factors are associated with lower BMI in African American youth. J Nutr. 2012;142:948–54.CrossRefPubMed
36.
Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL. 2000 CDC growth charts for the United States: methods and development. Vital Health Stat. 2002;11:1–190.
37.
U.S. Department of Agriculture & U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th ed. Washington, DC: Government Printing Office; 2010.
38.
McAlister AL, Perry CL, Parcel GS. How individuals, environments, and health behavior interact: social cognitive theory. In: Health behavior and health education theory research and practice, vol. 4th. 2008. p. 165–84.
39.
Kothe EJ, Mullan BA. A randomised controlled trial of a theory of planned behaviour to increase fruit and vegetable consumption. Fresh Facts. Appetite. 2014;78:68–75.CrossRefPubMed
40.
Kothe EJ, Mullan BA, Butow P. Promoting fruit and vegetable consumption. Testing an intervention based on the theory of planned behaviour. Appetite. 2012;58:997–1004.CrossRefPubMed
41.
Kubik MY, Lytle LA, Hannan PJ, Perry CL, Story M. The Association of the School Food Environment with Dietary Behaviors of Young Adolescents. Am J Public Health. 2003;93:1168–73.CrossRefPubMedPubMedCentral
42.
Deshmukh-Taskar PR, Nicklas TA, O’Neil CE, Keast DR, Radcliffe JD, Cho S. The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: the National Health and Nutrition Examination Survey 1999–2006. J Am Diet Assoc. 2010;110:869–78.CrossRefPubMed
43.
Cohen JFW, Richardson S, Parker E, Catalano PJ, Rimm EB. Impact of the new U.S. Department of Agriculture school meal standards on food selection, consumption, and waste. Am J Prev Med. 2014;46:388–94.CrossRefPubMedPubMedCentral
44.
45.
Robinson-O’Brien R, Burgess-Champoux T, Haines J, Hannan PJ, Neumark-Sztainer D. Associations between school meals offered through the National School Lunch Program and the School Breakfast Program and fruit and vegetable intake among ethnically diverse, low-income children. J Sch Health. 2010;80:487–92.CrossRefPubMedPubMedCentral
46.
Madaleno S. The Hunger-Free Schools Act of 2015, S. 334. Department of Legislative Services. Baltimore City, MD. 2015:1-6.
47.
Popkin BM, Duffey K, Gordon-Larsen P. Environmental influences on food choice, physical activity and energy balance. Physiol Behav. 2005;86:603–13.CrossRefPubMed
48.
Ganann R, Fitzpatrick-Lewis D, Ciliska D, Peirson L. Community-based interventions for enhancing access to or consumption of fruit and vegetables among five to 18-year olds: a scoping review. BMC Public Health. 2012;12:711.CrossRefPubMedPubMedCentral
49.
Anderson Steeves E, Jones-Smith J, Hopkins L, Gittelsohn J. Perceived social support from friends and parents for eating behavior and diet quality among low-income, urban, minority youth. J Nutr Educ Behav. 2016;48:304–10. e1.CrossRefPubMed
50.
Cobb LK, Anderson CAM, Appel L, Jones-Smith J, Bilal U, Gittelsohn J, Franco M. Baltimore City stores increased the availability of healthy food after WIC policy change. Health Aff. 2015;34:1849–57.CrossRef
51.
Glanz K, Hoelscher D. Increasing fruit and vegetable intake by changing environments, policy and pricing: Restaurant-based research, strategies, and recommendations. Prev Med (Baltim). 2004;39(S2):88-93.
52.
Sturm R, Datar A. Body mass index in elementary school children, metropolitan area food prices and food outlet density. Public Health. 2005;119:1059–68.CrossRefPubMed
53.
Robinson PL, Dominguez F, Teklehaimanot S, Lee M, Brown A, Goodchild M. Does distance decay modelling of supermarket accessibility predict fruit and vegetable intake by individuals in a large metropolitan area? J Health Care Poor Underserved. 2013;24(1 Suppl):172–85.CrossRefPubMedPubMedCentral
54.
St Sauver JL, Grossardt BR, Leibson CL, Yawn BP, Melton LJ, Rocca WA. Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project. Mayo Clin Proc. 2012;87:151–60.CrossRefPubMedPubMedCentral
55.
Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanowski CK, Paluch R. Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obes Res. 2001;9:171–8.CrossRefPubMed
Metadata
Title
Household, psychosocial, and individual-level factors associated with fruit, vegetable, and fiber intake among low-income urban African American youth
Authors
Angela Cristina Bizzotto Trude
Anna Yevgenyevna Kharmats
Kristen Marie Hurley
Elizabeth Anderson Steeves
Sameera A. Talegawkar
Joel Gittelsohn
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3499-6

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