Association of Fruit and Vegetable Consumption During Early Adulthood With the Prevalence of Coronary Artery Calcium After 20 Years of Follow-Up

BackgroundPrevious studies of the effect of school-based interventions to improve healthy behaviours have had important limitations.ObjectiveTo investigate the effectiveness of a school-based intervention to increase physical activity, reduce sedentary behaviour and increase fruit and vegetable consumption.DesignCluster randomised controlled trial.SettingSixty English primary schools.ParticipantsChildren in year 4 (aged 8–9 years) at recruitment, year 5 (aged 9–10 years) during the intervention and immediate follow-up and year 6 (aged 10–11 years) during 1 year of follow-up.InterventionActive for Life Year 5 (AFLY5) included teacher training, lesson plans, materials for 16 lessons, parent-interactive homework and written materials for school newsletters and parents.Main outcome measuresPrimary outcome measures included accelerometer-assessed levels of physical activity and sedentary behaviour, and child-reported consumption of fruit and vegetables. Secondary outcome measures included child-reported screen viewing; consumption of snacks, high-fat food and high-energy drinks; body mass index; and waist circumference.ResultsWe recruited 60 schools (2221 children). At the immediate follow-up, no difference was found between children in intervention and control schools for any of the three primary outcomes. The intervention was effective on three of the nine secondary outcomes; children in intervention schools reported spending less time screen viewing at weekends [–21 minutes per day, 95% confidence interval (CI) –37 to –4 minutes per day], eating fewer servings of snacks per day (–0.22, 95% CI –0.38 to –0.05 servings of snacks per day) and drinking fewer servings of high-energy drinks per day (–0.26, 95% CI –0.43 to –0.10 servings of high-energy drinks per day) than the children in control schools. The results remained consistent 1 year later. The intervention increased children’s perception of maternal efforts to limit the time they spent screen viewing and children’s knowledge about healthy physical activity and fruit and vegetable consumption, with these two mediators explaining approximately one-quarter of the effect of the intervention on screen viewing. The intervention did not affect other mediators. The cost of implementing the intervention from a provider perspective was approximately £18 per child. Process evaluation showed that AFLY5 was implemented with a high degree of fidelity. Teachers supported the aims of AFLY5, but their views of the programme itself were mixed.LimitationsResponses to parental questionnaires for the economic evaluation were low and we struggled to engage all teachers for the process evaluation. Although the participating schools included a range of levels of socioeconomic deprivation, class sizes and rural and urban settings, we cannot assume that results generalise to all primary schools.ConclusionsAFLY5 is not effective at increasing levels of physical activity, reducing sedentary behaviour and increasing fruit and vegetable consumption in primary school children, but may be effective in reducing time spent screen viewing at weekends and the consumption of snacks and high-energy drinks.Future workOur findings suggest that school-based interventions are unlikely to have a major impact on promoting healthy levels of physical activity and healthy diets in primary school children. We would recommend trials of the effect and cost-effectiveness of more intensive family and community interventions.Trial registrationCurrent Controlled Trials ISRCTN50133740.FundingThis project was funded by the National Institute for Health Research Public Health Research programme and will be published in full inPublic Health Research; Vol. 4, No. 7. See the NIHR Journals Library website for further project information.

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Fruit and Vegetable Consumption and Risk of Non-Hodgkin Lymphoma

Blood ◽

10.1182/blood-2019-128518 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 4127-4127

Author(s):

Brenda M Birmann ◽

Kimberly Bertrand ◽

Bernard Rosner ◽

Andres Ardisson Korat

Keyword(s):

B Cell ◽

Vegetable Intake ◽

Vegetable Consumption ◽

Fruit And Vegetable Consumption ◽

Fruit And Vegetable Intake ◽

Inverse Association ◽

Fruit And Vegetable ◽

Non Hodgkin Lymphoma ◽

Etiologic Role

Background: The few established risk factors for non-Hodgkin lymphoma (NHL) exhibit considerable heterogeneity by NHL subtype and suggest an etiologic role for factors with immune- or inflammation-modulating properties, or which otherwise influence lymphocyte proliferation and survival. Epidemiologic evidence supports a potential inverse association for fruit and vegetable intake and NHL risk, but with limited subtype-specific evidence. Glucosinates and indole-3-carbinol, both found in cruciferous vegetables, may mediate tumor suppressive effects, including anti-inflammatory and anti-proliferation effects or restoration of phosphatase and tensin homolog (PTEN), a known tumor suppressor frequently down-regulated in cancer cells. We conducted a prospective study to further elucidate the etiologic role of fruit and vegetable consumption for NHL and its most common histologic subtypes. Methods: We followed 47,971 men in the Health Professionals Follow-Up Study (HPFS; 1986-2012) and 77,115 women in the Nurses' Health Study (NHS; 1984-2012) with baseline information on diet and no baseline history of cancer. We queried diet every four years using validated food-frequency questionnaires. We calculated fruit and vegetable consumption, in broad categories and for specific food groups, by summing the intake of individual foods excluding fruit juices, potatoes and legumes. Incident NHL diagnoses were first self-reported in study questionnaires then confirmed by review of medical records. We classified histologic subtypes according to the World Health Organization (WHO) and International Lymphoma Epidemiology (InterLymph) Consortium guidelines. We analyzed all NHL (in aggregate) and separate endpoints of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, other B-cell NHL and T-cell NHL. We used multivariate Cox proportional hazards regression adjusting for potential confounding variables to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of various fruit and vegetable intake variables with risk of each NHL endpoint. Those intake variables were based on the pre-diagnosis questionnaire returned most recent to NHL diagnosis and modeled as continuous variables in increments of one serving/day. Results: During 2,747,939 person-years of follow-up, we confirmed 1,732 incident NHL cases (986 women, 746 men). In preliminary multivariable-adjusted analyses, no fruit and vegetable intake variable was significantly associated with risk of all NHL (Table 1). Each additional serving/day of all, green leafy, beta carotene rich and lycopene rich vegetables was significantly associated with a 15%-45% lower risk of DLBCL per serving/day but not with other NHL subtypes; cruciferous and lutein rich vegetable intakes had a suggestive but statistically non-significant inverse association with several B-cell NHL subtypes (Table 1). Other associations were only weakly suggestive or null. Conclusions: In this prospective investigation, preliminary findings suggest a modest reduction of risk of several individual B-cell NHL subtypes, including statistically significantly lower risks of DLBCL, with increasing intake of green and antioxidant rich vegetables. These findings warrant further exploration and confirmation in other study populations. We note that this abstract reports preliminary findings; ongoing analyses will extend the follow-up period, add a third large cohort (NHS II) and assess potential reverse causation, explore sex- and subtype-related heterogeneity and test for non-linearity of observed associations. If confirmed, these results will contribute to evidence-based prevention strategies for NHL and further support general health recommendations concerning benefits of fruit and vegetable intake. Disclosures No relevant conflicts of interest to declare.

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Fruit and vegetable consumption in adolescence and early adulthood and risk of breast cancer: population based cohort study

BMJ ◽

10.1136/bmj.i2343 ◽

2016 ◽

pp. i2343 ◽

Cited By ~ 47

Author(s):

Maryam S Farvid ◽

Wendy Y Chen ◽

Karin B Michels ◽

Eunyoung Cho ◽

Walter C Willett ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Vegetable Consumption ◽

Early Adulthood ◽

Population Based ◽

Fruit And Vegetable Consumption ◽

Fruit And Vegetable

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Maternal feeding practices and toddlers’ fruit and vegetable consumption: results from the DIT-Coombe Hospital birth cohort in Ireland

Nutrition Journal ◽

10.1186/s12937-021-00743-z ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Xiyao Liu ◽

Qianling Zhou ◽

Keara Clarke ◽

Katherine M. Younger ◽

Meijing An ◽

...

Keyword(s):

Birth Cohort ◽

Vegetable Intake ◽

Vegetable Consumption ◽

Feeding Practices ◽

Fruit And Vegetable Consumption ◽

Fruit And Vegetable Intake ◽

Fruit And Vegetable ◽

Total Diet ◽

Maternal Feeding Practices

Abstract Background Health benefits of fruit and vegetable have been well recognized. However, insufficient consumption of fruit and vegetable is prevalent among toddlers, and has become a global public health issue. Maternal feeding practices are potential factors influencing toddlers’ dietary intake, including fruit and vegetable intake. This study was conducted to explore the influence of maternal feeding practices on toddlers’ fruit and vegetable consumption in Ireland. Methods A follow-up to the DIT-Coombe Hospital birth cohort was conducted. Mothers in the original cohort were invited to participate in the present follow-up study by phone. A questionnaire assessing maternal feeding behavior and the child’s 3-day food diary was sent to mothers who agreed to take part in the present study by post, together with a self-addressed stamped envelope. Results There were 193 mother-children pairs included in the analysis, and the mean age of children was 2.4 (SD 0.7) years old. Toddlers’ mean daily intakes of vegetable and fruit were 67.57 (SD 45.95) g and 213.35 (SD 170.78) g, respectively. Logistic regression analyses showed that maternal practice of breastfeeding for more than 4 weeks was positively associated with fruit (OR = 2.93, 95% CI: 1.29–6.64) and vegetable (OR = 1.95, 95% CI: 1.00–3.81) intake or the contribution of fruit (OR = 2.62, 95% CI: 1.19–5.80) and vegetable (OR = 2.02, 95% CI: 1.02–3.99) to the total diet. Letting the child eat with other family members was associated with high vegetable intake (OR = 5.45, 95%CI: 1.69–17.61) and high contribution of vegetable to total diet (OR = 3.78, 95% CI: 1.04–13.82). Not being too worried about the child’s refusal to eat was positively associated with toddlers’ vegetable intake (OR = 2.10, 95%CI: 1.09–4.05). Conclusions To increase children’s fruit and vegetable intake, and develop good eating habits, parents should eat with their toddlers, be patient and not put much pressure on their children in the context of meal feeding.

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Building Healthy Eating Knowledge and Behavior: An Evaluation of Nutrition Education in a Skill Training Course for Construction Apprentices

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16234852 ◽

2019 ◽

Vol 16 (23) ◽

pp. 4852 ◽

Cited By ~ 1

Author(s):

Chung ◽

Chan

Keyword(s):

Nutrition Education ◽

Healthy Eating ◽

Vegetable Consumption ◽

Skill Training ◽

Fruit And Vegetable Consumption ◽

Construction Workers ◽

Fruit And Vegetable ◽

Post Intervention ◽

And Behavior

Background: Prior research has found poor health among construction workers is related to poor nutrition and low fruit and vegetable consumption. Promoting nutrition knowledge can improve dietary behaviors, but nutrition education among construction workers is limited. We evaluated the effectiveness of nutrition education on fruit and vegetable consumption among construction apprentices. In this pilot evaluative study, 36 construction apprentices enrolled in skill training programs received two 1.5-hour nutrition classes. Twelve questions addressing healthy eating knowledge and behavior were administered at baseline, after intervention, and at three months follow-up. After intervention, daily fruit consumption improved from baseline (mean (s.d.) =1.42 (0.55)) to post intervention (mean (s.d.) =1.72 (0.70)) (p < 0.05) and to three months follow-up (mean(s.d.) =1.94 (0.83)) (p > 0.05). After intervention, daily vegetable consumption improved from baseline (mean (s.d.) =1.67 (0.59)) to post intervention (mean (s.d.) =1.97 (0.74)) (p < 0.05) and to three months follow-up (mean (s.d.) = 2.19 (0.82)) (p > 0.05). Younger construction apprentices showed better healthy eating knowledge at post intervention and three months follow-up (p > 0.05). Working in normal hours showed better healthy eating knowledge at post intervention but not at three months follow up (p > 0.05). Both age groups and working hours did not show significant differences on healthy eating behaviour. Nutrition education implemented as a three-hour session within skill courses may possibly promote fruit and vegetable consumption among construction apprentices. Further research with control group is required to support the findings in this study.

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Joint associations of fruit and vegetable consumption and physical activity with mortality risk

European Journal of Public Health ◽

10.1093/eurpub/ckz187.028 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

E Mauramo ◽

J Salmela ◽

N Kanerva ◽

E Lahelma ◽

T Lallukka ◽

...

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Vegetable Consumption ◽

Premature Mortality ◽

Fruit And Vegetable Consumption ◽

Lower Mortality ◽

Fruit And Vegetable ◽

Lower Mortality Risk ◽

Joint Associations

Abstract Background Fruit and vegetable consumption (FVC) and leisure-time physical activity (LTPA) are associated with better health outcomes but less is known about their joint associations with the risk of mortality. We examined the joint associations of FVC and LTPA with premature mortality among midlife and ageing municipal employees, adjusting for key covariates. Methods Survey data collected in 2000–2002 among 40–60-year-old employees of the City of Helsinki, Finland, were linked with complete register data on mortality from Statistics Finland (4961 women, 1373 men; response rate 67%; written consent for register linkages 74%). FVC was dichotomised into daily or non-daily, and LTPA into high (>14 MET-hours/week including vigorous exercise) or low. Covariates included age, sex, marital status, socioeconomic position, binge drinking, smoking and self-rated health. Cox regression models were fitted. The follow-up continued until the event of death or the end of 2015. Results A total of 281 deaths occurred during the follow-up. The mortality rate was 7.1% in men and 3.7% in women. A gender interaction was found, showing differing associations for women and men. Men with both daily FVC and high LTPA had the lowest mortality risk (HR 0.19, 95% CI 0.06-0.63) after adjusting for covariates. Men with high LTPA and non-daily FVC also had a lower mortality risk (HR 0.51, 95% CI 0.29-0.90) compared to those with non-daily FVC and low LTPA. Women with daily FVC and high LTPA had a lower mortality risk initially, but after adjusting for covariates no statistically significant associations were observed. Conclusions The joint associations of FVC and LTPA with premature mortality differed between women and men. This could be related to gender differences in e.g. the causes of death, and further studies are needed to clarify this. Increasing FVC and LTPA might prevent premature mortality among men. Key messages Fruit and vegetable consumption jointly with physical activity decreased the risk of premature mortality among men only. Further studies are needed to clarify the gender difference which could be related to for example death causes.

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Fit “N” Cool Kids: The Effects of Character Modeling and Goal Setting on Children’s Physical Activity and Fruit and Vegetable Consumption

Clinical Medicine Insights Pediatrics ◽

10.1177/1179556518784296 ◽

2018 ◽

Vol 12 ◽

pp. 117955651878429 ◽

Cited By ~ 1

Author(s):

Jessyka N Larson ◽

Timothy A Brusseau ◽

Heidi Wengreen ◽

Stuart J Fairclough ◽

Maria M Newton ◽

...

Keyword(s):

Physical Activity ◽

Goal Setting ◽

Vegetable Consumption ◽

Overweight And Obesity ◽

Fruit And Vegetable Consumption ◽

Control Group ◽

Fruit And Vegetable ◽

Children’S Physical Activity ◽

Over Time

Efforts to decrease the risk of overweight and obesity should focus on children’s physical activity (PA) and fruit and vegetable (FV) consumption. Within school-based interventions, there is insufficient evidence on the effectiveness of the use of character modeling and goal setting to determine changes in step counts, MVPA, and FV consumption. Study participants were 187 students in grades 4 and 5 from 2 Title 1 elementary schools in the Southwest United States. The intervention was a quasi-experimental character modeling and goal setting program. New Lifestyles NL-1000 activity monitors were used to assess number of steps taken and MVPA by the participants. Fruit and vegetable consumption was measured by direct observation. School day steps, MVPA, and FV consumption were recorded at baseline, intervention, and during a 10-week follow-up. There were not differences between groups at baseline. Steps and MVPA were statistically significantly ( P < .05; Δ = ~2500 steps and ~5 minutes of MVPA) greater in the intervention compared with the control group over time. Fruit and vegetable consumption was not significantly ( P = .308) greater in the intervention compared with the control group over time. Students in the intervention school were significantly more active than students in the control school during the intervention phase and at follow-up. The findings reported here would suggest that character modeling and goal setting can increase PA among elementary aged children but did not increase FV consumption.

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Perceived access to fruits and vegetables associated with increased consumption

Public Health Nutrition ◽

10.1017/s1368980008004308 ◽

2009 ◽

Vol 12 (10) ◽

pp. 1743-1750 ◽

Cited By ~ 70

Author(s):

Erin M Caldwell ◽

M Miller Kobayashi ◽

WM DuBow ◽

SM Wytinck

Keyword(s):

Fruits And Vegetables ◽

Vegetable Consumption ◽

Fruit And Vegetable Consumption ◽

Grocery Store ◽

Community Interventions ◽

Average Increase ◽

Fruit And Vegetable ◽

Community Based ◽

Perceived Access

AbstractObjectiveTo examine the association between fruit and vegetable access in the community and change in fruit and vegetable consumption among participants in community-based health promotion programmes.DesignFruit and vegetable consumption and perceived access to fresh fruit and vegetables were measured by self-administered questionnaires at programme start, end and 1-year follow-up. Community produce availability was determined by grocery store assessments measuring the display space devoted to fruit and vegetable offerings, as well as price, variety and freshness. A total of nine communities were studied; 130 participants completed the fruit and vegetable portions of the questionnaires and could be linked to grocery store assessments.ResultsParticipants made modest but significant increases in fruit and vegetable consumption from programme start to end: the average increase was 2·88 (95 % CI 1·52, 4·25) servings weekly; the average increase from start to follow-up was 2·52 (95 % CI 1·09, 3·95) servings weekly. Greater perceived access to fruits and vegetables was significantly associated with higher increases in fruit and vegetable consumption from programme start to programme end. Greater availability of produce was associated with greater increases in fruit and vegetable servings from programme start to programme end as measured by store assessments.ConclusionsEnvironmental factors, such as access to fruits and vegetables, can modify the effects of community interventions. Interventions with the goal of increasing fruit and vegetable consumption should consider focusing on increasing access to fresh fruits and vegetables in target communities. Similarly, researchers may want to study access as an intervention, not just a contextual variable.

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5-Year Follow-Up of a Telephone Intervention to Increase Fruit and Vegetable Consumption in Preschoolers: The ‘Healthy Habits’ Cluster Randomised Trial

Nutrients ◽

10.3390/nu12123702 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3702

Author(s):

Rebecca Wyse ◽

Fiona Stacey ◽

Libby Campbell ◽

Serene Yoong ◽

Christophe Lecathelinais ◽

...

Keyword(s):

Food Environment ◽

Vegetable Consumption ◽

Fruit And Vegetable Consumption ◽

Parent Intervention ◽

Fruit And Vegetable ◽

Complete Case ◽

Cluster Randomised ◽

Environment Control

Little is known about the long-term impact of telephone-based interventions to improve child diet. This trial aimed to assess the long-term effectiveness (after 5 years) of a telephone-based parent intervention in increasing children’s fruit and vegetable consumption. Parents of 3–5 year olds were recruited from 30 Australian preschools to participate in a cluster randomised controlled trial. Intervention parents received four, weekly, 30-min support calls aimed at modifying the home food environment. Control parents received printed materials. Consumption was assessed using the Fruit and Vegetable subscale of the Children’s Dietary Questionnaire (F&V-CDQ) (children) and daily servings of fruit and vegetables (children and parents) via parent telephone interview. Of the 394 parents who completed baseline, 57% (99 intervention, 127 control) completed follow-up. After 5-years, higher intervention F&V-CDQ scores, bordering on significance, were found in complete-case (+1.1, p = 0.06) and sensitivity analyses (+1.1, p = 0.06). There was no difference in parent or child consumption of daily fruit servings. Complete-case analysis indicated significantly higher consumption of child vegetable servings (+0.5 servings; p = 0.02), which was not significant in sensitivity analysis (+0.5 servings; p = 0.10). This telephone-based parent intervention targeting the family food environment may yield promising improvements in child fruit and vegetable consumption over a 5-year period.

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