Nutr Res Pract.  2017 Apr;11(2):130-138. 10.4162/nrp.2017.11.2.130.

Prevalence and determinants of sufficient fruit and vegetable consumption among primary school children in Nakhon Pathom, Thailand

• Hong SA
• Piaseu N

• KMID: 2412025
• DOI: http://doi.org/10.4162/nrp.2017.11.2.130

Abstract

BACKGROUND/OBJECTIVES
Low consumption of fruit and vegetable is frequently viewed as an important contributor to obesity risk. With increasing childhood obesity and relatively low fruit and vegetable consumption among Thai children, there is a need to identify the determinants of the intake to promote fruit and vegetable consumption effectively.
SUBJECTS/METHODS
This cross-sectional study was conducted at two conveniently selected primary schools in Nakhon Pathom. A total of 609 students (grade 4-6) completed questionnaires on personal and environmental factors. Adequate fruit and vegetable intakes were defined as a minimum of three servings of fruit or vegetable daily, and adequate total intake as at least 6 serves of fruit and vegetable daily. Data were analyzed using descriptive statistics, the chi-square test, and multiple logistic regression.
RESULTS
The proportion of children with a sufficient fruit and/or vegetable intakes was low. Covariates of child's personal and environmental factors showed significant associations with sufficient intakes of fruit and/or vegetable (P < 0.05). Logistic regression analyses showed that the following factors were positively related to sufficient intake of vegetable; lower grade, a positive attitude toward vegetable, and fruit availability at home; and that greater maternal education, a positive child's attitude toward vegetable, and fruit availability at home were significantly associated with sufficient consumption of fruits and total fruit and vegetable intake.
CONCLUSIONS
The present study showed that personal factors like attitude toward vegetables and socio-environmental factors, such as, greater availability of fruits were significantly associated with sufficient fruit and vegetable consumption. The importance of environmental and personal factors to successful nutrition highlights the importance of involving parents and schools.

Keyword

Fruit; vegetables; self efficacy; child

MeSH Terms

Asian Continental Ancestry Group
Child*
Cross-Sectional Studies
Education
Fruit*
Humans
Logistic Models
Obesity
Parents
Pediatric Obesity
Prevalence*
Self Efficacy
Thailand*
Vegetables*

Reference

1. UNICEF. Situation Analysis of Children and Women in Thailand 2011. Bangkok: UNICEF Thailand Country Office;2011.

2. Jennings J, Gillespie S, Mason J, Lotfi M, Scialfa T. Managing successful nutrition programmes. Geneva: United Nations Administrative Committee on Coordination/Sub-Committee on Nutrition;1991.

3. Kachondham Y, Winichagoon P, Tontisirin K. Nutrition and Health in Thailand: Trends and Actions ( UN ACC/SCN country case study). Bangkok: Institute of Nutrition Mahidol University;1992.

4. The Office of Her Royal Highness Princess Maha Chakri Sirindhorn's Projects. Opportunities and equity beyond frontiers: Development work of Her Royal Highness Princess Maha Chakri Sirindhorn. Bangkok, Thailand: The Office of Her Royal Highness Princess Maha Chakri Sirindhorn's Projects;2015.

5. Winichagoon P. Thailand nutrition in transition: situation and challenges of maternal and child nutrition. Asia Pac J Clin Nutr. 2013; 22:6–15.

6. Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006; 84:289–298.

7. Kosulwat V. The nutrition and health transition in Thailand. Public Health Nutr. 2002; 5(1A):183–189.

8. Ramachandran A, Snehalatha C. Rising burden of obesity in Asia. J obes. 2010; 2010.

9. Yamborisut U, Mo-Suwan L. Prevalence of childhood and adolescent obesity in Thailand: a review. J Med Assoc Thai. 2014; 97:44–51.

10. Satheannoppakao W, Aekplakorn W, Pradipasen M. Fruit and vegetable consumption and its recommended intake associated with sociodemographic factors: Thailand National Health Examination Survey III. Public Health Nutr. 2009; 12:2192–2198.

11. Health Information System Development Office. Health status report of Thailand (in Thai). Nonthaburi, Thailand: Thai Health Promotion Foundation;2006.

12. Matthews VL, Wien M, Sabaté J. The risk of child and adolescent overweight is related to types of food consumed. Nutr J. 2011; 10:71.

13. Alinia S, Hels O, Tetens I. The potential association between fruit intake andbody weight -a review. Obes Rev. 2009; 10:639–647.

14. WHO. Diet, Nutrition, and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation WHO. 2003.

15. Lytle LA, Seifert S, Greenstein J, McGovern P. How do children's eating patterns and food choices change over time? Results from a cohort study. Am J Health Promot. 2000; 14:222–228.

16. Birch LL, Fisher JO. Development of eating behaviors among children and adolescents. Pediatrics. 1998; 101:539–549.

17. Bandura A. Social foundations of thought and action: A social cognitive theory. New York: Prentice-Hall;1986.

18. Rasmussen M, Krølner R, Klepp KI, 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.

19. Reinaerts E, de Nooijer J, Candel M, de Vries N. Explaining school children's fruit and vegetable consumption: The contributions of availability, accessibility, exposure, parental consumption and habit in addition to psychosocial factors. Appetite. 2007; 48:248–258.

20. Pearson N, Biddle SJ, Gorely T. Family correlates of fruit and vegetable consumption in children and adolescents: a systematic review. Public Health Nutr. 2009; 12:267–283.

21. Hearn DH, Baranowski T, Baranowski J, Doyle C, Smith M, Lin LS, Resnicow K. Environmental Influences on Dietary Behavior Among Children: Availability and Accessibility of fruits and vegetables Enable Consumption. J Health Educ. 1998; 29:26–32.

22. Kristjansdottir AG, Thorsdottir I, De Bourdeaudhuij I, Due P, Wind M, Klepp K. Determinants of fruit and vegetable intake among 11-year-old schoolchildren in a country of traditionally low fruit and vegetable consumption. Int J Behav Nutr Phys Act. 2006; 3:41.

23. Zarnowiecki DM, Parletta N, Dollman J. The role of socio-economic position as a moderator of children's healthy food intake. Br J Nutr. 2014; 112:830–840.

24. Wilson AM, Magarey AM, Mastersson N. Reliability and relative validity of a child nutrition questionnaire to simultaneously assess dietary patterns associated with positive energy balance and food behaviours, attitudes, knowledge and environments associated with healthy eating. Int J Behav Nutr Phys Act. 2008; 5:5.

25. Wind M, de Bourdeaudhuij I, te Velde SJ, Sandvik C, Due P, Klepp KI, Brug J. Correlates of fruit and vegetable consumption among 11-year-old Belgian-Flemish and Dutch schoolchildren. J Nutr Educ Behav. 2006; 38:211–221.

26. Hendrie GA, Riley MD. Performance of short food questions to assess aspects of the dietary intake of Australian children. Nutrients. 2013; 5:4822–4835.

27. Block G, Gillespie C, Rosenbaum EH, Jenson C. A rapid food screener to assess fat and fruit and vegetable intake. Am J Prev Med. 2000; 18:284–288.

28. Working Group on Food-Based Dietary Guidelines for Thai People. The Thai Nutrition Flag; Healthy eating for Thais. Bangkok, Thailand: Nutrition Division, Department of Health, Ministry of Public Health;2001.

29. Keihner AJ, Meigs R, Sugerman S, Backman D, Garbolino T, Mitchell P. The Power Play! Campaign's School Idea & Resource Kits improve determinants of fruit and vegetable intake and physical activity among fourth- and fifth-grade children. J Nutr Educ Behav. 2011; 43:4 Suppl 2. S122–S129.

30. Baranowski T, Davis M, Resnicow K, Baranowski J, Doyle C, Lin LS, Smith M, DT W. Gimme 5 fruit, juice, and vegetables for fun and health: outcome evaluation. Health Educ Behav. 2000; 27(1):96–111.

31. Saunders RP, Pate RR, Felton G, Dowda M, Weinrich MC, Ward DS, Parsons MA, Baranowski T. Development of questionnaires to measure psychosocial influences on children's physical activity. Prev Med. 1997; 26(2):241–247.

32. 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; 9:3575–3587.

33. Vadiveloo M, Zhu L, Quatromoni PA. Diet and physical activity patterns of school-aged children. J Am Diet Assoc. 2009; 109:145–151.

34. Te Velde SJ, Brug J, Wind M, Hildonen C, Bjelland M, Pérez-Rodrigo C, Klepp KI. Effects of a comprehensive fruit- and vegetable-promoting schoolbased intervention in three European countries: the Pro Children Study. Br J Nutr. 2008; 99:893–903.

35. Knai C, Pomerleau J, Lock K, McKee M. Getting children to eat more fruit and vegetables: a systematic review. Prev Med. 2006; 42:85–95.

36. Sallis JF, Owen N, Fisher EB. Ecological models of health behavior. In : Glanz K, Rimer BK, Viswanath K, editors. Health Behavior and Health Education: Theory, Research and Practice. San Francisco, CA: Jossey-Bass;2008. p. 465–485. .

37. Sandvik C, De Bourdeaudhuij I, Due P, Brug J, Wind M, Bere E, Pérez-Rodrigo C, Wolf A, Elmadfa I, Thórsdóttir I, Vaz de Almeida MD, Yngve A, Klepp KI. Personal, social and environmental factors regarding fruit and vegetable intake among schoolchildren in nine European countries. Ann Nutr Metab. 2005; 49:255–266.

38. Haerens L, Craeynest M, Deforche B, Maes L, Cardon G, De Bourdeaudhuij I. The contribution of psychosocial and home environmental factors in explaining eating behaviours in adolescents. Eur J Clin Nutr. 2008; 62:51–59.

39. Wolnicka K, Taraszewska AM, Jaczewska-Schuetz J, Jarosz M. Factors within the family environment such as parents' dietary habits and fruit and vegetable availability have the greatest influence on fruit and vegetable consumption by Polish children. Public Health Nutr. 2015; 18:2705–2711.

40. Bere E, Klepp KI. Correlates of fruit and vegetable intake among Norwegian schoolchildren: parental and self-reports. Public Health Nutr. 2004; 7:991–998.

41. Reynolds KD, Hinton AW, Shewchuk RM, Hickey CA. Social cognitive model of fruit and vegetable consumption in elementary school children. J Nutr Educ. 1999; 31:23–30.

42. Rakhshanderou S, Ramezankhani A, Mehrabi Y, Ghaffari M. Determinants of fruit and vegetable consumption among Tehranian adolescents: A qualitative research. J Res Med Sci. 2014; 19:482–489.

43. WHO. Effectiveness of Interventions and Programmes Promoting Fruit and Vegetable Intake. Geneva: WHO;2005.

44. Wijesinha-Bettoni R, Orito A, Löwik M, Mclean C, Muehlhoff E. Increasing fruit and vegetable consumption among schoolchildren: efforts in middle-income countries. Food Nutr Bull. 2013; 34:75–94.

45. Briefel RR, Crepinsek MK, Cabili C, Wilson A, Gleason PM. School food environments and practices affect dietary behaviors of US public school children. J Am Diet Assoc. 2009; 109:S91–S107.

46. Wardle J, Herrera ML, Cooke L, Gibson EL. Modifying children's food preferences: the effects of exposure and reward on acceptance of an unfamiliar vegetable. Eur J Clin Nutr. 2003; 57:341–348.

47. Perez-Rodrigo C, Wind M, Hildonen C, Bjelland M, Aranceta J, Klepp KI, Brug J. The pro children intervention: applying the intervention mapping protocol to develop a school-based fruit and vegetable promotion programme. Ann Nutr Metab. 2005; 49:267–277.

48. Glanz K, Mullis RM. Environmental interventions to promote healthy eating: a review of models, programs, and evidence. Health Educ Q. 1988; 15:395–415.