Health Psychology > lecture 4-Fruit and vegetable intake > Flashcards
lecture 4-Fruit and vegetable intake Flashcards
what are the health benefits of High intakes of fruits and vegetables (WHO, 1990)
- Cardiovascular disease
- Certain cancers, e.g. bowel cancers
- Type II diabetes
- Osteoporosis
- Obesity
- Dementia and Alzheimer’s disease
what are the current recommendations for fruit and veg intake? (WHO, 1990)
400g (5 portions) fruit & veg per day
explain the Bazzano LA, et al. (2002) study
FV intake negatively associated with stroke incidence, stroke mortality, cardiovascular disease mortality, all cause mortality
explain the Riboli E, Norat T. Am (2003) study
FV intake negatively associated with cancers of mouth, pharynx, oesophagus, lung, stomach, colon and rectum
explain the Harding AH, et al. (2008) study
FV intake negatively associated with diabetes
explain the Tohill BC. World Health Organization 2005 study
FV intake negatively associated with obesity
what is the outcome of the Keys A et al. Am J Epidemiol 1986 study?
Mediterranean diet negatively associated with CVD risk.
Dilis et al. B J Nutr, 2012 study
med diet
Mediterranean diet negatively associated with CHD incidence and mortality
Kontou et al. (2012)
med diet
Mediterranean diet negatively associated with colorectal cancer
Escrich et al. (2011)
med diet
Mediterranean diet negatively associated with breast cancer
McCall DO, et al. Circulation 2009
F&V intake
Increased FV intake improved microvascular function
Macready AL, et al.
F&V intake
Increased FV intake improved mf. and inflammatory status
Yeon JY, et al
F&V intake
Increased FV intake improved profiles in is. and oxidative stress
Gibson A, et al.
F&V intake
Increased FV intake improved immune function
Tanumihardjo SA, et al
F&V intake
Increased FV intake improved weight maintenance
Appleton KM, McGill R, Woodside JV. (2009) Fruit and vegetable consumption in older people in Northern Ireland: Levels and patterns.
Telephone survey on FV consumption in 1000 individuals over the age of 65 years, living in Northern Ireland.
FV consumption based on self-report questionnaires
Demographic and lifestyle variables
Results based on 426 respondents, representative of the target population
Average intakes = 4.0 FV portions/day
Weekdays: Fruit and vegetables intakes significantly predicted (R2=0.08, ajd. R2=0.06, F(10,418)=3.63, p<0.01
FV intakes depend on gender, age and deprivation score
The best predictors of high FV intakes are cognitions:
- Awareness of FV recommendations
- Nutritional Knowledge
- Health Knowledge
- Positive attitudes towards FV
- Positive attitudes towards health
- Beliefs in the benefits of FV for health
- Perceptions of others
- Beliefs in abilities
Appleton KM, McGill R, Neville C, Woodside JV. (2010) Barriers to increasing fruit and vegetable intakes in the older population of NI: Low levels of liking and low awareness of current recommendations.
Telephone survey on FV consumption and barriers / facilitators to FV consumption of 1000 individuals over the age of 65 years, living in Northern Ireland.
Results based on 426 respondents, representative of the target population
Low fruit and vegetable intakes were associated with:
1. low levels of liking 2. low awareness of current recommendations 3. low willingness to change 4. demographic variables
Ashfield-Watt P (2006). Fruits and vegetables, 5+ a day: are we getting the message across?
Two surveys to investigate the value of the 5+ a day campaign for fruits and vegetables in New Zealand
Household surveys 1999 – 200 ppts, 2000 – 520 ppts.
High awareness of campaign, high recognition of the logo,
High awareness of a need to consume more fruits and vegetables
Increased intentions to consume more fruit and vegetables
Intakes were not effected, but more effected by demographics
Rooney C, et al. (2017) How much is ‘5-a-day’?: A qualitative investigation into consumer understanding of fruit and vegetable intake guidelines.
Aim: to understand the knowledge or lack of knowledge of the 5-a-day FV message.
Mixed methods: Six semi-structured focus groups (28 adults) in low FV consumers. Questionnaires assessing knowledge of the 5-a-day FV message.
High awareness of the 5-a-day message. Low knowledge of the foods included and of portion sizes, and misunderstanding of the concept of variety.
Appleton KM, et al. (2018) Low fruit and vegetable knowledge is associated with low knowledge of the details of the 5-a-day fruit and vegetable message in the UK: Findings from two cross-sectional questionnaire studies.
Aim: to understand the knowledge or lack of knowledge of the 5-a-day FV message most associated with poor FV intakes.
Study 1:
A short questionnaire (7 questions) administered to a general population on the streets of Bournemouth.
A total of 507 individuals (males, females, aged 18-80+ years, from all SES categories) completed the questionnaire.
Results:
High awareness of the 5-a-day message. Awareness of the message was associated with FV intakes. Confusion over the details of the message were high, and higher confusion was associated with low FV intakes. Greatest confusion related to portion sizes.
Aim: to understand the knowledge or lack of knowledge of the 5-a-day FV message most associated with poor FV intakes.
Study 2:
A comprehensive questionnaire administered by post to a general UK population.
A total of 247 individuals (males, females, aged 18-80+ years, from all areas) completed the questionnaire.
Results:
High awareness of the 5-a-day message. Knowledge of the details of the message were low, and low knowledge was associated with low FV intakes.
Lowest knowledge related to portion sizes and variety, but intakes were not related to this specific knowledge.
Rooney C, et al. (2017)
Increased understanding is needed on portion sizes and variety
Smart 5-a-day mobile phone application to increase FV portion size knowledge
Appleton KM, Passmore D, Burn I, Pidgeon H, Nation P, Boobyer C, Jiang N. An interactive mobile phone application, Smart 5-a-day, for increasing knowledge of and adherence to fruit and vegetable recommendations
Randomized controlled test
94 individuals – 50 tested the app, 44 acted as controls
Testing for 2 weeks or 4 weeks
Outcomes – FV awareness, FV knowledge, FFQ intake, FV behaviour
Assessed at baseline, 2 weeks and 4 weeks
App usage and feedback Data collected during and after use
Rennie L, Uskul AK, Adams C, Appleton KM. (2014)
Online survey
532 participants either read vs. did not read a short informational health message about the benefits of increasing fruit consumption,
and then visualized from first-person perspective vs. from third-person perspective vs. did not visualise themselves increasing their fruit consumption.
Outcomes: intentions to increase fruit consumption, attitudes, social norms, perceived behavioural control, self-efficacy, action planning and coping planning.
Effects of visualization orientation were only found when combined with the health message,
and stronger effects were found for first-person perspective visualization vs. third-person perspective visualization.
Adams C, Rennie L, Uskul AK, Appleton KM. (2015) Visualising future behavior: Effects for snacking on biscuit bars, but no effects for snacking on fruit.
Aim: To investigate the impact of visualising a fruit eating experience on subsequent fruit consumption
Participants were randomized to: visualising eating fruit (N=72), visualising eating biscuit bars (N=75), or no visualisation (N=72).
Outcomes: subsequent intentions, snack choice, and self-reported fruit consumption two days later.
Other measures: liking, usual behaviour, previous behaviour, perceived social pressures, perceived control and self-efficacy.
Intentions:
No effects of fruit visualisation, without and with background variables
Effects of biscuit bar visualisation, without and with background variables.
Subsequent consumption:
No effects of fruit visualisation, without and with background variables
No effects of biscuit bar visualisation, without and with background variables
Appleton KM. Visualising healthy eating: A role for enjoyment in the use of visualisation for increasing fruit consumption.
Aim: To investigate the impact of visualising an enjoyable fruit eating experience on subsequent fruit consumption
Participants were randomized to visualising:
an enjoyable fruit eating experience (E+) (N=44),
a non-enjoyable fruit eating experience (E-) (N=48), or
neither an enjoyable or non-enjoyable experience (NE) (N=41).
Outcomes: subsequent intentions, snack choice, and self-reported fruit consumption two days later.
Other measures: liking, usual behaviour, previous behaviour, perceived social pressures, perceived control and self-efficacy.
Manipulation check –
differences in enjoyment, no difference in detail or clarity
Intentions differ by condition (enjoyment)
Intentions were determined by conditions (enjoyment) and attitudes (positive)
Behaviour was not predicted
Other predictors of high FV intakes?
- Taste / liking
- Availability and other environmental factors
- Higher consumption of meals and culinary skills
- Higher time and willingness to prepare meals
- Reduced cost
Appleton, KM. A role for enjoyment in promoting healthy eating: Greater fruit selection and consumption following the use of more enjoyable fruit on a health promotion poster.
Aim: To investigate the use of enjoyable fruit compared to traditional fruit on a health promotion poster
Participants were randomized to view health promotion posters that featured: traditional fruit (apples and bananas) (N=70), or enjoyable fruit (grapes and strawberries) (N=68).
Outcomes: subsequent intentions, snack
choice, and self-reported fruit consumption
two days later.
Other measures: liking, usual behaviour,
previous behaviour, perceived social norms,
perceived control and self-efficacy
Intention to consume fruit was positively associated with viewing the traditional poster, liking fruit and previous fruit consumption
Likelihood of consuming fruit was positively associated with likely enjoyment of the fruit, liking fruit and previous fruit consumption
Immediate fruit selection was positively associated with likely enjoyment of the fruit on the poster
Fruit consumption the following day was positively associated with viewing the enjoyable fruit poster and usual fruit consumption
Savage JS, et al. (2013). The addition of a plain or herb-flavoured reduced fat dip is associated with improved pre-schoolers intake of vegetables.
Aim: To increase veg tasting, liking and consumption in 3-5 year olds
Study 1. Participants were exposed to 3 target veg with: plain reduced fat dip favoured flavoured reduced fat dip no dip
Increased willingness to taste for dips compared to no dip. No differences between dips.
Study 2.
Participants were exposed to 2 target unfamiliar or disliked veg with:
favoured flavoured reduced fat dip
no dip
Increased willingness to taste for dip compared to no dip.
Wardle J, et al. (2003). Increasing children’s acceptance of vegetables: a randomised controlled trial of parent-led exposure
Aim: To increase liking and intake of a previously disliked veg in 2-6 year olds
Participants were randomised to receive: 14 daily exposures to a disliked veg no exposures (wait-list)
Increased liking, ranking and consumption of the veg from pre to post exposure period following exposure than following no exposure.
Appleton KM. Increases in fruit intakes in low consumers of fruit following two community-based repeated exposure interventions.
Aim: To increase liking and intake of fruit in older individuals
95 Participants were randomized to: Single exposure (E1): fruit sampling on one occasion only Repeated Exposure (E5): fruit sampling on one occasion per week for five weeks Repeated Exposure Plus (E5+): fruit sampling on one occasion per week for five weeks and fruit provision of one portion of fruit per day to consume at home for the five weeks.
Intakes of fruit and vegetables were assessed every week using 24 hour food recalls of the day before fruit sampling. Liking was also assessed at every fruit sampling occasion
Familiar were liked significantly more than novel fruits. No differences were found between groups
Low consumers (1 portion of fruit / day or less)
Fruit intake increased in repeated exposure groups over time but did not change in the single exposure group
Low consumers (<1 portion of fruit / day)
Familiar fruits were liked significantly more than novel fruits. No differences were found between groups
what are changing F&V intake interventions based on?
- Taste / liking
- Availability and other 3. environmental factors
- Higher consumption of meals and culinary skills
- Higher time and willingness to prepare meals
- Reduced cost
Spill MK, et al. (2011). Serving large portions of vegetable soup at the start of a meal affected children’s energy and vegetable
Aim: To increase vegetable intakes in 3-5 year olds
Participants received a starter at lunch of: 150g tomato soup 225g tomato soup 300g tomato soup No soup
Greater vegetable intakes in all soup conditions compared to no soup. Increasing the portion size increased vegetable intake.
Just DR, Wansink B. (2009). Smarter lunchrooms: using behavioural economics to improve meal selection.
Aim: To increase vegetable selection in a school canteen
Salad bar
No salad bar
More children choosing salad with salad bar compared to no salad bar.
Salad bar positioned in the centre of the canteen
Salad bar positioned at the side of the room
More children choosing salad selection with central salad bar compared to the side salad bar.
Schreinemachers P, et al. (2015). The effect of women’s home gardens on vegetable production and consumption in Bangladesh. Food Security, 7, 97-107
Aim: To increase vegetable production and consumption in families
Education, garden training, garden equipment, seeds, cooking skills No intervention (wait-list)
Increased vegetable production and consumption in the intervention group compared to the control.
Carney PA, et al. (2012). Impact of a community gardening project on vegetable intake, food security and family relationships: a community-based participatory research study
Aim: To increase vegetable intakes in families
Community gardening programme, including education, garden experiences, cooking and tasting, and social activities
No control
Increased vegetable intakes and reduced food insecurity from pre - post intervention.
Weinrich TR et al. (2012). Impact of community-based intervention on serving and intake of vegetables among low-income, rural Appalachian families.
Aim: To increase serving and consumption of vegetables in families
8 weekly interactive sessions for food preparers, including recipes and handouts
8 weekly mailings of the same recipes and handouts
More recipes use in the intervention group compared to the control. No differences in servings or intakes.
