Elsevier

Preventive Medicine

Volume 46, Issue 4, April 2008, Pages 331-335
Preventive Medicine

Children's fruit and vegetable intake: Associations with the neighbourhood food environment

https://doi.org/10.1016/j.ypmed.2007.11.011Get rights and content

Abstract

Objective

To examine associations between availability of different types of food outlets and children's fruit and vegetable intake.

Method

Parents of 340 5–6 and 461 10–12 year-old Australian children reported how frequently their child ate 14 fruits and 13 vegetables in the last week in 2002/3. A geographic information system (GIS) was used to determine the availability of the following types of food outlets near home: greengrocers; supermarkets; convenience stores; fast food outlets; restaurants, cafés and takeaway outlets. Logistic regression analyses examined the likelihood of consuming fruit ≥ 2 times/day and vegetables ≥ 3 times/day, according to access to food outlets.

Results

Overall, 62.5% of children ate fruit ≥ 2 times/day and 46.4% ate vegetables ≥ 3 times/day. The more fast food outlets (OR = 0.82, 95%CI = 0.67–0.99) and convenience stores (OR = 0.84, 95%CI = 0.73–0.98) close to home, the lower the likelihood of consuming fruit ≥ 2 times/day. There was also an inverse association between density of convenience stores and the likelihood of consuming vegetables ≥ 3 times/day (OR = 0.84, 95%CI = 0.74–0.95). The likelihood of consuming vegetables ≥ 3 times/day was greater the farther children lived from a supermarket (OR = 1.27, 95%CI = 1.07–1.51) or a fast food outlet (OR = 1.19, 95%CI = 1.06–1.35).

Conclusion

Availability of fast food outlets and convenience stores close to home may have a negative effect on children's fruit and vegetable intake.

Introduction

It is widely acknowledged that children eat fewer fruits and vegetables than is recommended for health (Guenther et al., 2006, Krebs-Smith et al., 1996, Magarey et al., 2001, Yngve et al., 2005). For example, on the day of the most recent National Nutrition Survey in Australia, 34% of 4–7 year olds ate no fruit and almost 30% ate no vegetables (McLennan and Podger, 1999). Adolescent consumption of fruit and vegetables is also known to be low, with 50% of 12–15 year olds in Australia eating no fruit and about 20% at no vegetables on the day before the survey (McLennan and Podger, 1999). Fruits and vegetables have important health-protective effects (World Health Organisation, 2002, World Health Organisation, 2003). Given evidence that fruit and vegetable intake behaviours are established in childhood (Lien et al., 2001, Wang et al., 2002), it is important to understand the correlates of children's consumption.

A recent review of determinants of fruit and vegetable consumption among 6–12 year olds concluded that the availability and accessibility of fruits and vegetables, and taste preferences (influenced by both genetics and availability) were most consistently and most positively related to consumption (Blanchette and Brug, 2005). Findings in relation to home availability of fruits and vegetables were supported by a review by Van der Horst and colleagues among 4–12 year-old children (van der Horst et al., 2007). In addition, the availability of less healthy food choices at home appears to be a robust predictor of consumption of these foods for both sexes, but particularly for girls (Ayala et al., 2007, Grimm et al., 2004, Haerens et al., in press).

The availability of fruits and vegetables in the home is likely to be influenced, at least in part, by access to food shops, restaurants, cafés and takeaway shops in the local neighbourhood that promote or compete with sales of these foods. It has also been argued that an ‘obesogenic’ environment promotes consumption of less healthy foods and discourages consumption of healthier options such as fruits and vegetables (Sallis and Glanz, 2006). The availability of different types of food stores, particularly fast food stores, is one aspect of an ‘obesogenic’ environment. However, few studies have examined associations between availability of food shops and dietary behaviours.

An ecological study conducted in the USA shows that the availability of at least one supermarket in census tracts was associated with a higher likelihood of meeting guidelines for fruit and vegetables, as well as guidelines for total fat and saturated fat, among adults who live in these census tracts (Morland et al., 2002). ‘Easy access’ to supermarket shopping has been associated with greater use of fruits, and greater distance from home was associated with lower use of fruits, in low-income households (Rose and Richards, 2004). Further studies have found similar results showing associations between availability of particular types of foods in local stores and consumption among adults (Cheadle et al., 1993). However, as far as we are aware, no such studies have been conducted among children.

Although availability of fruit and vegetables within the home has been consistently positively associated with children's fruit and vegetable intake, a recent review of determinants of fruit and vegetable consumption among children highlighted a lack of research examining the influence of availability of fruit and vegetables more broadly (Rasmussen et al., 2006). This study aimed to examine associations between the availability of a range of food stores close to home and children's consumption of fruit and vegetables.

Section snippets

Methods

This study included 5–6 and 10–12 year-old children recruited from 17–24 schools. Parents completed a self-administered survey that included questions about their child's fruit and vegetable intake. Survey data were collected from November 2002 to December 2003. These data were combined with data derived from a geographic information system (GIS) regarding the availability of various types of food outlets within 800 m from each child's home in 2004/5. The Deakin University Ethics Committee,

Participant profile

Data were available for 340 children aged 5–6 and 461 children aged 10–12 years. Half of the sample (49.3%) was boys and 42.5% were aged 5–6 years. Most children's mothers had a medium (38.4%) or high (39.2%) level of education, and 82.9% of parents were married or in a defacto relationship. Overall, 15.2% of mothers were employed full-time and 27.0% part-time in paid employment. Most families (89.1%) usually spoke English at home. Of these characteristics, only maternal education differed

Discussion

This study is one of the first to examine associations between the availability of a range of food stores close to home and children's consumption of fruit and vegetables. Strengths of the study are the inclusion of a large sample of children in a range of age groups (5–6 and 10–12 years), the objective assessment of the neighbourhood food environment using a GIS, and the fact that the availability of food stores was measured specific to each individual in this study, an approach that has been

Conclusions

This study found that the availability of convenience stores and fast food outlets close to home may have a detrimental effect on children's fruit and vegetable intake. Future studies should examine the role of availability of foods within the home as a mediator of the relationship between factors such as food availability within the built environment and children's dietary intake. The positive association between distance to the closest supermarket and the likelihood of consuming vegetables at

Acknowledgments

The survey data collection was funded by the Victorian Health Promotion Foundation. The collection and geocoding of data related to locations of foods stores was funded in part by the State of Victoria through its Department of Human Services (DHS) and in part by the ARC (DP0665242). The views and conclusions are those of the authors and do not necessarily represent those of DHS. The assistance of Michelle Jackson and Sophie Thal-Janzen, Jackie Newman, Anne Savige and Kate Udorovich, David

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