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Effect of a fruit and vegetable subscription in Danish schools

Published online by Cambridge University Press:  16 October 2007

Karen Eriksen ,
Jóhanna Haraldsdóttir ,
Robert Pederson  and
Hanne Vig Flyger
Karen Eriksen*
Affiliation:
6 A Day Research Project, Department of Cancer Prevention and Documentation, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, Denmark Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Rolighedsvej 30, DK-1958 Frederiksberg C, Copenhagen, Denmark
Jóhanna Haraldsdóttir
Affiliation:
Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Rolighedsvej 30, DK-1958 Frederiksberg C, Copenhagen, Denmark
Robert Pederson
Affiliation:
6 A Day Research Project, Department of Cancer Prevention and Documentation, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
Hanne Vig Flyger
Affiliation:
6 A Day Research Project, Department of Cancer Prevention and Documentation, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
*
*Corresponding author: Email [email protected]
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Abstract

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Objective:

To measure the effect of a school fruit and vegetable subscription on children's intake of fruit and vegetables after 5 weeks of intervention.

Setting:

Seven primary schools in Denmark.

Design and methods: Intervention schools (n = 4) were offered a fruit and vegetable subscription comprising one piece per day. Control schools (n = 3) situated in another municipality were not offered the subscription. Intake of fruit and vegetables was measured at baseline and 5 weeks after the start of the subscription. Two methods were used for dietary assessment: a pre-coded 24-hour recall form including total food intake and a food-frequency questionnaire (FFQ) including only fruit and vegetables.

Subjects:

Children aged 6–10 years (n = 804 from intervention schools and n = 689 from control schools). Response rate in the dietary assessment was 31%.

Results:

At intervention schools 45% of the children enrolled in the subscription. After 5 weeks of intervention, both subscribers and non-subscribers had increased their intake of fruit by 0.4 (P = 0.019) and 0.3 (P = 0.008) pieces per school day, respectively, but no change was observed in vegetable intake. Total intake increased only for non-subscribers by 0.4 piece/school day (P = 0.008), mainly due to the consistent increase in fruit intake. No change in intake was measured at control schools. Only the 24-hour recall questionnaire was sensitive enough to pick up the changes of the subscription, whereas the FFQ was not.

Conclusion:

Five weeks with the subscription affected both subscribers and non-subscribers to increase intake of fruit. This may indicate that the subscription had an additional effect of stimulating parents of non-subscribers to supply their children with fruit. The results stress the importance of evaluating the effect of this type of programme, and the carefulness needed in designing the evaluation study.

Keywords

SchoolchildrenIntervention effectDietary assessmentFruit and vegetable intakeFruit subscription24-Hour recallFood-frequency questionnaire6-a-day
Type
Research Article
Information
Public Health Nutrition , Volume 6 , Issue 1 , February 2003 , pp. 57 - 63
Copyright
Copyright © CABI Publishing 2003

References

1van't Veer, P, Jansen, MC, Klerk, M, et al. Fruits and vegetables in the prevention of cancer and cardiovascular disease. Public Health Nutr. 2000; 3: 103–7.CrossRefGoogle ScholarPubMed
2Block, G, Patterson, B, Subar, A. Fruit, vegetables, and cancer prevention: a review of the epidemiological evidence. Nutr. Cancer 1992; 18: 1–29.CrossRefGoogle ScholarPubMed
3Ness, AR, Powles, JW. Fruit and vegetables, and cardiovascular disease: a review. Int. J. Epidemiol. 1997; 26: 1–13.Google Scholar
4Foerster, SHJ, Di Sogra, LK, Pivonka, E. The national 5 a day for better health program: an American nutrition and cancer initiative. In: Wheelock, V, ed. Implementing Dietary Guidelines for Healthy Eating. London: Chapman & Hall, 1997; 447–79.Google Scholar
5 Statens Ernæringråd. Recommendations for Increased Intake of Fruit and Vegetables [in Norwegian] Oslo: Statens Ernæringråd, 1996.Google Scholar
6Williams, C. Healthy eating: clarifying advice about fruit and vegetables [published erratum appears in Br. Med. J. 1995; 310: 1665]. Br. Med. J. 1995; 310: 1453–5.Google Scholar
7Trolle, E, Fagt, S, Ovesen, L. Fruit and Vegetables, Recommendations for Intake [in Danish]. Publication No. 244.Copenhagen: Veterinær og Fødvaredirektoratet (Danish Veterinary and Food Administation), 1998.Google Scholar
8Andersen, D, Fagt, S, Groth, MV, et al. Danish Dietary Habits 1995, Main Results [in Danish with an English summary]. Publication No. 235.Copenhagen: Levenedsmiddelstyrelen (National Food Agency), 1996.Google Scholar
9 National Council on Nutrition and Physical Activity, Norwegian Fruit and Vegetable Marketing Board. School Participation, Who Participates [online]. Available at http://www.skolefrukt.net/fakta/fakta_eng.html. Accessed February 2002.Google Scholar
10 Department of Health. The National School Fruit Scheme [online]. Available at http://www.doh.gov.uk/schoolfruitscheme/. Accessed February 2002.Google Scholar
11Serdula, M, Coates, R, Byers, T, et al. Evaluation of a brief telephone questionnaire to estimate fruit and vegetable consumption in diverse study populations. Epidemiology 1993; 4: 455–63.Google Scholar
12Smith-Warner, SA, Elmer, PJ, Fosdick, L, et al. Reliability and comparability of three dietary assessment methods for estimating fruit and vegetable intakes. Epidemiology 1997; 8: 196–201.CrossRefGoogle ScholarPubMed
13Thompson, B, Demark-Wahnefried, W, Taylor, G, et al. Baseline fruit and vegetable intake among adults in seven 5 a day study centers located in diverse geographic areas. J. Am. Diet. Assoc. 1999; 99: 1241–8.CrossRefGoogle Scholar
14Haraldsdottir, J, Holm, L, Astrup, A, et al. Monitoring of dietary changes by telephone interviews: results from Denmark. Public Health Nutr. 2001; 4: 1287–95.Google Scholar
15Andersen, D, Hestbæk, AD. Responsibility and Values in Danish Families [in Danish]. Copenhagen: Socialforskningsinstitutet (The Danish National Institute of Social Research), 1999.Google Scholar
16Davis, M, Baranowski, T, Resnicow, K, et al. Gimme 5 fruit and vegetables for fun and health: process evaluation. Health Educ. Behav. 2000; 27: 167–76.CrossRefGoogle ScholarPubMed
17Reynolds, KD, Franklin, FA, Leviton, LC, et al. Methods, results, and lessons learned from process evaluation of the high 5 school-based nutrition intervention. Health Educ. Behav. 2000; 27: 177–86.CrossRefGoogle ScholarPubMed
18Story, M, Mays, RW, Bishop, DB, et al. 5-a-day Power Plus: process evaluation of a multicomponent elementary school program to increase fruit and vegetable consumption. Health Educ. Behav. 2000; 27: 187–200.Google Scholar
19Baranowski, T, Davis, M, Resnicow, K, et al. Gimme 5 fruit, juice, and vegetables for fun and health: outcome evaluation [published erratum appears in Health Educ. Behav. 2000; 27: 390]. Health Educ. Behav. 2000; 27: 96–111.CrossRefGoogle ScholarPubMed
20Reynolds, KD, Franklin, FA, Binkley, D, et al. Increasing the fruit and vegetable consumption of fourth-graders: results from the high 5 project. Prev. Med. 2000; 30: 309–19.CrossRefGoogle ScholarPubMed
21Gortmaker, SL, Cheung, LW, Peterson, KE, et al. Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children: eat well and keep moving. Arch. Pediatr. Adolesc. Med. 1999; 153: 975–83.Google Scholar
22Manios, Y, Moschandreas, J, Hatzis, C, et al. Evaluation of a health and nutrition education program in primary school children of Crete over a three-year period. Prev. Med. 1999; 28: 149–59.Google Scholar
23Nader, PR, Stone, EJ, Lytle, LA, et al. Three-year maintenance of improved diet and physical activity: the CATCH cohort. Child and Adolescent Trial for Cardiovascular Health. Arch. Pediatr. Adolesc. Med. 1999; 153: 695–704.Google Scholar
24Willett, WC, Lenart, E. Reproducibility and validity of food-frequency questionnaires. In: Willett, WC, ed. Nutritional Epidemiology. Oxford: Oxford University Press, 1998; 101–47.Google Scholar
25Wheeler, C, Rutishauser, I, Conn, J, et al. Reproducibility of a meal-based food frequency questionnaire. The influence of format and time interval between questionnaires. Eur. J. Clin. Nutr. 1994; 48: 795–809.Google ScholarPubMed
26Radimer, KL, Harvey, P, Lytle, L. Correspondence of self-reported fruit and vegetable intake with dietary intake data. Aust. N.Z. J. Public Health 1997; 21: 703–10.CrossRefGoogle ScholarPubMed
27Field, AE, Peterson, KE, Gortmaker, SL, et al. Reproducibility and validity of a food frequency questionnaire among fourth to seventh grade inner-city school children: implications of age and day-to-day variation in dietary intake. Public Health Nutr. 1999; 2: 293–300.CrossRefGoogle ScholarPubMed
28Bergstrand, R, Vedin, A, Wilhelmsson, C, et al. Bias due to non-participation and heterogeneous sub-groups in population surveys. J. Chronic Dis. 1983; 36: 725–8.CrossRefGoogle ScholarPubMed
29Sonne-Holm, S, Sorensen, TI, Jensen, G, et al. Influence of fatness, intelligence, education and sociodemographic factors on response rate in a health survey. J. Epidemiol. Community Health 1989; 43: 369–74.Google Scholar
30Jackson, R, Chambless, LE, Yang, K, et al. Differences between respondents and nonrespondents in a multicenter community-based study vary by gender ethnicity. The Atherosclerosis Risk in Communities (ARIC) Study Investigators. J. Clin. Epidemiol. 1996; 49: 1441–6.CrossRefGoogle Scholar
31Hill, A, Roberts, J, Ewings, P, et al. Non-response bias in a lifestyle survey. J. Public Health Med. 1997; 19: 203–7.Google Scholar
32Lerman, Y, Shemer, J. Epidemiologic characteristics of participants and nonparticipants in health-promotion programs. J. Occup. Environ. Med. 1996; 38: 535–8.Google Scholar
33Nicklas, TA, Johnson, CC, Myers, L, et al. Outcomes of a high school program to increase fruit and vegetable consumption: Gimme 5 – a fresh nutrition concept for students. J. Sch. Health 1998; 68: 248–53.Google Scholar