The present review provides an investigation into the food choice decisions made by individuals in relation to fruit and vegetable consumption. A comprehensive body of evidence now exists concerning the protective effect of fruit and vegetables against a number of diseases, particularly cardiovascular disease and certain forms of cancer. Current UK recommendations are to increase intakes of fruit and vegetables to 400 g/person per d. In the main body of the review the factors that affect food choice decisions of adults in relation to fruit and vegetable consumption are studied, following a suggested framework of food choice. Factors covered include sensory appeal, familiarity and habit, social interactions, cost, availability, time constraints, personal ideology, media and advertising and health. The content of the review shows just how complex the food choice process can be. Health promotion techniques can be better targeted towards certain groups of individuals, all holding similar sets of values, when making food choice decisions. Food choice, in relation to fruit and vegetable intake, needs to be studied in more depth, in order to provide effective nutrition education programmes, in particular the sets of priorities that different sub-groups of the population consider when making food choice decisions.
Objectives: To describe the characteristics of dietary supplement users in a large cohort of women and test the hypothesis that supplement users would be more likely to have a healthier lifestyle than non-users. Design: Comparison of nutrient intakes from food frequency questionnaire (FFQ) data for 8409 supplement users and 5413 non-users. Use of logistic regression modelling to determine predictors of supplement use in this cohort. Subjects: 13,822 subjects from the UK Women's Cohort Study (UKWCS) for whom data on supplement use was available. Results: Significant differences in nutrient intakes from FFQ were seen between the two groups, with supplement users having higher intakes of all nutrients, except for fat and vitamin B 12 . Use of dietary supplements was associated with being vegetarian, vegan or fish-eating, consuming more fruit and vegetables, being more physically active and having a lower alcohol intake. Supplement use was less likely in those with a body mass index above 25 and those who reported smoking regularly. Conclusions: The findings are consistent with the hypothesis that supplement use is associated with a healthier lifestyle profile and an adequate nutritional intake, suggesting that supplement users do not need to take supplements to meet a nutrient deficiency.
Background The prevalence of obesity is increasing globally and will, if left unchecked, have major implications for both population health and costs to health services. Objectives To assess the effectiveness of strategies to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese people. Search methods We updated the search for primary studies in the following databases, which were all interrogated from the previous (version 2) search date to May 2009: The Cochrane Central Register of Controlled Trials (which at this time incorporated all EPOC Specialised Register material) (The Cochrane Library 2009, Issue 1), MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), and PsycINFO (Ovid). We identified further potentially relevant studies from the reference lists of included studies. Selection criteria Randomised controlled trials (RCTs) that compared routine provision of care with interventions aimed either at changing the behaviour of healthcare professionals or the organisation of care to promote weight reduction in overweight or obese adults. Data collection and analysis Two reviewers independently extracted data and assessed study quality. Main results We included six RCTs, involving more than 246 health professionals and 1324 overweight or obese patients. Four of the trials targeted professionals and two targeted the organisation of care. Most of the studies had methodological or reporting weaknesses indicating a risk of bias. Meta-analysis of three trials that evaluated educational interventions aimed at GPs suggested that, compared to standard care, such interventions could reduce the average weight of patients after a year (by 1.2 kg, 95% CI −0.4 to 2.8 kg); however, there was moderate unexplained heterogeneity between their results (I2 = 41%). One trial found that reminders could change doctors’ practice, resulting in a significant reduction in weight among men (by 11.2 kg, 95% CI 1.7 to 20.7 kg) but not among women (who reduced weight by 1.3 kg, 95% CI −4.1 to 6.7 kg). One trial found that patients may lose more weight after a year if the care was provided by a dietitian (by 5.6 kg, 95% CI 4.8 to 6.4 kg) or by a doctor-dietitian team (by 6 kg, 95% CI 5 to 7 kg), as compared with standard care. One trial found no significant difference between standard care and either mail or phone interventions in reducing patients’ weight. Authors’ conclusions Most of the included trials had methodological or reporting weaknesses and were heterogeneous in terms of participants, interventions, outcomes, and settings, so we cannot draw any firm conclusions about the effectiveness of the interventions. All of the evaluated interventions would need further investigation before it was possible to recommend them as effective strategies.
Use of dietary supplements by women, particularly those over 40 years of age may be widespread in the United Kingdom. However, from surveillance data, there appears to be a disparity between nutrition and health needs and the rationale for and actual use of dietary supplements by women. This apparent paradox forms the basis for an inverse supplement hypothesis (i.e., supplement use in women appears to be most prevalent among those with least need). Little research has been done to examine the factors underlying the decision to use dietary supplements. Reasons for consuming dietary supplements are often complex, combining social, psychological, knowledge and economic factors. The theory of planned behavior is a widely used model for assessing factors influencing behavioral motivation and action that may be useful for assessing specific diet- and nutrition-related practices. It provided the basis for the development of a questionnaire to explore overall dietary supplement use in a cohort of women in the United Kingdom. The analysis of factors related to beliefs underlying dietary supplement use revealed differences between supplement users and nonusers. Differences included a stronger belief by users than nonusers that taking dietary supplements ensures against possible ill health. Both users and nonusers of supplements also perceived the media (books and magazines) to be a powerful influence on a person's decision to use supplements. These findings highlight the potential of the theory of planned behavior in exploring supplement-taking behavior while throwing light on the factors influencing an individual's motivations to use dietary supplements.
Active play has become a critical focus in terms of physical activity participation in young children. Unstructured or child-led play offers children the opportunity to interact with the environment in a range of different ways. Unstructured materials, often called loose parts, encourage child-led play, and therefore may also promote physical activity. The purpose of this scoping review was to determine what is currently known about how loose parts may influence physical activity participation. Following a systematic literature search, a total of 16 articles were retrieved, reviewed and categorized according to: (1) types of loose parts; (2) types of play; and (3) types of thinking. We found that there are currently a range of loose parts being used to support play, but the way in which they are implemented varies and there is a lack of clarity around how they might support the development of active outdoor play and physical literacy skills.
W alkability-the extent to which an area is supportive of walking-is a concept that emerged from the transportation literature and has been widely adopted in health research examining the impact of the built environment on physical activity and health outcomes. 1 Factors that make neighbourhoods more walkable include pedestrian amenities such as sidewalks, crosswalks, curb cuts and traffic lights; street connectivity; mixed-land use; and the presence of a variety of destinations within walking distance, features typically found in urban more than suburban neighbourhoods. 2-4 From a public health perspective, creating more walkable neighbourhoods might be expected to lead to a healthier environment by encouraging reduced car usage and therefore lower car emissions and air pollution, and also by increasing opportunities for active transportation (physically active modes of transportation, such as walking, biking, rollerblading, skateboarding), which could increase overall levels of physical activity and decrease obesity. 5-7 Although a significant amount of research has shown that adults living in urban neighbourhoods walk more and have a lower bodymass index (BMI) than their suburban counterparts, other studies have found that this association is not consistent in all urban neighbourhoods or with all demographic groups. 4,8,9 Very little research has examined the impact of neighbourhood design on activity levels in children and youth, and the few studies that have looked specifically at youth activity have also produced mixed findings. 10-13 A study of Belgian adolescents found that they were more likely to walk and bike in less walkable neighbourhoods than more walkable neighbourhoods. 14 Other studies have found that while boys are more active in neighbourhoods that are close to commercial areas and have connected streets, girls are more active in neighbourhoods with unconnected, curvilinear, low-traffic streets. 15,16 No consistent association has been established between children's BMI and neighbourhood design, but some research suggests that certain neighbourhood characteristics may be influential. For example, neighbourhood safety and access to parks, playgrounds, recreation centres and sidewalks were significantly associated with lower BMI in girls aged 10-11 years in a US study based on a survey conducted by the National Centre for Health Statistics. 17 Higher rates of overweight and obesity were found in both boys and girls
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