Role of free school lunch in the associations between family-environmental factors and children's fruit and vegetable intake in four European countries

Abstract

Objective: To determine whether an association exists between different clusters of fruit-and vegetable-specific family-environmental factors and children's daily fruit and vegetable intake, and whether these associations differ between countries with different school lunch policies. Design: Cross-sectional data from four European countries participating in the Pro Greens project in 2009. These countries have different school food policies: two serve free school lunches and two do not. Self-administered data were used. Food frequency questions served to assess fruit and vegetable intakes. The study assessed sixteen children-perceived family-environmental factors, which were clustered based on principal component analysis into five sum variables: fruit and vegetable encouragement; vegetable modelling, family routine and demand; fruit modelling; fruit and vegetable snacking practices; and fruit and vegetable allowing. Setting: Schools in Finland, Germany, Sweden and the Netherlands. Subjects: Schoolchildren aged 11 years (n 3317). Results: Multilevel logistic regression analyses revealed positive associations between nearly all clustered family-environmental factors and daily fruit and vegetable intake. The study tested a moderation effect between family-environmental factors and school lunch policy. In five out of twenty models significant interactions occurred. In the stratified analyses, most of the associations between family-environmental factors and raw and cooked vegetable intake were stronger in Germany and the Netherlands, neither of which provided free school lunches. Conclusions: Children reporting more fruit-and vegetable-promoting familyenvironmental factors had a more frequent intake of fruits and vegetables; the associations were stronger for vegetable intakes in countries providing no free school lunches, suggesting that parental involvement is crucial when schools offer no vegetables.

Preschool and School Meal Policies: An Overview of What We Know about Regulation, Implementation, and Impact on Diet in the UK, Sweden, and Australia

“…The availability of healthy nutritious choices influences diet positively in school children [ 19 ]. The provision of fruit and vegetables to children in schools increases their fruit and vegetable consumption [ 20 ], and has been shown to level family differences in fruit and vegetable intakes among 11-year-old children [ 21 ]. Changes to school cafeteria environments can improve food choices at school [ 22 ].…”

The PRO GREENS intervention in Finnish schoolchildren – the degree of implementation affects both mediators and the intake of fruits and vegetables

“…Multicomponent interventions that try to influence FV intake should attempt to influence factors that are associated with this behaviour. Such factors are, for example, knowledge of recommendations for FV intake, availability and accessibility, taste preferences, a liking for FV, parental modelling, attitudes towards FV and self-efficacy ( 7 – 10 ) . In a review of the mediating factors of interventions to improve children's food intake, only attitude and, to a smaller degree, the knowledge of recommendations and self-efficacy have been found to mediate the effect of school-based interventions on changes in FV intake ( 11 ) .…”

Familial aggregation and socio-demographic correlates of taste preferences in European children

“…Furthermore, parental encouragement and family rules have been reported to affect the eating habits of children [43,44]. Parents may tend to offer a healthier diet to younger children compared to adolescents.…”