Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies

Rikke Krølner, Mette Rasmussen, Johannes Brug, Knut-Inge Klepp, Marianne Wind, Pernille Due, Rikke Krølner, Mette Rasmussen, Johannes Brug, Knut-Inge Klepp, Marianne Wind, Pernille Due

Abstract

Background: Large proportions of children do not fulfil the World Health Organization recommendation of eating at least 400 grams of fruit and vegetables (FV) per day. To promote an increased FV intake among children it is important to identify factors which influence their consumption. Both qualitative and quantitative studies are needed. Earlier reviews have analysed evidence from quantitative studies. The aim of this paper is to present a systematic review of qualitative studies of determinants of children's FV intake.

Methods: Relevant studies were identified by searching Anthropology Plus, Cinahl, CSA illumine, Embase, International Bibliography of the Social Sciences, Medline, PsycINFO, and Web of Science using combinations of synonyms for FV intake, children/adolescents and qualitative methods as search terms. The literature search was completed by December 1st 2010. Papers were included if they applied qualitative methods to investigate 6-18-year-olds' perceptions of factors influencing their FV consumption. Quantitative studies, review studies, studies reported in other languages than English, and non-peer reviewed or unpublished manuscripts were excluded. The papers were reviewed systematically using standardised templates for summary of papers, quality assessment, and synthesis of findings across papers.

Results: The review included 31 studies, mostly based on US populations and focus group discussions. The synthesis identified the following potential determinants for FV intake which supplement the quantitative knowledge base: Time costs; lack of taste guarantee; satiety value; appropriate time/occasions/settings for eating FV; sensory and physical aspects; variety, visibility, methods of preparation; access to unhealthy food; the symbolic value of food for image, gender identity and social interaction with peers; short term outcome expectancies.

Conclusions: The review highlights numerous potential determinants which have not been investigated thoroughly in quantitative studies. Future large scale quantitative studies should attempt to quantify the importance of these factors. Further, mechanisms behind gender, age and socioeconomic differences in FV consumption are proposed which should be tested quantitatively in order to better tailor interventions to vulnerable groups. Finally, the review provides input to the conceptualisation and measurements of concepts (i.e. peer influence, availability in schools) which may refine survey instruments and theoretical frameworks concerning eating behaviours.

References

    1. He FJ, Nowson CA, MacGregor GA. Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet. 2006;8:320–326. doi: 10.1016/S0140-6736(06)68069-0.
    1. He FJ, Nowson CA, Lucas M, MacGregor GA. Increased consumption of fruit and vegetables is related to a reduced risk of coronary heart disease: meta-analysis of cohort studies. J Hum Hypertens. 2007;8:717–728. doi: 10.1038/sj.jhh.1002212.
    1. Van Duyn MA, Pivonka E. Overview of the health benefits of fruit and vegetable consumption for the dietetics professional: selected literature. J Am Diet Assoc. 2000;8:1511–1521. doi: 10.1016/S0002-8223(00)00420-X.
    1. Guenther PM, Dodd KW, Reedy J, Krebs-Smith SM. Most Americans eat much less than recommended amounts of fruits and vegetables. J Am Diet Assoc. 2006;8:1371–1379. doi: 10.1016/j.jada.2006.06.002.
    1. Yngve A, Wolf A, Poortvliet E, Elmadfa I, Brug J, Ehrenblad B, Franchini B, Haraldsdóttir J, Krølner R, Maes L, Pérez-Rodrigo C, Sjöström M, Thórsdóttir I, Klepp KI. Fruit and vegetable intake in a sample of 11-year-old children in 9 European countries: The Pro Children Cross-sectional Survey. Ann Nutr Metab. 2005;8:236–245. doi: 10.1159/000087247.
    1. Vereecken CA, De Henauw S, Maes L. Adolescents' food habits: results of the Health Behaviour in School-aged Children survey. Br J Nutr. 2005;8:423–431. doi: 10.1079/BJN20051513.
    1. Kelder SH, Perry CL, Klepp KI, Lytle LL. Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors. Am J Public Health. 1994;8:1121–1126. doi: 10.2105/AJPH.84.7.1121.
    1. Lien N, Lytle LA, Klepp KI. Stability in consumption of fruit, vegetables, and sugary foods in a cohort from age 14 to age 21. Prev Med. 2001;8:217–226. doi: 10.1006/pmed.2001.0874.
    1. Te Velde SJ, Twisk JW, Brug J. Tracking of fruit and vegetable consumption from adolescence into adulthood and its longitudinal association with overweight. Br J Nutr. 2007;8:431–438. doi: 10.1017/S0007114507721451.
    1. Dixon-Woods M, Fitzpatrick R, Roberts K. Including qualitative research in systematic reviews: opportunities and problems. J Eval Clin Pract. 2001;8:125–133. doi: 10.1046/j.1365-2753.2001.00257.x.
    1. Rasmussen M, Krølner R, Klepp KI, Lytle L, Brug J, Bere E, Due P. Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: quantitative studies. Int J Behav Nutr Phys Act. 2006;8:22. doi: 10.1186/1479-5868-3-22.
    1. Kuzel AJ. In: Doing qualitative research. Crabtree BF, Miller WL, editor. Thousand Oaks: Sage Publications, Inc.; 1999. Sampling in qualitative inquiry; pp. 33–45.
    1. Pearson N, Biddle SJ, Gorely T. Family correlates of fruit and vegetable consumption in children and adolescents: a systematic review. Public Health Nutr. 2009;8:267–283. doi: 10.1017/S1368980008002589.
    1. Kamphuis CB, Giskes K, de Bruijn GJ, Wendel-Vos W, Brug J, van Lenthe FJ. Environmental determinants of fruit and vegetable consumption among adults: a systematic review. Br J Nutr. 2006;8:620–635.
    1. van der Horst K, Oenema A, Ferreira I, Wendel-Vos W, Giskes K, van Lenthe F, Brug J. A systematic review of environmental correlates of obesity-related dietary behaviors in youth. Health Educ Res. 2007;8:203–226.
    1. Walker MA, Hill MM, Millman FD. Fruit and vegetable acceptance by students. Factors in acceptance and performance. J Am Diet Assoc. 1973;8:268–272.
    1. Harden A, Garcia J, Oliver S, Rees R, Shepherd J, Brunton G, Oakley A. Applying systematic review methods to studies of people's views: an example from public health research. J Epidemiol Community Health. 2004;8:794–800. doi: 10.1136/jech.2003.014829.
    1. Shepherd J, Harden A, Rees R, Brunton G, Garcia J, Oliver S, Oakley A. Young people and healthy eating: a systematic review of research on barriers and facilitators. Health Educ Res. 2006;8:239–257.
    1. Pound P, Britten N, Morgan M, Yardley L, Pope C, Daker-White G, Campbell R. Resisting medicines: a synthesis of qualitative studies of medicine taking. Soc Sci Med. 2005;8:133–155. doi: 10.1016/j.socscimed.2004.11.063.
    1. Mills E, Jadad AR, Ross C, Wilson K. Systematic review of qualitative studies exploring parental beliefs and attitudes toward childhood vaccination identifies common barriers to vaccination. J Clin Epidemiol. 2005;8:1081–1088. doi: 10.1016/j.jclinepi.2005.09.002.
    1. Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001;8:483–488. doi: 10.1016/S0140-6736(01)05627-6.
    1. Fade SA. Communicating and judging the quality of qualitative research: the need for a new language. J Hum Nutr Diet. 2003;8:139–149. doi: 10.1046/j.1365-277X.2003.00433.x.
    1. Kvale S, Brinkmann S. In: Interviews - Learning the craft of qualitative research interviewing. Kvale S, Brinkmann S, editor. Thousand Oaks: Sage publications, inc.; 2008. The social construction of validity; pp. 241–266.
    1. Strauss A, Corbin J. Basics of qualitative research. Techniques and procedures for developing grounded theory. 2. Thousand Oaks: Sage Publications; 1998.
    1. Cullen KW, Baranowski T, Baranowski J, Warnecke C, de Moor C, Nwachokor A, Hajek RA, Jones LA. "5 A Day" achievement badge for urban boy scouts: formative evaluation results. J Cancer Educ. 1998;8:162–168.
    1. Cullen KW, Hartstein J, Reynolds KD, Vu M, Resnicow K, Greene N, White MA. Improving the school food environment: results from a pilot study in middle schools. J Am Diet Assoc. 2007;8:484–489. doi: 10.1016/j.jada.2006.12.004.
    1. Nicklas TA, Johnson CC, Farris R, Rice R, Lyon L, Shi R. Development of a school-based nutrition intervention for high school students: Gimme 5. Am J Health Promot. 1997;8:315–322. doi: 10.4278/0890-1171-11.5.315.
    1. Monge-Rojas R, Garita C, Sanchez M, Munoz L. Barriers to and motivators for healthful eating as perceived by rural and urban Costa Rican adolescents. J Nutr Educ Behav. 2005;8:33–40. doi: 10.1016/S1499-4046(06)60257-1.
    1. Baranowski T, Domel S, Gould R, Baranowski J, Leonard S, Treiber F, Mullis R. Increasing fruit and vegetable consumption among 4th and 5th grade students - Results from focus groups using reciprocal determinism. J Nutr Educ. 1993;8:114–120.
    1. Campbell E. Dietary choices of urban minority high school students. Pediatr Nurs. 2009;8:171–180.
    1. Gellar LA, Schrader K, Nansel TR. Healthy eating practices: perceptions, facilitators, and barriers among youth with diabetes. Diabetes Educ. 2007;8:671–679. doi: 10.1177/0145721707303807.
    1. Hill L, Casswell S, Maskill C, Jones S, Wyllie A. Fruit and vegetables as adolescent food choices in New Zealand. Health Promot Int. 1998;8:55–65. doi: 10.1093/heapro/13.1.55.
    1. Keim KS, Swanson MA, Cann SE. Caucasian and Mexican American low-income children's thoughts about vegetables and fruits. Ecol Food Nutr. 2001;8:525–544. doi: 10.1080/03670244.2001.9991665.
    1. Kirby SD, Baranowski T, Reynolds KD, Taylor G, Binkley D. Children's fruit and vegetable intake - Socioeconomic, adult-child, regional, and urban-rural influences. J Nutr Educ. 1995;8:261–271.
    1. Kubik MY, Lytle L, Fulkerson JA. Fruits, vegetables, and football: findings from focus groups with alternative high school students regarding eating and physical activity. J Adolesc Health. 2005;8:494–500. doi: 10.1016/j.jadohealth.2004.05.010.
    1. Lautenschlager L, Smith C. Beliefs, knowledge, and values held by inner-city youth about gardening, nutrition, and cooking. Agric Human Values. 2007;8:245–258. doi: 10.1007/s10460-006-9051-z.
    1. Molaison EF, Connell CL, Stuff JE, Yadrick MK, Bogle M. Influences on fruit and vegetable consumption by low-income black American adolescents. J Nutr Educ Behav. 2005;8:246–251. doi: 10.1016/S1499-4046(06)60279-0.
    1. Wind M, Bobelijn K, De Bourdeaudhuij I, Klepp KI, Brug J. A qualitative exploration of determinants of fruit and vegetable intake among 10- and 11-year-old schoolchildren in the low countries. Ann Nutr Metab. 2005;8:228–235. doi: 10.1159/000087246.
    1. Zeinstra GG, Koelen MA, Kok FJ, de Graaf C. Cognitive development and children's perceptions of fruit and vegetables; a qualitative study. Int J Behav Nutr Phys Act. 2007;8:30. doi: 10.1186/1479-5868-4-30.
    1. Evans AE, Wilson DK, Buck J, Torbett H, Williams J. Outcome expectations, barriers, and strategies for healthful eating - A perspective from adolescents from low-income families. Fam Community Health. 2006;8:17–27.
    1. Fitzgerald E, Bunde-Birouste A, Webster E. Through the eyes of children: engaging primary school-aged children in creating supportive school environments for physical activity and nutrition. Health Promot J Austr. 2009;8:127–132.
    1. Kim LP, Harrison GG, Kagawa-Singer M. Perceptions of diet and physical activity among California Hmong adults and youths. Prev Chronic Dis. 2007;8:A93.
    1. Libman K. Growing youth growing food: How vegetable gardening influences young people's food consciousness and eating habits. Appl Environ Educ Comm Int J. 2007;8:87–95. doi: 10.1080/15330150701319388.
    1. McKinley MC, Lowis C, Robson PJ, Wallace JM, Morrissey M, Moran A, Livingstone MB. It's good to talk: children's views on food and nutrition. Eur J Clin Nutr. 2005;8:542–551. doi: 10.1038/sj.ejcn.1602113.
    1. Neumark-Sztainer D, Story M, Perry C, Casey MA. Factors influencing food choices of adolescents: findings from focus-group discussions with adolescents. J Am Diet Assoc. 1999;8:929–937. doi: 10.1016/S0002-8223(99)00222-9.
    1. Ross S. "Do I really have to eat that?": a qualitative study of schoolchildren's food choices and preferences. Health Educ J. 1995;8:312–321. doi: 10.1177/001789699505400306.
    1. Stevenson C, Doherty G, Barnett J, Muldoon OT, Trew K. Adolescents' views of food and eating: identifying barriers to healthy eating. J Adolesc. 2007;8:417–434. doi: 10.1016/j.adolescence.2006.04.005.
    1. Cullen KW, Baranowski T, Rittenberry L, Olvera N. Social-environmental influences on children's diets: results from focus groups with African-, Euro- and Mexican-American children and their parents. Health Educ Res. 2000;8:581–590. doi: 10.1093/her/15.5.581.
    1. Booth ML, Wilkenfeld RL, Pagnini DL, Booth SL, King LA. Perceptions of adolescents on overweight and obesity: the weight of opinion study. J Paediatr Child Health. 2008;8:248–252. doi: 10.1111/j.1440-1754.2007.01267.x.
    1. Khunti K, Stone MA, Bankart J, Sinfield P, Pancholi A, Walker S, Talbot D, Farooqi A, Davies MJ. Primary prevention of type-2 diabetes and heart disease: action research in secondary schools serving an ethnically diverse UK population. J Public Health (Oxf) 2008;8:30–37. doi: 10.1093/pubmed/fdm078.
    1. Husby I, Heitmann BL, O'Doherty JK. Meals and snacks from the child's perspective: the contribution of qualitative methods to the development of dietary interventions. Public Health Nutr. 2009;8:739–747. doi: 10.1017/S1368980008003248.
    1. O'dea JA. Why do kids eat healthful food? Perceived benefits of and barriers to healthful eating and physical activity among children and adolescents. J Am Diet Assoc. 2003;8:497–501.
    1. Goh YY, Bogart LM, Sipple-Asher BK, Uyeda K, Hawes-Dawson J, Olarita-Dhungana J, Ryan GW, Schuster MA. Using community-based participatory research to identify potential interventions to overcome barriers to adolescents' healthy eating and physical activity. J Behav Med. 2009;8:491–502. doi: 10.1007/s10865-009-9220-9.
    1. Kubik MY, Lytle LA, Hannan PJ, Perry CL, Story M. The association of the school food environment with dietary behaviors of young adolescents. Am J Public Health. 2003;8:1168–1173. doi: 10.2105/AJPH.93.7.1168.
    1. Hearn MD, Baranowski T, Baranowski J, Doyle C, Smith M, Lin LS, Resnicow K. Environmental influences on dietary behavior among children: availability and accessibility of fruits and vegetables enable consumption. J Health Educ. 1998;8:26–32.
    1. De Bourdeaudhuij I, Klepp KI, Due P, Pérez Rodrigo C, de Almeida MDV, Wind M, Krølner R, Sandvik C, Brug J. Reliability and validity of a questionnaire to measure personal, social and environmental correlates of fruit and vegetable intake in 10-11-year-old children in five European countries. Public Health Nutr. 2005;8:189–200.
    1. Bauer KW, Yang YW, Austin SB. "How can we stay healthy when you're throwing all of this in front of us?" Findings from focus groups and interviews in middle schools on environmental influences on nutrition and physical activity. Health Educ Behav. 2004;8:34–46. doi: 10.1177/1090198103255372.
    1. McClain AD, Chappuis C, Nguyen-Rodriguez ST, Yaroch AL, Spruijt-Metz D. Psychosocial correlates of eating behavior in children and adolescents: a review. Int J Behav Nutr Phys Act. 2009;8:54. doi: 10.1186/1479-5868-6-54.
    1. Blanchette L, Brug J. Determinants of fruit and vegetable consumption among 6-12-year-old children and effective interventions to increase consumption. J Hum Nutr Diet. 2005;8:431–443. doi: 10.1111/j.1365-277X.2005.00648.x.
    1. Resnicow K, Davis-Hearn M, Smith M, Baranowski T, Lin LS, Baranowski J, Doyle C, Wang DT. Social-cognitive predictors of fruit and vegetable intake in children. Health Psychol. 1997;8:272–276.
    1. de Sa J, Lock K. Will European agricultural policy for school fruit and vegetables improve public health? A review of school fruit and vegetable programmes. Eur J Public Health. 2008;8:558–568. doi: 10.1093/eurpub/ckn061.
    1. Currie C, Roberts C, Morgan A, Smith R, Settertobulte W, Samdal O, Rasmussen VB, (eds) WHO Policy Series: Health policy for children and adolescents Issue 4. Copenhagen: WHO Regional Office for Europe; 2004. Young People's Health in Context: international report from the HBSC 2001/02 survey.
    1. Jago R, Baranowski T, Baranowski JC. Fruit and vegetable availability: a micro environmental mediating variable? Public Health Nutr. 2007;8:681–689.
    1. Thomas J, Harden A, Oakley A, Oliver S, Sutcliffe K, Rees R, Brunton G, Kavanagh J. Integrating qualitative research with trials in systematic reviews. BMJ. 2004;8:1010–1012. doi: 10.1136/bmj.328.7446.1010.
    1. Jenkins S, Horner SD. Barriers that influence eating behaviors in adolescents. J Pediatr Nurs. 2005;8:258–267. doi: 10.1016/j.pedn.2005.02.014.
    1. Taylor JP, Evers S, McKenna M. Determinants of healthy eating in children and youth. Can J Public Health. 2005;8(Suppl 3):S20–S29.
    1. Shepherd R, Dennison CM. Influences on adolescent food choice. Proc Nutr Soc. 1996;8:345–357. doi: 10.1079/PNS19960034.
    1. Patrick H, Nicklas TA. A review of family and social determinants of children's eating patterns and diet quality. J Am Coll Nutr. 2005;8:83–92.
    1. Dixon-Woods M, Bonas S, Booth A, Jones DR, Miller T, Sutton AJ, Shaw RL, Smith JA, Young B. How can systematic reviews incorporate qualitative research? A critical perspective. Qual Res. 2006;8:27–44. doi: 10.1177/1468794106058867.
    1. McKibbon KA, Wilczynski NL, Haynes RB. Developing optimal search strategies for retrieving qualitative studies in PsycINFO. Eval Health Prof. 2006;8:440–454. doi: 10.1177/0163278706293400.
    1. Barroso J, Gollop CJ, Sandelowski M, Meynell J, Pearce PF, Collins LJ. The challenges of searching for and retrieving qualitative studies. West J Nurs Res. 2003;8:153–178. doi: 10.1177/0193945902250034.
    1. Shepherd J, Harden A, Rees R, Brunton G, Garcia J, Oliver S, Oakley A. Young people and healthy eating: a systematic review of research on barriers and facilitators. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London; 2001.
    1. Thomas J, Sutcliffe K, Harden A, Oakley A, Oliver S, Rees R, Brunton G, Kavanagh J. Children and healthy eating: a systematic review of barriers and facilitators. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London; 2003.
    1. Jensen LA, Allen MN. Meta-synthesis of qualitative findings. Qual Health Res. 1996;8:553–560. doi: 10.1177/104973239600600407.

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