Trude Angela Cristina Bizzotto, Kharmats Anna Yevgenyevna, Hurley Kristen Marie, Anderson Steeves Elizabeth, Talegawkar Sameera A, Gittelsohn Joel
The Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center and Center for Human Nutrition, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
Department of Nutrition, University of Tennessee, 1215 W. Cumberland Ave., Knoxville, TN, 37996, USA.
BMC Public Health. 2016 Aug 24;16(1):872. doi: 10.1186/s12889-016-3499-6.
Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV) are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors influencing FV and fiber consumption in low-income African-American (AA) youth in Baltimore, MD.
Cross-sectional analysis of data collected from 285 low-income AA caregiver-youth (age range: 10-14 y) dyads participating in the baseline evaluation of the B'More Healthy Communities for Kids obesity prevention trial. The Kid's Block FFQ was used to estimate daily intakes of FV (including 100 % fruit juice) and dietary fiber. Questionnaires were used to assess household socio-demographics, caregiver and youth food purchasing and preparation behavior, and youth psychosocial information. Ordered logit regression analyses were conducted to examine psychosocial and food-related behavior associated with FV and dietary fiber intake (quartile of intake) controlling for youth age, sex, BMI percentile, total calorie intake and household income.
On average, youth consumed 1.5 ± 1.1 (M ± SD) servings of fruit, 1.8 ± 1.7 serving of vegetables, and 15.3 ± 10.9 g of fiber/day. There were no differences by gender, age or household income. Greater youth's healthy eating intentions and self-efficacy scores were associated with greater odds ratio for higher intake of FV and fiber (Intention: ORfruit 1.22; 95 % CI: 1.06-1.41, ORvegetable 1.31; 1.15-1.51 and ORfiber 1.46; 1.23-1.74, Self-efficacy: ORfruit 1.07; 1.03-1.12, ORvegetable 1.04; 1.01-1.09, ORfiber 1.10; 1.04-1.16). Youth receiving free/low-cost breakfast were more than twice as likely to have higher fiber intake than those who did not receive free breakfast (OR 2.7; 1.10; 6.9). In addition, youth shopping more frequently at supermarkets were more likely to have greater vegetable and fiber intake (OR 1.26; 1.06-1.50; OR 1.28; 1.03-1.58, respectively). Also, youth with parents who shopped more frequently at fast-food stores had 7 % lower odds for higher vegetable intake (95 % CI: 0.88-0.99).
In this study, both, youth and household factors were associated with youth FV and fiber intake, underscoring the need for a multi-level approach to increasing youths' diet quality. These results will inform and shape an effective intervention program for improving youth dietary intakes.
儿童肥胖是公共卫生面临的最大挑战之一，对低收入城市少数族裔人群的影响尤为严重。水果和蔬菜是营养丰富的食物，可能与体重过度增加呈负相关。我们旨在确定影响马里兰州巴尔的摩市低收入非裔美国（AA）青少年水果、蔬菜和纤维摄入量的个体特征、心理社会因素及家庭因素。
对参与“B'More Healthy Communities for Kids”儿童肥胖预防试验基线评估的285对低收入非裔美国儿童及其照顾者（年龄范围：10 - 14岁）的数据进行横断面分析。使用儿童食物频率问卷（Kid's Block FFQ）估算水果、蔬菜（包括100%果汁）和膳食纤维的每日摄入量。通过问卷评估家庭社会人口统计学、照顾者及青少年的食物购买和准备行为，以及青少年的心理社会信息。进行有序逻辑回归分析，以检验与水果、蔬菜和膳食纤维摄入量（摄入量四分位数）相关的心理社会因素和食物相关行为，并对青少年年龄、性别、BMI百分位数、总热量摄入和家庭收入进行控制。
青少年平均每天摄入1.5 ± 1.1（均值 ± 标准差）份水果、1.8 ± 1.7份蔬菜和15.3 ± 10.9克纤维。在性别、年龄或家庭收入方面无差异。青少年更高的健康饮食意愿和自我效能得分与更高的水果、蔬菜和纤维摄入量的更高比值比相关（意愿：水果摄入量的比值比为1.22；95%置信区间：1.06 - 1.41，蔬菜摄入量的比值比为1.31；1.15 - 1.51，纤维摄入量的比值比为1.46；1.23 - 1.74，自我效能：水果摄入量的比值比为1.07；1.03 - 1.12，蔬菜摄入量的比值比为1.04；1.01 - 1.09，纤维摄入量的比值比为1.10；1.04 - 1.16）。接受免费/低成本早餐的青少年摄入较高纤维的可能性是未接受免费早餐青少年的两倍多（比值比为2.7；1.10；6.9）。此外，更频繁在超市购物的青少年更有可能摄入更多蔬菜和纤维（分别为比值比1.26；1.06 - 1.50；比值比1.28；1.03 - 1.58）。而且，父母更频繁在快餐店购物的青少年蔬菜摄入量较高的可能性低7%（95%置信区间：0.88 - 0.99）。
在本研究中，青少年因素和家庭因素均与青少年水果、蔬菜和纤维摄入量相关，强调需要采取多层次方法来提高青少年的饮食质量。这些结果将为制定有效的干预计划提供信息并指导其形成，以改善青少年的饮食摄入量。
