Do Fruit and Vegetable Policies, Socio-Environmental Factors, and Physical Activity Influence Fruit and Vegetable Intake Among Adolescents?

PURPOSE: Several factors are known to influence the intake of fruits and vegetables (FV) among adolescents. However, few studies have examined the role that FV policies and associated factors (such as availability of food at home, parental support, and physical activity) play on consumption of FV, particularly among adolescents in low- and middle-income countries (LMICs). METHOD: Adolescent data (except for FV policy status) were obtained from the Global School-based Student Health Survey from 2004 to 2013. Information on FV policies was obtained from government ministries, World Health Organization databases, Scopus, and PubMed. Countries were designated as having the policy if the policy was issued at least a year before Global School-based Student Health Survey data collection (n = 13 LMICs). Countries without FV policies were based on the absence of a policy between 2004 and 2013 (n = 11 LMICs). The total analytic sample included 89,843 adolescents from 24 countries. RESULTS: Logistic regression models revealed a positive association between the presence of FV policy and the adequate consumption of FV (adjusted odds ratio [AOR] = 2.04; 95% confidence interval [CI]: 1.74-2.40; p-value < .001). Parental supervision was positively associated with sufficient intake of FV (AOR = 1.62; 95% CI: 1.42-1.84; p-value < .001). Physical activity was also positively associated with adolescents consuming ≥5 servings of FV daily (AOR = 1.30; 95% CI: 1.13-1.50; p-value < .001). CONCLUSION: Adolescents' physical environment (presence of FV policies, unavailability of food), social environment (parental connectedness, supervision, and bonding), and physical activity behavior are all significant predictors of adolescents' intake of FV.

A comparative study of fruit and vegetable consumption and physical activity among adolescents in 49 Low-and-Middle-Income Countries.

Physical inactivity and low consumption of fruits and vegetables (FV) during adolescence may persist through adulthood, putting adolescents at risk of developing chronic diseases. Although studies from high-income countries have reported differences in FV consumption and physical activity (PA) between adolescent boys and girls, few exist from low-and-middle-income countries (LMICs). In this study, we examined patterns of FV consumption and PA among adolescent boys and girls in LMICs. Country selection was based on availability of Global School-Based Student Health Survey (GSHS) data from 2004 to 2013. The total analytic sample was 164,771 adolescents from 49 LMICs. Descriptive statistics were generated to determine adolescents meeting the World Health Organization (WHO) recommendations for FV and PA. A Rao-Scott adjusted chi-square statistic was computed to assess gender differences. Less than 30% of adolescents across all countries met the WHO guidelines for FV consumption or PA. Morocco (29.5%) and India (29.5%) however had the highest percentage of adolescents meeting recommendations for FV and PA, respectively. Adolescent boys were more active than girls, and this difference was more notable in the Middle East and North African region. Adolescents achieving the WHO recommendations for daily consumption of FV and PA were consistently low in all countries.

Physical Activity, Sleep, and BMI Percentile in Rural and Urban Ugandan Youth.

BACKGROUND: Uganda is experiencing a dual burden of over- and undernutrition, with overweight prevalence increasing while underweight remains common. Potential weight-related factors, particularly physical activity, sleep, and rural/urban status, are not currently well understood or commonly assessed in Ugandan youth. OBJECTIVE: The purpose of this study was to pilot test a survey measuring weight-related factors in rural and urban Ugandan schoolchildren. METHODS: A cross-sectional survey measured sociodemographics, physical activity, sleep patterns, and dietary factors in 148 rural and urban schoolchildren aged 11-16 in central Uganda. Height and weight were objectively measured. Rural and urban youth were compared on these factors using χ2 and t tests. Regression was used to identify correlates of higher body mass index (BMI) percentile in the full sample and nonstunted youth. FINDINGS: Youth were on average 12.1 ± 1.1 years old; underweight (10%) was more common than overweight (1.4%). Self-reported sleep duration and subjective sleep quality did not differ by rural/urban residence. Rural children overall had higher BMI percentile and marginally higher stunting prevalence. In adjusted analyses in both the full and nonstunted samples, higher BMI percentile was related to living in a rural area, higher frequency of physical activity, and higher subjective sleep quality; it was negatively related to being active on weekends. In the full sample, higher BMI percentile was also related to female gender, whereas in nonstunted youth, higher BMI was related to age. BMI percentile was unrelated to sedentary time, performance of active chores and sports, and dietary factors. CONCLUSIONS: This study is one of the first to pilot test a survey assessing weight-related factors, particularly physical activity and sleep, in Ugandan schoolchildren. BMI percentile was related to several sociodemographic, sleep, and physical activity factors among primarily normal-weight school children in Uganda, providing a basis for understanding weight status in the context of the nutrition transition.