Promoting fruit and vegetable consumption among European schoolchildren: rationale, conceptualization and design of the pro children project.

BACKGROUND/AIMS: The Pro Children Project was designed to assess fruit and vegetable consumption in European schoolchildren and their parents, as well as determinants of the children's consumption patterns. A second objective was to develop and test strategies, applicable across Europe, for promoting consumption of fruits and vegetables among schoolchildren and their parents. In this paper, the rationale, theoretical background, overall design and implementation of the project is presented. METHODS: Surveys of national, representative samples of 11-year-old schoolchildren and their parents were conducted in 9 countries, i.e. in Austria, Belgium, Denmark, Iceland, the Netherlands, Norway, Portugal, Spain and Sweden. Comprehensive school-based educational programmes have been developed and tested in three settings, i.e. in Spain, the Netherlands and in Norway. A precoded 24-hour recall form combined with a set of food frequency questions assessing regular intake were used to assess fruit and vegetable consumption. Determinants were assessed employing a comprehensive theoretical framework including personal, social and environmental factors related to fruit and vegetable consumption. The intervention programmes have been tested employing a group-randomized trial design where schools have been randomly allocated to an intervention arm and a delayed intervention arm. Surveys among all participating children and their parents were conducted prior to the initiation of the intervention, immediately after the end of the intervention and at the end of the subsequent school year. CONCLUSION: The project is expected to provide new information of great importance for improving our understanding of consumption patterns of fruits and vegetables and for guiding future efforts to promote increased consumption patterns across Europe.

Fruit and vegetable intake of mothers of 11-year-old children in nine European countries: The Pro Children Cross-sectional Survey.

OBJECTIVE: To describe and compare fruit and vegetable intakes of mothers of 11-year-old children across Europe. METHODS: Cross-sectional surveys were carried out in 9 European countries in October/November 2003. Self-administered questionnaires assessing fruit and vegetable consumption were used for data collection. The current paper presents dietary intake data obtained by a precoded 24-hour recall and a food frequency questionnaire. RESULTS: The consumption levels of fruit and vegetables (without fruit juice) were in line with World Health Organization recommendations of > or =400 g/day for only 27% of all participating mothers. Based on both instruments, the Pro Children results showed comparatively high average fruit intake levels in Portugal, Denmark and Sweden (211, 203 and 194 g/day) and the lowest intake in Iceland (97 g/day). High vegetable intake levels were found in Portugal and Belgium (169 and 150 g/day), the lowest in Spain (88 g/day). A south-north gradient could not be observed in the Pro Children study. CONCLUSION: Fruit and vegetable intakes are low in mothers of 11-year-olds across Europe. Especially vegetable consumption can be regarded as marginal in most of the studied European countries. A high percentage of mothers indicated to eat fruit and vegetables less than once a day. The results have shown that national and international interventions are necessary to promote fruit and especially vegetable consumption in the European population of mothers.

Use of dietary supplements in Denmark is associated with health and former smoking.

OBJECTIVES: To describe the use of dietary supplements in a group of Danish adults and to investigate the differences between users and non-users with respect to age, gender, health and lifestyle factors. DESIGN: Cross-sectional study in two Danish cities. SETTING: The Danish Investigation on Iodine Intake and Thyroid Diseases, 1997-1998. SUBJECTS: Participants were 3707 women (selected age groups between 18 and 65 years) and 942 men (60-65 years). Participation rate was 50%. Supplement data were collected in a personal interview. Data on education, smoking, alcohol intake, physical activity, use of medication and self-perceived health were derived from a self-administered questionnaire. Multiple logistic regression was used for the statistical analysis. RESULTS: Participants were asked about all kinds of supplements, ranging from products containing vitamins and minerals, to fish oils and products of herbal origin. On average 59% reported use of some kind of dietary supplement. Most common were combined multivitamin/mineral products (48%) followed by single vitamin C products (10%). Twelve per cent used three or more different supplements. Supplement use was strongly associated with age and gender, being highest among elderly women (78%). Ex-smokers were more likely to use supplements than subjects who had never smoked (odds ratio (OR) 1.36, 95% confidence interval (CI) 1.09-1.76). Supplement use was more likely among subjects who had many days of illness 95% CI 1.12-1.66) and among users of medication 95% CI 1.04-1.42). Subjects who perceived their health as poor were more likely to use supplements other than just a multivitamin/mineral tablet 95% CI 1.31-3.77). CONCLUSIONS: Use of dietary supplements was related to age, gender and smoking, but also to poor self-perceived health status and absence from work. This indicates that a group of people use supplements as a form of self-medication.