Academic journal article Journal of School Health

Weight Management and Fruit and Vegetable Intake among Us High School Students

Academic journal article Journal of School Health

Weight Management and Fruit and Vegetable Intake among Us High School Students

Article excerpt

The increasing prevalence of overweight among children, adolescents, and adults highlights the need for healthy and effective dietary strategies for weight management. (1) Diets rich in fruits and vegetables are associated with lower risks for many chronic diseases, including cancer, cardiovascular disease, and stroke. (2) Because fruits and vegetables are high in water and fiber content, low in calories and energy density, and nutrient rich, they are an important part of a healthy diet and have the potential to reduce long-term risk for obesity and unhealthy weight gain if substituted for energy-dense nutrient-poor foods (eg, foods high in fat, added sugars, and calories). (3,4) In 2001, The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity listed specific action steps schools should take including "Provide food options that are low in fat, calories, and added sugars, such as fruits, vegetables, whole grains, and low-fat or nonfat dairy foods." (5) Action steps for families and communities included "Promote healthful dietary patterns, including consumption of at least five servings of fruits and vegetables a day." (5)

Researchers are beginning to examine the relationship between fruit and vegetable consumption and weight management. (3) Although data directly relating intake of fruits and vegetables with risk of obesity and long-term weight gain are limited, studies of adults have suggested that increasing intake of fruits and vegetables may reduce long-term risk of obesity and weight gain. (6,7) School-based interventions to prevent obesity among youth have successfully incorporated a variety of strategies, including increased consumption of fruits and vegetables. (8,9) Planet Health is an example of an effective middle school-based obesity intervention that targeted 4 behavioral changes: reduced TV viewing, increased moderate and vigorous physical activity, reduced consumption of high-fat foods, and increased consumption of fruits and vegetables. (8) The prevalence of obesity among girls in intervention schools was reduced compared with controls. The intervention reduced hours of TV viewing among both girls and boys and increased fruit and vegetable consumption and resulted in a smaller increment in total energy intake among girls. Researchers have proposed 2 primary mechanisms for the association between TV viewing and obesity: reduced energy expenditure through displacement of physical activity and increased dietary energy intake either during viewing of as a result of food advertising. (8,10) An elementary school-based controlled intervention successfully reduced body mass index (BMI) while increasing physical activity and fruit and vegetable consumption among students. (9)

Increasing consumption of fruits and vegetables and levels of physical activity are 2 key strategies implemented by states in the Centers for Disease Control and Prevention's (CDC) Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases. (11) No recommendations exist about the amount of fruits and vegetables that needs to be consumed to help prevent unhealthy weight gain; however, national health objectives for the year 2010 recommend at least 5 servings of fruits and vegetables daily as part of a healthy diet. (12) Current dietary guidelines for adolescents recommend even more fruits and vegetables based on age, gender, and activity levels. (4) About hall (46%) of US high school students report that they are trying to lose weight, yet only 20% of all students consume 5 or more servings of fruits and vegetables daily. (13)

To develop interventions that effectively promote fruit and vegetable consumption within the context of healthy weight management, information is needed on fruit and vegetable intake among youth who are trying to control their weight and whether fruit and vegetable intake varies by the types of weight management strategies employed. The objectives of our study were 2-fold: (1) to identify patterns of weight management behavior involving 3 commonly recommended strategies (ie, being physically active, eating a reduced calorie or fat diet, and limiting TV viewing) among US high school students who were trying to lose weight or maintain their current weight and (2) to describe the associations between these weight management behaviors and the consumption of fruits and vegetables. …

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