Determinants of Fruits and Vegetables Consumption among Primary School Students: A Path Analysis Evidence
Abstract
Background: Around 3.9 million deaths worldwide in 2017 were caused by a lack of fruit and vegetable consumption. Consumption of fruits and vegetables in Indonesia is still less than recommended by World Health Organization. This study aimed to examine determinants of fruits and vegetables consumption among primary school children.
Subjects and Method: This was an analytic observational study with a cross sectional design. The study was conducted at 25 elementary schools in Tegal, Central Java, from April to May 2019. A sample of 200 primary schools was selected by simple random sampling. The dependent variable was fruits and vegetables consumption. The independent variables were gender, knowledge, economic status, fruits and vegetables availability, sources of information, food preference, food selection, and parental role. The data were collected by food frequency questioner (FFQ) and questionnaire. The data were analyzed by path analysis.
Results: Fruit consumption was directly influenced by male gender (b=-0.99; 95% CI= -1.86 to -0.12; p=0.025), knowledge (b= 0.92; 95% CI= 0.04 to 1.79; p=0.039), economic status (b=1.96; 95% CI= 1.09 to 2.83; p<0.001), fruits and vegetables availability (b= 0.92; 95% CI= 0.07 to 1.76; p= 0.034), source of information (b= 0.92; 95% CI= 0.01 to 1.82; p= 0.047), food selection (b= 1.77; 95% CI= 0.01 to 3.54; p= 0.049), and parental role (b= 1.19; 95% CI= 0.27 to 2.13; p=0.012). Vegetables consumption was directly influenced by male gender (b= -0.71; 95% CI= -1.37 to -0.05; p= 0.035), economic status (b= 0.81; 95% CI= 0.05 to 1.56; p=0.036), fruits and vegetables availability (b=0.98; 95% CI= 0.33 to 1.64; p=0.003), and parental role (b= 0.95; 95% CI= 0.19 to 1.69; p= 0.013). Fruit and vegetable consumption was indirectly influenced by gender, food preference, and economic status.
Conclusion: Fruit consumption is directly influenced by male gender, knowledge, economic status, fruits and vegetables availability, source of information, food selection, and parental role. Vegetables consumption is directly influenced by male gender, economic status, fruits and vegetables availability, and parental role. Fruit and vegetable consumption is indirectly influenced by gender, food preference, and economic status.
Keywords: consumption, fruits and vegetables, path analysis
Correspondence: Siti Shafridha Hidayah. Masters Program Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: shafridhahidayah@yahoo.com. Mobile: +6287737376507.
Journal of Health Promotion and Behavior (2019), 4(1): 64-75
https://doi.org/10.26911/thejhpb.2019.04.01.07
References
Arganini C, Saba A, Comitato R, Virgili F, Turrini A (2012). Gender differences in food choice and dietary intake in modern Western societies. Public Health-Social and Behavioral Health. https://doi.org/10.5772/37886
Awuni TK, Kye-Duodu G, Duodu C, Zotor FB, Ellahi B (2017). Knowledge and determinants of fruit and vegetable consumption among adults in Hohoe Municipality, Ghana. Food Science and Nutrition Studies, 2(1):1. https://doi.org/10.22158/fsns.v2n1p1.
Badan Pusat Statistik (2017). Buletin pemantauan ketahanan pangan Indonesia (Indonesian food security monitoring bulletin). German Humanitarian Assistance, 8: 1–24. Retrieved from https://docs.wfp.org/api/documents/WFP0000024091/download/
Draxten M, Fulkerson JA, Friend S, Flattum CF, Schow R (2014). Parental role modeling of fruits and vegetables at meals and snacks is associated with children’s adequate consumption. Appetite, 78:1–7. https://doi.org/10.1016/j.appet.2014.02.017
Elda F, Kusharisupeni (2018). Associations of peer group and social media with healthy eating behavior among adolescents. Proceedings of International Conference on Public Health, 133–133. https://doi.org/10.26911/theicph.2018.02.14.
FAO (2017). Fruit and vegetables for health initiative. Retrieved from http://www.fao.org/3/a-i6807e.pdf
Freisling H, Haas K, Elmadfa I (2010). Mass media nutrition information sources and associations with fruit and vegetable consumption among adolescents. Public Health Nutrition, 13(2): 269–275. https://doi.org/10.1017/S136898009991297
Groele B, Głąbska D, Gutkowska K, Guzek D (2018). Mother’s fruit preferences and consumption support similar attitudes and behaviors in their children. International Journal of Environmental Research and Public Health, 15 (12): 28-33. https://doi.org/10.3390/ijerph15122833
Hartley L, Igbinedion E, Holmes J, Flowers N, Thorogood M, Clarke A, Rees K (2013). Increased consumption of fruit and vegetables for the primary prevention of cardiovascular diseases. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD009874.pub2.
Kementerian Kesehatan RI (2014). Pedoman gizi seimbang (Balanced nutrition guide). Retrieved from https://linisehat.com/download-pedoman-gizi-seimbang-kementerian-kesehatan/
Konttinen H, SarlioLähteenkorva S, Silventoinen K, Männistö S, Haukkala A (2013). Socio-economic disparities in the consumption of vegetables, fruit and energy-dense foods: the role of motive priorities. Public Health Nutrition, 16(5):873–882. https://doi.org/10.1017/S1368980012003540
Landais E, Bour A, Gartner A, McCullough F (2015). Socio-economic and behavioural determinants of fruit and vegetable intake in Moroccan women. Public Health Nutrition, 18(5). http://doi.org/10.1017/s136890014001761
Leng G, Adan RAH, Belot M, Brunstrom JM, de Graff K, Dickson SL, Hare T, et al (2016). The determinants of food choice. Kees de Graaf. https://doi.org/10.1017/S002966511600286X.
Noia JD, ByrdBredbenner C (2013). Adolescent fruit and vegetable intake: influence of family support and moderation by home availability of relationships with afrocentric values and taste preferences. Journal of the Academy of Nutrition and Dietetics,113(6):803–808.https://doi.org/10.1016/j.jand.2013.02.001.
Pearson N, Biddle SJH, Gorely T (2009). Family correlates of fruit and vegetable consumption in children and adolescents: a systematic review. Public Health Nutrition, 12(2):267–283. https://doi.org/10.1017/S1368980008002589.
Pem D, Jeewon R (2015). Fruit and vegetable intake: benefits and progress of nutrition education interventionsnarrative review article. Iranian Journal of Public Health, 44(10): 1309–1321.
Rachman BN, Mustika IG, Kusumawati, IGAW (2018). Faktor yang berhubungan dengan perilaku konsumsi buah dan sayur siswa SMP di Denpasar (Factors related to fruit and vegetable consumption behavior of junior high school students in Denpasar). Jurnal Gizi Indonesia, 6(1):9. https://doi.org/10.14710/jgi.6.1.916.
Utami AD, Indarto D, Dewi YLR (2017). The effect of nutrient intake and socioeconomic factor toward stunting incidence among primary school students in Surakarta. Journal of Epidemiologi and Public Health, 2(1): 1–10.
Wati EDA, Pamungkasari EP, Dharmawan R (2017). Effects of fruit and vegetable consumption, a socioeconomic factor of adolescent obesity in Surakarta City. Journal of Health Promotion and Behavior, 02(01): 55–64. https://doi.org/10.26911/thejhpb.2017.02.01.05
Wolnicka K, Taraszewska AM, Jaczewska-Schuetz J, Jarosz M (2015). Factors within the family environment such as parents’ dietary habits and fruit and vegetable availability have the greatest influence on fruit and vegetable consumption by polish children. Public Health Nutrition, 18(15):2705–2711. https://doi.org/10.1017/S1368980015000695
