The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70572

Tracy Thomas, MPH¹, Reneé Boynton-Jarrett, SM², Karen Peterson, ScD, RD³, Jean L. Wiecha, PhD², Arthur Sobol², and Steven Gortmaker, PhD⁴. (1) Department of Epidemiology, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, 617-541-3325, tthomas@hsph.harvard.edu, (2) Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, (3) Department of Maternal and Child Health, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, (4) Health and Social Behavior, Harvard School of Public Health, 677 Huntington Avenue, 7th Floor, Boston, MA 02115

Objective: This study examines whether change in television (TV) viewing mediates the effect of an interdisciplinary intervention on fruit and vegetable intake in middle school students.

Background: Survey data document inadequate consumption of fruits and vegetables among youth. Prior research shows TV viewing significantly impacts adolescents’ dietary behavior. This study examines the effectiveness of a school-based intervention to increase fruit and vegetable consumption through two pathways: 1) directly via the educational intervention and 2) indirectly through change in TV viewing as a mediating variable.

Methods: A randomized trial measured change in dietary and lifestyle behaviors over 2 academic years (1995-1997) (N=1,156). Schools participating in the intervention integrated Planet Health sessions within existing curricula. Linear regressions (controlling for clustering) estimated the impact of the intervention (and change in TV viewing as a mediator variable) on change in fruit and vegetable consumption, adjusting for energy intake, baseline fruit and vegetable intake consumption and TV viewing and sociodemographic characteristics.

Results: Students in the intervention showed a greater decrease in hours of TV viewing than control students (coeff.=-0.54, p<0.0001) and an increase in fruit and vegetable consumption (coeff.=0.23, p=0.05) . This intervention effect became statistically non-significant after controlling for change in the (mediating) TV variable (coeff. = 0.14, p=0.26).

Conclusion: The intervention program was effective in increasing fruit and vegetable consumption among adolescents. This effect was mediated through change in TV viewing, possibly related to reduced exposure to TV advertisements that may encourage youth to replace fruits and vegetables with foods heavily advertised on TV.

Learning Objectives:

By the completion of this session, the participant will be able to:
• Describe the major intervention approaches shown to be effective in increasing fruit and vegetable intake among youth.
• Evaluate the evidence linking TV viewing to fruit and vegetable intake among youth.
• Explain the role of broad social and economic factors (fast food industry, mass media) on dietary choices among youth and identify points of intervention.

Keywords: Nutrition, Adolescents

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.