Theory-based fruit and vegetable consumption interventions in children and adolescents: Assessing the evidence and where to go from here

BACKGROUND. For children and adolescents, obesity is the most prevalent nutrition-related disease in the United States. Currently, 17.1% of US children and adolescents are overweight and only 21.4% of youth meet the minimum recommendations of 5 servings of fruits and vegetables per day. Those who are overweight or obese are at higher risk for developing chronic diseases later in life, but have also shown to experience immediate physical and emotional ramifications while still young. METHODS. An electronic literature review was conducted using PubMed, PsychINFO, and the Web of Knowledge to identify two sets of articles: 1) determinant and 2) intervention articles regarding fruit and vegetable consumption in children and adolescents, aged 6-18. The search was limited to those published between 1996 and 2008, written in the English language, and used a psychosocial theoretical framework to guide the data collection and/or analysis. RESULTS. Studies that incorporated constructs from multiple psychosocial models found higher predictive power (R2) in their models explaining fruit and vegetable intake in youth, compared to studies using a single model. Similarly, the theoretically-based interventions yielded greater and more consistent increases in servings of fruit and vegetable consumption at follow-up when compared to single-model studies. DISCUSSION. Future studies may want to include constructs that have demonstrated success in changing this behavior, namely Social Cognitive Theory and the Transtheoretical Model for Behavior Change. Incorporating constructs from ecological models may be useful in constructing future interventions as well. Continued research in this area is important and should remain a national priority.