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Title: Fruit and vegetable availability: a micro environmental mediating variable?

Author
item JAGO, RUSSELL - UNIV OF BRISTOL
item Baranowski, Thomas
item Baranowski, Janice

Submitted to: Public Health Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/31/2006
Publication Date: 2/20/2007
Citation: Jago, R., Baranowski, T., Baranowski, J.C. 2007. Fruit and vegetable availability: A micro environmental mediating variable? Public Health Nutrition. 10(7):681-689.

Interpretive Summary: This manuscript reviews findings over the previous 10 years from a series of studies we have conducted concerning home availability of fruit and vegetables. This research has revealed that families who keep more fruit and vegetables at home (i.e., home fruit and vegetable availability) have children who eat more fruit and vegetables. Intervention studies with children reveal that home fruit and vegetable availability can be increased, and these increases lead to increased children's fruit and vegetable consumption. The influence of home availability or consumption appears to include beverages, and appears to extend to availability in schools and restaurants near home. Increasing availability appears to be an important intervention tool to help children eat more or less of targeted foods, but more research needs to be done.

Technical Abstract: Our objective was to examine the association between fruit and vegetable (F&V) availability and consumption, the possible influences on this association, research gaps, and implications for developing strategies to increase F&V consumption. This was a systematic review of studies that have examined associations between F&V availability and consumption. Qualitative studies conducted among children and adults indicated that greater availability was associated with greater consumption. This finding was supported by cross-sectional studies among children. Availability was associated with dietary psychosocial variables such as preferences, and it appears that availability may moderate the relationship between these psychosocial variables and consumption. Intervention studies attempting to increase availability have resulted in increased consumption, and availability has predicted change in consumption over an 18-month period. Availability appears to be a key proximal determinant of consumption, especially of F&V, and thereby provides a target for change. However, the mechanisms that relate these variables are unclear, and there is a need to clarify the direction of causality. We suggest that the possible causal mechanisms may include: (1) availability simply facilitates increased consumption; (2) the visual cues of available food may stimulate consumption; and (3) available food exposure may increase preference, which leads to increased consumption. Each of these possibilities requires close examination, as do policy-level interventions. F&V availability is associated with increased consumption. Research that elucidates the mechanisms between availability and intake, and tests policy-level interventions, is needed to advance increased availability as a public health procedure.