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The European Journal of Public Health Advance Access published online on September 11, 2008

The European Journal of Public Health, doi:10.1093/eurpub/ckn081
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© The Author 2008. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Why do Parents’ Education Level and Income Affect the Amount of Fruits and Vegetables Adolescents Eat?

Elling Bere1, Frank van Lenthe2, Knut-Inge Klepp3 and Johannes Brug4

1 Faculty of Health and Sport, University of Agder, Kristiansand, Norway
2 Department of Public Health, Erasmus University Medical Centre Rotterdam, The Netherlands
3 Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
4 EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands

Correspondence: Elling Bere, Faculty of Health and Sport, University of Agder, Serviceboks 422, 4604 Kristiansand, Norway, tel: +47 38142329, fax: +47 38141301, e-mail: elling.bere{at}uia.no

Received March 11, 2008 , accepted July 18, 2008

Background: There are large socioeconomic disparities in food behaviours. The objective of the present study is to longitudinally explore socioeconomic disparities in adolescents’ fruit and vegetable (FV) intake and to assess mediators of the disparity. Methods: A longitudinal study containing 896 adolescents from 20 randomly selected elementary schools within two Norwegian counties (response rate 84%). Questionnaires were administered in May 2002 (mean age 12.5 years) and again in May 2005. FV intake was measured by four food frequency questions (times/week). Socioeconomic status was based on parents’ reports of their own educational level and family income (both dichotomized). Data were analysed with repeated mixed models. Results: A disparity in adolescents’ FV intake was observed with family income (1.1 times/week, P = 0.05). An interaction between parental education and time (survey) was found for parental education (P = 0.04) and the educational disparity was greater in 2005 (2.4 times/week, P < 0.001) than in 2002 (1.3 times/week, P = 0.03). In multiple mediation analyses, a total of 92% (2002) and 60% (2005) of the educational disparity and 89% of the income disparity, were explained. For both, the adolescents’ reports of the accessibility of FV at home explained most of the disparity. Conclusions: Perceived accessibility appears to be the strongest mediator of the relationship between adolescents’ FV intake and their parents’ educational level and income and may therefore be an important target for future interventions that aim to reduce socioeconomic disparities in adolescents’ FV intake.

Keywords: adolescents, fruits, mediators, socioeconomic disparity, vegetables


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