Home environmental determinants of children's fruit and vegetable consumption across different SES backgrounds

Objective To investigate the association between home environmental determinants of fruit and vegetable consumption with childhood overweight separately for low, medium and high social economic status (SES) families. Method A cross-sectional study was carried out in 2006 among 4072 children aged 4-13 years in the city of Zwolle, the Netherlands. Of these children, data were available on measured height and weight, and from a parental questionnaire, on sociodemographic characteristics and children's fruit and vegetables intake. Associations were studied using logistic regression analyses. Results Not eating the recommended amounts of vegetables daily was associated with overweight for children with a low SES background (odds ratio [OR]: 1.17; 95% confidence interval [CI]: 0.66-2.07) and medium SES background (OR: 1.73; 95% CI: 1.20-2.49). Eating-<-2 pieces of fruit daily was associated with a lower OR for overweight among children with a high SES background (OR: 0.66; 95% CI: 0.50-0.88). Determinants of eating vegetables-<-7-d were: permission to take candy without asking, eating at the table-<-7-d per week, eating a takeaway meal-≥-1-d per week, eating a home cooked meal-<-6-d per week and cooking together with caregiver less than 5-d per week. Conclusion Interventions regarding vegetable consumption should be tailored to families with low and medium SES background. The most promising avenues for intervention seem to be (i) to prevent eating takeaway meals on a weekly basis and, (ii) to promote eating a home cooked meal at the table and (iii) to involve children in the cooking process. Interventions should support parents in making these home environmental changes.