title: Association between fruits and vegetables intake and frequency of breakfast and snacks consumption: a cross-sectional study.
abstract: BACKGROUND
  There are very few studies on the frequency of breakfast and snack consumption and its relation to fruit and vegetable intake. This study aims to fill that gap by exploring the relation between irregular breakfast habits and snack consumption and fruit and vegetable intake in Tuscan adolescents. Separate analyses were conducted with an emphasis on the potentially modifying factors of sex and age.
  
  
  METHODS
  Data was obtained from the 2010 Tuscan sample of the Health Behaviour in School-aged Children (HBSC) study. The HBSC study is a cross-sectional survey of 11-, 13- and 15-year-old students (n = 3291), selected from a random sample of schools. Multivariate logistic regression was used for analyzing the food-frequency questionnaire.
  
  
  RESULTS
  A significant relation was found between low fruit and vegetable intake and irregular breakfast habits. Similarly, low fruit intake was associated with irregular snack consumption, whereas vegetable intake did not prove to be directly related to irregular snack consumption. Different patterns emerged when gender and age were considered as modifying factors in the analyses. A statistically significant relation emerged only among female students for irregular breakfast habits and fruit and vegetable intake. Generally, older female participants with irregular breakfast habits demonstrated a higher risk of low fruit and vegetable intake. Age pattern varied between genders, and between fruit and vegetable consumption.
  
  
  CONCLUSIONS
  Results suggest that for those adolescents who have an irregular consumption of breakfast and snacks, fruit intake occurs with a lower frequency. Lower vegetable consumption was associated with irregular breakfast consumption. Gender and age were shown to be moderators and this indicated the importance of analyzing fruit and vegetable intake and meal types separately. This study also confirmed that health-promotion campaigns that aim to promote regular meal consumption and consumption of fruits and vegetables need to take into account gender and age differences in designing promotional strategies. Future research should identify evidence-based interventions to facilitate the achievement of the Italian guidelines for a healthy diet for fruit, vegetables and meals intake.
authors: Department of Molecular Developmental Medicine, University of Siena, Via A, Moro 2, Siena 53100, Italy. lazzeri@unisi.it.
authors: Giacomo
authors: G
authors: Lazzeri
authors: Andrea
authors: A
authors: Pammolli
authors: Elena
authors: E
authors: Azzolini
authors: Rita
authors: R
authors: Simi
authors: Veronica
authors: V
authors: Meoni
authors: Daniel Rudolph
authors: DR
authors: de Wet
authors: Mariano Vincenzo
authors: MV
authors: Giacchi
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology; D041923:Adolescent Development; D062408:Breakfast / Q000208:ethnology; D002648:Child; D002652:Child Behavior / Q000208:ethnology; D002657:Child Development; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D005638:Fruit; D006293:Health Promotion; D006801:Humans; D007558:Italy; D008297:Male; D018673:Nutrition Policy; D010349:Patient Compliance; D012727:Sex Characteristics; D062410:Snacks / Q000208:ethnology; D014675:Vegetables
references: Atherosclerosis. 2013 Mar;227(1):147-52
references: 23294925
references: Int J Public Health. 2009 Sep;54 Suppl 2:140-50
references: 19639259
references: Arch Pediatr Adolesc Med. 2007 Dec;161(12):1154-61
references: 18056560
references: J Am Diet Assoc. 2007 Sep;107(9):1502-10
references: 17761227
references: Eur J Cancer Prev. 2013 Jan;22(1):90-5
references: 22644232
references: J Am Diet Assoc. 1993 Nov;93(11):1280-4
references: 8227878
references: J Am Diet Assoc. 1998 Feb;98(2):159-64
references: 12515416
references: Eur J Clin Nutr. 2003 Jul;57(7):842-53
references: 12821884
references: Prev Med. 2001 Sep;33(3):217-26
references: 11522162
references: J Am Diet Assoc. 2005 May;105(5):743-60; quiz 761-2
references: 15883552
references: J Pediatr Gastroenterol Nutr. 2012 Jul;55(1):4-13
references: 22437477
references: Ann Intern Med. 2001 Jun 19;134(12):1106-14
references: 11412050
references: J Am Diet Assoc. 2007 Apr;107(4):662-5
references: 17383272
references: Br J Nutr. 2013 May;109(9):1704-13
references: 22958341
references: J Am Diet Assoc. 2003 Mar;103(3):317-22
references: 12616252
references: Physiol Behav. 1991 Jun;49(6):1289-91
references: 1896512
references: Public Health Nutr. 2003 Sep;6(6):581-8
references: 14690039
references: Public Health Nutr. 2013 May;16(5):883-93
references: 22857517
references: Int J Behav Nutr Phys Act. 2006 Aug 11;3:22
references: 16904006
references: J Am Diet Assoc. 2009 Feb;109(2 Suppl):S67-78
references: 19166674
references: Proc Nutr Soc. 2006 Nov;65(4):348-60
references: 17181901
references: Public Health Nutr. 2002 Oct;5(5):671-81
references: 12372162
references: Physiol Behav. 2010 Jul 14;100(5):567-73
references: 20457172
references: Int J Public Health. 2008;53(6):297-305
references: 19112592
references: BMJ. 2000 May 6;320(7244):1240-3
references: 10797032
references: J Sch Health. 2006 Mar;76(3):87-92
references: 16475983
references: J Epidemiol Community Health. 2002 Aug;56(8):595-9
references: 12118050
references: Rev Neurol. 2012 Feb 1;54(3):137-50
references: 22278890
references: Int J Behav Nutr Phys Act. 2012 Feb 06;9:9
references: 22309975
references: Obes Res. 2004 Sep;12 Suppl:20S-31S
references: 15489464
references: Can J Diet Pract Res. 2008 Fall;69(3):152-4
references: 18783641
references: J Nutr Educ Behav. 2011 Sep-Oct;43(5):308-15
references: 20965787
references: Public Health Nutr. 2009 Feb;12(2):267-83
references: 18559129
references: Prev Med. 2003 Sep;37(3):198-208
references: 12914825
references: Qual Life Res. 2010 Dec;19(10):1487-500
references: 20668950
references: Public Health Nutr. 2013 Aug;16(8):1487-96
references: 22894987
references: Soc Sci Med. 2008 Mar;66(6):1429-36
references: 18179852
references: Value Health. 2008 Jul-Aug;11(4):645-58
references: 18179669
references: J Hum Nutr Diet. 2005 Dec;18(6):431-43
references: 16351702
references: Prev Med. 1996 Sep-Oct;25(5):497-505
references: 8888316
references: BMC Public Health. 2011 Jun 21;11:487
references: 21693055
references: Nat Rev Cardiol. 2009 Sep;6(9):599-608
references: 19652655
references: Ann Ig. 2013 May-Jun;25(3):225-33
references: 23598806
references: Nutrients. 2012 Nov 12;4(11):1692-708
references: 23201841
references: Eur J Public Health. 2008 Jun;18(3):294-9
references: 18252752
references: Scand J Public Health. 1999 Mar;27(1):63-72
references: 10847674
references: Int J Behav Nutr Phys Act. 2011 Dec 22;8:141
references: 22192661
references: Public Health Nutr. 2007 Jan;10(1):16-23
references: 17212838
references: Obesity (Silver Spring). 2008 Aug;16(8):1826-30
references: 18551108
references: Eur J Nutr. 2012 Sep;51(6):637-63
references: 22684631