Mediation of parental educational level on fruit and vegetable intake among schoolchildren in ten European countries.
OBJECTIVE
To examine which factors act as mediators between parental educational level and children's fruit and vegetable (F&V) intake in ten European countries.


METHODS
Cross-sectional data were collected in ten European countries participating in the PRO GREENS project (2009). Schoolchildren completed a validated FFQ about their daily F&V intake and filled in a questionnaire about availability of F&V at home, parental facilitation of F&V intake, knowledge of recommendations about F&V intake, self-efficacy to eat F&V and liking for F&V. Parental educational level was determined from a questionnaire given to parents. The associations were examined with multilevel mediation analyses.


METHODS
Schools in Bulgaria, Finland, Germany, Greece, Iceland, the Netherlands, Norway, Portugal, Slovenia and Sweden.


METHODS
Eleven-year-old children (n 8159, response rate 72%) and their parents.


RESULTS
In five of the ten countries, children with higher educated parents were more likely to report eating fruits daily. This association was mainly mediated by knowledge but self-efficacy, liking, availability and facilitation also acted as mediators in some countries. Parents' education was positively associated with their children's daily vegetable intake in seven countries, with knowledge and availability being the strongest mediators and self-efficacy and liking acting as mediators to some degree.


CONCLUSIONS
Parental educational level correlated positively with children's daily F&V intake in most countries and the pattern of mediation varied among the participating countries. Future intervention studies that endeavour to decrease the educational-level differences in F&V intake should take into account country-specific features in the relevant determinants of F&V intake.
1Folkhälsan Research Center,Paasikivenkatu 4,00250 Helsinki,Finland.
Elviira
E
Lehto
1Folkhälsan Research Center,Paasikivenkatu 4,00250 Helsinki,Finland.
Carola
C
Ray
3EMGO Institute for Health and Care Research and Department of Epidemiology and Biostatistics,VU University Medical Center,Amsterdam,the Netherlands.
Saskia
S
Te Velde
4National Center of Public Health and Analyses,Sofia,Bulgaria.
Stefka
S
Petrova
4National Center of Public Health and Analyses,Sofia,Bulgaria.
Vesselka
V
Duleva
5Institute of Nutrition Sciences,Justus-Liebig-University Giessen,Giessen,Germany.
Michael
M
Krawinkel
5Institute of Nutrition Sciences,Justus-Liebig-University Giessen,Giessen,Germany.
Isabel
I
Behrendt
7Department of Social Medicine,Preventive Medicine and Nutrition Clinic,University of Crete,Heraklion,Crete,Greece.
Angeliki
A
Papadaki
9Unit for Nutrition Research,Landspitali-University Hospital and Faculty of Food Science and Human Nutrition,University of Iceland,Reykjavik,Iceland.
Asa
A
Kristjansdottir
9Unit for Nutrition Research,Landspitali-University Hospital and Faculty of Food Science and Human Nutrition,University of Iceland,Reykjavik,Iceland.
Inga
I
Thorsdottir
10School of Hospitality,Culinary Arts and Meal Sciences,Örebro University,Campus Grythyttan,Sweden.
Agneta
A
Yngve
12Department of Nutrition, Faculty of Medicine,University of Oslo,Oslo,Norway.
Nanna
N
Lien
11Department for Biosciences and Nutrition at Novum,Karolinska Institutet,Stockholm,Sweden.
Christel
C
Lynch
11Department for Biosciences and Nutrition at Novum,Karolinska Institutet,Stockholm,Sweden.
Bettina
B
Ehrenblad
13Faculty of Nutrition and Food Sciences of Porto University,Porto,Portugal.
Maria Daniel
MD
Vaz de Almeida
14National Institute of Public Health,Chronic Diseases Prevention Centre,Ljubljana,Slovenia.
Cirila Hlastan
CH
Ribic
15National Education Institute of the Republic of Slovenia,Ljubljana,Slovenia.
Irena
I
Simčic
1Folkhälsan Research Center,Paasikivenkatu 4,00250 Helsinki,Finland.
Eva
E
Roos
D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000208:ethnology; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000191:economics / Q000208:ethnology; D004034:Diet Surveys; D004522:Educational Status; D005060:Europe; D005260:Female; D005518:Food Preferences / Q000208:ethnology; D005523:Food Supply / Q000191:economics; D005638:Fruit / Q000191:economics; D006801:Humans; D008297:Male; D018673:Nutrition Policy; D016487:Parenting / Q000208:ethnology; D010290:Parents / Q000193:education*; D010349:Patient Compliance / Q000208:ethnology; D020377:Self Efficacy; D014675:Vegetables / Q000191:economics
Children; Daily fruit and vegetable intake; Europe; Parental educational level