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To determine whether an association exists between different clusters of fruit- and vegetable-specific family-environmental factors and children's daily fruit and vegetable intake, and whether these associations differ between countries with different school lunch policies.
Design
Cross-sectional data from four European countries participating in the Pro Greens project in 2009. These countries have different school food policies: two serve free school lunches and two do not. Self-administered data were used. Food frequency questions served to assess fruit and vegetable intakes. The study assessed sixteen children-perceived family-environmental factors, which were clustered based on principal component analysis into five sum variables: fruit and vegetable encouragement; vegetable modelling, family routine and demand; fruit modelling; fruit and vegetable snacking practices; and fruit and vegetable allowing.
Setting
Schools in Finland, Germany, Sweden and the Netherlands.
Subjects
Schoolchildren aged 11 years (n 3317).
Results
Multilevel logistic regression analyses revealed positive associations between nearly all clustered family-environmental factors and daily fruit and vegetable intake. The study tested a moderation effect between family-environmental factors and school lunch policy. In five out of twenty models significant interactions occurred. In the stratified analyses, most of the associations between family-environmental factors and raw and cooked vegetable intake were stronger in Germany and the Netherlands, neither of which provided free school lunches.
Conclusions
Children reporting more fruit- and vegetable-promoting family-environmental factors had a more frequent intake of fruits and vegetables; the associations were stronger for vegetable intakes in countries providing no free school lunches, suggesting that parental involvement is crucial when schools offer no vegetables.
By
David A. Brent, Academic Chief, Child and Adolescent Psychiatry, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Suite 112, Pittsburgh, PA 15213 USA; Professor of Psychiatry, Pediatrics and Epidemiology, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Suite 112, Pittsburgh, PA 15213 USA e-mail: brentda@msx.upmc.edu tel: +1-412-624-5172, fax: +1-412-624-7997,
J. John Mann, Dept. of Neuroscience/Psychiatry, NY State Psychiatric Institute, Columbia Presbyterian Medical Center, 722 W. 168th St., Box 28, New York, NY 10032 (011-61-3) 9527-2867 USA e-mail: jjm@columbia.edu tel: +1-212-543-5000 / 5571, fax: +1-212-543-6017 or (212) 781-0503
This chapter examines both genetic and family-environmental factors associated with suicide and suicidal behavior, with an emphasis on youthful suicidal behavior. A family history of suicide was associated with a higher rate of suicide attempts in patients with a wide variety of disorders, including schizophrenia, unipolar and bipolar disorder, depressive neurosis, and personality disorders. The choice of candidate genes to examine in studying the etiology of suicide is made easier by the extensive and rather consistent findings from post-mortem studies of suicide victims, and in vivo studies of suicide attempters. A parent who is a suicide attempter most likely has at least two sets of liabilities: difficulties with regulation of aggression and the presence of a mood disorder or other type of psychopathology. The familial transmission of suicidal behavior appears to be independent or interactive with the familial transmission of psychopathology.
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