Associations between characteristics of the home food environment and fruit and vegetable intake in preschool children: A cross-sectional study

BACKGROUND Early childhood is critical to the development of lifelong food habits. Given the high proportion of children with inadequate fruit and vegetable consumption, identification of modifiable factors associated with higher consumption may be useful in developing interventions to address this public health issue. This study aimed to identify the characteristics of the home food environment that are associated with higher fruit and vegetable consumption in a sample of Australian preschool children. METHODS A cross-sectional telephone survey was conducted with 396 parents of 3 to 5 year-old children attending 30 preschools within the Hunter region, New South Wales, Australia. Children's fruit and vegetable consumption was measured using a valid and reliable subscale from the Children's Dietary Questionnaire. Associations were investigated between children's fruit and vegetable intake and characteristics of the home food environment including parental role-modeling, parental providing behaviour, fruit and vegetable availability, fruit and vegetable accessibility, pressure to eat, family eating policies and family mealtime practices. Characteristics of the home food environment that showed evidence of an association with children's fruit and vegetable consumption in simple regression models were entered into a backwards stepwise multiple regression analysis. The multiple regression analysis used generalised linear mixed models, controlled for parental education, household income and child gender, and was adjusted for the correlation between children's fruit and vegetable consumption within a preschool. RESULTS The multiple regression analysis found positive associations between children's fruit and vegetable consumption and parental fruit and vegetable intake (p=0.005), fruit and vegetable availability (p=0.006) and accessibility (p=0.012), the number of occasions each day that parents provided their child with fruit and vegetables (p<0.001), and allowing children to eat only at set meal times all or most of the time (p=0.006). Combined, these characteristics of the home food environment accounted for 48% of the variation in the child's fruit and vegetable score. CONCLUSIONS This study identified a range of modifiable characteristics within the home food environment that are associated with fruit and vegetable consumption among preschool children. Such characteristics could be considered potential targets for interventions to promote intake among children of this age.