Mediation of Parental Education Level on Fruit and Vegetable Intake Among Schoolchildren in European Countries
1Folkhälsan Research Center, Paasikivenkatu 4, Helsinki, Finland
2University of Iceland, Unit for Nutrition Research, Reykjavik, Iceland
3VU University Medical Center, EMGO Institute for Health and Care Research and the Department of Epidemiology & Biostatistics, Amsterdam, The Netherlands
4Karolinska Institutet, Unit for Public Health Nutrition, Department for Biosciences and Nutrition at Novum, Stockholm, Sweden
5University of Oslo, Department of Nutrition, Norway
Background The present study examined which factors mediate the association between parental educational level (PEL) and children’s fruit and (FV) intake in ten European countries. Methods In total, 8159 11-year-old children (response rate 72%) and their parents, in ten European countries, participated in the PRO GREENS project in 2009. Children completed a validated food frequency questionnaire about their daily FV intake and a validated questionnaire about availability of FV at home, parental facilitation of FV intake, liking for FV, self-efficacy to eat FV and knowledge of the FV intake recommendations. PEL was reported by parents. Associations were examined with mediation analyses with Mplus. Findings Higher PEL was associated with more frequent daily fruit intake among children in five of the ten countries. This association was mediated mainly by knowledge. Positive association between PEL and children’s daily vegetable intake, found in seven countries, was mediated mainly by availability and knowledge. Discussion Future intervention studies, which aim to decrease PEL differences in FV intake, should target the country-specific determinants of FV intake.