Understanding barriers to fruit and vegetable intake in the Australian Longitudinal Study of Indigenous Children: a mixed-methods approach

Thurber, Katherine A; Banwell, Cathy; Neeman, Teresa; Dobbins, Timothy; Pescud, Melanie; Lovett, Raymond; Banks, Emily

doi:10.1017/s1368980016003013

Cited by 20 publications

(26 citation statements)

References 62 publications

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“…In the focus group, the RAOs echoed that, for many families, there were 'more important' things to worry about, so what their children were drinking was not their highest concern. The observed association between discrimination and children's SSB consumption is consistent with previous LSIC findings of an association between caregivers' racism experiences and reduced access to nutrition for their children (47) and qualitative findings identifying a link between current health behaviours and current and historical experiences of discrimination and exclusion (31) .…”

Section: Socio-economic Position and Stressorssupporting

confidence: 88%

Sugar-sweetened beverage consumption among Indigenous Australian children aged 0–3 years and association with sociodemographic, life circumstances and health factors

Thurber

Long

Salmon

et al. 2019

Public Health Nutr.

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Objective:To explore beverage intake and associations between sugar-sweetened beverage (SSB) intake and sociodemographic, life circumstances, health and well-being factors in a national cohort of Indigenous children.Design:We calculated prevalence ratios for any SSB consumption across exposures, using multilevel Poisson regression (robust variance), adjusted for age group and remoteness. A key informant focus group contextualised these exploratory findings.Setting:Diverse settings across Australia.Participants:Families of Indigenous children aged 0–3 years, in the Longitudinal Study of Indigenous Children.Results:Half (50·7 %, n 473/933) of children had ever consumed SSB at survey, increasing from 29·3 % of 0–12-month-olds to 65·7 % of 18–36-month-olds. SSB consumption prevalence was significantly lower in urban and regional v. remote areas, and in families experiencing socio-economic advantage (area-level advantage, caregiver employed, financial security), better life circumstances (caregiver social support, limited exposure to stressors) and caregiver well-being (non-smoking, social and emotional well-being, physical health). SSB consumption prevalence was significantly lower among those engaged with health services (adequate health-service access, regular prenatal check-ups), except SSB consumption prevalence was higher among those who received home visits from an Aboriginal Health Worker compared with no home visits. Key informants highlighted the role of water quality/safety on SSB consumption.Conclusions:A substantial proportion of Indigenous children in this sample consumed SSB from an early age. Health provider information needs to be relevant to the context of families’ lives. Health system strategies must be paired with upstream strategies, such as holistic support programmes for families, reducing racism and improving water quality.

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Section: Socio-economic Position and Stressorssupporting

confidence: 88%

Sugar-sweetened beverage consumption among Indigenous Australian children aged 0–3 years and association with sociodemographic, life circumstances and health factors

Thurber

Long

Salmon

et al. 2019

Public Health Nutr.

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“…Our findings suggest that reducing consumption of sugar‐sweetened beverages and high‐fat foods from an early age could have a beneficial impact on children's BMI trajectories; despite the small magnitude of observed effects, reducing consumption could have a substantial impact at the population level given the high level of current consumption . However, it is imperative that programs and policy are developed in partnership with Indigenous communities, address the broader sociocultural and environmental context in which health behaviors occur , and are sustainable.…”

Section: Resultsmentioning

confidence: 83%

Body mass index trajectories of Indigenous Australian children and relation to screen time, diet, and demographic factors

Thurber

Dobbins

Neeman

et al. 2017

Obesity

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ObjectiveLimited cross‐sectional data indicate elevated overweight/obesity prevalence among Indigenous versus non‐Indigenous Australian children. This study aims to quantify body mass index (BMI) trajectories among Indigenous Australian children aged 3‐6 and 6‐9 years and to identify factors associated with the development of overweight/obesity.MethodsThree‐year BMI change was examined in up to 1,157 children in the national Longitudinal Study of Indigenous Children. BMI trajectories among children with normal baseline BMI (n = 907/1,157) were quantified using growth curve models.ResultsBaseline prevalences of overweight/obesity were 12.1% and 25.4% among children of mean age 3 and 6 years, respectively. Of children with normal baseline BMI, 31.9% had overweight/obesity 3 years later; BMI increased more rapidly for younger versus older (difference: 0.59 kg/m2/year; 95% CI: 0.50‐0.69), female versus male (difference: 0.15 kg/m2/year; 95% CI: 0.07‐0.23), and Torres Strait Islander versus Aboriginal (difference: 0.36 kg/m2/year; 95% CI: 0.17‐0.55) children. Results were consistent with less rapid rates of BMI increase for children with lower sugar‐sweetened beverage (including fruit juice) and high‐fat food consumption. Children's BMI was lower in more disadvantaged areas.ConclusionsOverweight/obesity is common, and increases rapidly, in early childhood. Interventions are required to reduce the overweight/obesity prevalence among Indigenous Australian children in the first 3 years of life and to slow the rapid overweight/obesity onset from age 3 to 9 years.

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“…By implication therefore, it becomes apparent with regard to wild fruits and vegetables that information on attitude obtained from a given geographic location may not be applicable in another location, thus providing further justification for the current study. Culture is an important factor that modulates consumer attitude toward a particular food type (Kruger & Gericke, 2002; Thurber et al., 2016). It is therefore plausible that cultural differences between communities in Acholi subregion of Uganda and those in Ethiopia and Spain where the respective studies were conducted could explain the disparity.…”

Section: Discussionmentioning

confidence: 99%

The mix of good nutritional attitude and poor nutritional knowledge is associated with adequate intake of vitamin A and iron from wild fruits and vegetables among rural households in Acholi subregion of Northern Uganda

Okidi

Odongo

Ongeng

2018

Food Science & Nutrition

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Nutritional knowledge and attitude of a population greatly affect intake of essential micronutrients. Much of the understanding on the impact of nutritional knowledge and attitude on nutrient intake has been derived from studies conducted among affluent societies using commercial food products. However, information on the link between status of nutritional knowledge and attitude on intake of essential nutrients from wild fruits and vegetables among rural communities is largely lacking. This study examined the status of nutritional knowledge and attitude associated with intake of vitamin A and iron from wild fruits and vegetables among rural households in Acholi subregion of northern Uganda. A cross‐sectional study design making use of individual household questionnaire and proximate dietary recall of a calendar year consumption period involving 248 randomly selected rural households was applied. Results showed that households had good nutritional attitude but poor nutritional knowledge. Status of knowledge was dependent on nutrition training (p = 0.028; coefficient, β = 0.710) and age of the respondent (p = 0.044; β = −0.023), whereas status of attitude was predicted by age of the respondent (p = 0.014; β = 0.048). Consumption of wild fruits and vegetables contributed adequately to the dietary vitamin A and iron requirements of the households. The results have demonstrated that intake of vitamin A and iron from wild fruits and vegetables among rural households is associated with good nutritional attitude but poor nutritional knowledge. A concerted effort is necessary to improve household nutritional knowledge for better utilization of wild fruits and vegetables.

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Understanding barriers to fruit and vegetable intake in the Australian Longitudinal Study of Indigenous Children: a mixed-methods approach

Cited by 20 publications

References 62 publications

Sugar-sweetened beverage consumption among Indigenous Australian children aged 0–3 years and association with sociodemographic, life circumstances and health factors

Sugar-sweetened beverage consumption among Indigenous Australian children aged 0–3 years and association with sociodemographic, life circumstances and health factors

Body mass index trajectories of Indigenous Australian children and relation to screen time, diet, and demographic factors

The mix of good nutritional attitude and poor nutritional knowledge is associated with adequate intake of vitamin A and iron from wild fruits and vegetables among rural households in Acholi subregion of Northern Uganda

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