Nutr Res Pract.  2017 Aug;11(4):340-346. 10.4162/nrp.2017.11.4.340.

Factors affecting vegetable preference in adolescents: stages of change and social cognitive theory

• Woo T
• Lee KH

• KMID: 2385473
• DOI: http://doi.org/10.4162/nrp.2017.11.4.340

Abstract

BACKGROUND/OBJECTIVES
Despite the importance of consuming sufficient amounts of vegetables, daily vegetable intake among adolescents in Korea is lower than the current dietary recommendation. The objective of this study was to examine determinants affecting vegetable preference in order to suggest a stage-tailored education strategy that can promote vegetable consumption in adolescents.
SUBJECTS/METHODS
Adolescents (n = 400, aged 16-17 years) from two high schools participated in a cross-sectional study. Survey variables were vegetable preference, the social cognitive theory (SCT) and stages of change (SOC) constructs. Based on vegetable preference, subjects were classified into two groups: a low-preference group (LPG) and a high-preference group (HPG). SOC was subdivided into pre-action and action/maintenance stages. To compare SCT components and SOC related to vegetable preference, chi-squared and t-tests, along with stepwise multiple-regression analysis, were applied.
RESULTS
In the LPG, a similar number of subjects were classified into each stage. Significant differences in self-efficacy, affective attitudes, and vegetable accessibility at home and school were detected among the stages. Subjects in the HPG were mainly at the maintenance stage (81%), and there were significant differences among the stages regarding self-efficacy, affective attitudes, and parenting practice. In the predictions of vegetable preference, self-efficacy and parenting practice had a significant effect in the "pre-action" stage. In the action/maintenance stage, outcome expectation, affective attitudes, and vegetable accessibility at school had significant predictive value. In predicting the vegetable preference for all subjects, 42.8% of the predictive variance was accounted for by affective attitudes, self-efficacy, and vegetable accessibility at school.
CONCLUSION
The study revealed that different determinants affect adolescent vegetable preference in each stage. Self-efficacy and affective attitudes are important determinants affecting vegetable preference. Additionally, school-based nutrition intervention that focuses on enhancing affective attitudes, self-efficacy, and vegetable exposure may constitute an effective education strategy for promoting vegetable consumption among adolescents.

Keyword

Stages of change; social cognitive theory; vegetable preference; adolescents

MeSH Terms

Adolescent*
Cross-Sectional Studies
Education
Humans
Korea
Parenting
Parents
Penicillin G Benzathine
Vegetables*
Penicillin G Benzathine

Figure

• 

  Fig. 1 Diagnosis of the stages of change in regard to vegetable consumption

Reference

1. World Health Organization. Healthy diet [Internet]. Geneva: World Health Organization;2015. cited 2016 May 10. Available from: http://www.who.int/mediacentre/factsheets/fs394/en.

2. Choi MK, Bae YJ. Vegetable intake is associated with lower Frammingham risk scores in Korean men: Korea National Health and Nutrition Survey 2007-2009. Nutr Res Pract. 2016; 10:89–98.

3. Hildebrand DA, Betts NM. Assessment of stage of change, decisional balance, self-efficacy, and use of processes of change of low-income parents for increasing servings of fruits and vegetables to preschool-aged children. J Nutr Educ Behav. 2009; 41:110–119.

4. Food and Agriculture Organization of the United Nations. Food-based dietary guidelines [Internet]. Rome: Food and Agriculture Organization of the United Nations;2017. cited 2017 February 10. Available from: http://www.fao.org/nutrition/education/food-dietary-guidelines/home/en.

5. Ministry of Health and Welfare (KR). The 4^th health plan 2020. [Internet]. Sejong: Ministry of Health and Welfare;2016. cited 2016 February 10. Available from: http://www.mohw.go.kr/front_new/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=0319&CONT_SEQ=330479&page=1.

6. Ministry of Health and Welfare. Korea Center for Disease Control and Prevention. Korea Health Statistics 2015: Korea National Health and Nutrition Examination Survey (KNHANES VI-3) [Internet]. Sejong: Korea Center for Disease Control and Prevention;2016. cited 2017 January 20. Available from: http://knhanes.cdc.go.kr/.

7. Kim Y, Kwon YS, Park YH, Choe JS, Lee JY. Analysis of consumption frequencies of vegetables and fruits in Korean adolescents based on Korea youth risk behavior web-based survey (2006, 2011). Nutr Res Pract. 2015; 9:411–419.

8. Hong JH, Cho MS. Acceptance of vegetable menus of a school lunch program by high school students in Seoul and its association with health and dietary behavioral factors. Korean J Food Sci Technol. 2012; 44:121–134.

9. Lee KH, Kim GW, Lee YK, Lee SM, Son SM. Practice in Nutrition Education & Counseling. 3rd ed. Seoul: Life Science Publishing Co;2015. p. 31p. 353–364.

10. Pearson N, Ball K, Crawford D. Predictors of changes in adolescents' consumption of fruits, vegetables and energy-dense snacks. Br J Nutr. 2011; 105:795–803.

11. Suh Y, Choi A, Chung YJ. Psychosocial factors related with the intake of vegetables and fruits by stage of change of elementary school children in Chungnam province. Korean J Nutr. 2009; 42:639–649.

12. Kim SJ, Choi MK. Factors associated with fruit and vegetable consumption of subjects having a history of stroke: using 5th Korea National Health and Nutrition Examination Survey (2010, 2011). Korean J Community Nutr. 2014; 19:468–478.

13. Ahn Y, Kim KW. Beliefs regarding vegetable consumption, self-efficacy and eating behaviors according to the stages of change in vegetable comsumption among college students. Korean J Community Nutr. 2012; 17:1–13.

14. Contento IR. Nutrition Education: Linking Research, Theory, and Practice. 3rd ed. Burlington (MA): Jones & Bartlett Learning;2016. p. 161–163. p. 249

15. Wyker BA, Davison KK. Behavioral change theories can inform the prediction of young adults' adoption of a plant-based diet. J Nutr Educ Behav. 2010; 42:168–177.

16. Molaison EF, Connell CL, Stuff JE, Yadrick MK, Bogle M. Influences on fruit and vegetable consumption by low-income black American adolescents. J Nutr Educ Behav. 2005; 37:246–251.

17. Birch LL. Development of food preferences. Annu Rev Nutr. 1999; 19:41–62.

18. Suh Y, Chung Y. Comparison of mineral and vitamin intakes according to the stage of change in fruit and vegetable intake for elementary school students in Chungnam Province. Korean J Nutr. 2008; 41:658–666.

19. Kwak S, Woo T, Lee KA, Lee KH. A comparison of dietary habits and influencing factors for vegetable preferences of adolescents in Gyeongnam province. Korean J Community Nutr. 2015; 20:259–272.

20. Kim SH, Cho SW, Hwang SS, Ahn M, Lee D, Kang SW, Park YK. Increased whole grain, fruits and vegetable intake reduced oxidative stress in high school students. Korean J Nutr. 2012; 45:452–461.

21. Jee YJ, Kim YH. Factors influencing obesity among adolescent: analysis of 2011 Korean Youth Risk Behavior Survey. Korean J Obes. 2013; 22:39–49.

22. Granner ML, Evans AE. Measurement properties of psychosocial and environmental measures associated with fruit and vegetable intake among middle school adolescents. J Nutr Educ Behav. 2012; 44:2–11.

23. Van Duyn MA, Kristal AR, Dodd K, Campbell MK, Subar AF, Stables G, Nebeling L, Glanz K. Association of awareness, intrapersonal and interpersonal factors, and stage of dietary change with fruit and vegetable consumption: a national survey. Am J Health Promot. 2001; 16:69–78.

24. Ding D, Sallis JF, Norman GJ, Saelens BE, Harris SK, Kerr J, Rosenberg D, Durant N, Glanz K. Community food environment, home food environment, and fruit and vegetable intake of children and adolescents. J Nutr Educ Behav. 2012; 44:634–638.

25. Savage JS, Fisher JO, Birch LL. Parental influence on eating behavior: conception to adolescence. J Law Med Ethics. 2007; 35:22–34.

26. Neumark-Sztainer D, Wall M, Perry C, Story M. Correlates of fruit and vegetable intake among adolescents. Findings from Project EAT. Prev Med. 2003; 37:198–208.

27. Szczepanska WK, Scholz U, Liszewska N, Luszczynska A. Social and cognitive predictors of fruit and vegetable intake among adolescents: the context of changes in body weight. J Health Psychol. 2013; 18:667–679.