@article{57b61cb0014811dfaefb000ea68e967b,
title = "Does school environment affect 11-year-olds' fruit and vegetable intake in Denmark?",
abstract = "It is often found that adolescents eat too little fruit and vegetables. We examined the importance of school for 11-year-olds' daily intake measured by food frequency- and 24-h recall questionnaires in Danish data from the European 2003 Pro Children Survey. Multilevel logistic regression analyses included matched student-parent-school questionnaire data (N=1410) from a random sample of 59 schools and were conducted for fruit and vegetables separately: 1) without explanatory variables, to decompose the between-school and within-school variance; 2) with individual level covariates (socioeconomic position, parental intake, etc.) to examine if the between-school variance was attributable to different student compositions of schools; and 3) with individual- and school-level covariates (school availability of fruit/vegetables and unhealthy food) to examine the effect of context. Additional analyses stratified by gender and home availability of fruit/vegetables examined if school food availability influenced subgroups differently. Between-school variations were quantified by intra class correlations and median odds ratios. We found that 40% of the students ate > or = 200 g fruit/day and 25% ate > or = 130 g vegetables/day. Most of the total variance in students' intake occurred at the individual level (93-98%). There were larger between-school variations in vegetable intake than in fruit intake. Fruit and vegetable consumption clustered within schools to a larger degree for boys than girls. The between-school variance did not differ by home availability. Boys and students from high availability homes consumed more fruit and/or vegetables if enrolled in schools with access to fruit/vegetables and unhealthy food or contrarily with no food available versus schools with only fruit/vegetables available. The small school-level effects on 11-year-olds' fruit and vegetable intake imply that family level interventions may be more important and that the success of school interventions will rely on the degree of parental involvement.",
keywords = "Child, Denmark, Diet Surveys, Female, Fruit, Humans, Logistic Models, Male, Schools, Social Environment, Vegetables",
author = "Rikke Kr{\o}lner and Pernille Due and Mette Rasmussen and Damsgaard, {Mogens Trab} and Holstein, {Bj{\o}rn E} and Knut-Inge Klepp and John Lynch",
year = "2009",
month = apr,
day = "1",
doi = "10.1016/j.socscimed.2009.01.022",
language = "English",
volume = "68",
pages = "1416--24",
journal = "Social Science & Medicine",
issn = "0277-9536",
publisher = "Elsevier",
number = "8",
}