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PubMed2005

The pro children intervention: applying the intervention mapping protocol to develop a school-based fruit and vegetable promotion programme.

BACKGROUND/AIMS: The importance of careful theory-based intervention planning is recognized for fruit and vegetable promotion. This paper describes the application of the Intervention Mapping (IM) protocol to develop the Pro Children intervention to promote consumption of fruit and vegetable among 10- to 13-year-old schoolchildren. METHODS: Based on a needs assessment, promotion of intake of fruit and vegetable was split into performance objectives and related personal, social and environmental determinants. Crossing the performance objectives with related important and changeable determinants resulted in a matrix of learning and change objectives for which appropriate educational strategies were identified. Theoretically similar but culturally relevant interventions were designed, implemented and evaluated in Norway, the Netherlands and Spain during 2 school years. RESULTS: Programme activities included provision of fruits and vegetables in the schools, guided classroom activities, computer-tailored feedback and advice for children, and activities to be completed at home with the family. Additionally, optional intervention components for community reinforcement included incorporation of mass media, school health services or grocery stores. School project committees were supported. CONCLUSION: The Pro Children intervention was carefully developed based on the IM protocol that resulted in a comprehensive school-based fruit and vegetable promotion programme, but culturally sensible and locally relevant.

Adolescent↗

PubMed2006

A vegetable to meat consumption ratio as a relevant factor determining cancer preventive diet. The Mediterranean versus other European countries.

The observed growth of cancer incidence in certain regions has been usually linked to frequent consumption of 'unhealthy' food. Such food often contains genotoxic substances as heterocyclic aromatic amines (HAAs) and/or polycyclic aromatic hydrocarbones (PAHs), occurring during food preparation, which induce DNA damage in cells. These substances are mainly formed during frying or grilling of meat and they can be removed from the body in a two-stage metabolic process of detoxification (phase 1 and phase 2). If they are not excreted, they form DNA adducts. The effectiveness of detoxification depends on the activity of enzymes encoded by polymorphic genes. A diet containing plenty of fruits and vegetables, due to the presence of biologically active polyphenols, can modulate activity of detoxifying enzymes. Such a diet can decrease the extent of DNA adducts, breaks and oxidative damage, supporting the body's enzymatic system in sufficient removal of DNA damage. The antioxidant vitamins' content in such a diet also enhances the DNA protection by increasing the scavenging of radical oxidative species that occurs during metabolic reactions. The lack of balance between the amount of 'unhealthy' and 'healthy' food leads to the accumulation of unrepaired damage, initiating DNA instability and inducing cancer development. Such damage is often used as a biomarker of cancer risk in epidemiological studies. Moreover, in in vitro studies, the amount of the DNA damage is used as indicator of the protective ability of vitamins, plant extracts and/or individual flavonoids. The incidences of certain dietaryrelated cancers in European Mediterranean countries is lower than in Central and Northern European countries; there is simultaneously variation in the habitual diet in these regions. This suggests that some features of routine nutrition in the Mediterranean countries may be responsible for this preventing effect. However, inconsistency in the epidemiological data, associating the meat and fruit and vegetable intake with cancer risk, suggests that another strategy for evaluation dietary influence on cancer risk should be undertaken. This article argues that it is not the consumption of a single food product or an individual component of diet, but rather a proper ratio of vegetable to meat consumption that is responsible for cancer prevention. This hypothesis is tested comparing the association between certain dietaryrelated cancer incidences (colon & rectum, breast and prostate cancer), registered in 2002, with the ratio between consumption of these two groups of food products in the Mediterranean region and in Central and Northern European region over the last three decades. The results clearly showed that both the ratio between vegetables and meat consumption as well as the ratio between the amount of energy from vegetables and from animal products can be used successfully to evaluate the dietary pattern related to cancer risk.

Antioxidants↗

PubMed1992

Vegetable foods in weaning.

Vegetable foods (cereals, non-starchy vegetables, legumes) make a unique nutritional and metabolic contribution during weaning. They provide proteins that are of low biological value individually but whose value can be raised by consuming appropriate combinations: minimal amounts of lipids, mostly essential polyunsaturated fats; complex carbohydrates; and soluble fibre, which are fermented by colonic flora to short-chain fatty acids that have beneficial effects. Insoluble fibre, minerals, trace elements and vitamins are also nutritionally important components of vegetable foods. Vegetable foods lower the calorific density of meals, modulate nutrient and antigen absorption, and promote a physiological copropoiesis. Recent nutritional surveys have shown that 12-month old children eat an excessive amount of animal proteins. Whole cereals and non-starchy vegetables, including whole legumes, should be routinely eaten during weaning to improve nutritional balance and to make children accustom to eating fibre, which has prophylactic properties. The daily intake of fibre should be progressively increased to 5 g during the first year of life.

Humans↗

PubMed1995

Vegetable and fruit consumption: some past, present and future practices.

In Western populations, historically, from early times until the 19th century, diets were composed largely of plant foods-cereals, beans, vegetables and fruit. The huge majority of populations were very poor with restricted food choices. The same situation prevails with most present-day Third World populations, although principally with rural dwellers. In Western populations, in recent times, stemming largely from urbanization and rise in prosperity, and accompanying increased partiality to animal foods, there have been falls in the intake of some plant foods yet rises in others. Potato intake has halved, whereas vegetable consumption has increased only slightly, although that of fruit more so. National consumptions of these foodstuffs vary widely, those in the United Kingdom and United States of American being only about half of those in Mediterranean countries, Spain, Portugal and Greece. In the former countries, present dietary guidelines urge that vegetable consumption be doubled, with fruit up by a half. In southern Africa, consumption of vegetables and fruit by the white population appears similar to those in The USA and UK. Yet in African cities, intake is low due to their cost. In view of the protective role of high vegetable and fruit intake in the combating of coronary heart disease and many forms of cancer, the relatively low consumption of these foodstuffs, especially in the poorer populations, is disappointing, and alas, appears unlikely to rise in the near future.

Diet↗

PubMed2004

Cruciferous vegetables: cancer protective mechanisms of glucosinolate hydrolysis products and selenium.

Dietetic professionals urge Americans to increase fruit and vegetable intakes. The American Institute of Cancer Research estimates that if the only dietary change made was to increase the daily intake of fruits and vegetables to 5 servings per day, cancer rates could decline by as much as 20%. Among the reasons cited for this health benefit are that fruits and vegetables are excellent sources of fiber, vitamins, and minerals. They also contain nonnutritive components that may provide substantial health benefits beyond basic nutrition. Examples of the latter are the glucosinolate hydrolysis products, sulforaphane, and indole-3-carbinol. Epidemiological studies provide evidence that the consumption of cruciferous vegetables protects against cancer more effectively than the total intake of fruits and vegetables. This review describes the anticarcinogenic bioactivities of glucosinolate hydrolysis products, the mineral selenium derived from crucifers, and the mechanisms by which they protect against cancer. These mechanisms include altered estrogen metabolism, protection against reactive oxygen species, altered detoxification by induction of phase II enzymes, decreased carcinogen activation by inhibition of phase I enzymes, and slowed tumor growth and induction of apoptosis.

Anticarcinogenic Agents↗

PubMed2006

The effects of a controlled worksite environmental intervention on determinants of dietary behavior and self-reported fruit, vegetable and fat intake.

BACKGROUND: Eating patterns in Western industrialized countries are characterized by a high energy intake and an overconsumption of (saturated) fat, cholesterol, sugar and salt. Many chronic diseases are associated with unhealthy eating patterns. On the other hand, a healthy diet (low saturated fat intake and high fruit and vegetable intake) has been found important in the prevention of health problems, such as cancer and cardio-vascular disease (CVD). The worksite seems an ideal intervention setting to influence dietary behavior. The purpose of this study is to present the effects of a worksite environmental intervention on fruit, vegetable and fat intake and determinants of behavior. METHODS: A controlled trial that included two different governmental companies (n = 515): one intervention and one control company. Outcome measurements (short-fat list and fruit and vegetable questionnaire) took place at baseline and 3 and 12 months after baseline. The relatively modest environmental intervention consisted of product information to facilitate healthier food choices (i.e., the caloric (kcal) value of foods in groups of products was translated into the number of minutes to perform a certain (occupational) activity to burn these calories). RESULTS: Significant changes in psychosocial determinants of dietary behavior were found; subjects at the intervention worksite perceived more social support from their colleagues in eating less fat. But also counter intuitive effects were found: at 12 months the attitude and self-efficacy towards eating less fat became less positive in the intervention group. No effects were found on self-reported fat, fruit and vegetable intake. CONCLUSION: This environmental intervention was modestly effective in changing behavioral determinant towards eating less fat (social support, self-efficacy and attitude), but ineffective in positively changing actual fat, fruit and vegetable intake of office workers.

Adult↗

PubMed1995

Transfer factors of some selected radionuclides (radioactive Cs, Sr, Mn, Co and Zn) from soil to leaf vegetables.

Transfer factors of radionuclides from soil to leaf vegetables (cabbage, Chinese cabbage, komatsuna, spinach and lettuce) have been studied by radiotracer experiments using Andosol as a representative of Japanese soils. The transfer factors of radioactive Cs, Sr, Mn, Co and Zn for edible parts of vegetables (average of five vegetables) were 0.11, 0.24, 0.61, 0.05 and 0.52, respectively. These values should be used in safety assessment for Japanese agricultural environment. The transfer factors of Mn, Co and Zn for spinach were higher than those for the other vegetables. The transfer factors of Cs for different organs of the leaf vegetables were rather homogeneous. The transfer factors of Sr and Mn were higher for older (outer) leaves than younger (inner) ones. In contrast to Sr and Mn, transfer factors of Zn for younger leaves were higher than those for older ones. The distribution ratios of the elements between soil-solution and soil were in the order Sr > Mn > Cs > Co > Zn, whereas the distribution ratios of the elements between plant and soil-solution were in the order Zn > Cs > Mn > Co > Sr. These results indicate that the selectivity for Sr by plants from the soil-solution was low and that for Zn was very high.

Biological Availability↗

PubMed2002

Onion and a mixture of vegetables, salads, and herbs affect bone resorption in the rat by a mechanism independent of their base excess.

Prevention of low bone mass is important to reduce the incidence of osteoporotic fractures. In man, the consumption of fruits and vegetables is associated with greater bone mineral density (BMD), an effect that is claimed to be caused by their base excess buffering metabolic acid, thought to dissolve bone. We showed previously that in the rat the consumption of several vegetables, salads, and herbs inhibits bone resorption and that onion increases bone mass. In this study we show that, although the intake of onion is associated with a decrease in urinary noncarbonic acid excretion and a concomitant inhibition of bone resorption of similar magnitude, the two findings are not causally related. Onion retains its bone resorption inhibitory activity in the rat even when added to a vegetarian diet with typical base excess. Onion and a mixture of vegetables, salads, and herbs retain their inhibitory activity even when metabolic acid is buffered with potassium citrate. In addition, neither the pH nor the potassium content of individual ashed vegetables, salads, and herbs correlates with inhibition of bone resorption. The effect of vegetables, salads, and herbs, which inhibit bone resorption in the rat, therefore is not mediated by their base excess but possibly by a pharmacologically active compound(s).

Animals↗

PubMed2001

Methemoglobinemia and consumption of vegetables in infants.

OBJECTIVE: To assess clinical and epidemiologic data of 7 infants diagnosed with acquired methemoglobinemia at the pediatric emergency department between 1993 and 1998. All cases were attributed to the consumption of mixed vegetables. METHODS: Medical records were reviewed to collect anamnestic data; history of food ingestion; and results of physical examination, pulse oximetry, gasometry, cooximetry, urinalysis, and outcome. Local health authorities provided information on nitrate concentration in running water and in vegetables of common consumption in the area. RESULTS: The mean age of the patients was 8.14 months (range: 7-13). None of the infants was undernourished, had diarrhea, or was given any drug. Drinking water showed a nitrate concentration of 3 to 6 ppm. All were fed homemade purée of mixed vegetables, prepared in advance and kept in the refrigerator for 12 to 27 hours. Silver beets were a common ingredient. No case showed metabolic acidosis. Methemoglobin level ranged between 10% and 58%. Three cases had nitrituria. Silver beets in our area were the vegetables with the highest nitrate concentration (mean: 3200 mg/kg). CONCLUSIONS: Consumption of silver beets and incorrect storage of homemade purées of mixed vegetables were potential causes of methemoglobinemia in this series. The disease may occur in children older than 6 months of age. Nitrituria in a cyanotic infant may suggest the diagnosis of methemoglobinemia.methemoglobinemia, nitrates, nitrites, food analysis, infant food, food preservation.

Cyanosis↗

PubMed1992

[Presence of intestinal parasites in vegetables sold in the metropolitan region of São Paulo, SP, Brazil. I--Search of helminths].

Vegetables in natura, commercially traded in the metropolitan area of S. Paulo, were analysed by the appropriate methodology with a view to discovering an identifying the paths of transmission of enteroparasites of medical interest. The vegetables under study consisted of 50 samples of each variety listed below: lettuce (Lactuca sativa)-oily leaves and crisphead varieties, endive (Chicorium sp) and water-cress (Nasturtium Officinale). Results showed high rates of contamination in all the vegetable varieties analysed. However, the water-cress was that which presented the highest frequencies of enteroparasites. The endive presented middle values ranking, in general, between the lettuces and the water-cress. Though high, the average number of helminth eggs and larvae obtained per 100 gr. of sample did not present statistically significant differences as between the four vegetable varieties studied. A great variety of helminths and protozoans such as occur frequently in the resident population of the metropolitan area of S. Paulo, were observed in the samples. However, the most frequent were: hookworms and Ascaris sp. Eggs of Toxocara sp, Fasciola sp and Trichostrongylidae were also recovered from the samples thus corroborating the occurrence of vegetables contamination with faeces of domestic animals. In view of the results obtained, the importance of these kinds of food in the transmission of enteroparasites is stressed, as well as the need for actions which improve the sanitary conditions of these products.

Animals↗

PubMed2004

Knowledge, barriers, and benefits of fruit and vegetable consumption and lay conceptions of nutrition among rural and semi-urban Black South Africans.

This study investigated fruit and vegetable consumption and psychosocial variables among rural and semi-urban Black adults in South Africa. The sample consisted of 200 adults, 100 from a semi-urban and 100 from a rural area chosen by two-stage cluster sampling. Only seven (7%) of the villagers and none of the semi-urban dwellers reported the recommended 5 or more fruit or vegetable servings per day. The majority (63% rural and 58% semi-urban dwellers) indicated that they had 2-4 servings a day. Fruit and vegetable intake was not associated with perceived barriers, perceived health benefits, or diet knowledge, but there was a significant correlation between good perceived eating habits and fruit and vegetable consumption. Villagers perceived more barriers to fruit and vegetable consumption regarding expense, confusing recommendations, and time and effort than semi-urban dwellers. Insensitivity to high exposure was seen in responses to the question about positively regarded nutrients: for vitamins, 54% and 37% and for protein 63% and 53% of semi-urban and rural dwellers, respectively, believed that one cannot consume too much. The majority recognized the essential values of salt and fat. More semi-urban participants did not recognize that salt and fat are dietary essentials and that too much salt or fat is better than none at all.

Adolescent↗

PubMed1995

Dietary intake of fruits and vegetables in Norway: influence of life phase and socio-economic factors.

The aim of the study was to contribute to a better understanding of factors influencing the consumption of fruits, vegetables and potatoes among consumers in Norway. It is built on data from two consumer surveys; one including 1103 persons and the other including 13,857 persons. The data indicate that a considerable proportion of the consumers had a very low frequency of consumption when compared to present recommendations of intake; 31% consumed vegetables, and 24% fruits twice a week or less. Data from multivariate analyses (logistic regression) showed that age, sex, income and household structure were important determinants for the consumption of fruits. These factors, as well as education and place of living were important determinants of the consumption of vegetables and potatoes. Consumers who were very interested in health issues, were more likely to have a high consumption of fruits and vegetables, whereas those who had a preference for quickly prepared food tended to have a low consumption of vegetables. These results are discussed in relation to the consumers own perception of important limitations for consumption of these products.

Adolescent↗

PubMed1996

Are whole extracts and purified glucosinolates from cruciferous vegetables antioxidants?

Fruits and vegetables contain several classes of compounds that can potentially contribute to antioxidant activity, including vitamins, simple and complex phenolics, sulphur-containing compounds and glucosinolates. The glucosinolates are found in high concentration in many cruciferous vegetables, and it is well established that their breakdown products induce endogenous antioxidant defences such as quinone reductase and glutathione S-transferase in cells and in vivo. Despite the anticarcinogenic effect of these compounds in animal models, the direct antioxidant properties of this class of compounds have not been systematically studied. We therefore examined the free radical-scavenging properties of representative extracts and of purified glucosinolates from cruciferous vegetables, by measuring their effect on ascorbate- or NADPH/iron-induced peroxidation of human liver microsomes, ascorbate/iron-induced peroxidation on phospholipid liposomes, iron chelation and hydroxyl radical scavenging using the deoxyribose assay, total antioxidant potential using ABTS (2,2'-azinobis(3-ethyl-benzothiazoline-6-sulphonate)) and the bleomycin assay. Most of the extracts from cruciferous vegetables exhibited some antioxidant properties, although extracts from cooked Brussels sprouts increased the rate of microsomal lipid peroxidation. The effects in these assays were dependent upon processing and species of crucifer, and the glucosinolate content appeared to play a minor role in these effects, since purified glucosinolates exhibited only weak antioxidant properties. The total antioxidant activities of extracts from cooked and autolysed Brussels sprouts were identical within experimental error. This is probably due to the content of phenolics which is unaltered by autolysis, despite the differences between these samples in other assays especially NADPH-iron-induced lipid peroxidation of human liver microsomes. The results demonstrate that glucosinolates are unlikely to account for the direct antioxidant effects of extracts from cruciferous vegetables.

Antioxidants↗

PubMed2003

Levels and congener distributions of PCDDs, PCDFs and Co-PCBs in Japanese retail fresh and frozen vegetables.

To evaluate dioxin contamination in retail vegetables, congener analyses of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and coplanar polychlorinated biphenyls (Co-PCBs) were performed on sixty varieties of fresh vegetables including cereals and mushrooms, obtained from Japanese supermarkets in 2002. The toxic equivalent quantity (TEQ) levels for dioxins in samples ranged from < 0.001 to 0.089 pg-TEQ/g wet weight, when undetected and trace were taken as zero. Among the samples, dioxins were generally detected in green leafy vegetables. The highest TEQ value was for mulukhiya (0.089 pg-TEQ/g), followed by spinach and komatsuna (Japanese mustard spinach) (0.077 and 0.074 pg-TEQ/g, respectively). Additionally, the dioxin levels in seventeen varieties of frozen vegetables were also determined, and showed TEQ values ranging from < 0.001 to 0.080 pg-TEQ/g. The total TEQ in commercial vegetables mainly reflected the levels of 1,2,3,7,8-PeCDD, 2,3,4,7,8-PeCDF and 3,3',4,4',5-PeCB (#126) (the sum of them represented 63% of the total TEQ).

Benzofurans↗

PubMed1997

Isolation of Cryptosporidium parvum and Cyclospora cayetanensis from vegetables collected in markets of an endemic region in Peru.

Cryptosporidium parvum and Cyclospora cayetanensis are protozoan pathogens that cause prolonged diarrhea in both immunocompetent and immunocompromised hosts. Cryptosporidium parvum can be transmitted via the fecal-oral route, while the exact mechanisms of transmission of Cyclospora cayetanensis have not been fully determined. Humans appear to be the sole host for the latter and a distinct seasonality has been observed in endemic areas around the world. Samples of vegetables were collected at several small markets in a periurban slum in Peru during the seasons of high and low incidence. The vegetables were washed, the supernatants were collected and centrifuged, and the pellets were resuspended in a solution of 2.5% potassium dichromate. Pellets were examined using direct microscopic observation, acid-fast staining, and immunofluorescent assays for C. parvum and Cyclospora cayetanensis oocysts. Samples were collected during three time periods: the season of low incidence, the beginning of the season of high incidence, and end of the season of high incidence. Of the total vegetables examined, 14.5% contained C. parvum oocysts and 1.8% had Cyclospora oocysts. Thus, market vegetables may provide a route by which Cryptosporidium and Cyclospora can be transmitted. Our study also suggests that washing vegetables does not completely remove Cryptosporidium and Cyclospora oocysts.

Animals↗

PubMedDate not supplied

The relationship between self-efficacy, attitudes, intake compared to others, consumption, and stages of change related to fruit and vegetables.

PURPOSE: This study examined whether eating practices and psychosocial factors differed across stages of change for fruit and vegetables. DESIGN: Data were collected using a self-administered written survey among a convenience sample of 739 Dutch adults. Response rate was 92%. SETTING: Data were collected as part of the baseline assessment for a nutrition intervention study. MEASURES: Fruit and vegetable intake was measured as self-reported consumption with a validated eight-item food frequency questionnaire. Psychosocial variables were measured with six items on bipolar seven-point scales and stage-of-change classifications were based on separate four-item algorithms for fruits and vegetables. Differences in psychosocial factors and consumption were analyzed using one-way analysis of variance with Scheffé's multiple-comparison test. RESULTS: Significant differences were found between stages of change in dietary intake, attitudes, self-efficacy, and judgment of one's own intake compared to others. Attitudes were most positive in preparation and action and least positive in precontemplation. Intake and self-efficacy were more positive in action/maintenance than in pre-action stages. CONCLUSIONS: The findings suggest that nutrition education aimed at encouraging higher intake of fruits and vegetables might be most effective if it is stage-tailored. Messages to influence attitudes about fruits and vegetables are likely to affect people in precontemplation, and self-efficacy information to increase confidence in overcoming barriers to consumption is likely to be effective with persons in contemplation and preparation stages.

Adult↗

PubMedDate not supplied

Applying theory of planned behavior to fruit and vegetable consumption of young adolescents.

PURPOSE: The purpose of this research was to investigate how well Theory of Planned Behavior (TPB) predicted frequency of consumption of fruits and vegetables among seventh graders and to investigate whether gender or socioeconomic status (SES) had moderating effects on the relationships between the constructs in the model. DESIGN: Two identical self-administered paper and pencil surveys were distributed 6 months apart. Path analyses of the TPB models by gender and SES were performed with AMOS software. SETTING: The study occurred in eight middle schools from school districts in the Minneapolis--St. Paul metropolitan area, where a minimum of 20% of the students qualified for free or reduced-price meals. SUBJECTS: Of the invited seventh graders, 1406 (74%) completed data for the model constructs at baseline and for behavior at interim data collection. MEASURES: We assessed frequency of consumption of fruits and vegetables and attitudes, subjective norms, barriers, and intentions related to this behavior. Three levels of SES were created based on questions about free lunch, parents' education, and work. RESULTS: No significant direct effects of attitudes and subjective norms on behavior were found, but for barriers, both indirect effects through intentions and direct effects on behavior were significant. Seven percent of the variation in the frequency of fruit and vegetable consumption and 31% of the variation in intention to eat more fruits and vegetables were explained by the model. Gender appeared to have moderating effects on the relationships between attitudes and intention and between intentions and behavior in the model. There were no moderator effects of SES, but the larger dropout rates from the low-SES group could have caused the groups to become more homogeneous. CONCLUSION: The data fit the model well; still, large proportions of the variance in the frequency of consumption of fruits and vegetables were unexplained. This may be related to the operationalization of the model constructs or to missing important factors in the model. Furthermore, there appeared to be strong relationships between subjective norms or barriers and intentions as well as gender differences in the strengths of the relationships in the model that may have implications for intervention methods or messages.

Adolescent↗

PubMedDate not supplied

Work-to-family spillover and fruit and vegetable consumption among construction laborers.

PURPOSE: Spillover is the effect of one role on another as working adults attempt to integrate demands from work and family. We conducted a survey to understand how worker, job, and family characteristics were related to negative work-to-family spillover and how spillover was related to fruit and vegetable consumption to inform intervention design. DESIGN: A combined mail and telephone survey. SETTING: A national random sample in the United States. SUBJECTS: 1108 (44% response) unionized construction laborers. MEASURES: Personal characteristics, job factors, family factors, work-to-family spillover, and fruit and vegetable consumption. ANALYSIS: Multivariable logistic and least-squares regression. RESULTS: A range of 20% to 50% of respondents reported negative work-to-family spillover, agreeing that work demands, time, fatigue, and stress interfered with family meals or food choices. Higher spillover was associated with job factors, being of white race/ethnicity, and having children at home. Lower fruit and vegetable consumption was associated with higher work-to-family spillover (p = .002), being of white race or ethnicity (p < .0001), and working the graveyard or day shift (p = .02). CONCLUSION: Negative experience of work-to-family spillover may link employment to fruit and vegetable consumption and thus to worker health. Understanding the contribution of spillover to fruit and vegetable consumption aids understanding of how work experience affects health.

Adult↗