Observational study: determinants for vegetable consumption among elementary school students in Indonesia

Abstract

Background: The prevalence of obesity in school children has been increasing worldwide, including in developing countries such as Indonesia. Childhood obesity is associated with an unbalanced diet, especially the lack of fruit and vegetable consumption. This study aimed to determine the factors that influence vegetable consumption behavior in school children in Indonesia. Methods: The cross-sectional study was conducted in eight public elementary schools in a suburban area of Bogor Regency involving 433 students from the fifth grade. Data collection was conducted from November to December 2018. Data on the students’ characteristics, knowledge, and attitude as well as availability of vegetables at home and at school were collected using a structured questionnaire. While, a 24-hour food recall was utilized to obtain information on vegetable consumption and overall diet. Data analysis was done using Chi-squared test and logistic regression. Results: The average daily intake of vegetables was 47.11 g, far below the recommend amount (250 g). Female students had significantly better vegetables intake compared with their male counterparts. The availability of vegetables at home and students’ positive attitude toward vegetables were also significantly associated with better vegetable intake. Logistic regression analysis showed that availability of vegetables at home almost tripled the likelihood of better vegetable consumption (OR 2.822, 95% CI  1.822–4.372). Additionally, availability of vegetables at school and positive attitude toward vegetables doubled the odd for better vegetable consumption, OR 2.2 and 2.1 respectively (p<0.005). Conclusions: Vegetable consumption among schoolchildren was very low compared with the recommended portion. Better vegetable consumption was significantly associated with sex, availability, and students’ attitudes. Vegetable availability at home was the strongest determinant influencing vegetable consumption among elementary school students involved in the study. Hence, parental support or home food environment is key in improving their diet quality to prevent obesity.