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Tuesday, July 15, 2008

Did You Eat Your Fruits and Vegetables Today?

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ResearchBlogging.orgAnswering seems simple enough. For many people however, the need to avoid criticism and seek praise causes them to respond in a manner consistent with expected norms. Self-reports of dietary intake can be biased by these tendencies, tainting consumption data collected by the health community. Everyone knows they should eat five or more servings of fruits and vegetables a day, so that’s what they say when they’re asked — many even really believe it to be true.

The findings, published in the Nutrition Journal, demonstrate that self-reports of fruit and vegetable consumption are susceptible to substantial social approval bias [1]. Such biases are the presence of social desirability (the tendency to respond in such a way as to avoid criticism) and social approval (the tendency to seek praise) [2-3].

fruit_vegetable_box.jpg
Creative Commons License photo credit: karimian

Researchers from the University of Colorado Denver randomly selected 163 women to complete what they were told would be a future telephone survey about health. Randomly half the women were sent a letter prior to the interview describing it as a study of fruit and vegetable intake. Included with the letter was a brief statement on the benefits of fruit and vegetable consumption, a 5-A-Day sticker and a 5-A-Day refrigerator magnet. The other half of the women in the study recieved the same letter but it described the study purpose only as a more general nutrition survey and contained neither the fruit and vegetable message nor the 5-A-Day materials.

Within 10 days of receiving the letters, each of the women answered a food frequency questionnaire and were asked how many fruits and vegetables they had eaten in the last 24 hours. Since the two groups were randomly selected, fruit and vegetable consumption should have been the same in each group. However, those women that recieved the fruit and vegetable message and the 5-A-Day materials reported a significantly higher intake of total fruits and vegetables, and 40% of individuals were categorized as eating 5 or more servings of fruits and vegetables a day compared to just 18% in the other group.

In response to the 24-hour recall questions, 61% of women who received the fruit and vegetable message and the 5-A-Day materials reported eating fruits and/or vegetables on three or more occasions throughout the previous day compared to 32% in the other group. These percentages were independent of age, race, educational level, self-perceived health status and time since last medical check-up.

According to the authors of the study [1]:

This study therefore suggest that social approval bias might well be a substantial problem in the interpretation of nutritional intervention effects that are dependent on education and awareness to affect behavior change. The magnitude of this bias is similar to the intervention effects reported in many studies evaluating changes in fruit and vegetable intake (ranging from 0.93 to 1.25 servings per day). Thus, a major challenge facing nutritional intervention researchers is assessing true behavioral change based on self-reports from reporting bias.

This doesn’t mean that health questionnaires are useless. Rather, it means that many people simply aren’t being entirely truthful when it comes to how many fruits and vegetables they eat. The authors suggest that, in large dietary intervention trials, subgroups can be evaluated with biomarkers or other independent assessments to estimate the reporting bias size. Additionally, bias can also be controlled to some degree by assessing different intensities of an intervention, whereby everyone receives at least a minimal prompt for change instead of one group not receiving any prompt at all.

A growing body of evidence shows that fruits and vegetables are critical to promoting good health. Here’s 5 tips to help you eat more:

  1. Keep fruits and vegetables on the counter or at eye level in the refridgerator. Make them easy to find and you’ll be more likely to eat them.
  2. If you’re worried about fruits and vegetables spoiling, try canned and frozen fruits and vegetables.
  3. Eat fruits and vegetables at every meal. For snacks, try carrot sticks, raisins or apple slices.
  4. Buy precut fruits and vegetables. They may cost a bit more than unprepared fruits and vegetables, but there’s less work and they’re ready to eat.
  5. Skip the potatoes. They have a high glycemic index compared to other vegetables such as broccoli, cauliflower, asparagus, string beans or peas.

Fruits and vegetables contain essential vitamins, minerals and fiber. In addition to the numerous health benefits of eating more fruits and vegetables, increased consumption lowers your risk of developing several cancers.

Additional resources can be found in the Nutrition category of the Highlight HEALTH Web Directory.

How about you? Do you lie to yourself about the fruits and vegetables you eat?

References

  1. Miller et al. Effects of social approval bias on self-reported fruit and vegetable consumption: A randomized controlled trial. Nutr J. 2008 Jun 27;7(1):18. [Epub ahead of print] DOI: 10.1186/1475-2891-7-18
    View abstract
  2. Hebert et al. Social desirability bias in dietary self-report may compromise the validity of dietary intake measures. Int J Epidemiol. 1995 Apr;24(2):389-98.
    View abstract
  3. Hebert et al. Gender differences in social desirability and social approval bias in dietary self-report. Am J Epidemiol. 1997 Dec 15;146(12):1046-55.
    View abstract

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Thursday, August 9, 2007

Health Highlights - August 9th, 2007

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Tuesday, July 24, 2007

The Highlight HEALTH Web Directory is Now HONcode Accredited

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I’ve written previously about the Highlight HEALTH Web Directory and my effort to catalog and make available health-related websites I find to be informative and useful.

I’m very pleased to announce that, similar to Highlight HEALTH, the Highlight HEALTH Web Directory is now an HONcode accredited website.

The Health On the Net (HON) Foundation is a non-profit organization that is attempting to guide the growing community of healthcare providers and consumers on the World Wide Web to sound, reliable medical information and expertise through quality assessment and systematic and stringent peer review. HON is the largest voluntary accreditation network on the Web with over 4,700 HONcode accredited websites that honor the standards for disclosure and responsibility in online medical publishing [1].

There are 8 principles of the HON Code of Conduct (HONcode):

  1. Authority - Indicate the qualifications of the author(s).
  2. Complementarity - Information should support, not replace, the doctor-patient relationship, which is the desired means of contact.
  3. Privacy - Respect the privacy and confidentiality of personal data submitted to the site by the visitor.
  4. Attribution - Cite the source(s) of published information, date and medical and health pages.
  5. Justifiability - The website must back up claims relating to benefits and performance.
  6. Transparency - Accessible presentation, accurate email contact of authors.
  7. Financial disclosure - Sponsorship should be transparent and funding sources identified.
  8. Advertising policy - Clearly distinguish advertising from editorial content.

Below is a list of HONcode accredited websites in a number of categories from the Highlight HEALTH Web Directory that I recommend. Hint: click on the category title to see all the websites currently listed.

Health 2.0

Personalized Medicine

Children’s Health

Health and Medicine Blogs

Health News

Technology

Is your site listed in the Highlight HEALTH Web Directory?
Send me an email if you would like to be included!

References

  1. Boyer and Geissbuhler. A decade devoted to improving online health information quality. Stud Health Technol Inform. 2005;116:891-6.
    View abstract

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