1999 California Healthy Eating and Exercise Practices Survey:

Programmatic Implications for the

California Children’s

5 a Day–Power Play! Campaign

Authors:

Angie Keihner1, Tanya Garbolino1, Mark Hudes2

1 Public Health Institute, 2 University of California, Berkeley

The Problem

Diet and Exercise

• Only 1% of children eat a diet consistent with federal nutrition recommendations (1989-1991 CSFII).1

• Fewer than half of California children meet the 60 minute PA recommendation, and 14% get fewer than 30 minutes of PA a day.2

1 Munoz K, et al., Food Intakes of U.S. Children and Adolescents Compared with Recommendations. Pediatrics, 1997. 100(3): p. 323 - 329.

2 California Department of Health Services, 1999 California Children's Healthy Eating and Exercise Practices Survey: Unpublished data. In press: Sacramento, CA.

Trends in the Prevalence of Overweight Among Children and Adolescents in the U.S.

4 4

7

11

15

56

5

11

16

1963-70 1971-74 1976-80 1988-94 1999-000

5

10

15

20Percent of Children and Adolescents, 6-19 Years

Age in Years 6-11 12-19

Sources: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey, Hispanic Health and Nutrition Examination Survey (1982-84), and National Health Examination Survey (1963-65 and 1966-70).

Marketing to Children

• In 1997, U.S. children spent $7.7 billion on foods and beverages– Ranked first among expenditures

– Accounted for one-third of the total $23.4 billion spent

McNeal JU. The kids market: Myths and realities. Ithaca, NY: Paramount Market Publishing, 1999.

The Child Consumer

Median Age

Consumer Behavior

Primary Stores

Primary Products

2 months First store visit Supermarkets

2 yearsFirst in-store gesture/ request

SupermarketsCereals and snacks

3½ years First in-store selections

SupermarketsCereals, toys, and snacks

5½ yearsFirst assisted purchases

Mass discounters

Toys

8 yearsFirst independent purchase

Convenience stores

Snacks

California Children’s Healthy Eating and Exercise

Practices Survey (CalCHEEPS)

Survey Purpose

• Fills a monitoring gap - no comprehensive statewide surveys on nutrition for 9-11 year-old age group

• Includes dietary and physical activity practices on a typical school day; knowledge, attitudes, beliefs

• Evaluates knowledge and awareness of 5 a Day–Power Play!

Sample Selection and Administration

• Market research panel population• Demographically diverse, English-

speaking sample• Conducted April - June 1999• Parent-assisted 2-day food and physical

activity diary: Mailed, filled out, and returned

• Unassisted telephone survey– 14 minutes, 44 questions

Sampling and Response Rate

• Quota sampling– Demographically reflect California

households with 9-11 year old children – Pool of 2000 qualified households

selected from the market research panel• 814 returned food and activity diary

– 41% response rate• 394 completed telephone interview

– 51% response rate

5 a Day—Power Play! TV Spots and Recall

Paid Advertising and Public Service Announcements (PSA) in 1999

• Commercial– Three Wishes

• FV make you faster, stronger, and learn more

• FV give you power

• 5 a Day is important

• PSA– Shaq’s Secret

• 5 a Day is important

• FV give you power

California Children Aware of 5 a Day-Power Play! Campaign TV Spots, 1999,

by Gender**, Ethnicity*, and Income*

31

1822

48

2024

35

21 21

BoysGirls

WhiteAfrican American

LatinoAsian/Other

$19,999 or less$20,000-$49,999

$50,000 or more0

10

20

30

40

50

Percent of Children

* p<.05; ** p<.01Source: California Department of Health Services, Preliminary data.

California Children Aware of 5 a Day-Power Play! Campaign TV Spots Were More Likely to Know

that 5 or More Servings of Fruits and Vegetables Are Needed for Good Health, 1999

20

27

53

24

47

28

0-2 Servings 3-4 Servings 5+ Servings

Fruits and Vegetables Believed Needed

0

10

20

30

40

50

60

Percent of Children

Aware of 5 a Day-Power Play! Yes No/Don't Know

p<.001Source: California Department of Health Services, Preliminary data.

California Children Aware of 5 a Day-Power Play! Campaign TV Spots Were More Likely to Eat

5 or More Servings of Fruits and Vegetables, 1999

12

26

38

25

5

40 39

17

0 Servings 1-2 Servings 3-4 Servings 5+ Servings

Fruit and Vegetable Intake

0

10

20

30

40

50

60Percent of Children

Aware of 5 a Day-Power Play! Yes No/Don't Know

p<.05Source: California Department of Health Services, Preliminary data.

Food Preparation

Who Prepares Meals and Snacks?

Meals and Snacks Who Fixed Them

Breakfast Parent, Child, School

Lunch School, Parent, Child

Dinner Parent

After-school snack Child, Parent

Evening snack Parent, Child

Associations Between Who Makes Meals and Snacks and Fruit and Vegetable Intake, 1999

15

56

21

29

52

7

47

71

0

10

20

30

40

50

60

70

80Percent of Children Who Ate a Serving of Fruit or Vegetable

Who Made Meal/Snack Child Alone

Mom/Dad/Adult

School

** p<.01; *** p<.001Source: California Department of Health Services, Preliminary data.

After-School Snack***

Lunch**Breakfast***

School Environment

California Children Who Participated in School Meals Were More Likely to Eat 5 or More Servings

of Fruits and Vegetables, 1999

37

23

17 16

0

10

20

30

40

Percent of Children Meeting 5 a Day Goal

Participated in School Meals Yes No

School Breakfast*** School Lunch**

** p<.01; *** p<.001Source: California Department of Health Services, Preliminary data.

California Children's Access to Soda Vending Machines, Candy Vending Machines, and

Fast Food on School Campuses, 1999

24

16

8

0

5

10

15

20

25

30Percent of Children

Source: California Department of Health Services, Preliminary data.

School Cafeteria Serves Fast Food

Vending Machine with Chips and Candy

Vending Machine with Soda

Vending Machines Linked to Vegetable Intake

• Soda vending machines at school – Ate significantly fewer servings of

vegetables (0.7 vs. 1.3 servings, p<.001)

• Vending machines stocked with chips and candy at school– Ate significantly fewer servings of salad

(0.1 vs. 0.3 servings, p<.001)

California Children's Participation in Physical Education by Total Minutes

of Daily Physical Activity, 1999

69 66

93 9691

None 1 or Less Times 2 Times 3-4 Times 5 Times

Physical Education Per Week

0

20

40

60

80

100

Minutes of Physical Activity

Source: California Department of Health Services, Preliminary data.

Physical Education Linked to Daily Physical Activity

• Schools made students exercise (84 vs. 63 minutes of daily PA, p<.01)

• Children who participated in PE 2 or more times per week (22-30 minutes more daily PA, p<.001)

5 a Day—Power Play! Programmatic Implications

Prioritize Campaign Activities:Food Preparation

Meals and SnacksCampaign Efforts

Should Target

After-school snack Parent, Child

Breakfast Child, Parent

Lunch Parent

• Encourage children to participate in school meal programs

Prioritize Campaign Activities:School Environment

• Address soda vending machines, vending machines stocked with chips and candy, and fast food in schools

• Replace soda, chips, and candy with more nutritious foods– Promote the voluntary adoption of school

nutrition guidelines– Educate legislators

Prioritize Campaign Activities:School Environment

• Encourage schools to enforce existing PE requirement of 200 minutes of PE every 10 days– Promote the voluntary adoption of

school PE guidelines– Educate legislators

Angie Keihner

916-449-5389

akeihner@dhs.ca.gov

www.ca5aday.com