Banana Etiquette
1. Always leave what you are eating.
2. Use utensils to eat at the same time as other people.
3. Wash your hands before you eat.
4. Eat quietly.
5. Don't share food that has been touched by others.
6. Don't make other people feel self-conscious about their food.
The banana etiquette survey included five items with each participant receiving scores between 1 and 5 points for a total score of 15 points, with higher scores indicating higher fruit and vegetable intake.
Anthropometric measurement {#sec2-4}
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Height was measured by using a stadiometer. Weight was measured on a digital weight scale (HBF-514; Omron, Kyoto, Japan) to the nearest 0.1 kg with the participant wearing light clothing and no shoes. Waist circumference (WC) was measured to the nearest 0.1 cm with a flexible and non-elastic measuring tape positioned at a point midway between the lowest rib and the iliac crest after a normal expiration. Hip circumference (HC) was measured at the level of the maximum extension of the buttocks with a flexible measuring tape. Body mass index (BMI) was calculated as weight in kilograms divided by height in meters squared. Weight status was classified based on BMI: normal weight (18.5-24.9 kg/m^2^), overweight (25.0-29.9 kg/m^2^), or obese (≥30 kg/m^2^)\[[@ref27]\].
### Fitness assessment {#sec3-1}
Aerobic fitness was assessed using a multi-stage sub-maximal treadmill exercise test. The test was preceded by a five-minute warm-up on a stationary bicycle. The test was terminated when the participant was unable to complete the running section of the test, or if any contraindications were observed. Participants were instructed to adjust their running pace according to the perceived exertion scale.\[[@ref28]\] The test started at a running pace of 8 km/h and increased by 2 km/h each minute until the participant was not able to keep up with the pace and reached to an estimated maximum exertion of 17 km/h. The test result was determined by calculating the estimated VO~2~max from the speed, time and grade according to the formula below.\[[@ref29]\]
VO2max (ml/kg/min)=Speed(km/h)+\[9.6 × Time(min)\]+3.5
### Statistical analysis {#sec3-2}
Data were analyzed by using SPSS version 23 (IBM, SPSS, Armonk, NY, USA) for Windows. Sample characteristics were described using descriptive statistics. Fitness was calculated and expressed in ml/kg/min. Fitness was also presented as a percentage of predicted fitness value.
The independent-samples t-test was used to compare the mean anthropometric measurements, fitness and food attitude variables between the low and high fruit and vegetable intakes, i.e. fruit and vegetable intake \< or ≥ 2 serving/d.
Ethics {#sec2-5}
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Written informed consent was obtained from all participants. The Research Ethics Committee of the Faculty of Medicine, Alexandria University, approved the study.
RESULTS {#sec1-3}
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[Table 1](#T1){ref-type="table"} shows that the prevalence of fruit and vegetable intake was low among all samples. Around one third (33%) had high fruit and vegetable intake. Among them, 29.3% had high fruit and vegetable intake at every meal while 45.9% had high fruit and vegetable intake for breakfast. The mean age was 35.6±13.7 years, and the majority of participants were females (71.1%) and non-smokers (76.5%). Mean BMI and WC were 28.18±5.1 kg/m^2^ and 89.2±12.3 cm, respectively, with 33% of participants with a normal weight. Most of the participants had BMI \<25 kg/m^2^ (60.5%). The mean score for attitude toward fruit and vegetable intake was 14.6±3.4 (range: 7-24).
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Demographic and clinical characteristics of participants according to fruit and vegetable intake (n=400)
Variables Total (n=400) Fruit and vegetable intake (serving/d) *P*-value
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Demographic characteristics
Age (years) 35.60±13.69 35.69±13.73 35.54±13.69 0.906
Gender
Male 51.8 60 48 50 50.00%
Female 48.2 40 52 50 50.00%
BMI 28.18±5.10 27.87±5.11 28.29±5.08 27.93±5.08 0.436
Smoking status
Yes 24.1 20 27 25 25.00%
No 75.9 80 73 75 75.00%
Educational level
University 33.8 35 32 35 35.00%
High school 27.5 25 29 26 26.00%
Secondary school 18.2 20 16 20 20.00%
Primary school 18.4 20 21 18 18.00%
SES
Low SES 38.2 35 41 40 40.00%
Employment status
Employed 51.8 60 47 50 50.00%
Unemployed 48.2 40 53 50 50.00%
Physical activity level
Low 46.5 50 46 47 47.00%
Moderate 38.8 40 38 40 40.00%
High 14.7 10 16 13 13.00%
TV viewing time (hours/d) 2.61±1.80 2.67±1.82 2.62±1.78 2.64±1.80 0.781
Sleeping time (hours/d) 8.33±1.52 8.25±1.56 8.37±1.50 8.31±1.54 0.532
Monthly household income (Egyptian pounds/month)
\<1,000 44.8 60 46 50 50.00%
1,000-2,000 47.5 40 48 50 50.00%
\>2,000 8.7 0 0 0.00%
Physical activity level
Low 38.3 50 42 40 40.00%
Moderate 43.8 40 45 50 50.00%
High 17.9 10 13 10 10.00%
Time since menopause (years) 5.18±4.66 5.21±4.69 5.18±4.65 5.22±4.69 0.923
Duration of menopause (years) 5.10
