Association between parental knowledge, attitudes, and behaviours and Children aged 6-12 years ' consumption of fruits, vegetables, and pulses in three European countries: Finland, Poland, and Spain.

Abstract: Background Home food environment, particularly parents, play an important role in influencing food preferences and food consumption patterns of children. While extensive research has explored the impact of home food environment on children’s intake of fruits and vegetables, limited attention has been given to the role of parental attitudes, behaviours, and knowledge, particularly regarding pulse consumption, across different cultural settings. This is important, as many European children consume fewer fruits, vegetables, and pulses than recommended. Aims This study aimed to examine and compare the relationship between parental knowledge, attitudes, and behaviour (KAB) and children’s intake of fruits, vegetables, and pulses in Finland, Spain, and Poland. Methods The EU-funded TITAN project surveyed 720 families (240/country) in Finland, Spain, and Poland in 2023. Participants were Parents/caregivers (age ≥18y, responsible for food purchasing of the household) having at least one child in the age range 6–12 years. Principal Component Analysis (PCA) was used to identify parental KAB patterns. Linear regression analyses were conducted to explore associations between KAB patterns and children’s intake of fruits, vegetables, and pulses, adjusting for key confounders. Results Three KAB patterns were identified: Health Conscious, Knowledge but No Action, and Health by Habit, Not Choice. All were associated with increased fruit, vegetable, and legume intake, except for Knowledge but No Action, which showed a negative association with legume consumption (B = -1.63, 95% CI: -0.284 to -0.042, p = 0.008). Health by Habit, Not Choice had the strongest associations with fruit, vegetables, and legume intake across the three countries (p < 0.001). Knowledge but No Action was linked to higher vegetable intake in all three countries and fruit intake in Spain, but showed no significant or negative associations with fruit and pulse intake in Poland and Finland. Conclusion In conclusion, knowledge alone doesn’t lead to healthy eating; habitual parental behaviours and the broader cultural food environment play an important role. Interventions should focus not only on improving knowledge but also on supporting parents to establish healthy food habits through practical tools and culturally sensitive strategies. Practical, routine-based strategies are needed to promote sustainable intake, especially of pulses, as they support both dietary health and environmental sustainability. Thus, encouraging their consumption is a win–win for both individual well-being and planetary health.