Knowledge alone is not enough: Parental factors associated with children's vegetable, fruit, and pulse consumption across three European countries

Background The home food environment plays an important role in shaping food preferences and food consumption of children. While extensive research has explored the role of home food environment on children’s intake of fruit and vegetable, limited attention has been given specifically to the role of parental knowledge, attitudes, and behaviors, particularly regarding pulse consumption, across different cultural settings. This is important, as many European children consume fewer fruits, vegetables, and pulses than recommended. This study aims to examine and compare the relationship between parental knowledge, attitudes, and behaviors (KAB) and children’s intake of fruits, vegetables, and pulses in Finland, Spain, and Poland. Methods A cross-sectional online survey was conducted in 2023 among 720 families in Finland, Poland, and Spain, with quota sampling by household income tertiles to ensure socioeconomic variation. Eligible participants were caregivers aged ≥ 18 years, responsible or partly responsible for household food purchasing, and with at least one child aged 6–12 years. Principal Component Analysis (PCA) identified parental knowledge, attitudes, and behavior (KAB) patterns, and linear regression was used to assess their associations with children’s vegetable, fruit, and pulse intake. Results Three KAB patterns were identified: Health Conscious, Knowledge but No Action , and Health by Habit, Not Choice . All were positively associated with consumption of vegetable, fruit, and pulse, except for Knowledge but No Action, which showed a negative association with pulse consumption in Finland (B = -1.63, 95% CI: (-0.284, -0.042)). Health by Habit, Not Choice had the strongest positive association with consumption of vegetable, fruit, and pulses across the three countries (p < 0.001). The Knowledge but No Action pattern was linked to frequent servings of vegetable in all three countries, and with frequent servings of fruit in Spain. Conclusion In conclusion, knowledge alone is insufficient to ensure healthy eating. Parental habits and the cultural food environment are key factors associated with children’s dietary intake. Interventions should combine nutrition education with practical, culturally appropriate strategies to build healthy routines, with particular focus on increasing pulse consumption for both health and sustainability benefits.