Objective: To examine the sociodemographic determinants of fruit and vegetable (F&V) consumption in England and determine the differential effects of socioeconomic variables at various parts of the intake distribution, with a special focus on severely inadequate intakes. Design: Quantile regression, expressing F&V intake as a function of sociodemographic variables, is employed. Here, quantile regression flexibly allows variables such as ethnicity to exert effects on F&V intake that vary depending on existing levels of intake. Setting: The 2003 Health Survey of England. Subjects: Data were from 11 044 adult individuals. Results: The influence of particular sociodemographic variables is found to vary significantly across the intake distribution. We conclude that women consume more F&V than men; Asians and blacks more than whites; co-habiting individuals more than single-living ones. Increased incomes and education also boost intake. However, the key general finding of the present study is that the influence of most variables is relatively weak in the area of greatest concern, i.e. among those with the most inadequate intakes in any reference group. Conclusions: Our findings emphasise the importance of allowing the effects of socio-economic drivers to vary across the intake distribution. The main finding, that variables which exert significant influence on F&V intake at other parts of the conditional distribution have a relatively weak influence at the lower tail, is cause for concern. It implies that in any defined group, those consuming the least F&V are hard to influence using campaigns or policy levers.
Keywords
Fruit and vegetables Socio-economic determinants United Kingdom RegressionIncreased consumption of fruit and vegetables (F&V) is at the heart of healthy eating campaigns around the world. The WHO's Global Strategy on Diet, Physical Activity and Health, endorsed by member countries in 2004, includes a global quantitative norm that per capita F&V consumption should exceed 400 g/d. In the UK, this aggregate norm of 400 g/d has been broken down into '5-a-day' portions of at least 80 g each by the Department of Health. The government has invested substantially in promoting the 5-a-day programme, elements of which include the National School Fruit Scheme and a communication strategy incorporating the 5-a-day logo.In keeping with this interest in F&V consumption, a large volume of research has been produced analysing the determinants of F&V intakes by individuals or households. These range from studies involving analysis of large samples drawn from representative populations, to purposively collected information on population subgroups of interest. Research, depending on the available data, has alternatively attempted to relate F&V intakes to sociodemographic, socio-economic, psychological or sensory variables. Often, studies have restricted themselves to statistical comparisons of F&V consumption across demographic or socio-economic groups, in an attempt to identify sub-populations for policy targetin...