Determinants of fruit and vegetable intake in England: a re-examination based on quantile regression

Abstract

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...

Identifying Critical Nutrient Intake in Groups at Risk of Poverty in Europe: The CHANCE Project Approach

“…In two studies [17,28], food intakes were compared between income groups and nutrient intakes were compared with reference values and between income groups. Diverse dietary assessment methods were used to estimate the food and/or nutrient intakes: a 24-h diet recall (24HDR) [11,13,29], food frequency questionnaire (FFQ) [11,12,14,15,19,21,22,23,24,25,30,31,32], diet record (DR) [16,17,20,25,26,28], food behavior surveys [18,28], and household food consumption survey [5] were employed, whereas an FFQ along with 24 HDR and 4 days of DR were used in two studies [11,25]. …”

Is a Nutrition Education Intervention Associated with a Higher Intake of Fruit and Vegetables and Improved Nutritional Knowledge among Housewives in Mauritius?

“…The fact that having children does not increase household fruit and vegetable intake may be explained by the fact that children themselves were found to not consume adequate servings of fruits and vegetables [36]. According to Boukouvalas et al [37], as income increases, fruit and vegetable intake also increases, however, this effect tends to level off as income gets larger. Likewise, in this study, as household income level increases, so does mean daily fruit and vegetable intake with a mean intake of 6.86 daily reported by participants with household income greater than 966 USD.…”

“…Being a caregiver was found to affect fruit and vegetable intake significantly. As aging is associated with chronic diseases, caregivers may identify fruits and vegetables as being an important part of a healthy diet [37]. The marital status of the participants did not affect the fruit and vegetable intake.…”

Socioeconomic Factors and Their Relation to Eating Habits in Two Communities in Nova Scotia, Canada

“…1,[3][4][5][6]8,9 This study aimed to examine these factors in King's County as compared to Glace Bay and determine whether there was a difference in food consumption patterns. Another study looking at socioeconomic status and its relation to household eating habits found that household size composition, education, and income combined explained only 21% to 29% of the variation in food purchasing.…”

“…Obtained education level influences the type of job and resulting income an individual can obtain as well as the awareness of healthy behaviors and eating practices. 7,8 Higher education as well as an increased income correlate with greater fruit and vegetable consumption, 1 whereas lower education tends to correlate with a higher occurrence of unhealthy behaviors such as increased smoking and fat consumption with lower levels of physical activity. 6 Stable employment with an adequate income is important to maintain household food security and balance other household expenses.…”