Monotony in the consumption of fruits and vegetables and food environment characteristics

Abstract

OBJECTIVE: To analyze the quantity and diversity in the consumption fruits and vegetables, as well as its relationship with the consumer’s purchase characteristics and food environment. METHODS: Baseline study stemming from a controlled and randomized community trial investigating a sample representative of Primary Health Care services (Health Academy Program) of Belo Horizonte, state of Minas Gerais. The intake of fruits and vegetables was analyzed in servings/day, whereas diversity was assessed by the Food Frequency Questionnaire. Users were also questioned on the frequency, purchase location and availability of these foods at their households. To assess the consumer’s food environment, commercial establishments within a 1.6 km radius around the program unit sampled were audited. RESULTS: 3,414 adults and older adults (88.1% women) were investigated, as well as 336 commercial establishments, in 18 units of the Health Academy Program. The average consumption of fruits and vegetables was adequate [5.4 (SD = 2.1) servings/day] but monotonous, with average daily intake of two different types. In the establishments audited, a good diversity (77.7% and 85.0%) and variety (74.5% and 81.4%) of fruits and vegetables was observed, although with lower quality of vegetables (60.4%). After adjusting for sociodemographic variables, we identified that knowledge on food crops (p = 0.006), increased monthly availability of fruits at households (p < 0.001), and greater variety of fruits (p = 0.03) and quality of vegetables (p = 0.05) in commercial establishments could improve the quantitative intake of fruits and vegetables, whereas a greater variety of fruits (p = 0.008) would increase consumption diversity. CONCLUSIONS: The intake of fruits and vegetables was quantitatively adequate but monotonous, being influences by the consumer environment. Such results highlight the need for improving educational actions in health services and programs, in addition to acting on the consumer environment, aiming to promote and maintain the adequate and diversified consumption, as recommended by Brazilian guidelines for proper and healthy eating.

A Scoping Review of the Operationalization of Fruit and Vegetable Variety

“…Three studies included child participants [ 18 , 33 , 34 ] and four studies included adolescent participants [ 35 , 36 , 37 , 38 ]. Thirty-seven studies included adult participants [ 14 , 15 , 16 , 17 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 31 , 32 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ]; seven studies included a combination of children or adolescents and adults [ 63 , 64 , 65 , 66 , 67 , 68 , 69 ].…”

“…Falciglia et al (2005) found increased fruit variety intake among participants that received an intervention to increase FV consumption and improve dietary quality [ 32 ]. Additionally, increasing environmental FV variety could be a useful strategy to increase FV variety consumption; in a study examining FV variety consumption, purchasing characteristics, and food environment, de Deus Mendonça et al (2019) posited that greater fruit variety in commercial outlets would increase fruit variety consumption [ 45 ].…”

“…The cross-sectional study design was the most common design among the included studies (Table 3), reported in 23 papers [15,18,[34][35][36][38][39][40][41][42][43][44][45]47,[51][52][53]58,[63][64][65]67,68]. These studies included analysis of existing, ongoing national surveillance datasets in the United States [15,18,44], cross-sectional studies in USA [47,51], and in international populations [34][35][36][38][39][40][41][42][43]45,52,63,65,67]. Cross-sectional analyses from prospective cohort studies were also included [40,43].…”

“…Less commonly used measurement instruments included a Dietary Variety Questionnaire which included a checklist of FV over three days [41,42], a Brief Evaluation Questionnaire on Fruit and Vegetable Consumption (QBrief-FV) [45], FV checklists [25,32], and seven-day food diaries [21]. Studies conducted with Australian participants included the Australian Recommended Food Score [36,67].…”

“…Usual intake was also considered over a period of six months [45,51], four months [60], three months [24,37], four weeks [26,47], past month [25,57,65,66], fifteen days [32], a week [21,49,68], past three days [41,42], a two-day period [52], and a single 24-h period [18,34,38,44,53].…”