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Summary Of Key Findings
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Fruit and vegetable consumption

The World Health Organisation recommends eating at least five 80g portions of fruit and vegetables per day, a total of 400g per day. Consumption in England is known to be below this desirable level. A 'Five-a-day' programme was accordingly introduced in order to encourage increased fruit and vegetable consumption. Its central message is that people should eat at least five portions of fruit and vegetables a day; that a variety of fruit and vegetables should be consumed and that fresh, frozen, canned and dried fruit, vegetables and pulses all count in making up these portions.

The Health Survey for England is an important means of monitoring consumption of fruit and vegetables in the population to inform Five-a-day policy, complementing other surveys such as the Expenditure and Food survey (formerly the National Food Survey) and the National Diet and Nutrition Survey, which has assessed diet through diary records of weighed intake, supplemented by a dietary interview. In the Health Survey, no diary recording or weighing was undertaken. The survey's questions about fruit and vegetables related to the previous day (the 24 hours ending the previous midnight). Since interviewing on the survey was spread throughout the week and throughout the year, variations in consumption by day of week or by season will be reflected in the results. The questions were asked of all persons aged 5 and over.

Fruit and vegetable portions per day

A higher proportion of women (28%) than men (24%) consumed five or more portions a day, and the mean number of portions per day (based on the whole sample, not just on those consuming any fruit and vegetables) was higher for women (3.7 portions) than men (3.4 portions). These differences between the sexes, however, were confined to those of working age: among those aged 65 and over, there was little difference between the sexes in the proportion consuming five or more portions a day.


The chart shows marked differences between age groups. The proportion consuming five or more portions a day was lowest among those aged 16-24, and increased with age to a peak among those aged 55-64, after which it decreased. Among men aged 16-24, the proportion was 14%, rising to 31% at age 55-64 and then declining to 25% at age 75 and over. Among women, the three comparable figures were 20%, 34% and 24%.

The mean number of portions, not shown in the chart, also varied in the same way with age, but a little less markedly. For men, mean consumption was 2.6 portions among those aged 16-24, climbing to 4.0 among those aged 55-64, corresponding figures for women being 3.0 and 4.2. Thus mean consumption for men was around one and a half times as high at age 55-64 than it was at 16-24, and a little less for women. But even among those aged 55-64, mean consumption fell short of the five-a-day recommendation.

The clear difference between the sexes in fruit and vegetable consumption found in adults was not replicated among children aged 5-15. Although the mean number of portions consumed by girls (2.8) was slightly higher than by boys (2.6), the proportion consuming five or more portions a day was lower among girls (13%) than boys (14%). (This difference is not statistically significant.)

The most striking feature of a comparison between adults and children is that consumption was generally a good deal lower among children than adults, as the chart illustrates. Among children, the proportion consuming less than one portion a day was as great as the proportion consuming five or more portions.

For men, the overall mean number of portions per day (not shown on the chart) was 3.4, but for boys only 2.6; for women 3.7, but for girls only 2.8.


Children's consumption showed a slight tendency to be higher at age 10-15 than at age 5-10, but this difference by age was not marked (no chart shown).

Types of fruit and vegetables consumed

Fruit and vegetables were classified into nine categories. Levels of consumption of each category are shown in two charts for adults and two for children. The first chart of each pair shows the proportion who had consumed each type on the previous day, while the second shows the mean number of portions consumed (based on all informants, not just on those consuming that type of fruit or vegetable).

The first of these four charts shows that five of the categories were much more widely consumed than the others. For these five, the proportion of adults who had consumed them on the previous day ranged from about 31% for salad up to about 63% for fresh fruit. Vegetables (fresh, tinned or frozen), fruit juice and pulses came in between these. The proportions were higher for women than men in all five leading categories, except for pulses.

The second chart shows the mean amount consumed. On this basis, fresh fruit was not only still the leading category but was more dominant, accounting for about double the quantity of the next category, vegetables, which was in turn followed by fruit juice, pulses and salad. The mean number of portions of fresh fruit consumed was 1.6 for women, 1.4 for men, compared with about 0.7 for vegetables.

The two charts dealing with children show a broadly similar picture, with the same five categories being the most consumed, and fresh fruit accounting for the largest quantity by a wide margin. However, children were relatively less likely than adults to eat vegetables and salad.





Fruit and vegetable consumption by socio-economic position

Adults' responses were analysed by various socio-economic characteristics, of which household income is shown in the accompanying chart. This shows that the proportion eating five or more fruit and vegetable portions a day increased steeply as equivalised household income increased. (This is a measure of income that takes account of the number of persons in the household by allocating scores that take account of such things as their age and economic dependency.)

The relationship between income and the proportion eating five or more portions a day was approximately linear for both sexes, but the gradient was steeper for women: that is to say, the difference between opposite ends of the income scale was greater for women than men. The proportion of women consuming five or more portions a day was almost twice as great among those in the highest income quintile as in the lowest. The proportion of men consuming five or more portions a day in the highest income quintile was almost half again as high as in the lowest quintile. A further analysis carried out to remove the effects of any age differences between income quintiles did not change the picture.

The mean number of portions per day (not shown in chart) followed a similar pattern. In the lowest income quintile the mean number (based on all informants) was 2.8 for men and 3.1 for women. In contrast, in the highest income quintile the equivalent figures were 3.9 and 4.5.





A marked relationship was also seen between fruit and vegetable consumption and area deprivation, measured on the basis of a composite index derived from six socio-economic indicators of deprivation.

Consumption decreased as area deprivation increased, the trend again being stronger for women than men. The association of fruit and vegetable consumption with area deprivation, though strong, was not quite as strong as the association with income. However, in regression models, once equivalised household income had been controlled for, area deprivation effects were weak, proving to be significant for women, but not for men. In contrast, the regression model showed that equivalised income was significantly associated with fruit and vegetable consumption among both men and women.


Fruit and vegetable consumption by cigarette smoking

The final chart on this topic shows that fruit and vegetable consumption had a strong inverse relationship with cigarette smoking. A much smaller proportion of current smokers than of non-smokers (or ex-smokers) consumed five or more portions a day. Among smokers, this proportion decreased as the number of cigarettes smoked increased. There was no marked difference between ex-smokers and those who had never smoked.

The proportion of heavy smokers (20 or more a day) eating five or more portions of fruit and vegetables was, for men, only about a third as high as the proportion of non-smokers eating five or more portions, the difference for women being not very much less. Differences were also apparent among current smokers. The proportion of heavy smokers (20 or more a day) consuming five or more portions was only about half that found among moderate smokers (10 to under 20 a day).

As both cigarette smoking and fruit and vegetable consumption were related to age and socio-economic circumstances, regression analysis to control for these effects was carried out. This confirmed that fruit and vegetable consumption was significantly lower among current cigarette smokers compared with non-smokers, and declined steadily with an increase in the number of cigarettes smoked per day.

An analysis of mean portions (chart not shown) offers a similar picture.





 
       
 

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