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Disparities in vegetable and fruit consumption: European cases from the north to the south

Published online by Cambridge University Press:  02 January 2007

Gun Roos*
Affiliation:
National Institute for Consumer Research, Norway
Lars Johansson
Affiliation:
National Council on Nutrition and Physical Activity, Norway
Anu Kasmel
Affiliation:
Centre for Health Education and Promotion, Estonia
Jurate Klumbiené
Affiliation:
Kaunas University of Medicine, Lithuania
Ritva Prättälä
Affiliation:
National Public Health Institute, Finland
*
*Corresponding author: Email [email protected]
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Abstract

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Objective:

To present disparities in consumption of vegetables and fruits in Europe and to discuss how educational level, region and level of consumption influence the variation.

Design:

A review of selected studies from 1985 to 1997.

Setting/subjects:

33 studies (13 dietary surveys, nine household budget surveys and 11 health behaviour surveys) representing 15 European countries were selected based on criteria developed as part of the study. Association between educational level and consumption of vegetables and fruits was registered for each study and common conclusions were identified.

Results:

In the majority of the studies, with the exception of a few in southern and eastern Europe, consumption of vegetables and fruits was more common among those with higher education. The results suggest that in regions where consumption of vegetables and fruits is more common, the lower social classes tend to consume more of these than the higher social classes.

Conclusions:

The differences in the patterns of disparities in vegetable and fruit consumption between regions, as well as within populations, need to be considered when efforts to improve nutrition and health are planned.

Type
Research Article
Copyright
Copyright © CABI Publishing 2001

References

1Davey Smith, G, Brunner, E. Socio-economic differentials in health: the role of nutrition. Proc. Nutr. Soc. 1997; 56: 7590.Google Scholar
2James, WPT, Nelson, M, Ralph, A, Leather, S. The contribution of nutrition to inequalities in health. Br. Med. J. 1997; 314: 1545–9.CrossRefGoogle ScholarPubMed
3Marmot, MG, Davey Smith, G, Stansfeld, S, Patel, C, North, F, Head, J. et al. Health inequalities among British civil servants: the Whitehall II study. Lancet 1991; 337: 1387–93.CrossRefGoogle ScholarPubMed
4Kunst, A. Cross-national comparisons of socio-economic differences in mortality [dissertation]. Rotterdam: Erasmus University Rotterdam; 1997.Google Scholar
5Valkonen, T. Adult mortality and level of education: a comparison of six countries. In: John, Fox, ed. Health Inequalities in European Countries. Aldershot: Gower Publishing Company, 1989; 142–62.Google Scholar
6Kunst, AE, Cavelaars, AEJM, Groenhof, F, Guerts, JJM and Mackenbach, JP, EU Working Group on Socio-economic Inequalities in Health. Socio-economic Inequalities in Morbidity and Mortality in Europe: A Comparative Study. Rotterdam: Department of Public Health, Erasmus University, 1996.Google Scholar
7Mackenbach, JP, Kunst, AE, Cavelaars, AEJM, Groenhof, F and Geurts, JJM, EU-Working Group on Socio-economic Inequalities in Health. Socio-economic inequalities in mobidity and mortality in western Europe. Lancet 1997; 16: 93113.Google Scholar
8Wilkinson, R. Unhealthy Societies: The Afflictions of Inequality. London: Routledge, 1996.Google Scholar
9Blaxter, M. Health and Lifestyles. London: Routledge, 1990.CrossRefGoogle Scholar
10Cavelaars, A. Cross-national comparisons of socio-economic differences in health indicators [dissertation]. Rotterdam: Erasmus University; 1998.Google Scholar
11Whitehead, M. Bridging the gap. Working towards equity in health and health care [dissertation]. Karolinska Institutet, Department of Public Health Sciences, 1997.Google Scholar
12Macintyre, S. The Black Report and beyond; what are the issues. Soc. Sci. Med. 1997; 44: 723–45.CrossRefGoogle ScholarPubMed
13Roos, E. Social patterning of food behaviour among Finnish men and women [dissertation]. Helsinki: Publications of the National Public Health Institute A6/1998, 1998.Google Scholar
14Stronks, K, van de Mheen, D, Looman, CWN and Mackenbach, JP. Behavioural and structural factors in the explanation of socio-economic inequalities in health: an empirical analysis. Sociol. Health Illness 1996; 18: 653–74.Google Scholar
15Bourdieu, P. Distinction. A Social Critique of the Judgement of Taste. London: Routledge and Kegan Paul, 1989.Google Scholar
16Hulshof, KFAM, Löwik, MRH, Kok, FJ, Wedel, M, Brants, HAM, Hermus, RJJ and ten Hoor, F. Diet and other life-style factors in high and low socio-economic groups. Eur. J. Clin. Nutr. 1991; 45: 441–50.Google Scholar
17Lahelma, E, Rahkonen, O, Berg, M-A, Helakorpi, S, Prättälä, R, Puksa, P. et al. Changes in health status and health behaviour among Finnish adults 1978–1993: Scand. J. Work Environ. Health 1997; 23 (Suppl. 3): 8590.Google Scholar
18Osler, M. Livsstil og forebyggelse. Fokus på befolkningens ryge-, motions- og kostvaner [dissertation]. Copenhagen: Foreningen af Danske Laegestuderendes Forlag Aktieselskab; 1994.Google Scholar
19Prättälä, R. Social class and food in the Nordic countries. In: Feichtinger, E, Köhler, B, eds. Current Research into Eating Practices. Contributions of Social Sciences. Frankfurt-am-Main: AGEV publication series vol. 10. Ernährungs-Umschau 1995; 42 (Suppl.): 1620.Google Scholar
20Johansson, L, Thelle, D, Solvoll, K, Bjørneboe, G-EAa & Drevon, CA. Healthy dietary habits in relation to social determinants and lifestyle factors. Br. J. Nutr. 1999; 81: 211–20.CrossRefGoogle ScholarPubMed
21Karisto, A, Prättälä, R and Berg, M-A. The good, the bad and the ugly. Differences and changes in health related lifestyles. In: Kjaernes, U, Holm, L, Ekstroöm, M, Fürst, E and Prättälä, R, eds. Regarding Markets—Regulating People. On Food and Nutrition Policy. Oslo: Novus Press, 1993: 185204.Google Scholar
22WHO. Diet, Nutrition and the Prevention of Chronic Disease Risk. Washington, DC: National Academy Press, 1989.Google Scholar
23Block, G, Patterson, B & Subar, A. Fruit, vegetables and cancer prevention: a review of the epidemiological evidence. Nutr. Cancer. 1992; 18: 129.Google Scholar
24Wandel, M. Dietary intake of fruits and vegetables in Norway: influence of life phase and socio-economic factors. Int. J. Food Sci. Nutr. 1995; 46: 291301.Google Scholar
25Johansson, L & Andersen, LF. Who eats 5 a day?.: Intake of fruits and vegetables among Norwegians in relation to gender and lifestyle. J. Am. Diet. Assoc. 1998; 98: 689–91.Google Scholar
26Havas, S, Heimendinger, J, Reynolds, K, Baranowski, T, Nicklas, TA, Bishop, D. et al. 5 a day for better health: A new research initiative. J. Am. Diet. Assoc. 1994; 94: 32–6.CrossRefGoogle Scholar
27Tetens, I. 6 a day—development project. Scand. J. Nutr. 1999; 43: 176.Google Scholar
28FAO. Food balance sheets, 1999. Available from http://apps.fao.org/.Google Scholar
29EPIC Group of Spain. Dietary intake of vegetables and fruits among adults in five regions of Spain. Eur. J. Clin. Nutr. 1999; 53: 174–80.CrossRefGoogle Scholar
30Johansson, L, Becker, W, Fagt, S, Thorgeirsdottir, H and Valsta, L. Grønnsak-og fruktinntaket i Norden. Scand. J. Nutr. 1999; 43: 812.Google Scholar
31Thompson, RL, Margetts, BM, Speller, VM and McVey, D. The Health Education Authority's health and lifestyle survey 1993: who are the low fruit and vegetable consumers? J. Epidemiol. Community Health 1999; 53: 294–9.Google Scholar
32Roos, E, Lahelma, E, Virtanen, M, Prättälä, R and Pietinen, P. Gender, socioeconomic status and family status as determinants of food behaviour. Soc. Sci. Med. 1998; 46: 1519–29.Google Scholar
33Agudo, A and Pera, G. EPIC Group of Spain. Vegetable and fruit consumption associated with anthropometric, dietary and lifestyle factors in Spain. Public Health Nutr. 1999; 2: 263–71.CrossRefGoogle ScholarPubMed
34Roos, E, Prättälä, R, Lahelma, E, Kleemola, P, Pietinen, P. Modern and healthy? Socioeconomic differences in the quality of diet. Eur. J. Clin. Nutr. 1996; 50: 753–60.Google ScholarPubMed
35Roos, G and Prättälä, R. FAIR-97-3096 Disparities Group. Disparities in Food Habits: Review of Research in 15 European Countries. Helsinki: Publications of the National Public Health Institute B24/1999, 1999.Google Scholar
36Trichopoulou, A, Lagiou, P, eds. Methodology for the Exploitation of HBS Food Data and Results on Food Availability in 5 European Countries. DAFNE I. Luxembourg: European Commission COST Action 99, 1997.Google Scholar
37Trichopoulou, A, Lagiou, P, eds. Methodology for the Exploitation of HBS Food Data and Results on Food Availability in 6 European Countries. DAFNE II. Luxembourg: European Commission COST Action 99, 1999.Google Scholar
38Lahelma, E, Rahkonen, O, and Huuhka, M. Changes in social patterning of health? The case of Finland 1986–1994. Soc. Sci. Med. 1997; 44: 788–99.Google Scholar
39National Nutrition Council. NORKOST 19931994. Oslo: National Nutrition Council.Google Scholar
40Kleemola, P, Roos, E and Pietinen, P. Suomalaisen ravinnon muutokset eri koulutusryhmissä vuodesta 1982 vuoteen 1992. Sosiaalilääketieteellinen Aikakauslehti 1996; 33: 916.Google Scholar
41Becker, W. Befolkningens kostvanor och näringsintag i Sverige 1989. Metod-och resultatanalys. Uppsala: Statens Livsmedelsverk, 1994.Google Scholar
42Haraldsdottir, J, Holm, L, Hojmark Jensen, JH and Moller, A. Danskernes kostvaner 1985. 2. Hvem spiser hvad? Publikation nr. 154. Copenhagen: Levnedsmiddelstyrelsen, 1987.Google Scholar
43Gregory, J, Foster, K, Tyler, H and Wiseman, M. The Dietary and Nutritional Survey of British Adults: A Survey of the Dietary Behaviour, Nutritional Status and Blood Pressure of Adults 16 to 64 living in Great Britain. London: HMSO, 1990.Google Scholar
44Kussmaul, B, Döring, A, Stender, M, Winkler, G and Keil, U. Zusammenhang zwischen Ernährungsverhalten und Bildungsstand: Ergebnisse der Ernährungserhebung 1984/85 des MONICA-Projektes Augsburg. Z. Ernährungswiss. 1995; 34: 177–82.CrossRefGoogle ScholarPubMed
45Ministry of Agriculture, Fisheries and Food. The National Food Survey 1985–1988: Household Food Consumption and Expenditure. London: HMSO, 19861989.Google Scholar
46Piha, T, Niemensivu, H and Puska, P. Suomalaisen aikuisväestön terveyskäyttäytyminen, kevät 1986. Helsinki: Publications of the National Public Health Institute B4/1986, 1986.Google Scholar
47Berg, M-A, Peltoniemi, J and Puska, P. Suomalaisen aikuisväestön terveyskäyttäytyminen, kevät 1990. Helsinki: Publications of the National Public Health Institute B3/1990, 1990.Google Scholar
48Helakorpi, S, Uutela, A, Prättälä, R, Berg, M-A and Puska, P. Suomalaisen aikuisväestön terveyskäyttäytyminen, kevät 1994. Helsinki: Publications of the National Public Health Institute B 8/1994, 1994.Google Scholar
49Lipand, A, Kasmel, A, Kivilo, M, Tasa, E, Puska, P and Berg, M-A. Eesti täiskasvanud elanikkonna tervisekäitumise uuring, kevad 1990. Helsinki: Publications of the National Public Health Institute B1/1992, 1992.Google Scholar
50Lipand, A, Kasmel, A, Tasa, E, Leinsalu, M, Uutela, A and Puska, P, et al. Eesti täiskasvanud elanikkonna tervisekäitumise uuring, kevad 1994. Helsinki: Publications of the National Public Health Institute B5/1995, 1995.Google Scholar
51Grabauskas, V, Klumbiene, J, Petkeviciene, J, Dregval, L, Cepaitis, Z and Nedzelskiene, J. et al. Suaugusiu letuvos zmoniu gyvensenos tyrimas, 1994. Helsinki: Publications of the National Public Health Institute B7/1997, 1997.Google Scholar
52Osler, M and Heitmann, BL. Food patterns associated with intakes of fat, carbohydrate and dietary fibre in a cohort of Danish adults followed for six years. Eur. J. Clin. Nutr. 1997; 51: 354–61.Google Scholar
53Osler, M & Schroll, M. Lifestyle and prevention of ischaemic heart disease in Denmark: changes in knowledge and behaviour 1982–1992. Eur. J. Public Health 1995; 5: 109–12.CrossRefGoogle Scholar
54de Bruin, A. Gezondheidsenquêtes. Voedingsgewoonten, 1989. Maandbericht Gezondheit 1991; 10: 522.Google Scholar
55Eicholzer, M, Bisig, B and Gutzwiller, F. Ernährung in der Schweiz. Schweizerische Gesundheitsbefragung 1992/93. Bern: Bundesamt für Gesundheitswesem in Zusammenarbeid mit dem Insitut für Sozial- und Präventivmedizin der Universität Zürich, 1995.Google Scholar
56Pryer, J, Brunner, E, Elliott, P, Nichols, R, Dimond, H and Marmot, M. Who complied with COMA 1984 dietary fat recommendations among a nationally representative sample of British adults in 1986–7 and what did they eat? Eur. J. Clin. Nutr. 1995; 49: 718–28.Google ScholarPubMed
57Hirvonen, T, Männistö, S, Roos, E, Pietinen, P. Increasing prevalence of underreporting does not necessarily distort dietary surveys. Eur. J. Clin. Nutr. 1997; 51: 297301.Google Scholar
58Stallone, DD, Brunner, EJ, Marmot, MG and Bingham, SA. Dietary assessment in Whitehall II: The influence of reporting bias on apparent socioeconomic variation in nutrient intakes. Eur. J. Clin. Nutr. 1997; 51: 815–25.Google Scholar
59Johansson, L, Solvoll, K, Bjørneboe, G-EAa and Drevon, CA. Under- and overreporting of energy intake related to weight status and lifestyle in a nationwide sample. Am. J. Clin. Nutr. 1998; 68: 266–74.CrossRefGoogle ScholarPubMed
60Macdiarmid, J and Blundell, J. Assessing dietary intake: who, what and why of under-reporting. Nutr. Res. Rev. 1998; 11: 231–53.Google Scholar
61Turrell, G and Najman, JM. Collecting food-related data from low socio-economic groups: how adequate are our current research designs? Aust. J. Public Health 1995; 19: 410–6.Google Scholar
62Wandel, M & Fagerli, R. Norwegians' opinions of a healthy diet in different stages of life. J. Nutr. Educ. 1999; 31: 339–46.Google Scholar
63Caraher, M, Dixon, P, Lang, T and Carr-Hill, R. Access to healthy foods: part I. Barriers to accessing healthy food: differentials by gender, social class, income and mode of transport. Health Educ. J. 1998; 57: 191201.Google Scholar