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Soil-geomorphic heterogeneity governs patchy vegetation dynamics at an arid ecotone.

Soil properties are well known to affect vegetation, but the role of soil heterogeneity in the patterning of vegetation dynamics is poorly documented. We asked whether the location of an ecotone separating grass-dominated and sparsely vegetated areas reflected only historical variation in degradation or was related to variation in inherent soil properties. We then asked whether changes in the cover and spatial organization of vegetated and bare patches assessed using repeat aerial photography reflected self-organizing dynamics unrelated to soil variation or the stable patterning of soil variation. We found that the present-day ecotone was related to a shift from more weakly to more strongly developed soils. Parts of the ecotone were stable over a 60-year period, but shifts between bare and vegetated states, as well as persistently vegetated and bare states, occurred largely in small (<40 m2) patches throughout the study area. The probability that patches were presently vegetated or bare, as well as the probability that vegetation persisted and/or established over the 60-year period, was negatively related to surface calcium carbonate and positively related to subsurface clay content. Thus, only a fraction of the landscape was susceptible to vegetation change, and the sparsely vegetated area probably featured a higher frequency of susceptible soil patches. Patch dynamics and self-organizing processes can be constrained by subtle (and often unrecognized) soil heterogeneity.

Ecosystem↗

Fruit and vegetable intakes of children and adolescents in the United States.

OBJECTIVES: To identify the ways in which fruits and vegetables are consumed by children, to provide estimates of their intakes compared with recommendations, and to estimate the percentage of children meeting those recommendations. DESIGN: We examined 3 days of dietary data from respondents in the US Department of Agriculture's 1989-1991 Continuing Survey of Food Intakes by Individuals. All foods reported in the survey were disaggregated into their component ingredients; all fruit and vegetable ingredients were assigned specific weights to correspond with a serving as defined by current dietary guidance materials; and the number of servings of each fruit and vegetable was tallied. PARTICIPANTS: A total of 3148 children and adolescents aged 2 to 18 years in the 48 conterminous United States. MAIN OUTCOME MEASURES: Percentages of fruit and vegetable servings consumed in various forms, mean number of servings consumed per day, and percentage of persons meeting various recommendations by sex/age, race/ethnicity, and household income. RESULTS: Nearly one quarter of all vegetables consumed by children and adolescents were french fries. Their intakes of all fruits and of dark green and/or deep yellow vegetables were very low compared with recommendations. Only one in five children consumed five or more servings of fruits and vegetables per day. CONCLUSION: Pediatricians should encourage the consumption of fruits and vegetables, especially dark green and deep yellow vegetables, by children.

Adolescent↗

Consumption of vegetables and fruits and risk of breast cancer.

CONTEXT: The intake of vegetables and fruits has been thought to protect against breast cancer. Most of the evidence comes from case-control studies, but a recent pooled analysis of the relatively few published cohort studies suggests no significantly reduced breast cancer risk is associated with vegetable and fruit consumption. OBJECTIVE: To examine the relation between total and specific vegetable and fruit intake and the incidence of breast cancer. DESIGN, SETTING, AND PARTICIPANTS: Prospective study of 285,526 women between the ages of 25 and 70 years, participating in the European Prospective Investigation Into Cancer and Nutrition (EPIC) study, recruited from 8 of the 10 participating European countries. Participants completed a dietary questionnaire in 1992-1998 and were followed up for incidence of cancer until 2002. MAIN OUTCOME MEASURES: Relative risks for breast cancer by total and specific vegetable and fruit intake. Analyses were stratified by age at recruitment and study center. Relative risks were adjusted for established breast cancer risk factors. RESULTS: During 1,486,402 person-years (median duration of follow-up, 5.4 years), 3659 invasive incident breast cancer cases were reported. No significant associations between vegetable or fruit intake and breast cancer risk were observed. Relative risks for the highest vs the lowest quintile were 0.98 (95% confidence interval [CI], 0.84-1.14) for total vegetables, 1.09 (95% CI , 0.94-1.25) for total fruit, and 1.05 (95% CI , 0.92-1.20) for fruit and vegetable juices. For 6 specific vegetable subgroups no associations with breast cancer risk were observed either. CONCLUSION: Although the period of follow-up is limited for now, the results suggest that total or specific vegetable and fruit intake is not associated with risk for breast cancer.

Adult↗

Consumption of vegetables and fruits and risk of ovarian carcinoma.

BACKGROUND: To the authors' knowledge, only a few prospective studies to date have investigated the correlation between vegetable and fruit consumption and the risk of ovarian carcinoma and their results have been inconclusive. METHODS: Vegetable and fruit intake was assessed in relation to ovarian carcinoma, among 62,573 postmenopausal women participating in The Netherlands Cohort Study on Diet and Cancer. Women reported on dietary habits and on other risk factors for cancer in a self-administered questionnaire in 1986. Follow-up of cancer was implemented by annual record linkage with The Netherlands Cancer Registry and a pathology register. After 11.3 years of follow-up, data regarding 252 incident invasive epithelial ovarian carcinoma cases and of 2216 subcohort members were available for case-cohort analyses. RESULTS: Multivariable-adjusted rate ratios (RR) of ovarian carcinoma for women in the highest compared with the lowest quintile of intake (RR(Q5 vs. Q1)) were 0.98 (95% confidence interval [95% CI], 0.61-1.58) for total vegetables and 1.11 (95% CI, 0.70-1.78) for total fruit. The RR(Q5 vs. Q1) values of ovarian carcinoma with intake of cooked vegetables, raw vegetables, brassicas, legumes, cooked leafy vegetables, and raw leafy vegetables were 1.35 (95% CI, 0.83-2.21), 0.75 (95% CI, 0.48-1.18), 1.42 (95% CI, 0.88-2.29), 0.93 (95% CI, 0.60-1.44), 1.05 (95% CI, 0.66-1.67), and 1.23 (95% CI, 0.75-2.02), respectively. With the exception of raw endive (multivariable-adjusted RR, 0.24; 95% CI, 0.07-0.78), none of the individual vegetable or fruit items showed a statistically significant association with ovarian carcinoma. CONCLUSIONS: The results of the current study did not support a significant association between vegetable or fruit consumption and ovarian carcinoma risk in a cohort of postmenopausal women.

Adult↗

Fruits, vegetables and risk of renal cell carcinoma: a prospective study of Swedish women.

Findings of epidemiologic studies on the relationship between fruit and vegetable consumption and renal cell carcinoma (RCC) risk have been inconclusive. To study the association between fruits and vegetables and risk of RCC in a population-based prospective cohort study of Swedish women, we collected dietary information from 61,000 women age 40-76 years by a food-frequency questionnaire. During 13.4 years of follow-up 122 women developed RCC. Cox proportional hazards models were used to estimate relative risks (RR) with 95% confidence interval (CI). Women consuming 5 or more servings of fruit and vegetables daily had a relative risk of 0.59 (95% CI = 0.26-1.34) in comparison to them consuming less than once daily. When fruits and vegetables were examined separately, those who consumed more than 75 servings per month of fruits or vegetables had multivariate relative risk of 0.59 (95% CI = 0.27-1.25) and 0.60 (95% CI = 0.31-1.17) respectively, compared to those consuming 11 or less servings per month. Within the group of fruits, the strongest inverse association was observed for banana (p = 0.07 by Wald test). The risk of RCC increased monotonically with increasing intake frequencies of fruit juice (p-value for trend = 0.10). Within the group of vegetables, the strongest inverse association was observed for root vegetables (p = 0.03 by Wald test). The risk of RCC decreased with increasing consumption frequencies of white cabbage (p for trend = 0.07). Frequent consumption of salad vegetables (once or more per day) decreased the risk by 40% (RR = 0.60; 95% CI = 0.30-1.22), in comparison to no consumption. Our results suggested that high consumption of fruits and vegetables might be associated with reduced risk of RCC.

Aged↗

Fruit and vegetable consumption, nutritional knowledge and beliefs in mothers and children.

Increasing fruit and vegetable consumption is an important health behaviour. Parental and other psychosocial influences on children's fruit and vegetable consumption are poorly understood. The contribution of a variety of psychosocial and environmental factors to consumption of fruit and vegetables by children aged 9-11 years was explored. Ninety-two mothers and children (48 girls and 44 boys) were recruited via urban primary health-care practices. Socio-economic and educational level, nutritional knowledge and health- and diet-related beliefs and attitudes were assessed in mothers and children by questionnaires and semistructured interviews. Mothers>> diets were measured by a food frequency questionnaire, while children's diets were assessed by 3-day diaries (N=80). The pattern of influence of the various measures on fruit and vegetable consumption was compared with that on children's confectionery intake. The children's intakes of macronutrients were typical for the U.K. (37% fat, 50% carbohydrate and 13% protein by energy; 12 g/day fibre), while median fruit, fruit juice and vegetable intake amounted to about 2.5 servings/day. Univariate correlations and subsequent multiple regression analyses revealed quite different influences on the three food types. Independent predictors of children's fruit intake included mothers>> nutritional knowledge (beta=0.37), mothers>> frequency of fruit consumption (beta=0.30) and mothers>> attitudinal conviction that increasing fruit and vegetable consumption by their children could reduce their risk of developing cancer (beta=0.27; multiple r2=0.37,p<0.0001). Children's vegetable consumption was independently explained by the child's liking for commonly eaten vegetables (beta=0.36) and the mother's belief in the importance of disease prevention when choosing her child's food (beta=-0.27 r2=0.20,p<0.001). Children's confectionery consumption was predicted by the mother's liking for confectionery (beta=0.32) and the children's concern for health in choosing what to eat (beta=-0.26 r2=0.16, p<0.005). Children's consumption of fruit and vegetables are related to different psychosocial and environmental factors. Promotion of this behaviour may require attention to nutritional education and child feeding strategies of parents.

Adult↗

[Inadequate fruit and vegetable consumption in Switzerland: results of the Swiss Health Survey 1992/93].

Inadequate consumption of fruit and vegetables increases the risk of various (chronical) diseases. It is therefore recommended to eat at least three portions of vegetables and two portions of fruit every day. The present study aims to determine the prevalence of inadequate fruit and vegetable (potatoes are not regarded as vegetables in Switzerland) consumption in Switzerland and to determine sociodemographic and lifestyle correlates of inadequate consumption. Data presented in this study were taken from the first national representative health survey for Switzerland (conducted 1992/1993) including 7930 men and 7358 women (response rate 71%), age 15 and over. Bivariate analyses and multivariate logistic regressions controlling for sociodemographic and lifestyle factors were done. Inadequate consumption of fruit and vegetables was common among the study population. Less than daily consumption of fruit was reported by about 30%, of vegetables by 17%. About 25% of study participants do not eat fruit or vegetables every day, for 11% the consumption of both is insufficient. Men, young people, study participants with a low educational background, people living in the French and Italian speaking part of Switzerland, smokers and participants with low physical activity reported more often inadequate fruit and vegetable intake than women, older people, well educated study participants, inhabitants of the German speaking part of Switzerland, nonsmokers, and less physically active people. These results stress the need for nutrition education programs aimed at increased consumption of fruit and vegetables in Switzerland.

Adolescent↗

Do 'food deserts' influence fruit and vegetable consumption?--A cross-sectional study.

Lack of access to affordable healthy foods has been suggested to be a contributory factor to poor diet. This study investigated associations between diet and access to supermarkets, transport, fruit and vegetable price and deprivation, in a region divergent in geography and socio-economic indices. A postal survey of 1000 addresses (response rate 42%) gathered information on family demographics, supermarket and shop use, car ownership, mobility and previous day's fruit and vegetable intake. Postcode information was used to derive road travel distance to nearest supermarket and deprivation index. Fruit and vegetable prices were assessed using a shopping basket survey. Generalised linear regression models were used to ascertain predictors of fruit and vegetable intake. Male grocery shoppers ate less fruit than female grocery shoppers. Consumption of vegetables increased slightly with age. Deprivation, supermarket fruit and vegetable price, distance to nearest supermarket and potential difficulties with grocery shopping were not significantly associated with either fruit or vegetable consumption. These data suggest that the three key elements of a food desert, fruit and vegetable price, socio-economic deprivation and a lack of locally available supermarkets, were not factors influencing fruit or vegetable intake. We suggest that food policies aimed at improving diet should be orientated towards changing socio-cultural attitudes towards food.

Cross-Sectional Studies↗

Arsenic and heavy metal contamination of vegetables grown in Samta village, Bangladesh.

Drinking of arsenic (As) contaminated well water has become a serious threat to the health of many millions in Bangladesh. However, the implications of contamination of agricultural soils from long-term irrigation with As-contaminated groundwater for phyto-accumulation in food crops, and thence dietary exposure to As, and other metals, has not been assessed previously in Bangladesh. Various vegetables were sampled in Samta village in the Jessore district of Bangladesh, and screened for As, Cd, Pb, Cu and Zn by inductively coupled plasma emission spectrometry (ICP-AES) and inductively coupled plasma mass spectrometry (ICP-MS). These local food products are the basis of human nutrition in this region and of great relevance to human health. The results revealed that the individual vegetables containing the highest mean As concentrations microg x g(-1)) are snake gourd (0.489), ghotkol (0.446), taro (0.440), green papaya (0.389), elephant foot (0.338) and Bottle ground leaf (0.306), respectively. The As concentration in fleshy vegetable material is low. In general, the data show the potential for some vegetables to accumulate heavy metals with concentrations of Pb greater than Cd. Some vegetables such as bottle ground leaf, ghotkol, taro, eddoe and elephant foot had much higher concentrations of Pb. Other leafy and root vegetables, contained higher concentrations of Zn and Cu. Bioconcentration factors (BCF) values, based on dry weight, were below 1 for all metals. In most cases, BCF values decreased with increasing metal concentrations in the soil. From the heavily As-contaminated village in Samta, BCF values for As in ladies finger, potato, ash gourd, brinjal, green papaya, ghotkol and snake gourd were 0.001, 0.006, 0.006, 0.014, 0.030, 0.034 and 0.038, respectively. Considering the average daily intake of fresh vegetables per person per day is only 130 g, all the vegetables grown at Samta had Pb concentrations that would be a health hazard for human consumption. Although the total As in the vegetables was less than the recommended maximum intake of As, it still provides a significant additional source of As in the diet.

Arsenic↗

Polycyclic aromatic hydrocarbons (PAHs) in agricultural soil and vegetables from Tianjin.

Several types of vegetables were collected from two contaminated sites in Tianjin, China. The bulk soil and the rhizosphere soil samples were also collected from the same plots. Sixteen PAHs in the samples were measured. The total concentrations of PAH16 in the bulk soil from the two sites were 1.08 and 6.25 microg/g, respectively, with similar pattern. The concentrations of PAH16 and individual compounds in the rhizosphere were significantly higher than those in the bulk soil with mean values of 2.25 and 7.82 microg/g for the two sites, respectively. The contents of both total and dissolved organic matter in the rhizosphere were also higher than those in the bulk soil. Almost all PAH compounds studied were detected in both roots and aerial parts of the vegetables studied. Abundance of higher molecular weight PAHs in vegetable, however, was lower than that in soil. Concentrations of PAH16 in vegetable were higher than those reported in the literature for other areas. It appears that agricultural soils and vegetables in Tianjin, especially those from the site located immediately next to an urban district and irrigated with wastewater for several decades, are severely contaminated by PAHs. Among the eight types of vegetable studied, the highest concentration of PAHs was found in cauliflower. By average, the concentration of PAH16 in the aerial part of vegetables was 6.5 times higher as that in vegetable root, suggesting that foliar uptake is the primary transfer pathway of PAHs from environment to vegetables.

China↗

Estimation of fruit and vegetable intake using a two-item dietary questionnaire: a potential tool for primary health care workers.

BACKGROUND AND AIM: High fruit and vegetable intake is associated with health benefits for cancer and cardiovascular disease. An increase is therefore integral in recommendations for the prevention of chronic disease. However, measuring intake requires either extensive dietary assessment or the measurement of specific bio-markers which is neither cheap nor feasible for the routine assessment of an individual's diet in a community or primary care setting. Within the context of a study evaluating a dietary counselling programme to increase fruit and vegetable intake our aim was to assess the use of a simple tool to estimate fruit and vegetable intake. METHODS AND RESULTS: We studied associations between bio-markers [plasma ascorbic acid, beta-carotene and alpha-tocopherol 24-hour urinary potassium excretion] and a two-item fruit and vegetable consumption questionnaire in 271 subjects (105 men and 166 women), aged 18 to 70 years. After controlling for age, sex, vitamin supplement use, smoking and body mass, those reporting a daily intake of > or = 5 portions of fruit and vegetables had higher potassium excretion (difference 15.6 [95% confidence interval: 6.2 to 25.0] mmol/24 h), urinary potassium/creatinine ratio (1.2 [0.5 to 2.0]) and plasma vitamin C (10.0 [-0.9 to 20.8] mumol/L) than those reporting < or = 2.5 portions per day. beta-carotene (p = 0.04), vitamin C (p = 0.01) and potassium excretion (p < 0.001) were associated with fruit rather than vegetable intake. The two-item questionnaire had high specificity; over 3/4 of participants who reported low intake also had bio-markers below the upper third of the distribution. CONCLUSION: Self report of fruit and vegetable intake through a simple questionnaire is confirmed by bio-markers for those eating less than five portions of fruit and vegetables a day. Although the tool is amenable to improvements for the detection of vegetable portions, it may prove useful for monitoring dietary preventive approaches in primary care without the use of invasive and costly biochemical measurements.

Adolescent↗

Take Five, a nutrition education intervention to increase fruit and vegetable intakes: impact on consumer choice and nutrient intakes.

This study reports results from a randomized controlled intervention trial, focusing on: (1) the identification of successful consumer strategies for increasing fruit and vegetable intakes to the recommended levels of more than five (80 g) portions per day and (2) impact on overall diet and nutrient intakes. Adult men and women (n 170) fulfilling the main recruitment criterion of eating less than five fruit and vegetable portions per day but contemplating increasing intakes were recruited. Complete valid dietary data was provided by 101 intervention (fifty-nine estimated fruit and vegetable intakes, and forty-two simultaneous weighted total dietary and estimated fruit and vegetable intakes) and twenty-four control subjects (weighed total dietary intakes). Intervention advice included the specific association of high fruit and vegetable intake with reduced risk of disease, practicalities, and portion definition with a target intake of greater than five 80 g fruit and vegetable portions per day for 8 weeks. There were significant effects (P < 0.001) on weighed intakes of fruit and vegetables in the intervention group, rising from 324 (SE 25) to 557 (SE 31) g/d and reflected by validated portion measures at 8 weeks intervention. Successful strategies chosen by 'achievers' of the target intake (65% of subjects) were conventional (fruit as a snack, vegetables with main meals etc.) and favoured fruit. There were significant increases in percentage energy from carbohydrate (from sugars not starch), vitamin C, carotenes and NSP and there was a significant decrease in percentage energy from fat for subjects who had high fat intakes (> 35% energy) at baseline. Follow-up self-reported measures at 6 and 12 months indicated mean intakes of 4.5 and 4.6 defined portions/d respectively, suggesting some sustainable effect. In conclusion, the intervention led to significant increases in fruit and vegetable intakes largely via conventional eating habits, with some desirable effects on macro- and micronutrient intakes.

Adolescent↗

Polyphenols and antioxidant capacity of vegetables under fresh and frozen conditions.

The phenolic and oxygen radical absorbance capacity (ORAC) values have been measured in six fresh and frozen vegetables (beet green, spinach, broccoli, carrot, onion, and celery) from the same cultivar by analyzing the whole juice (WJ) and the acetonic extract of the squeezed pulp. To exploit the effect of the acid environment on the stability and recovery of the phenolics, perchloric acid (PCA) was added directly to WJ and to the pulp before the extraction with acetone. In both fresh and frozen vegetables, PCA markedly increased the recovery of phenolics extracted from the pulp, but PCA had no effect on the WJ. Four of six frozen vegetables showed lower phenolic and ORAC values than the fresh vegetables, whereas in the other two cases, values were significantly higher compared to fresh samples. Among the fresh vegetables, beet green showed the highest ORAC and phenolic values; however, when measured in two different cultivars of beet green, the ORAC value showed as much as 4.5-fold variation, whereas total phenolics and flavonoids showed 1.2- and 3.5-fold variations, respectively. The results show that total phenolics and ORAC, compared in fresh and frozen vegetables, represent an index of the mildness of blanching in the industry of frozen vegetables and provide a measure of the gap in antioxidants in the diet of people who consume frozen instead of fresh vegetables. The plant genotype is an important source of variability in the ORAC value, which can be conveniently used to increase the intake of antioxidants from vegetables.

Antioxidants↗

Nutritive value and effect of blanching on the trypsin and chymotrypsin inhibitor activities of selected leafy vegetables.

Proximate composition, energy, mineral and vitamin contents and the effect of blanching methods and times on the trypsin and chymotrypsin inhibitor activities were studied using cabbage, collard, turnip, peanut, and sweet potato leaves. Results of this study indicated that, crude protein, crude fat, carbohydrate and ash contents were in the range of 15.5-25.6%, 1.4-6.5%, 60.4-73.1% and 6.8-7.5%, respectively. Total dietary fiber was lowest in cabbage (28.2 g/100 g) and highest in the collard leaves (43.1%) while energy content per 100 g of vegetables was highest in sweet potato leaves (402 kcal) and lowest in cabbage (379 kcal). The mineral content per 100 g of vegetables were in the range of 33.4-249.8 mg, 241.2-471.2 mg, 12.1-75.1 mg, 14.9-98.9 mg, 0.5-3.5 mg and 0.9-3.1 mg for Ca, K, Na, Mg, Fe and Zn, respectively. For ascorbic acid, riboflavin, thiamin and total carotenoids, concentrations in 100 g of vegetables were in the range of 45.1-112.7 mg, 0.2-0.3 mg, 0.3-0.8 mg and 2.0-7.3 mg, respectively. The trypsin inhibitory activity per gram of the vegetables was highest in collard (60.1 TIU/g) and lowest in peanut leaves (41.0 TIU/g). Chymotrypsin inhibitor activity was highest in the peanut (69.6 CIU/g) but lowest in the collard leaves (48.0 CIU/g). Both trypsin and chymotrypsin inhibitor activities were significantly (p < 0.05) reduced by most of the treatments in either the conventional or microwave blanching methods. In the conventional blanching method, trypsin inhibitor activity was reduced by 0.5, 6.8, 11.9, 9.0 and 19.3 percent in cabbage, collard, turnip, sweet potato and peanut leaves, respectively, when the vegetables were blanched for 2.5 minutes but after blanching for 10 minutes, the trypsin inhibitor activity was reduced by 29.7, 34.9, 54.3, 52.3 and 65.6 percent in cabbage, collard, turnip, sweet potato and peanut greens, respectively. For the microwave oven blanching, trypsin inhibitor activity was reduced by 3.8, 3.3, 32.7, 5.0 and 9.5 percent in cabbage, collard, turnip, sweet potato and peanut leaves, respectively when the vegetables were blanched for 30 seconds. When blanched for 60 seconds, trypsin inhibitor activity was reduced by 16.2, 45.8, 46.2, 51.0 and 42.4 percent in cabbage, collard, turnip, sweet potato and peanut greens, respectively. Similar trends in the reduction of chymotrypsin inhibitor activity were observed when the vegetables were conventionally blanched for 2.5, 5 and 10 minutes and when blanched by microwave oven for 30, 45 and 60 seconds. Based on the results of this study, the vegetables were good dietary sources of minerals, vitamins, carbohydrate and proteins. Also, blanching was an effective method for reducing the trypsin and chymotripsin inhibitor activities in the leafy vegetables, however, further investigation on the heating times for both conventional and microwave blanching methods is suggested.

Chymotrypsin↗

By how much does fruit and vegetable consumption reduce the risk of ischaemic heart disease?

OBJECTIVE: To quantify the relationship between fruit and vegetable consumption and the incidence of ischaemic heart disease. DESIGN: A meta-analysis of cohort studies of the relationship between ischaemic heart disease and markers of fruit and vegetable consumption, namely dietary intake of fruit, vegetables, carotenoids, vitamin C, fruit fibre and vegetable fibre, and serum concentration of carotenoids and vitamin C, adjusted for other risk factors. MAIN OUTCOME MEASURES: Risk of ischaemic heart disease at the 90th centile of consumption relative to that at the 10th, equivalent to about a four-fold difference in fruit consumption and a doubling of vegetable consumption. RESULTS: The association with ischaemic heart disease was of similar magnitude for all six dietary markers of fruit and vegetable consumption. The median of the six estimates was that risk was 15% (range 12-19%) lower at the 90th centile of consumption than at the 10th. The estimates were generally adjusted for the possible confounding effect of other heart disease risk factors. The serum studies of vitamin C were consistent with this; those of carotenoids suggested a larger difference (43%) but were not adjusted for the important confounding effect of smoking. The substances in fruit and vegetables responsible for the protective effect on heart disease are uncertain but the effect is commensurate with the estimated protective effects of the potassium and folate in fruit and vegetables. Beta-carotene or vitamin E are not likely to be important because randomised trials of these vitamins in large doses have shown no reduction in heart disease mortality. CONCLUSIONS: The risk of ischaemic heart disease is about 15% lower at the 90th than the 1Oth centile of fruit and vegetable consumption.

Adult↗

Six carotenoids in plasma used to assess recommended intake of fruits and vegetables in a controlled feeding study.

BACKGROUND: There is a need for objective and universally applicable biomarkers for the intake of foods believed to affect human health. OBJECTIVE: The purpose of this feeding study was to test whether plasma concentrations of carotenoids could be used to distinguish recommended consumption of mixed fruits and vegetables (five a day) from the current national intake of fruits and vegetables (two a day). DESIGN: A strict crossover design was chosen to correct for observed interindividual variations in carotenoid response. A total of 40 healthy subjects were included in the study. After 1 week run-in period with no fruits and vegetables in the diet, one group was given two portions (300 g) of fruits and vegetables daily, while another group was given five portions (750 g) for 14 days. Following a 2 week wash-out period and 1 week run-in, the regimens were switched between the groups. Fruits and vegetables were combined to match a typical Norwegian diet. RESULTS: Enhanced intake from two to five portions of mixed fruits and vegetables increased plasma concentrations of alpha-carotene (P=0.033) and lutein (P=0.051) in a crossover analysis. Analysis of data in the parallel part of the study revealed differences between the high and low intake for plasma concentrations of alpha-carotene (P=0.013) and beta-carotene (P=0.016). A trend was also evident for plasma concentrations of lycopene (P=0.057) and lutein (P=0.076) in the parallel analysis. No effect of high vs low intake of fruits and vegetables was observed for plasma concentrations of beta-cryptoxanthin, zeaxanthin, cholesterol and triacylglycerols. CONCLUSION: The study indicates that plasma concentration of alpha-carotene, beta-carotene and lutein may be used to assess changes of fruit and vegetable intake corresponding to an increase from the present national intake in Norway to the recommended amount of five portions of fruits and vegetables daily. SPONSORSHIP: Norwegian Research Council, National Nutrition Council, Throne Holst Foundation for Nutrition Research and Freia Chokoladefabriks Medisinske Fond.

Adult↗

Validity of a questionnaire to assess fruit and vegetable intake in adults.

OBJECTIVE: To validate a method for assessing fruit and vegetable intake among adults in a population of low intake. The method assesses mean intake and ranks individuals by their usual intake. DESIGN: A precoded fruit and vegetable Questionnaire included a 24-h recall and a food frequency. The participants filled in the Questionnaire, a week later they started a 7-day food record, 1-day weighed record and 6 days using household measures. SUBJECTS: Following advertisements 40 participants were recruited, 36 returned food records(mean age=37 years). RESULTS: No difference was observed between the average intake yielded by the 24-h recall and that from the 1-day weighed food record of fruits or vegetables. Correlation coefficients between results from the food frequency questionnaire and the 7-day food records were 0.45 (P=0.007) for vegetables, 0.63 (P<0.001) for fruits and 0.73 (P<0.001) for fruits and vegetables combined. Cross-classification into quartiles showed that the proportion of participants in the same or the adjacent quartile of the intake distribution were 94% for fruit intake and 80% for vegetable intake. Registered intake of fruits and vegetables was higher the first 4 days of the record than the last 3 days (P=0.002). The 4-day food record correlated with the food frequency questionnaire in similar manner as the 7-day record. CONCLUSION: The present study indicates that the precoded 24-h recall may be valuable tool for measuring average intake of fruits and vegetables among adults in a population of low intake. Moreover, the food frequency questionnaire was valid for ranking individuals according to their usual intake. A 4-day food record might be sufficient when validating food frequency questionnaires for fruits and vegetables.

Adult↗

Low-income consumers' attitudes and behaviour towards access, availability and motivation to eat fruit and vegetables.

OBJECTIVE: To determine low-income consumers' attitudes and behaviour towards fruit and vegetables, in particular issues of access to, affordability of and motivation to eat fruit and vegetables. DESIGN AND SETTING: Questionnaire survey mailed to homes owned by a large UK housing association. PARTICIPANTS: Participants were 680 low-income men and women, aged 17-100 years. RESULTS: Age, employment, gender, smoking and marital status all affected attitudes towards access, affordability and motivation to eat fruit and vegetables. Few (7%) participants experienced difficulty in visiting a supermarket at least once a week, despite nearly half having no access to a car for shopping. Fruit and vegetables were affordable to this low-income group in the amounts they habitually bought; purchasing additional fruits and vegetables was seen as prohibitively expensive. Less than 5% felt they had a problem with eating healthily and yet only 18% claimed to eat the recommended 5 or more portions of fruit and vegetables every day. CONCLUSIONS: Supported by research, current UK Government policy is driven by the belief that low-income groups have difficulties in access to and affordability of fruit and vegetables. Findings from this particular group suggest that, of the three potential barriers, access and affordability were only a small part of the 'problem' surrounding low fruit and vegetable consumption. Thus, other possible determinants of greater consequence need to be identified. We suggest focusing attention on motivation to eat fruit and vegetables, since no dietary improvement can be achieved if people do not recognise there is a problem.

Adolescent↗