Fruit and vegetable consumption according to socioeconomic and cultural characteristics of Belgian adolescents

Abstract

Introduction Regular consumption of fruit and vegetables is a protective factor for chronic diseases. Adolescence is a crucial period for acquiring healthy dietary habits. Some socioeconomic and cultural disparities have been observed in fruit and vegetable consumption in adolescents living in high-income countries. The aim of this research was to examine how the daily consumption of fruit and vegetables differs according to socioeconomic and cultural characteristics of adolescents living in Belgium, a country characterized by a very diverse population. Methods Data of the 2014 Belgian National Food Consumption Survey, a nationally representative cross-sectional study conducted in the general population were used. Persons aged 3 to 64-years-old were randomly selected from the National Population Register, following a multistage stratified sampling procedure. Overall, 917 adolescents between 10 and 17-years-old completed two non-consecutive 24-hour dietary recalls, a food frequency questionnaire (FFQ) and a face-to-face interview with a trained dietician. The mean daily consumption of fruit and vegetables (together and separately) was examined according to the household structure, siblings, highest education level in the household, parental occupations, country of birth, language spoken at home, and region of residency. A weighting factor calculated according to age, gender, day of the first dietary recall (weekday or weekend), season, and province of residency was applied. Univariable and multivariable linear regressions analyses were performed with STATA Version 14. Results Including potential under-reporters, 98% of the adolescents consumed fruits or vegetables during both study days. The mean daily fruit and vegetable consumption was 193.5 g (SEM: 5.1), mean daily fruit consumption was 82.8 g (4.0), and mean daily vegetable consumption was 110.7 g (2.7). Adjusted for the total energy consumption and for all variables included in the multivariable model [R2 = 12.4%; constant: 125.3 g/day (ES: 41.4)], boys [b = −28.3 (11.2)], adolescents living in less-educated households [vs. university: b = −39.2 (11.8)], those with a manual worker mother [vs. managerial or academic occupation: b = −63.2 (27.9)], those born in Belgium [vs. born outside the EU: b = −101.9 (28.9)], and those living in Wallonia [vs. Flanders: b = −34.8 (10.7)] significantly consumed lower fruit and vegetable amounts. Differences in fruit and vegetable consumption across education categories were more pronounced in girls than in boys (p for interaction = 0.04). Consuming less fruit was significantly associated with being male [b = −25.7 (8.8)], living in a less-educated household [vs. university: b = −22.8 (9.3)], having a manual worker mother [vs. managerial or academic occupation: b = −47.8 (23.0)], and living in Wallonia [vs. Flanders: b = −21.0 (8.6)]. Consuming less vegetables was associated with living in a household having completed a secondary education [vs. university: b = −18.6 (6.2)], being born in Belgium [vs. born outside the EU: b = −38.4 (16.2)], living in Wallonia [vs. Flanders: b = −15.0 (5.9)], and was nearly significantly associated with being the second in the siblings [vs. the eldest: b = −13.4 (5.6); p = 0.06]. Living with one or both parents, number of the siblings, paternal occupation, and language spoken at home were not associated with differences in fruit and vegetable consumption. Conclusions Despite elevated overall amounts consumed, our results confirm disparities in fruit and vegetable consumption observed in other high-income countries, particularly in favor of higher socioeconomic status. We observed different socioeconomic inequities for fruit and vegetables separately, like maternal occupational disparities specific to fruit consumption and differences according to the country of birth specific to vegetable consumption. Cultural differences also need to be further explored in such a multiregional and multilinguistic country like Belgium.