Trends in the inequality of fruit and vegetable consumption between education levels indicated by the Korea National Health and Nutrition Examination Surveys

Abstract

The objective of this study was to investigate whether an inequality in fruit and/or vegetable (FV) consumption exists between adults of different educational levels in Korea and whether this has changed over the past decade. This study included adults ≥ 20 years) who participated in the Korea National Health and Nutrition Examination Survey (1998-2009). The FV intakes were examined using 24-h dietary-recall surveys (n=35,725) and food frequency questionnaires (n=35,400). The relative index of inequality (RII) was used to examine the magnitude and trend of inequality in insufficient FV intake (<500 gram/day for total FV; <100 gram/day, less than once per day for fruits) between educational levels. The low-education group had lower intakes of total FV, vegetables excluding Kimchi and fruit (both by frequency and quantity), but higher intakes of Kimchi, in both sexes in most years in which surveys were conducted. This group also had a higher proportion of adults with insufficient total FV and fruit intakes. The inequality, as indicated by the RII, was apparent in both sexes and in each survey year. The inequality in insufficient total FV intake increased between 1998 and 2009 in both sexes (P<0.05). An increase in the inequality in fruit intake was only detected in women (P<0.0001 for frequency and P=0.0285 for quantity, from 2007 to 2009). There is a wide discrepancy in total FV and fruit consumption across education levels among Korean adults. This inequality has increased over time for total FV intake in both sexes and for fruit intake in women.