Low fruit and vegetable intake is associated with poor self-rated health in the Czech part of the HAPIEE study

Background: Although fruits and vegetables are considered a pillar of healthy eating, previous evidence suggests that their consumption in Eastern European countries is low, and their association with health outcomes has rarely been researched in this region. Aim: To examine the effect of fruit and vegetable intake on self-rated health (SRH) in the Czech arm of the Health, Alcohol and Psychosocial factors in Eastern Europe prospective cohort study. Methods: Dietary data on fruit and vegetable intake was measured at baseline using food frequency questionnaires, and SRH from the second wave was chosen as the main outcome. The relationship between fruit and vegetable intake and SRH was analysed using multivariable ordinal regression. Results: A total of 4255 persons aged 45–69, in good and very good SRH at baseline were included in the longitudinal analysis, with a median follow-up time of 3.7 years. In the second wave, 218 (5.1%) individuals reported poor or very poor SRH. In the fully adjusted model, individuals in the lowest fruit and vegetable intake quartile had higher odds of poor SRH compared to those in the highest quartile (OR = 1.24, 95% CI: 1.01–1.52). When examined separately, the results were similar: for vegetables (OR = 1.25, 95% CI: 1.03–1.51) and fruit (OR = 1.18, 95% CI: 0.97–1.44). Conclusion: The observed longitudinal association suggests that low fruit and vegetable intake is associated with poor SRH in the Czech Republic. Considering almost half of our sample reported less than the daily recommended intake of 400 grams of fruits and vegetables, higher consumption should be supported.

The impact of diet and lifestyle on wellbeing during COVID-19-lockdown

A healthy diet and lifestyle may protect against adverse mental health outcomes, which is especially crucial during stressful times, such as the COVID-19 pandemic. This preregistered longitudinal online study explored whether diet and lifestyle (physical activity, sleep, and social interactions) could predict wellbeing and mood during a light lockdown in Germany. Participants (N = 117, 72 males; 28 9 years old) answered mental health and lifestyle questionnaires (social connections, sleep, activity) followed by submitting one week of food and mood-lifestyle diary (food intake, positive and negative mood, mental wellbeing, sleep quality, physical activity level, quantity and quality of social interactions) via a smartphone app. We used multivariate linear and mixed-effects models to predict mood and wellbeing by using dietary components and lifestyle factors. Inter-individual analyses revealed that sleep and social interaction significantly impacted mood and wellbeing. Interestingly, fruit and vegetable intake predicted wellbeing, even when controlling for all lifestyle factors. Fruit and vegetable intake also significantly predicted daily fluctuations in wellbeing within individuals next to sleep, physical activity, and social interactions. We observed gender differences in fruit and vegetable intake and anxiety levels. Our results emphasize the importance of diet contributing to individual wellbeing, even in the challenging times of a pandemic.

Breakfast Habits and Associations with Fruit and Vegetable Intake, Physical Activity, Sedentary Time, and Screen Time among Swedish 13–14-Year-Old Girls and Boys

This study explored whether breakfast habits were associated with intake of fruits and vegetables, minutes in moderate-to-vigorous physical activity (MVPA), minutes spent sedentary, and screen time among adolescents. Cross-sectional data were collected among 13–14-year-old boys and girls (n = 1139). Breakfast habits and screen time were determined via questionnaire, fruit and vegetable intake were determined through dietary recall, and physical activity and sedentary time were determined via accelerometers. Multilevel mixed models and general estimation equation models were applied. Almost 40% of participants skipped breakfast at least one day of the week. Participants with irregular breakfast habits on weekdays had lower fruit and vegetable consumption by 26.7 g (95% CI = −49.3, −5.9) while irregular breakfast habits during the whole week were associated with higher levels of screen time (OR = 1.5, 95% CI = 1.1, 2.1) compared to regular breakfast habits. Girls with irregular breakfast habits on weekdays had 7.7 min more sedentary time (95% CI = 0.8, 15.7) than girls with regular breakfast habits, while the opposite was found in boys (β = −13.3, 95% CI = −25.3, −2.6)). No significant associations were found for MVPA. Regular breakfast habits should be encouraged, as they might contribute to a higher intake of fruit and vegetables and are associated with lower levels of screen time, although further studies are necessary to establish causation.

Association between Fruit and Vegetable Intake and Physical Activity among Breast Cancer Survivors: A Longitudinal Study

This study examines the association between rates of change in daily fruit and vegetable intake and in weekly levels of moderate-to-vigorous intensity physical activity (MVPA) over a 15-month period in women following primary treatment completion for breast cancer. Breast cancer survivors (N = 199) self-reported fruit and vegetable intake and wore an accelerometer for 7 consecutive days to measure levels of MVPA on five occasions every 3 months. Multivariate latent growth modeling revealed that the rate of change in fruit and vegetable intake was not associated with the rate of change in levels of MVPA. Baseline (Mean = 3.46 months post-treatment) levels of MVPA were not associated with the rate of change of daily fruit and vegetable intake; likewise, baseline fruit and vegetable intake was not associated with the rate of change in levels of MVPA. Behavioral interventions promoting fruit and vegetable intake should not be assumed to yield concomitant effects in promoting MVPA or vice versa.

Food security and related health risk among adults in the Limpopo Province of South Africa

Food insecurity, obesity and hypertension remain major public health issues related to nutrition in South Africa. The purpose of this study was to determine household food security and the health risk of the adult population in the Limpopo Province using cross-sectional designs. A stratified random sampling method was used to recruit adults aged 18 to 65 years in the Limpopo Province of South Africa. Data were collected using a validated, structured questionnaire. All data were analysed using SPSS version 25.0. The study included 640 participants with an average age of 36.2±17.6 years and a household size of five persons; 74.5% of participants fell in the low monthly income bracket (≤ZAR3000). The mean dietary diversity score was 3.99 (CI: 2.79–5.19). The prevalence of food insecurity was 31.3%, obesity 35.2% and hypertension 32.3%. Being a woman, older and married significantly positively influenced obesity and hypertension. Also, a healthy eating lifestyle such as high dietary diversity was found to positively influence obesity status, while daily eating of fruit and vegetables positively significantly influenced the hypertension status of participants (p<0.05). Food insecurity, obesity and hypertension rates remain high among adults in the Limpopo Province of South Africa with consumption of a diet low in dietary variety. Aged and married women were more likely to be obese and hypertensive, while daily fruit and vegetable intake were found to be a protective factor. Educational and nutritional intervention should be designed and geared towards promoting fruit and vegetable intake in the community.

The Effects of a Brief Lifestyle Intervention on the Health of Overweight Airline Pilots during COVID-19: A 12-Month Follow-Up Study

The aim of this study was to perform a 12-month follow-up of health parameters after a 17-week lifestyle intervention in overweight airline pilots. A parallel-group (intervention and control) study was conducted amongst 72 overweight airline pilots (body mass index > 25) over a 12-month period following the emergence of COVID-19. The intervention group (n = 35) received a personalized dietary, sleep, and physical activity program over a 17-week period. The control group (n = 37) received no intervention. Measurements for subjective health (physical activity, sleep quality and quantity, fruit and vegetable intake, and self-rated health) via an electronic survey, and objective measures of body mass and blood pressure were taken at baseline and at 12 months. Significant interactions for group × time from baseline to 12-months were found for all outcome measures (p < 0.001). Body mass and mean arterial pressure significantly decreased in the intervention group when compared to the control group (p < 0.001). Outcome measures for subjective health (physical activity, sleep quality and quantity, fruit and vegetable intake, and self-rated health) significantly increased in the intervention group when compared to the control group (p < 0.001). Results provide preliminary evidence that a brief three-component healthy sleep, diet and physical activity intervention can elicit and sustain long-term improvements in body mass and blood pressure management, health behaviors, and perceived subjective health in pilots and may support quality of life during an unprecedented global pandemic.

Healthy lifestyle initiatives for increasing fruit and vegetable intake among Aboriginal and Torres Strait Islander peoples: a rapid review

Adequate fruit and vegetable intake is key to reducing chronic disease risk among Australian Aboriginal and Torres Strait Islander peoples. This rapid review collated evidence on healthy lifestyle initiatives that focused on increasing fruit and vegetable intake among Australian Aboriginal and Torres Strait Islander peoples residing in major cities. Due to limited studies conducted within major cities, we extended our inclusion criteria to regional and remote areas. Sixteen studies were included. Five (31%) studies were rated as good quality (least risk of bias), ten (63%) were rated as fair, and one (6%) was rated as poor (significant risk of bias). Five (31%) studies employed participatory research in the design and/or execution, and seven (44%) studies included minimal community involvement. Only five (31%) studies were undertaken in major cities; four of these combined major cities with regional and/or remote areas. All five studies reported positive findings, such as an increase in fresh fruit availability, usage of fresh vegetables, or self-reported fruit and vegetable intake. This review provides evidence confirming the need for high-quality healthy lifestyle initiatives to increase fruit and vegetable intake targeted at Aboriginal and Torres Strait Islander peoples living in major cities. This evidence will assist community organisations in designing effective health promotion interventions, providing insight into improving the structure and function of such programs. PROSPERO registration number: CRD42020194522 Novelty • Five studies were undertaken in major cities and all reported positive findings; only one study was rated as good quality. • Presented data supports the need for high-quality studies to be conducted among those residing in major cities.

Relationship between Prefecture-Level Yield of Not-for-Sale Fruits and Vegetables and Individual-Level Fruit and Vegetable Intake in Japan: A Cross-Sectional Study

This study investigated the relationship between prefecture-level yield of not-for-sale fruits and vegetables and individual-level fruit and vegetable intake in Japan. Data were drawn from the Japanese National Health and Nutrition Survey and National Crop Survey of 2016. Random intercept models were used for the analyses. Individual-level fruit and vegetable intake was used for the dependent variable, and prefecture-level yield of not-for-sale fruits and vegetables was used for the independent variable as a fixed effect. In addition, participants’ characteristics and health-related factors at the individual level were also put into independent variables as fixed effects. The prefectures were used as random intercepts. It was found that prefecture-level yield of not-for-sale fruits and vegetables was significantly related to individual-level fruit and vegetable intake (vegetable: B = 0.390, p < 0.001; fruit: B = 0.268, p = 0.003; fruits and vegetables: B = 0.357, p < 0.001). These relationships were also significant in the gender-specific analysis. Thus, the yield of not-for-sale fruits and vegetables might contribute to the intake of fruits and vegetables in Japan.

Disparities in Fruit and Vegetable Intake at the Intersection of Gender and Education in Northern Sweden: A Cross-Sectional Study

Background: Even though the existence of inequalities in fruit and vegetable consumption has been well established, it is not clear how it is patterned across intersections of multiple social positions and identities. This study aims to investigate disparities in fruit and vegetable intake between groups at the intersection of education and gender in northern Sweden, and to estimate the discriminatory accuracy of the intersectional groups.Methods: Cross-sectional data from the 2018 Health on Equal Terms survey conducted in four regions in northern Sweden was used (N=21,853). Four intersectional groups were created: high and low educated men, and high and low educated women. Prevalence differences corresponding to joint, referent, and excess intersectional inequalities, were estimated using linear binomial regression for three binary outcome variables: inadequate fruit and vegetable intake combined, inadequate fruit intake, and inadequate vegetable intake. The analysis was adjusted for potential confounders. The discriminatory accuracy of the intersectional groups was estimated by the area under the receiver operating characteristic curve.Results: Low educated men had the highest prevalence of inadequate intake of fruits and vegetables combined (81.4%), fruits (53.5%), and vegetables (54.2%), while high educated women had the lowest (47.7%, 28.6%, and 19.2% respectively). The joint disparities between high educated women and low educated men were both significant and substantial for all outcome variables (34.6 pp, 28.7pp, and 34.9pp respectively, adjusted). They were mostly explained by the two referent disparities for gender and education – the part of the joint disparity explained by differences in gender and education, respectively. An inconsistent direction, magnitude, and significance between outcomes was observed for the excess intersectional disparity - the part of the joint disparity not explained by either referent disparity (-5.5pp, 0.1pp, and 3.9pp respectively, adjusted). The discriminatory accuracy of the intersectional groups was moderate (0.67, 0.64, and 0.66 respectively).Conclusion: An intersectional approach can provide a more detailed view of inequalities in fruit and vegetable consumption between groups combining several social positions. The moderate discriminatory accuracy observed here suggests that interventions and policies aiming to reduce diet inequalities should not solely be targeted at certain groups, but also be universal.