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Sixteen-year trends in fruit consumption and related socioeconomic inequalities among adolescents in Western European countries

European Journal of Nutrition volume 62, pages 3287–3296 (2023)Cite this article

Abstract

Purpose

To investigate time trends in daily fruit consumption among Western European adolescents and in related socioeconomic inequalities.

Methods

We used nationally representative data from 18 countries participating in five rounds (2002 to 2018) of the cross-sectional “Health Behaviour in School-aged Children” (HBSC) survey (n = 458,973). The questionnaire, standardised across countries and rounds, was self-administered at school by 11-, 13- and 15-year-old adolescents. Daily fruit consumption was assessed using a short food frequency questionnaire (sFFQ). Socioeconomic inequalities were measured using the Family Affluence Scale (FAS). Multilevel logistic regressions were applied to study linear time trends in daily fruit consumption, overall, by country and by FAS.

Results

Between 2002 and 2018, daily fruit consumption increased in 10 countries (OR range, 1.04 to 1.13, p < 0.05) and decreased in 3 (OR range 0.96 to 0.98, p < 0.05). In all survey years combined, prevalence of daily fruit consumption was significantly higher among high FAS groups (42.6%) compared to medium (36.1%) and low FAS groups (31.7%; all countries: p < 0.001). Between 2002 and 2018, socioeconomic inequalities in fruit consumption increased in Austria, Germany, Italy, Netherlands, Scotland, Sweden, and Switzerland. Only in Norway FAS inequalities decreased while the prevalence increased.

Conclusion

The prevalence of daily fruit consumption generally increased among adolescents between 2002 and 2018 in Western European countries, yet socioeconomic inequalities increased in some countries. Public health interventions should continue to promote fruit consumption with special attention to lower socioeconomic groups.

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Fig. 1

Data availability

Stata do-files are available on request.

Abbreviations

FAS:

Family Affluence Scale

HBSC:

Health Behaviour in School-aged Children

OR:

Odds ratio

CI:

Confidence interval

SEP:

Socioeconomic position

sFFQ:

Short Food Frequency Questionnaire

WHO:

World Health Organisation

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Acknowledgements

HBSC is an international survey carried out under the aegis of the WHO Regional Office for Europe. Data collection is funded at the national level for each HBSC survey.

Funding

The work of AC related to this article was possible thanks to the academic support of the Université libre de Bruxelles, Belgium, and the financial support of the University of Lausanne, Switzerland (UNIL/CHUV mobility fellowship). ASF is a postdoctoral fellow in the CO-CREATE project, which has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No. 774210.

Author information

Author notes

  1. Katia Castetbon and Angeline Chatelan have contributed equally to this work.

Authors and Affiliations

  1. Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles (ULB), CP 598, Route de 24 Lennik 808, 1070, Brussels, Belgium

    Charlotte Nicolas, Manon Rouche, Katia Castetbon & Angeline Chatelan

  2. Research Institute LABIRIS, Brussels, Belgium

    Charlotte Nicolas

  3. Department of Public Health and Primary Care, Ghent University, Ghent, Belgium

    Maxim Dierckens

  4. Health Promotion Research Centre, School of Health Sciences, University of Galway, Galway, Ireland

    Colette Kelly

  5. Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway

    Anne-Siri Fismen

  6. Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway

    Anne-Siri Fismen

  7. National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore Di Sanità), Rome, Italy

    Paola Nardone

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Contributions

CN, AC, and KC conceived and designed the manuscript as well as defined the methodology. CN analyzed the data, and drafted the manuscript under the supervision of AC and KC. All co-authors reviewed the manuscript, provided critical recommendations, and approved the final manuscript.

Corresponding author

Correspondence to Charlotte Nicolas.

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Conflicts of interest

CN, MR, MD, CK, ASF, PN, KC, and AC declare no conflict of interest.

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Nicolas, C., Rouche, M., Dierckens, M. et al. Sixteen-year trends in fruit consumption and related socioeconomic inequalities among adolescents in Western European countries. Eur J Nutr 62, 3287–3296 (2023). https://doi.org/10.1007/s00394-023-03199-5

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