To investigate time trends in daily fruit consumption among Western European adolescents and in related socioeconomic inequalities.
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.
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.
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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Family Affluence Scale
Health Behaviour in School-aged Children
Short Food Frequency Questionnaire
World Health Organisation
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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.
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.
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