healthscotland.com

Health Education Population Survey (HEPS): Update from 2004 Survey - Final Report

4. Diet

Healthy eating is of particular relevance to health promotion given its implications for cardiovascular disease, cancers, oral health and the rising levels of childhood obesity. It has also been shown that high consumption of fruit and vegetables is associated with reduced risks of cardiovascular disease and certain cancers. The current dietary target for fruit and vegetables is to increase the current average intake to at least 400g (five portions) per day by the year 2005. There has been a high level of concerted health education activity across all sectors in Scotland focused on the 5-a-day message during the survey period.

For the purposes of this survey, eating fruit and vegetables daily is used as a proxy indicator of a generally healthy diet, since good nutrition has been found to be particularly strongly correlated with a high consumption of fruit and vegetables. Additional analyses of the HEPS data showing that respondents consuming fruit and vegetables daily had a healthier diet in terms of eating more complex carbohydrate and fish and less sugar and high-fat foods than other respondents, and were more likely to have tried to change their diet in the past year to improve their health.

4.1 Reported Behaviour

There has been a significant change over time in reported consumption of fruit and vegetables (Figure 4.1).

Figure 4.1 Time trends in fruit and vegetable consumption (1996-2004)

Base: all respondents (2004:1784)

For the first time in 2004, a higher proportion of respondents ate five or more portions of fruit and vegetables a day than ate no fruit and vegetables each day. On average people reported eating 3.6 portions per day which has risen from 2.8 in 1996. Clearly this is still some way short of the “five a day” target, but clear improvements have been made.

Table 4.2 Percentage eating at least five portions daily by sex/age/social grade/DEPCAT

There are clear gradients in behaviour by sex, age, social grade and DEPCAT (Table 4.2). Women are still more likely than men to meet the targets, as are those in social grades AB and those living in the least deprived areas. Nevertheless, there has been significant improvement in almost all subgroups since 1996. The only exceptions are young people aged 16-24 and those living in the most deprived areas. This means that over the last nine years there has been a growing divergence between the under-25s and those aged 25+, and between those in the most and least deprived areas.

In 2004 there have been particular improvements for men and for the lower social grades – groups that had been slower to improve in the past. Given the small base sizes of the social grade groups it will be important to look at future data to see if these increases are sustained.

4.2 Knowledge and motivation

Whilst knowledge of the recommended daily consumption of fruit and vegetables has continued its increasing trend, there has not been an increase in motivation to increase consumption since 2001 (Figure 4.3).

Figure 4.3 Time trends in knowledge of recommended consumption and motivation to increase consumption of fruit and vegetables (1996-2004)

Base: all respondents (2004:1784)

Six in ten give a figure of five or more as the recommended daily level of consumption, and almost all of these give the exact figure of five a day (57% of all respondents). As in previous years there are clear gradients by age, sex, social grade and DEPCAT (Figure 4.4). The differences by sex, social grade and depcat are in line with consumption, with men and the more deprived less likely to be aware of the recommendations. For age, however, whilst young people are consistently much less likely to meet the recommendations, they are no less likely to be aware of them than older people. In fact, those aged 55 or over are least likely to be aware of the recommendations, whilst being amongst the most likely to consume fruit and vegetables daily.

Figure 4.4 Percentage who know recommended consumption by sex/age/social grade/DEPCAT

Base: all respondents 2004 (1784)

Main points

• Consumption of fruit and vegetables was higher among women, older respondents and those from higher socio-economic groups.
• There was continued increase among all respondents in terms of consuming the recommended amount of fruit and vegetables (reaching 33% in 2004) with the exception of the youngest age group (aged 16-24) and those living in more deprived areas.
• In 2004 there have been particular increases in reported fruit and vegetable consumption for men and those in the lower social grades. These should be monitored in the future to determine if they will be sustained.
• There have been continued increases in knowledge levels regarding the current recommendation for fruit and vegetable intake (63%).