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To investigate socio-economic differences in changes in fruit and vegetable intake between 2004 and 2011 and explore the mediating role of financial barriers in this change.
Respondents completed a self-reported questionnaire in 2004 and 2011, including questions on fruit and vegetable intake (frequency per week), indicators of socio-economic position (education, income) and perceived financial barriers (fruits/vegetables are expensive, financial distress). Associations were analysed using ordinal logistic regression. The mediating role of financial barriers in the association between socio-economic position and change in fruit and vegetable intake was studied with the Baron and Kenny approach.
Longitudinal GLOBE study.
A total of 2978 Dutch adults aged 25–75 years.
Respondents with the lowest income in 2004 were more likely to report a decrease in intake of cooked vegetables (P-trend<0·001) and raw vegetables (P-trend<0·001) between 2004 and 2011, compared with those with the highest income level. Respondents with the lowest education level in 2004 were more likely to report a decrease in intake of fruits (P-trend=0·021), cooked vegetables (P-trend=0·033), raw vegetables (P-trend<0·001) and fruit juice (P-trend=0·027) between 2004 and 2011, compared with those with the highest education level. Financial barriers partially mediated the association between income and education and the decrease in fruit and cooked vegetable intake between 2004 and 2011.
These results show a widening of relative income and educational differences in fruit and vegetable intake between 2004 and 2011. Financial barriers explained a small part of this widening.
Nutritional intakes of food bank recipients and consequently their health status largely rely on the availability and quality of donated food in provided food parcels. In this cross-sectional study, the nutritional quality of ninety-six individual food parcels was assessed and compared with the Dutch nutritional guidelines for a healthy diet. Furthermore, we assessed how food bank recipients use the contents of the food parcel. Therefore, 251 Dutch food bank recipients from eleven food banks throughout the Netherlands filled out a general questionnaire. The provided amounts of energy (19 849 (sd 162 615) kJ (4744 (sd 38 866) kcal)), protein (14·6 energy percentages (en%)) and SFA (12·9 en%) in a single-person food parcel for one single day were higher than the nutritional guidelines, whereas the provided amounts of fruits (97 (sd 1441) g) and fish (23 (sd 640) g) were lower. The number of days for which macronutrients, fruits, vegetables and fish were provided for a single-person food parcel ranged from 1·2 (fruits) to 11·3 (protein) d. Of the participants, only 9·5 % bought fruits and 4·6 % bought fish to supplement the food parcel, 39·4 % used all foods provided and 75·7 % were (very) satisfied with the contents of the food parcel. Our study shows that the nutritional content of food parcels provided by Dutch food banks is not in line with the nutritional guidelines. Improving the quality of the parcels is likely to positively impact the dietary intake of this vulnerable population subgroup.
We aimed to identify barriers for meeting the fruit, vegetable and fish guidelines in older Dutch adults and to investigate socio-economic status (SES) differences in these barriers. Furthermore, we examined the mediating role of these barriers in the association between SES and adherence to these guidelines.
Longitudinal Aging Study Amsterdam (LASA), the Netherlands.
We used data from 1057 community-dwelling adults, aged 55–85 years. SES was measured by level of education and household income. An FFQ was used to assess dietary intake and barriers were measured with a self-reported lifestyle questionnaire.
Overall, 48·9 % of the respondents perceived a barrier to adhere to the fruit guideline, 40·0 % for the vegetable and 51·1 % for the fish guideline. The most frequently perceived barriers to meet the guidelines were the high price of fruit and fish and a poor appetite for vegetables. Lower-SES groups met the guidelines less often and perceived more barriers. The association between income and adherence to the fruit guideline was mediated by ‘perceiving any barrier to meet the fruit guideline’ and the barrier ‘dislike fruit’. The association between income and adherence to the fish guideline was mediated by ‘perceiving any barrier to meet the fish guideline’ and the barrier ‘fish is expensive’.
Perceived barriers for meeting the dietary guidelines are common in older adults, especially in lower-SES groups. These barriers and in particular disliking and cost concerns explained the lower adherence to the guidelines for fruit and fish in lower-income groups in older adults.
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